Oregon Physician Critical of Oregon Health Plan Proposal to Force Taper Medicaid Patients.

Oregon Physician Critical of Oregon Health Plan Proposal to Force Taper Medicaid Patients.

Dr. Darryl George has a practice in Roseburg, Oregon and he has added his voice to the growing chorus of opposition to plans for force taper their Medicaid patients. The meeting is scheduled for at the Wilsonville Training Center located at SW Town Center Loop E Wilsonville, Oregon 97070.

Here are some of his thoughts.

This is all about money. “Quality of care” is used to justify their reasons for these actions. Medicare has stated that it will be “following” the CDC Guidelines, but that doesn’t mean they are cutting all their patients OFF opiates. Medicare plans to continue payments for opiates but only up to the 90 MME threshold recommended as the maximum that family practitioners and non-pain specialists should be prescribing. That means if your opiate prescription exceeds 90 MME then Medicare will pay up to that level, but anything beyond that will be paid out of your own pocket. Why doesn’t the Oregon Health Plan (OHP) adopt that type of plan? Because that means that they are still spending millions of dollars a year on chronic pain medications and visits for care that they don’t WANT to pay for anymore. OHP patients often get shorter visits to their providers than any commercial plan patients. Why? Because OHP pays so little for those visits that providers don’t want to waste more time with those patients. I see chart notes all the time that are incomplete, not properly updated with details of medications and more (despite claiming that they did “reconcile” the record), documenting one thing in one section and then basically contradicting themselves in another section, and multiple examples of “cutting and pasting” parts of previous chart notes to speed through the documentation process. That makes the visit look longer and more complete, but in reality less really occurred. Why? More documentation makes it look good to the reviewer (if they are ever really reviewed before payment), so the provider and their clinic get more money. I talk to patients all the time who say their provider hasn’t touched them in months, but almost every chart note says a physical examination was performed, some very extensive ones, so how can that be true? Medical FRAUD is rampant in Oregon and licensing boards could care less. Providers rush through their visits, cutting and pasting to support a higher billing fee. Insurance companies like OHP have decreased payments to providers to control costs. Those “savings” go on to the owners and doctors of the local CCO that has been denying care for its’ patients in the form of “bonuses.” When a provider is paid less per visit, the only solution is to see more patients in a shorter amount of time. Instead of sit-down quality time, you get fast drive-thru care with providers. Money beats quality of care almost every time.

Just to add, please note that there are two parts to the HERC meeting. The first starts at 8:00am and is the Value-based Benefits Subcommittee that will be discussing the main issues of the Chronic Pain Task Force (CPTF) findings at 8:15 and then changes to coverage for Urine Drug Testing (UDT) at 11:30. There is supposed to be public comment after each topic per their own notes on the agenda: “Note: Public comment will be taken on each topic per HERC policy at the time at which that topic is discussed.” They will take a short break between sessions at 1pm and resume at 1:30pm. That will be the formal HERC meeting where the subcommittee will present its CPTF report at 1:45 and then review the UDT recommendations at 2:30. There is supposed to be public comment time after each of those topics are discussed too. While it will be difficult for most chronic pain patients to sit through both sessions, it would be good to have people present before, during, and after both sessions.

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Authored by: Ed Coghlan

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I have typing errors, I am sorry, but this iPad keyboard is terrible. If I was on a normal typing board set up like a typewriter instead of a flat keyboard then I could type better. If it dies not make sense please try to be patient. I saw no button to edt out mistakes,

Holly there is a class action suit against the DEA online at petition2change.org and another one on the same place that is citing drs. who refuse to give suffering legitimate patients pain medication they need to function and setting up repercussions that are very strict if they refuse to treat us and give us the pain medication we need. Just go there and you will see them both. Be sure to sign them. Also I get a lot if good info from drs.of courage.com online and on YouTube. They are fighting with us against this scapegoating of pain patients! They are also trying to help colleagues wrongly accused or threatened by the DEA and CDC. The CDC misquoted data and did not correct it. There was a really good dr. on YouTube testifying for us and he let them know we were in a crisis worse than the biggest out if control forest fire. He also let them know he could not be bought. He was not recueving grants or any money to stick up fir pain patients. He is one drs. from of the drs.of courage and his testimony is on YouTube under their name. Sadly we lost a great man Dr. Forest Tenant who stood up to them until they raided his office. In his 70’s he has announced with deep sadness his retirement. I worry so much about his patientscwho are very very serious case abs cane from all over the US to see him in California. It has gotten to resemble a dictatorship in history where the insane leader killed all the sick people, and disabled including babies with TB and other children. It was not just minorities he murdered and tortured but the sick and disabled. He believed in only the Strong should survive,(until that is that got sick or hurt) I bet you know who I am talking about. We fought a war trying to prevent him from taking over the world, and here we are torturing our sick/disabled people.. Many who could get better with medication and treatment. You cannot get better if you are in too much pain to get out if bed. Hope the info helps.

