Thursday, February 24, 2011

Governor Scott and the PDMP: Accusations replace Facts

Unfortunately, Governor Scott pulls out all the stops to attack the supporters of the PDMP including the PDMP Foundation.
These are indeed groundless accusations without factual evidence to support the arguments made.


http://www.palmbeachpost.com/opinion/editorials/scott-makes-it-up-again-accusations-against-group-1276631.html?sms_ss=email&at_xt=4d6663c1bb07e380%2C0

Excerpt from the article above:

Gov. Rick Scott is inventing another excuse for opposing a statewide prescription pill database.

Without offering any evidence, the governor this week accused the private foundation that is raising money for the database of wasting donations. "It's come to my attention that thousands of dollars have been spent on lawyers, travel, meals for board members," Gov. Scott told reporters on Tuesday. "I believe it's an invasion of privacy. And right now with that database, it appears that the money's been wasted."

In fact, board members of the Prescription Database Monitoring Program haven't charged a single expense to the foundation. A private company started by the former chairman of the foundation's board has picked up most of the legal expenses. "The first communication from the governor's office to our foundation was a baseless accusation. It's desperate," said foundation Vice Chairman Rene Bruer. He is a financial analyst who worked for the director of Florida's drug control office under Gov. Jeb Bush. "We're rising up above the politics. We just want to deal with the problem."

http://www.palmbeachpost.com/news/state/fla-drug-database-fund-raiser-disputes-gov-scotts-1273905.html?page=2&viewAsSinglePage

Excerpt from article above:

Scott's attack on the foundation took Bruer [Vice-Chairman of PDMP Foundation] by surprise, he said.

"We've never ever had anybody from Rick Scott's office ask us questions, join one of our phone calls. Nothing. Ever. There has been no dialogue between us. We welcome that," he said.

The foundation is caught in the middle of a political battle of wills, Bruer said.

"The PMDP Foundation is not here to play political ping-pong. We're strictly here to look at the overarching issue which is people dying from prescription drug abuse and doing what we can within the letter of the law to make sure that one of Florida's worst public health epidemics is dealt with," he said.

Wednesday, February 23, 2011

Tip of the Iceberg

Attached an article from today's Miami Herald highlighting the arrest of several oxycontin dealers, wrongly called "doctors", Unfortunately, they represent just a tiny sample of the hundreds of drug dealers in white coat in South Florida who make millions in ill-gotten profits.
Meanwhile, the Oxy-Cartels are reinventing their business model and open "life style enhancement" and " wellness" clinics.
We have to stop them now!
Yours
Bernd



The Miami Herald
Posted on Wed, Feb. 23, 2011
Pill-mill arrests hit right target: doctors

Fred Grimm
fgrimm@MiamiHerald.com
Law enforcement tested a promising antidote for Florida’s oxy epidemic Wednesday – doctors in handcuffs.

Arrests of so many drug-addled users and low-rent street dealers hardly matters. Not compared to that ignominious image of Dr. Zvi Harry Perper led out of a “pain management clinic” in Delray Beach Wednesday. That stuck at the very nub of the pill-mill industry. In tan scrubs and steel cuffs. Dr. Perper on a perp walk.

Fifteen pill mills were raided in Broward, Miami-Dade and Palm Beach counties. A few oxy street dealers and a handful of clinic employees were arrested, all replaceable entities in the pill-mill business model. But five doctors were busted. Seven others “voluntarily” surrendered their federal license to prescribe narcotic medicines. Doctors, cranking out oxycodone prescriptions for phantom pain and fake injuries, are the essential elements.

While a doctor may be a crucial to a pill mill, actual doctoring is just a bother. Undercover agents, posing as patients, were prescribed hundreds of oxycodone pills without so much as an examination by Dr. Jeffrey Lipman at Midtown Pain Management in Miami-Dade, according to Lipman’s arrest warrant.

It was easy to see why the DEA might have been suspicious of Lipman’s bedside manner. In the first six months of 2010, he ordered up 288,560 oxy pills for his patients. (There are more prolific oxy docs in the United States. All 39 of them work out of South Florida pill mills.)

