The Centers for Medicare Services, CMS New Policy February 2019

In my recent book, I wrote about the federal government's overreaching into the physicians' private treatment of the pain patient.  I pointed out that the Veterans Administration was making life difficult and increasing the pain levels of VA patients.

How?  VA Administrators have been crawling all over their doctors and mid-level practitioners to enforce their policy of limiting pain meds and quantities of meds for patients.  VA also has discontinued a doctor's authority to combine two different classes of meds in a particular patient: opioids and benzodiazepines.

CMS, the Center of Medicare Services, issued a new policy that pain meds in the opioid category would be limited to a 7-day supply.  To me that is federal politics butting into health care.  This is important stuff to patients.  Let the doctor play doctor, let the politicians play politics.

Additionally, CMS is recruiting pharmacists to be the enforcers of the new regulations.  Young pharmacists will get their kicks being the pain prescription police; old pharmacists will see it as one more pain in the butt.  CMS will have their hound dogs--pharmacists--enforce their policies by means of transmitting warning messages to the pharmacy computer.  This is all being done 'in the interest of patient safety' because the government cannot control the influx of narcotics into the USA.  It has little to do with patient safety; it is politics, pure and simple, and I oppose it all.

You may go to a pharmacy hoping to obtain the script that your doctor just prescribed for you.  If you are taking a med from CMS's banned class--anti-anxiety drugs--the pharmacist will study your secret PDMP report: your Prescription Drug Monitoring Report.  Also any electronic messages from Medicare, other insurers, or Rx processing companies must be addressed by the understaffed pharmacist.  Electronic alerts include messages like patient safety, refill too soon, duplication of therapy, excessive quantity or dose, soft halts and hard halts.

A pharmacist can override some warnings; others require that the prescriber be consulted.  Additional information from the doctor may be required by the claims processor.  Think time and hassle and stress and worry.  Don't expect a positive outcome.  This new CMS standard will be disseminated and most insurers will follow suit.

Expect things to get worse if you are a pain patient and/or an anxiety patient.  The USA intends to punish you.  Without your meds you will get worse, you will have a more difficult time working, living a meaningful life, and possibly surviving the day.  This is secret stuff.  You only find out when your refills are denied.  Good luck.