Steven

Please bear with me just one more thought. If the government is going to kill us by taking away or medication I would like to know why this is not a violation of our civil liberties let alone our right to breathe air? Any lawyers out there answer that for me? Can’t we as a group file a cease and desist order that Will Keep Us Alive until some sense of reason returns to these maniacs driving the political wind? We need help yesterday. Why don’t they just line us up and shoot us in a firing squad lineup? At least that would be more humane.

Steven

One more thing! As any pain patient knows 90 m m e is not enough medication to get a fly high let alone treat any medical condition. This whole movement is absolutely insanity. Until bodies start raining down from above This treatment of the most vulnerable in the country is going to continue thanks to the Obama health care plan.

Steven

This nonsensical forced torture of people in pain will be the start of civil unrest in this country! Why do you think Walmart at the government’s insistence has been preparing FEMA camps. These are not anything but concentration camps for the masses. Make no mistake. This country has set itself up for Anarchy in the streets that will be starting fairly soon. I suggest everyone that is able to prepare themselves with a minimum of six months of food and supplies do so immediately. If martial law is declared it will leave little time to prepare and food shelves will be empty by that time. Going to work will be the last thing you’ll have to worry about for the first few weeks . We most likely will be restricted to our homes if we have one so you will have to have as much provision as you can stockpile in your house at the time of the Declaration of martial law . Start preparing tomorrow you may be glad you did . The United States has no more then 25 days of food more than what is needed to feed the country. This means that if there is a run on stores supplies will disappear in no time and will not be replaced. Empty food stores. This goes for all daily items like for instance Banks, gasoline stations and everything else. What I’m suggesting sounds impossible but if I’m wrong you will have done nothing but prepare yourself with food that you like and will store without spoiling. This concept should be applied to all things needed on a daily basis including and especially your pain medication. Keep your medication locked in a safe box with you having the only key. Good luck everyone and stay safe.

Holly

I am a basket case today for everything happening to all of us.I just cant stop crying.I hurt so effing bad…..I go to my pain Dr. and she wont even look at me when I cry due to more cutbacks. She just continues to type on her computer. Then writes that I may need psychological help. Are you kidding me?

Where are any lawyers to help us damn it????? Also I live in Md. I am on medical assistance, I am disabled. BUT if my Dr. writes an amount of pain medicine and they say I can only have X amount, we are not allowed to pay for the extra. This is soooooooo bad!

Notasheep

JENNY SAXON

I use the USA Pain clinic. There is one in Alb. I travel from Ute lake there. Please, please contact them for help!!!!!

Teresa

DEE TEE

Thank you Doctor George! I am so happy that you are making your voice heard! As your patient, I feel so fortunate to have you as my doctor. I stand behind you ALL the way. Proud to say you are my doctor. Thank you, so much for having the EMPATHY many doctors are severely lacking here in Oregon.

Why don’t they just dig a big hole and kill all of the chronic pain patients. That’s what they are doing anyway. I have given up. I will either succumb to the pain and kill myself or I will live out my years in horrifying pain. I wish I could have each decision maker live in my body for 24 hours. Within 25 hours there would be a total suspension of CDC guidelines. I would love to know how many family members of CDC employees who are in my shoes are getting the same treatment that I am. What about the Drs oath: I WILL DO NO HARM?????????

I did not see the date of the h.e.r.c. meeting listed. Only times. I’d have liked to go but,no way of getting there anyway after I tried to think of anyone that could or would give me a ride to Portland. I’m old sick,disabled and have lost all hope of staying in my apt. even with caregivers help. Makes me breakdown into tears when I even think about going into assisted living again. I already knew I’d end up in a wheelchair just NOT THIS SOON. Sincerely first tampered my defective HIP implant dislocated three times within two weeks periods between each dislocations. Then cut off completely. I was sent to one of the two pain clinics in Salem,Or.they automatically started with injections in my lumbar section. I have had scoliosis since birth. Now I have three bulging discs in a row right at the top of my lumbar with a cyst right on top where the injections were at. I’d told them none have ever helped before. At 400$ a pop not bad for a few minutes of his time. 1000$ if sedated. Plus kick backs for underprescribing or cutting people off completely. Just had MRI and I know I did not have a cyst before the injections but, OMG my back hurts more than ever. I’ve also got fibromyalgia and really bad crippling arthritis throughout almost every joint in my body. Now I need both hips replaced ASAP and I don’t know if I’ll be able to get around with my walker this winter. Last winter was God awful pain I couldn’t even stand long enough to make myself a sandwich. I’m trying so hard to remain as independent as I can but,even just typing it is making me tear up.
I really hope this deliberate abuse of our civil rights to be treated humanely and get needed care by our primaries instead of these abusive incentive driven BRAINWASHED PAIN CLINIC DR.S.But, no one’s listening and you can bet more will die because of this media frenzy created by gov.officials behind closed doors. I’VE YET TO MEET ONE PAIN DR.THAT ACTUALLY CARES. The last one insisted I was an addict and that I did not need them but,INSISTED I CRAVED THEM THUS JUST AN ADDICT. Went on to say he’s not going to risk his license for anyone plus everyone in the entire nation will eventually be cut off any and all pain medications regardless.
He was the worst type of a typical male chauvinistic male dr. I’ve ever met. His hostility was so freaking obvious I was stunned at first then absolutely furious with him. I’ve never hated a Dr. as much as I felt for Him before in my entire life.
Hopeless in Oregon.

