Pain Management Community

Dear Opal,

I am in agreement that the insurance companies and lobbyists have much-more influence than the general public is aware.

The drug companies are for profit and do not represent themselves as anything other-than this.

The DEA does not mandate specified interval urine testing for persons who are prescribed controlled substances. It is my insurance company that mandates random annual urine screening.

The social climate of drug use vs abuse, addiction vs dependence has heightened awareness, and some unwarranted fears.

It seems that the primary response is to blame the DEA.
In most instances discussed on this forum, the problems with MDs prescribing and pharmacies dispensing is not related to any DEA mandates.

Your specific state laws and the DEA regulations are all documents that can be easily accessed via an internet search.

Mostly, regarding your post, I don't understand what point that you're trying to make.

Yes, MDs, labs, drug companies, drug company reps make money. I don't think that's any secret.

Do you really think that this is the objective for urine screening for pain management patients?

I do not know anything about Ameritox. I'll look them up.

You seem pretty angry about some aspect of lab presence at pain management MD's offices.

My point is profits, at patients expense, as my insurance does not cover this testing.....The drug labs go around to doctor's offices like Big Pharma.....They produce fear in doctors....They are sales people and are selling the doctor that one of their patients could be selling their drugs and/or not taking them and selling them......The lab can check the patients algorithms....I wonder if that's a bunch of garbage science in medicne.....Or they could be smoking marijuana or something else.....These companies tried to get states to test welfare recipants, in Florida.....Only 1% was found to be using drugs.....Now they have to target another group.....Pain patients.....

.nytimes.com 4 April 2012


"From July through October in Florida — the four months when testing took place before Judge Scriven's order — 2.6 percent of the state's cash assistance applicants failed the drug test, or 108 of 4,086, according to the figures from the state obtained by the group".

All the news reports I heard and remember were 1%..... Still 2.6% isn't really bad..... 108 people didn't get welfare, their children may not have eaten and 4,086 people got tested. $500.00 per person = $2,043,000.00 to the drug lab that did the testing!.... It's all about the bottomline..... It's all a corporate scam.

Hi Opal,

I cannot find any documentation of the cost per person.

I do remember when it was in the news, before it became policy.

I paid little attention as it is far from me- both literally and figuratively.

How was this policy voted into law?

I cannot help but wonder what it is about which you are so upset.

Does this effect you or your pain management in any way?

If you do not like the lab policy of your MD's practice, go to a different MD.

This is the USA, not the UK. We get to pick our own MDs here.

Yeah, we live in a free market economy.
Pharmaceutical companies, insurance companies, MDs, attorneys, health administrators- anyone- all have the potential to become wealthy enterprises or individuals.

Anyone can get rich in America. There is no feudal or caste system, and you have the freedom to pick your own MD.

USA is a democracy, a free-market economy, not an autocracy or a dictatorship.

Laws do not just appear because some Mr Big says that they do.

It is called due process. Sometimes it works well; other times not-as-well.

2.6% is not bad, but it is over 150% difference than 1%.

If this Ameritox is involved in illegal activities, they will have to answer to the laws of the land.

Again, about what is it that is upsetting you so?

Someone had to pay the Drug Lab......The Florida House and Senate made this law......I think it may have been a trial or it became a bust I don't remember......The cost does depend on what tests they had done.....I used the fee I was charged to calculate.....I am sure everyone in that office was charged the same if no close to it.....I talked with an insurance person and they have an insured who pays $1,500.00 for urine and blood work every time she goes.....You talk about free market....You are corrrect that anyone can charge any fee the like and if we don't like it go somewhere else.....Where do you go?....Try another doctor HAAAA!.....It is called Doctor Shopping......Not every one does get to pick their own doctor here.......Kaiser Permanante doc's get paid not to send their patients for tests.....I won't get into that because a friend died of a 2nd bout of cancer 6 months ago......Maybe he would have died but he souldh have been able to get help at his 1st complaints not pushed aside for 6 months.....Laws do appear because Mr Big says so.....Now everyone knows where to buy stocks only I cannot contribute to their wealth as i am on a fixed income.

Dear Opal,



Just FYI, here is my summation of HB 353.


You can read the text by clicking on the hyperlink below.

Florida passed a law requiring all applicants for TANF benefits to be tested.



Applicants must be notified of the drug testing requirement at the time of application, and are required to pay for the test.



If they test negative the applicant will be reimbursed for the cost by adding the amount to their benefit check.



If an applicant tests positive the applicant is ineligible for benefits for one year, but can reapply in 6 months if he/she completes an approved substance abuse treatment program.



A parent's positive test result does not affect the child's eligibility for benefits; however, any benefits received must be disbursed through a protective payee who must also pass a drug test.



The Governor signed the bill on May 31, 2011 and went into effect on July 1, 2011.



Florida's law is the first since Michigan's pilot program was challenged in the courts and ruled unconstitutional in 2003.



The American Civil Liberties Union filed a lawsuit to stop the bill from being implemented.



A federal judge ordered a temporary injunction and Governor Scott has appealed the decision.



The issue is still pending a final court ruling.



The House and Senate do not MAKE laws; they vote on laws.



Again, I ask how does this have any effect on your pain management?