The agents told the doc of prior drug abuse and taking oxy with alcohol. They described only minimal pain. In Dr. Lipman’s waiting room, another patient, who said he planned to sell his pills in North Carolina, asked an agent (who he thought was from Tennessee), “How easy was it to sell up there?” The doctor even discussed the “street value” of the oxy he was dispensing with the undercover agents. He figured $8 to $16 a pill.

Medical experts cited in the arrest warrant described Lipman’s clinic as “consistent with those of the usual pill mill, where cash is the only form of payment, patients often travel from long distances and sell prescribed controlled substances , physical examinations are not performed . . . and controlled substances are prescribed in excessive dosages and potentially fatal combinations.”

The raids came the day after Gov. Rick Scott reiterated his fervent, ideological opposition to a drug database, designed to prevent oxy shoppers from filling multiple prescriptions, moving from one pill mill to another – circumstances captured nicely by the pain clinics raided Wednesday.

The warrants noted how the pill mills flourish in Florida with minimal regulations, without the tracking system used in most states. “Consequently, individuals have been able to obtain unlimited and unmonitored quantities of controlled substances from multiple pain clinics for either personal consumption or resale in Florida and elsewhere.”

The raids only reinforced the notion, widely held by law enforcement and most of the state’s medical associations, that without a monitoring system, Florida invites criminal operations in the guise of medical clinics.

But after Wednesday, the pill mill industry will be forced to limp along with a dozen fewer doctors.


© 2011 Miami Herald Media Company. All Rights Reserved.
http://www.miamiherald.com


Read more: http://www.miamiherald.com/2011/02/23/v-print/2082013/pill-mill-arrests-hit-right-target.html#ixzz1EqMoYvC7

Sunday, February 13, 2011

The Stubborn Rejection of Common Sense

Rick Scotts decision to derail the Prescription Drug Monitoring Program (PDMP) is either based on ideological rigidity, or plain simple ignorance.

The attached articles and editorials clearly highlight the absolute necessity to declare a public health emergency and to implement the PDMP immediately!


1. More babies born addicted to pain drugs http://articles.sun-sentinel.com/2011-02-12/health/fl-prescription-drugs-born-addicted-20110211_1_newborns-prescription-drug-winnie-palmer-hospital



a. In 2009, nearly 1,000 babies born in Florida hospitals were treated for drug withdrawal syndrome. The most recent data show no signs of a slowdown. During the first half of 2010, 635 cases were reported.

b. From 2006 to 2009, there was a 173 percent increase in newborns treated at Florida hospitals for drug withdrawal syndrome, according to Agency of Health Care Administration records obtained by the Orlando Sentinel.

2. Why does Gov. Scott oppose Florida prescription drug database? http://articles.sun-sentinel.com/2011-02-12/news/fl-rick-scott-pills-mayocol-b021311-20110211_1_pain-clinics-prescription-drug-pill-mill-epidemic



a. “Scott's move to scrap a prescription narcotic database intended to temper the excesses of South Florida's rogue pain clinics makes no sense. Unless the governor somehow likes the drug tourism, overdoses and other human wreckage spawned by our pill-friendly culture. If it's not government's role to monitor controlled substances, then why bother monitoring anything? Let's just do away with driver's licenses, vehicle registrations and concealed weapons permits too, since cars and guns are legal. The database had support from just about everyone — legislators, law enforcement, responsible doctors and pharmacists and legitimate pain clinics.”

3. Pill mills: Scott, legislators undermining efforts, by Mike Fasano and Nan Rich http://www.sun-sentinel.com/news/opinion/fl-pills-oped0213-20110213,0,3980383.story

a. “Legislature is essentially allowing unneeded deaths to continue. It is, therefore, imperative that the legislature get out of the business of approving rules for bills that it has already passed. In the case of the Board of Medicine's rules, lives are at stake. Finally, the governor has eliminated the Office of Drug Control, which provides an important focus on the problem of drug abuse, and coordinates the numerous state agencies affected by this issue. State agencies across the board must deal directly or indirectly with the consequences of drug abuse, including our courts, law enforcement, prisons, foster care system, Veterans' Administration, health departments, mental health programs and even port security agencies. That's why the work of the ODC to coordinate the drug control efforts of each of these agencies is imperative, and why we're disappointed to see Gov. Scott unilaterally shut down this agency by laying off its entire staff. We therefore hope our legislative colleagues will consider taking immediate action to put our tough new pill mill regulations into action, and that the governor will put the Office of Drug Control back to work, and preserve the Prescription Drug Monitoring Program. This issue isn't about bureaucracy or the size of government — it's literally a matter of life and death.”



