Tag Archives: outrage

AI used to increase medical billing

AI-based product aims to help providers identify missed charges | Health Data Management – By Joseph Goedert – Sep 2019

It’s always interesting to look at a subject from a different point of view because it gives a more complete picture. I found this article in a publication called “Health Data Management”, which is focused on the health data and computing aspect of healthcare and has nothing to do with medical care.

This article predictably uses the generic functional term “provider” for doctors and nurses, a standardized and interchangeable version of the real people actually practicing medicine.

This is a hint of what we can expect in the future of healthcare after AI systems are embedded in every facet of our care: standardized “providers” will follow standard algorithms to diagnose and treat “standard” patients, who are all assumed to be the mythical “average human”. Continue reading

How Did We Come to Abandon America’s Pain Patients?

How Did We Come to Abandon America’s Pain Patients? – Filter Magazine – Alison Knopf – July 2019

Overdoses—not those involving prescription opioids, but of heroin and illicit fentanyl, often combined with benzodiazepinescontinue to go up. But

And many physicians, caught in the middle, have stopped prescribing because they don’t want to get in trouble and possibly lose their livelihood.   Continue reading

Diagnosis Codes Index – Opioid related disorders

Diagnosis Codes Index – Opioid related disorders (F11)

In the new ICD-10 system for medical billing codes, there’s a specific code for anything and everything to do with opioids. There’s even a code for “opioid use, unspecified, uncomplicated, which seems to indicate that any “use” of opioids is a medical problem in itself. 

We can see how “the medical system” is organized by looking at how healthcare services are billed. Looking at the hierarchy of categories in this billing scheme, we can discover how they see us, pain patients, using opioids.

The problems start at the top level: our “code” is listed under the category of “Mental disorders”:

Mental and behavioural disorders (F00–F99)    Continue reading

Opioids allocated based on business decision

‘Business decision’: Former DEA official works for opioid lawyers but set standards for how many pills were madeBy John O’Brien | Sep 3, 2019

The DEA knew more about what quantities of opioids went where than anyone else, so I’m baffled why they didn’t stop the excessive orders that everyone is complaining about now.

Asked what would’ve happened if a pharmaceutical distributor wanted advice on whether a large order of opioids was suspicious, the man in charge of federal regulation of those pills for 10 years said he wouldn’t have helped.

Instead, Joe Rannazzisi, who set always-increasing opioid quotas for theindustry while he headed a Drug Enforcement Agency department from 2005-15, said the company would be left on its own to figure it out.    Continue reading

Obscenely High Pay for Health-Care CEOs

Health-Care CEOs Made an Infuriating Amount of Money Last Year – by Luke Darby – Apr 2019

While I know that CEOs are ridiculously overpaid these days, I’m disgusted by the amount of money, much of it from taxpayers, that’s sloshing around in the healthcare industry.

Last year, 62 CEOs of health-care companies made a combined total of $1.1 billion in compensation.

That’s according to a new report out from Axios, which coincidentally notes that CEO compensation eclipses what the Centers for Disease Control spent on chronic disease prevention by $157 million.    Continue reading

Opioid Taper Associated with Termination of Care

Opioid Taper Is Associated with Subsequent Termination of Care: a Retrospective Cohort Study. – Pub Med – J Gen Intern Med. – Aug 2019

This study exposes the horrific aftermath of forced opioid tapers when patients are expelled from medical care because doctors have a reasonable fear of losing their livelihoods if treating pain with opioids.

BACKGROUND

Opioid tapering is increasingly utilized by providers to decrease risks of chronic opioid therapy, but it is unknown whether tapering is associated with termination of care.

Continue reading

Addiction Is Not Dependence

Addiction Is Not Dependencepracticalpainmanagement.com – Aug 2019

In this editorial, Jennifer P. Schneider, MD, PhD, digs into a common—and frustrating—misunderstanding in pain medicine terminology.

FDA approved the buprenorphine implant, branded as Probuphine, in 2016 “for the maintenance treatment of opioid dependence.”

  • Was it approved for the treatment of what we now call Opioid Use Disorder (OUD)?
  • Or was the intent to approve it for physical dependence, a condition found in most opioid-treated chronic pain patients as well as opioid addicts?

It is not clear from the language.   Continue reading

Authors of the CDC guideline protest misapplication

The authors of the CDC’s opioid guidelines say they’ve been misapplied – By ANDREW JOSEPH @DrewQJoseph and ED SILVERMAN @Pharmalot – Apr 2019

The authors of influential federal guidelines for opioid prescriptions for chronic pain said Wednesday that doctors and others in the health care system had wrongly implemented their recommendations and cut off patients who should have received pain medication.

They said some health care players had used the guidelines to justify an “inflexible application of recommended dosage and duration thresholds and policies that encourage hard limits and abrupt tapering of drug dosages,” when the guidelines did not actually endorse those policies.

The new paper comes three years [of unrelieved agony and suicides] after the Centers for Disease Control and Prevention published the prescribing guideline.   Continue reading

NarxCare score does not predict adverse outcomes

NarxCare narcotics score does not predict adverse outcomesReviewed by Kate Anderton, B.Sc. (Editor)Jul 2019

The increasingly used NarxCare narcotics score does not predict adverse outcomes or patient dissatisfaction after elective spine surgery,

An opioid use score based on state prescription databases does not predict complications or other adverse outcomes in patients undergoing spinal surgery, reports a study in the journal Spine.

They write, 

“the current study did not identify perioperative outcome/satisfaction differences based on preoperative narcotics use criteria.”     Continue reading

Public Health Impact of DEA and DOJ Overreach

Harris, Senators Press HHS About Public Health Impact of “Fentanyl-Related” Scheduling | U.S. Senator Kamala Harris of CaliforniaJuly 10, 2019

Several U.S. Senators sent a letter to the Department of Health and Human Services (HHS) Secretary Alex Azar regarding their concerns about the proposed new fentanyl scheduling (restrictions).

We are concerned that the Drug Enforcement Administration (DEA) and Department of Justice (DOJ) have not adequately consulted with public health agencies in connection with the DEA/DOJ’s recent request that Congress legislatively place all “fentanyl-related” substances into Schedule 1 of the Controlled Substances Act (CSA). 

Since we’ve allowed the DEA and DOJ to “practice medicine” by deciding what and how much of our medication we should use, it comes as no surprise that they now expect to rule on health issues without consulting medical experts. This would have been unthinkable when doctors and STate boards still controlled the practice of medicine. Continue reading