You are wrong: Laws do not appear just because Mr Big says so. We have due process in the origination of bills/ laws, voting for reps who support the communities that they serve, plus the right to personally inspect the transcript of any meeting of law-making representatives.


If people are unhappy with the laws of his state, take action! Americans have freedom of speech plus freedom of assembly.


Kaiser is an HMO. No one is forced to use an HMO. If one does so, he/ she will have less options for care, but if this system is unpalatable for anyone, he/ she should join a different insurance plan other than an HMO.


The policies and procedures are available before joining; If one does not like the way that HMOs work, it would be best this person not join an HMO and examine other insurance options.



Persons who are opposed to any law, bill, etc, there are processes to initiate to have ones voice heard.


Americans have so much freedom that most cannot imagine what life is like without these freedoms.


How can we, a pain management support community, help you?

This is how bills become laws.

Really, they do not just appear; there is a process.


http://www.myfloridahouse.gov/Sections/Bills/billsdetail.aspx?BillId=48048&;

This effects my pain management because I cannot affort to pay $500.00 for a prescription......And that is for 1 test.....There is no limit per year.....Every one here has insurance that pays for this?....As for HMO's people ARE forced into them and you appear to live in a bubble.....People have benefits with jobs.....I don't know if you have either.....They have to accept what the company offers.....Once you are in any plan and get sick no other company will accept you.....That is now changing with Obama care.....As to being wrong with Congress & Senate I am not.....They do write bills THEN vote on them.....Mr Big also writes laws for the Senate and Congress.....Then it is voted on.....If Mr Big may not write the whole bill but maybe what part concerns them.....I could probably get an attorney and have one written.....I see you are pro corporation.....As for your last question I have one....Are you the Webmd police?.....

Opal40,
I found the Ameritox website for Florida drug tests
http://www.ameritox.com/florida-front-line-in-illegal-pill-trade/
It "appears" that the tests they do are more complex than just to see what meds are in your system
http://www.ameritox.com/urine-drug-testing-lab-services/rxguardian/
This link states the info they say they give the patients in regards to billing, ect.
http://www.ameritox.com/toxicology-testing/billing-reimbursement/

I think all these medications are way to overpriced,thank God for Insurance !I used to pay !60.00 a Dr, visit and another about another 200.00 because at that time we did not have Insurance!Be grateful if you do!
77grace

Hi Grace,

In the past, I had to pay for my meds up front and got re-imbursed 80%. That sounds fine, but when I was using Duragesic, that one Rx alone was over $1,000 per month.

I do not use Duragesic any more. My long-acting generic opiate cost less-than $50.00 per month.

I've been urine tested but twice and the cost was in the $100.00 range. I do know that my MD does not do the GC test unless the UA is equivocal. The practice has a zero tolerance policy.

I do not pay up front for lab tests, so I don't know the exact amount, but it is not $500.00. That's insane, especially if his MD requires monthly UAs.

Perhaps the MD orders UA more frequently for patients they consider high risk, have complex medical diagnoses, or whose metabolism is not fitting into their, "propriety algorithm".

The Ameritox site info is pretty intense. The billing link does refer to a sliding scale type of payment arrangement.

Yeah, when I come on the site, I usually read every discussion and reply. I think I am more noticed than some because I have my big ole mug shot beside my replies.

I still have friends and family in the UK. There is an average of six months wait for any MD visit. No one has the right to pick his own MD. They ( UK) don't really conceptualize how it's done here. When we compare the health care USA to the UK system, the UK system is archaic.

Naturally, there are provisions for emergency, but even with that, medical care moves a whole lot slower than here.

I live in New England now and my town is getting hit hard by the Nemo Blizzard/ Nor-Easter. We have about four feet of snow in my front garden due to the drifting- and the winds are howling!

The greyhound is cuddled up in front of the fireplace, my cats are in a kitty cluster on my bed, my daughter is asleep, and I am having such strong spasm that I cannot get comfortable.....oh well, could be worse

Nice to "see" you again.

Take care and stay warm,

Bet

Hi Blessed Lady,

Pretty intense stuff!

This is directly from the Ameritox page:

http://www.ameritox.com/urine-drug-testing-lab-services/rxguardian/

The Rx Guardian INSIGHT Report provides physicians with a clear view of their chronic pain patient's medication monitoring results in the following key areas:


1. Drugs of Abuse: Identify illicit drugs


2. Medications Or Metabolites Detected But Not Listed On The Requisition Form: Discover medications not prescribed by you


3. Medication Monitoring Results: Evaluate prescription medications being taken — or not being taken


4. Rx Guardian CD"120 Standard Scores (Current): Compare your patients' results to a dynamic reference database of chronic pain patients clinically assessed as adherent


5. Rx Guardian CD"120 Historical Trend: Track your patient's medication monitoring results over time

That is quite an urine analysis.

Seems like a bit of overkill to have this done monthly, unless the MD identifies indication that this level of analysis is warranted.

Perhaps the practice that orders this level of monitoring monthly wants to have a few months of a trend, then the patient can be monitored at a more conventional interval.

The site does allude to a sliding scale sort of billing. If the person who is paying $500.00 per month is not insured, one would hope that Ameritox would honour its statements and offer him this program option. That's 6K per year for urine analysis, which seems pretty steep.

I hope that you are relatively well and far away from our blizzard.

Sincerely,

Bet.