We should not ponder the question why our new Governor is not getting it. Instead, we should take action and develop a collaborative network of allies and supporters across the political spectrum to push back. Now its time to act! You can follow me on Twitter www.twitter.com/dadedoc or at http://floridadocs.blogspot.com



Yours truly,



Bernd Wollschlaeger.MD

Tuesday, February 8, 2011

Governor Scott and the PDMP

Governor Scott and the PDMP:



The Governors proposal to eliminate the Prescription Drug Monitoring Program (PDMP) surprised many supporters of this project. Currently, the PDMP implementation has been stalled by a protest from a software company, which bid for the contract and lost.

The PDMP would require doctors and pharmacies to enter and report each and every prescription for controlled substances. With the help of the database healthcare professionals and, under very restricted and monitored circumstances, the police could then crosscheck the database for anyone who has received multiple prescriptions of narcotic drugs from multiple sources, a common practice among addicts and drug dealers who amass large quantities of drugs from so-called “pain clinics.”

The law establishing the PDMP clearly stipulated that it to be financed without tax dollars. It would be run with more than $500,000 raised from drug makers, foundations and federal grants, which would have to be returned.

Without a functioning PDMP unscrupulous pill-mill owners and their drug dealer cronies in white coat can obscure and conceal the dispensation of millions of prescription narcotics taking place behind the pain-mill walls.

Governor Scott argues, "That program has not been working," even though is has yet to be implemented! The fact that NO tax dollars have been or will be used for developing and deploying the PDMP one is left to ponder the question what is driving our Governor to make such a foolish decision?

The reason is clear: ideological blinders prevent him from realizing that seven (7) Floridians die every day from prescription narcotic overdose. He firmly believes that government can do only harm and that regulations will prevent business to thrive and prosper. That includes drug dealers, fraudsters and thieves too!!

The time has come to stand up and speak up. We cannot allow him to dismantle the product of years of hard work. Lets not waste this opportunity to protect our public health and safety.



Yours truly,

Bernd

Friday, February 4, 2011

AG Bondi and Pill Mills

During a news conference in Panama City today Florida Attorney General Pam Bondi outlined her strategy to address the pain clinic issue and related prescription drug abuse. She announced four recommendations:


A mandatory six-month suspension and $10,000 fine for doctors who violate standards of care when prescribing controlled substances.

A third-degree felony charge for those who use fraud or misrepresentation to register as a pain clinic.

Escalating criminal penalties for doctors who fail to perform a physical examination before dispensing 72-hours worth of controlled substances.

Require anyone maintaining an inventory of controlled substances to report the discovery of theft to local law enforcement or the Florida Department of Law Enforcement within 48 hours or risk fines and administrative penalties.


She also called for strict enforcement of current laws and aggressive prosecution of violators.
I applaud AG Bondi for her efforts but prosecution and regulations alone won't solve the issue.
State Attorney Glenn Hess (Panama City) is correct stating that the penalties might not discourage the doctors because of the affluence of the doctors and the substantial($$$$$) profits they stand to make dispensing the pills. This explains why the number of registered pain clinics statewide increased to 932 , but police say many violators are unregistered. The Florida Department of Law Enforcement counts 1,167 "pill mills" in the state.
Vague language will also make some of the recommendations difficult to prosecute. Defining “standards of care” and a “physical exam” then showing how a doctor violated those requirements before writing a prescription will be a challenge.
AG Bondi omitted mentioning the most important linchpin of a successful strategy: a Prescription Drug Monitoring Program (PDMP) which can provide a valuable tool for physician to identify doctor shoppers and to safely prescribe narcotics to patients who often do not disclose other source of prescription drugs. The PDMP implementation is currently stalled due to a contested bid. Shortly after Statute 893.055 , which mandates the creation of the PDMP, was passed in early 2009, the Department of Health opened bidding on the contract to create the Prescription Drug Monitoring Program. When bidding closed this summer, the losing bidder contested the winner, and the DoH opened bidding again. The same loser, Optimum Technology, lodged another complaint -- this one about the terms of the bidding themselves. Which means construction of the database has yet to get underway. Meanwhile, seven Floridians die every day from a prescription drug overdose, 49 per week, 200 per month.
AG Bondi could resolve this issue by declaring a public health emergency, thereby enforcing the immediate implementation of the PDMP.
I hope she will listen and we should ask her to show the courage to make this decision.

