So how do you deal with suspected drug abuse without violating privacy rights or making false accusations?
But as they also say in Italian, con amore ma non troppo with love but not too much. In other words, I have some compassion but not too much empathy. What causes bleeding in the insurance industry? Hemorrhaging is caused by unanticipated innovations in the way of drugs, devices, or tests, but more particularly unanticipated utilization and submission for payment.
And right now, unanticipated utilization of urine drug testing is causing a hemorrhage. It is through the roof. So much so, that there are several policies on the table that could jeopardize the availability to state of the art lab tests for those of us who treat pain and addiction and use laboratory testing only as medically necessary.
Reverting to a strictly immunoassay IA outpatient drug rehab business plan sample policy and denying confirmatory testing either entirely or of IA negative specimens, the re-instituting of this forensic testing method and mindset is a desperate effort on their parts to curb skyrocketing lab costs.
If this were all it was, my compassion for the insurance industry paying for these lab tests would be zero! But good patient care is not the only reason that labs are ubiquitously ordered. Without a doubt, I believe that most pain clinicians who choose to treat with medication management as part of an overall armamentarium certainly have their heart in the right place.
They care for medically complex patients that are frequently outcast by other providers.
They carry a high liability, much anxiety, deal with political issues, the DEA and state regulatory agencies, and are often living in a nerve wracking nightmare for providing compassionate care. Indeed, they could come under scrutiny for ordering such tests without adequate documentation for need or for lack of follow-up and actionable outcomes based on the lab test results.
Nevertheless, while we have all heard about fraud and abuses in the industry, perhaps it also exists, in some cases, on the provider end. There are providers in some instances who used to test urine infrequently but now test patients over and over again with large and expensive panels, as this has become a huge revenue source.
These entrepreneurs are not doing anything illegal; in fact they are driving through a loophole in Stark Laws so big you could drive a Mack truck full of urine through it.
Some greedy labs are threatening the availability of a tool that many of clinicians rely on in our clinics. But interestingly no one seems to regulate or write about this aspect of unethical practice interesting in a time when regulating pain practice is at a Zenith and I find this transgressive and embarrassing for the professions.
And the poor patients, afraid of losing access to their medications, who need urine drug testing to help them objectively demonstrate their adherence in an era when they are constantly stigmatized, are often frightened to question [over-the-top] testing themselves even if they recognize it as excessive.
At a time when fewer and fewer patients can rely on finding prescribers willing to treat them with the opioids they need, if they get the message they can only have their medications with frequent testing, they will do it — they are over a barrel.
So many politicians railing about prescription drug abuse and wanting to do something about it and no one wants to be the next Pete Stark?
While he had to apologize on many occasions for ill-advised and offensive comments over the years, Stark was his own man. The first openly atheist member of Congress he was vocal about taking unpopular positions. He was for national healthcare reform….
He voted against the Iraq war. He was against the government buy out after the crash.
Whether you agree with these positions or not, he was his own man, an iconoclast and someone not afraid of taking on powerful and sacred cows.
Stark, as many others, knew that physician ownership and fractional ownership of imaging centers and labs and other forms of self-referral were bad for healthcare and bad for healthcare costs. Studies have shown for example, that when doctors have a financial interest in imaging centers they order a lot more imaging…and particularly a lot more negative imaging.
Exceptions were made for labs to provide instant and point of care information and facilitate providers to work together and share cases in large institutions. This is the stark reality. And we need a solution other than a blunt, ill advised, regressive set of payer policies that will render pain and addiction treatment far less safe for people with these already stigmatized problems.
As usual, chime right in folks!Mountain Laurel Medical Center has an opening for a behavioral health provider. See description below. If you have any questions or require additional information, please contact Amy Barnhouse, HR Specialist, at ext.
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