Rochelle

Thank you Dr. George for stating the obvious, especially Medicare will only cover up to 90 mme a day. I know of two people in CA that have to pay out of pocket for opioid medication over that “magic” number which for most of us in pain does squat for pain!

Has herc made a decision yet? I personally think Oregon may be the “test case” to try to implement their cruel and certainly money driven possible move. Where ard the legal experts to battle the gov?

Maureen M.

Dr. George, Thank you very much for being supportive and voicing you opinion.
We need more doctors like you! Best of all to you.

jenny saxon

Tapering hell!! Albuquerque, NM. 10 years on hydrocodone,10/325 mg. Was doing wonderful. Had to have 9 joint surgeries due to bone on bone,knees,shoulders ankle toe.Total joint replacements! Drs. after 10 years pulled me off in 12 weeks.!!?? Feeling like hell now and Drs. gave me no alternatives!. Medical profession sucks.Is it true that these Drs are getting rewarded for getting people off these drugs!??

Cindy Deim

It is all just a nightmare.

Robert

Dr. George,
Thank you for your article sir, it’s the driving reason for the Trumped up Opioid Epidemic. The general public has no idea just how dyer our economic situation truly is.

The CBO (congressional budget office) reported in 2014 that our unfunded liabilities stood at a staggering $205 Trillion. The amount is our government’s obligation to pay retirees Social Security and Medicare benefits. The amount by which future payment obligations exceed the present value of funds available to pay them and with Baby Boomers entering retirement at a rate of 10,000 each day, our government is broke!

Currently the Medicare & Social Security will be insolvent starting in 2026 and 2034 at current government estimated projections.
How can they possibly afford to pay for the promised government retirement plan each of us has paid into our entire lives or for disabled citizens whose promise of government help will go unheard

Simply put, our government cannot afford us “old folks” any longer.

Michael

Thank you Dr. George, and Ed. Excellent commentary dis-robing down to the naked truth., to reveal these FACTS. Where is the Attorney General for the State of Oregon? Nothing new here. Oregon is exempleary of perverting the law to mold it’s own new paradigm for medical patients: Advancing personal career platforms at the expense of Human Suffering. We are all too smart for this guise of greedy gain – I strongly suggest the formation of a PAC / Political Action Committee to represent Chronic, Mortal and Acute Pain Patients , beginning here in Oregon. The OHA needs to know this: We’re too smart for this, because many of us, like myself, have empowered ouselves with the knowledge of “how it all works”.

Louis Ogden

Not only is this ill advised, it’s dangerous for people that are older and have been on opioids for a long time and responding well. Excruciating pain can cause high blood pressure, increasing stress and making these folks targets for heart failure and/or strokes.

Chip

Once again the hierarchy you puts this into effect as no idea but people with chronic pain suffer through. I myself and very limited as to the abilities I can accomplish such a shopping going out to a restaurant, and the things that normal people do common without my medication. If you were to remove this from my life’s existence I would not be able to do anything and any reason or fashion to get out of the house to accomplish the chores that I must do. Please stop this idiotic thoughts that you weren’t pushing down the throats of people like myself who do suffer through chronic pain and the only temporary satisfaction we get is true are opioid medications which myself and many millions of others
Do not abuse! In other words get your S#I?…. together versus destroying our lives!

Alice Carroll

Well finally! Someone has printed the government’s plan for Medicare patients using opioid therapy for chronic pain, thanks Dr. George.
He states:
Medicare plans to continue payments for opiates but only up to the 90 MME threshold recommended as the maximum that family practitioners and non-pain specialists should be prescribing. That means if your opiate prescription exceeds 90 MME then Medicare will pay up to that level, but anything beyond that will be paid out of your own pocket.

So now that we know the governments plan what can we do about it? I will be meeting my Congressional Representative tomorrow to discuss this among other things. I guess all those letters we wrote to MCS back in Winter had little effect. These Guidelines are supposed to be “Guidelines” not law, but the MCS is treating them as law. How can this be legal? How can MCS deny patient care and refuse to pay for some therapies for Americans on Social Security Disability? The Americans With Disabilities Act states that those with disabilities should not be discriminated against in health care matters. The following is from ada.gov on the Barrier-Free Healthcare Initiative page. “The Civil Rights Division and U.S. Attorneys’ offices have long enforced the ADA in this area. This nationwide initiative seeks to focus and leverage the Department’s resources together and aggregate the collective message that disability discrimination in health care is illegal and unacceptable.” The US Attorneys Office is charged with enforcement. It’s time to contact them at https://www.justice.gov/usao/

The US Government’s War on Chronic Pain Patients is wrong minded and mean-spirited. If we do not speak up they will continue to deny care and ignore us. We owe it to ourselves and to those in intractable pain.