Yours

Bernd



Bernd Wollschlaeger,MD,FAAFP,FASAM

Wednesday, February 2, 2011

Florida Health Grades

Attached links to two articles which made me feel ashamed being a Floridian. Why do our elected officials wage their ideological battles on the back of those in need. Its clear to me who will loose: our children and the most needy in our state.

* "Florida Official sends back $1M " http://www.healthnewsflorida.org/index.cfm/go/public.articleView/article/21614 reporting that state Insurance Commissioner Kevin McCarty said Tuesday he will forfeit a $1 million federal grant that was supposed to go toward beefing up oversight of health-insurance rates.McCarty's disclosed the decision to give up the $1 million grant during the conference call and also sent a letter Tuesday to a top federal health official. The Office of Insurance Regulation was awarded the grant last year to hire workers and upgrade technology. McCarty gave a brief explanation for his decision, saying he was concerned about intrusiveness of the federal government. He also pointed to a Pensacola judge's ruling. He did not give any indication whether Gov. Rick Scott influenced the move, though Scott said earlier in the day that the state will not spend much time or money carrying out the law until court challenges are resolved. Tuesday's decision was not the first time Florida has foregone federal funding that could help carry out the law. The state did not apply last year for money in what is known as the "Consumer Assistance Program" --- which is designed to help people with insurance decisions and information. Goodhue said that program could have provided $2 million to Florida, which was one of about 15 states that did not receive a grant. It also is unclear whether the state Agency for Health Care Administration will apply for a newly available grant to prepare for creating a health-insurance exchange, which would provide a sort of marketplace where consumers could shop for coverage. AHCA did not respond to repeated questions during the past two weeks from Health News Florida about whether it would apply for the exchange grant. Late Tuesday afternoon, AHCA referred all questions about the federal health law to the governor's office, which did not return a phone call.
* "Uninsured kids propel Florida's low health care rating" http://jacksonville.com/news/florida/2011-02-02/story/uninsured-kids-propel-floridas-low-health-care-ratin. It's a good thing for Texas, Arizona, Mississippi and Nevada.
Without those states' abysmal child health systems, Florida's would rank last in the nation, according to a new analysis Read the complete study http://news.jacksonville.com/documents/020111scorecard.pdf compiled by the Washington-based Commonwealth Fund. Still, at 47th overall, the Sunshine State's efforts to ensure that children receive timely, effective health care fall far short of the national standard. The group's report card included all 50 states as well as the District of Columbia. Individual state scores were based on 20 health indicators. They include a state's insurance coverage rates, typical premium costs to families, the percentage of children who see a regular doctor, infant mortality rates and childhood obesity statistics. Insurance rates depended not only on geography but also race: Florida's uninsured rate of more than 20 percent among black children was the highest in the country, according to the report. Florida's low ranking was driven by its high rate of uninsured children, said Cathy Schoen, one of the report's authors. The state's 17.8 percent was second only to Texas, with 18 percent. Both states could dramatically lower their uninsured rates if they raised the maximum a family could earn to be eligible for Medicaid and the Children's Health Insurance Program, Schoen said. Both cap incomes at up to 200 percent of the federal poverty level, or $44,100 for a family of four. How Florida's children rank vs. nation
50th - Percentage of insured children
51st - Percentage of children with a preventive dental visit in past year
15th - Percentage of young children receiving all doses of six key vaccines
35th - Percentage of children aged 10-17 overweight or obese
32nd - Infant mortality rate
0 - Rankings among 20 indicators in which Florida is in top 5

Yours

Bernd