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News - 2018

Pill Popping Protocols

Dec
11

 

We are learning that the fight to contain opioids is multifaceted. There are many tentacles and cutting one off doesn’t mean the others have gone away. One major tentacle that persists in the opioid crisis is, believe it or not, your local health care provider and your hospital.

Emma Passé, writing in the October 3, 2018 issue of USA Today, recounts her battle against her doctors and the hospital staff when she refused to allow them to treat her pre and post-surgical pain with opioids. Leading up to her surgery she repeatedly told them “no opioids” and every time they fought her, assuring her that the new generation of opioids was safe.

Emma correctly identified pain as being something she could live with when the alternative was to suffer the side effects of various drugs. She was fully aware she might be uncomfortable for a little while – but preferred that over an opioid. At every turn the medical staff attempted to persuade her otherwise, even making arrangements to send her home with 40 codeine tablets. This, when she wanted none.

Hospitals are dangerous places for a number of reasons. Surgeries are dangerous and are the site of many injuries. Opioids are deadly. Know that the hospital and the medical staff can be relentless in encouraging the use of opioids.

Good utilization review can be invaluable in keeping claimants out of the hospital.

Call us. We can do better.

William Faris, JD
Chief Executive Officer
502-495-5040
william.faris@omca.biz
www.omca.biz

Shocked to Their Senses

Dec
04

I’m linking to an Associated Press article by Mitch Weiss and Holbrook Mohr that recently ran in The Courier-Journal. The story highlights the safety, expense and efficacy of spinal cord stimulators.

 

We have a long and successful history of evaluating and approving these medical devices on an extremely limited basis. As you read the article, you will get the CliffsNotes version regarding these invasive procedures.

 

They are expensive. They are dangerous. They have little supporting evidence.

 

Believe it or not, many years ago we encountered payors who approved spinal cord stimulators as they thought they were just TENS units.

 

These medical requests should always be subject to aggressive Utilization Review by highly credentialed clinicians.

 

Don’t have your bank account overstimulated.

 

 

Call us. We can do better.

William Faris, JD
Chief Executive Officer
502-495-5040
william.faris@omca.biz
www.omca.biz

That’s One Small Step For Kentucky…

Oct
30

 

Actually, it’s a pretty big step.

 

The most recent session of the General Assembly gave a very big task to Department of Workers’ Claims Commissioner Robert Swisher. Legislators instructed the Commissioner to develop treatment guidelines and a drug formulary before the end of the year. Many of us thought that to be nearly impossible, but we wished him well.

 

To our surprise and delight, the DWC has now adopted both treatment guidelines and a drug formulary!  This is truly big news.

 

In the weeks and months ahead, you are going to be hearing and learning a lot about both of these  In this note, I want to hit on the big picture.

 

Some folks ask why this is needed. Don’t physicians treat similar injuries in a similar fashion? And the answer would be NO. Many are unfamiliar with treating based upon principles of evidenced-based medicine. Treatment guidelines, as developed by ODG (Official Disability Guidelines) and adopted by the state, make the latest evidence-based medicine available to anyone who would be treating a workers’ compensation claimant. This standardizes treatment throughout the state, minimizes cost fluctuations, and most importantly, gives injured workers the best possible care.

 

As we have learned over the last several years, the best care produces the best outcomes and results in lower medical costs.

 

I’ve run out of space.  More will follow on the drug formulary. But congratulations to the Commissioner, his staff, and the volunteers who gave of their time and experience to make this possible.

 

Call us. We can do better.

William Faris, JD
Chief Executive Officer
502-495-5040
william.faris@omca.biz
www.omca.biz

Fill Me Up Buttercup

Oct
24

Today’s lesson is on a Big Pharma term that may be new to my readers. “Overfill” is the extra drug quantity, over and above the labeled dose, in FDA-approved containers. This is a standard manufacturer’s practice to ensure that clinicians who administer the drug will always be assured the full labeled dose can be extracted.  It’s a patient quality assurance control, and overfill is NOT included in the vial price.

 

A recent article by Jonathan Stempel from Reuters explained how a unit of AmerisourceBergen Corp, a large drug wholesaler, agreed to pay a Department of Justice settlement fine of $625 million relating in part to overfill fraud.

 

The scheme worked when the drug product was removed from the original FDA-approved glass vials. Then the medication was pooled into untested and unapproved plastic containers. Finally, the drug (which included the overfill) was extracted and repackaged into syringes. Over a million unapproved syringes per year were manufactured, and Big Pharma’s profit was overfilled by $100 million.

 

The FDA did not take kindly to this process, which they believed risked the safety and efficacy of these medications, and placed greed over the protection of vulnerable patients.

 

Big Pharma never ceases to amaze.

Call us. We can do better.

William Faris, JD
Chief Executive Officer
502-495-5040
william.faris@omca.biz
www.omca.biz

Consistency is the Hobgoblin of Little Minds

Oct
16

“Consistency is the hobgoblin of little minds.”

~ Ralph Waldo Emerson, Self-Reliance

There was a recent publication from NPR concerning a study of physicians who treat with Seroquel (an antipsychotic drug). These physicians received letters from Medicare that gave a general warning that they were being “flagged/warned” as above-average prescribers of this medication. Guess what, two years later and without follow-up, the physicians’ usage of this drug dropped dramatically.

We have found that scientific peer-to-peer intervention with treating physicians is one of the most cost-effective techniques to improve outcomes. This is best handled by a professional, highly credentialed panel of providers who will engage treating physicians with data on the latest science and industry guidelines. Nothing is more rewarding and cost-effective than providers who are willing to listen and then voluntarily modify their protocols.

No attorneys. No regulators. No disputes. No appeals.

Just doctors who decide to do better and change their minds. Sometimes you need a hobgoblin to correct a wrong.

Call us. We can do better.

William Faris, JD
Chief Executive Officer
502-495-5040
william.faris@omca.biz
www.omca.biz

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