There is a lot of confusion because hydrocodone combination meds are about to be moved from Schedule III to Schedule II. If this particular medications is as widely abused as we are being told, then why add to the problem with introducing a hydrocodone only formula that is not abuse deterrent ? There also seems to be confusion because the REMS recommended the reclassification of the hydrocodone combination meds which the FDA followed, But, the REMS also was against the approval of Zohydro, which the FDA ignored.View Thread
If the stats are correct and hydrocodone is among the most widely abused medication, it concerns me that Zohydro has no abuse deterrent properties. Purdue is in the final stages of developing a hydrocodone extended release with abuse deterrent properties. What difference would waiting make ? The state of Mass has already ban the sale of Zohydro, if other states follow, it won't matter if the FDA has approved it.View Thread
It is also possible they could be coming to see if you qualify for any Personal Care Services. PCS is when someone comes in to help you bathe, prepare meals, do your laundry, etc. They have to do an evaluation to see if someone really needs this help and if they do, to determine the number of hours a week they qualify for.View Thread
Have you looked into Medicare Savings Program & Extra Help for Medicare Prescription Part D ? They are income based, but the criteria is different than regular Medicaid. They help with Medicare Premiums, Deductibles and Co/Pays, your meds are also cheaper.
There is nothing new regarding the DEA and Federal Laws. The rescheduling of hydrocodone combination meds from Schedule III to Schedule II should go into effect later this year. They are still taking public comments on the change. The rescheduling will mean that no refills are allowed and you must have a written rx from your dr each time it is filled. It also means that you must see your dr every 9o days. Drs can write rx's for 3 30 day supply of Schedule II.
It is possible the insurance company wants to be sure you are getting the right services. It may be that they feel that your dose of pain meds is low enough that with alternative therapy you may not need as much or need them at all. The mind set of the drs and insurance companies is to reduce the amount of opioid meds as much as possible. The days of just taking a pain pill and nothing else is ending. They may want to evaluate you for other services as well.
Is the mandatory ? Do you know if your private physician is aware of this ? How will your private physician view it is you say no ? The dr/dr office and insurance companies communicate. Medicare and Medicaid plans often discuss what is the best treatment and what is not with our drs, as well as which meds are best and which aren't. This is done to cut costs and is also suppose to ensure proper care. Some private insurance companies are doing the same.
First, hydrocodone combinations meds has not been reclassified from a Schedule III to a Schedule II yet. There are no laws federal or state that Require a dr to do tox screens. They are encouraged to do them, but it is left up the each individual dr/clinic to decide.
Second, when you signed the Pain Management Contract, you agreed to certain things, among which was no illegal substances. Marijuana is still an illegal substance to the majority of those i the medical field. One of the reasons is because it ia listed as a Schedule I med federally. Which meas that it has no acceptable medical use and is highly addictive.
You are going to have a very difficult time finding a dr to rx you pain meds, if you can find one at all. Because your dr has written in your medical records that you broke the pain contract by consuming illegal substances. In addition, you were not honest with your dr. It will make it nearly impossible for another dr to trust you. And the other things you mentioned don't matter. If you were that unhappy with the dr, you should have changed. Also itis your word against the drs notes in your medical records. The medical records carry far more weight because they are proof.View Thread
A lot depends on the dr. If the dr knows you well and has been treating you for a number of yrs and their practice is not majority Medicaid, then they seem to be more open to using their own judgement. When a dr doesn't know a patient well and hasn't been treating them for a very long time and the majority of their patients are Medicaid, they tend do to what they have to to keep from taking a chance on causing any problems with the medicaid health plan and/or state medicaid.View Thread
Low levels of education and low income are linked to drug abuse and diversion as well as Medicaid. Also, the politicians have been sending letters to state medicaid's wanting to know how they are going to punish high prescribers of pain meds and some other meds. Many Medicaid drs feel that the patient won't know the difference if they lie. And what is a patient going to do about it ? Some may say you can file a complaint, which is true. BUT, it won't go anywhere and other drs may not want you as a patient. I have looked and looked for the info in the original post and it does not exist. Bottom line is that many on Medicaid are either not being treated for their pain or are being undertreated.
cweinbl is right. "Not everything you hear from a physician, or any other person, is necessarily true or accurate. When such an event occurs, consider the person's potential motivation."
An ER doc doesn't have your history like your regular dr does. Sometimes the ER docs have a knee jerk reaction to certain things. What I meant was maybe the ER doc lied about the health plan restricting you. If this is the first you're hearing about this you need to ask you GP about it. You can also get the notes from your ER visit to see exactly what the ER doc wrote down. If the ER doc wrote down something that would make other drs that may see you there think you're a drug seeker, you may want to avoid that ER for this problem all together.View Thread
krc1108 , there was one thing I forgot to mention. If you're in Pain Management and have a contract or have a contract with any dr stating that you won't get any pain meds from anyone else but him, that could also be the problem. If it is, you will know the next time you see your reg dr for pain rxs. It is also possible that the ER dr lied to you. Some may not agree, but it does happen, especially with Medicaid. The Lock-in program is also used for those services that Medicaid feels a person has used without good medical reason. I have put a link below to explain more.
77grace , Medicaid Lock-In program is the States way of preventing abuse of meds and services.