Just A Thought

[icollect]

Having just read the article from the Washington post, I was really struck with the picture it painted. It lumped us right in with a demerol addicted pedophile who raped a thirteen year old.


According to the DEA they are trying to avert drug seeking behavior, but reading this article it sounded like we were a bunch of shady characters, not advertising agencies.


Anyway to the point. These are the issues that have to be addressed to detooth the DEA.


1. Indentify Patients that are engaged in drug seeking behavior.


a. Establish a database to analyze ordering patterns. This is already in place and is used to deny patients ordering too early. Data sharing between ops to indentify abusers could be implemented with threats of sanctions aganist those who engage in abusive behavior. HIPPA guidelines would be honored via a release agreed to prior to ordering meds.


b. Work with the DEA to establish a database of known drug offenders. Instant


c. Put the DEA on the defensive by offering inovative solutions and not slanderizing.


2. Establishment of the doctor patient relationship.


a. Doctors involved in online telemedicine should organize. Any honest doctor should sue the hell out of the Washington post for slander.


b. Establish procedures for patients to appoint doctors as their specialist. Pain, diet, birth control, anxiety stress and other. Most people have no problem faxing or emailing thier medical records. Most people would be outraged that the government is trying to involve themselves in their health care.


3. Appointment of industry spokes people.


a. I am shocked as hell there is no response from our industry. We offer a service that is the future of medicine. It actually suprised me that abureaucrat would slap congress on the hand for not passing laws. It's not this jerks place to legislate. God help us if anybody other than elected officials write laws. I'm sure the Washington post would allow a response from our industry. So hire a mouthpiece already.

[kaylowe]

As far as a central database, what we have now is very close. My goodness, I can get an rx filled at my Walgreens near home and get it refilled across the country. The record is there. They can look it up in minutes.


I have never liked the idea of a centralized database of rx. Smacks too much of "big brother" to me.


Of course, to some of you, "big brother" is justa reality TV show. Who is George Orwell, anyway?


(Do they read "1984" in high school anymore?)


Kay

[chicago]

yes they do

[chicago]

icollect,


the abusive blacklist, IMO is a wonderful idea. I have thought about something like that many times. I also thought that OPs should warn that credit card charge backs, bad checks, and abusive ordering patterns (med info that doesnt match last order, multiple orders, etc) would have the street address blocked and all other order information blocked.

[icollect]

I think all authorities are looking for is a signal that we are not oranized crime, but that there is some organization. The additional components of chargebacks, badchecks or even criminal record would indicate that we are preventing abuse. Super idea. The knowledge that such a check was in place would deter abuse. It would work much better than a doctor in an emergency room.


We could accomplish these things but by using our minds to help people, save the government money, prevent fraud and abuse and redeisn healthcare for the next century. We're not being painted as inovators now, but drug dealers. It wouldn't take much to change the perception, but it has to start now.


If we do this thing and do it right, we will be remembered for doing something that eased the suffering of this life, because there is untreated, unbelieveable suffering in this world. Do nothing and we're just another notch in the belt of law enforcement. Quite frankly it's not jail I'm afraid of, it's them hurting a lot of innocent people because of the 10% that abuse the system.

[MedsDirect]

:)

[redex]

"I want to be an OP when I grow up!" Kay


I don't want to grow up! smileys/smiley2.gif

[MWS_Brian]

icollect,





Great ideas.


Problems: HIPPA to name one and some other legal issues. Main reason why most states do NOT have any "central" script db. If they did, they could catch them all !!


Too many legal issues to address, but give me and a few of the other OPs some days with our attonorneys. I am sure you will be Happy.

[redex]

A central DB has already met resistance because the little mom and pop brick and mortars ould have to shell out a sh*tload of money on the technology and equipment required to accomplish this. The state could rewrite their HIPAA policy to ensure the legality of the central DB. State HIPAA regulations override the feds.


All the consumers have to do is get together and put in a formal request as to who their information was shared with and if they all did it once a month, the system would be bogged down with requests, the state would be over budget in maintaining the db and who knows what would happen after that.. LOL

[kaylowe]

You know, actually, some states HAVE set up a database for controlled substances, there was one under consideration in TN, and I'm sure that there was one in place in KY. A friend of mine got into trouble (she was an addict) b/c the DEA picked up her pattern of "doctor-shopping" (going to different docs for the same complaint) and even calling in fake scripts. That was how the DEA picked it up. I do believe the laws differ from state to state on that, however.


I don't know what the criteria are, however. I could see problems with that, too. What if I, or my husband, to to a doctor with legit. pain, doc gives an rx for hydrocodone. The next day we realize that the lortab is not doing the job, and the doc gives an rx for percocet, oxy, whatever. That drug does not relieve the pain, either, so the doctor rx Fentanyl (very potent) patches. In a month or two, he goes to a surgeon for a procedure to relieve the pain and is rx'ed a different pain relief drug. (Believe me, all of this is feasible, not a fantasy). Would the DEA come investigate this pattern? All of it is legitimate.


Kay Lowe

[redex]

I think they would be looking for the person that got the eight hydro scripts refilled at eight different pharms from eight different doctors in a short period of time.

[kaylowe]

You are absolutely right, Red, but - where do they draw the line?


Also, just had a thought - if the issue here is having a physical exam before the doc. gives an rx, that would outlaw docs who presribe for another MDs patients while taking call. One reason they HAVE schedule 3 is the ease of call-in orders (schedule 2 require written script w/DEA number). I would assume that was to alleviate problems when a doctor gets a call at 10pm from a patient who is in pain, or for whom the doctor/dentist wishes to call in a small amount of pain reliever until the patient can be seen. Doctors and dentists take call for each other all the time so that they can have time OFF. If they were required to do a physical exam, that would certainly put a stop to that!!


Oh, well.


Kay Lowe

[daverx]

What exists now is not centralized; some states have their own databases for tracking controlled substances (Florida is one, ironically). What they are looking for are dealers; people getting huge amounts from several doctors using similar names/addresses. I am only aware of people getting caught for doctor-shopping Schedule II's like OxyContin, but I'm sure it will be extended to hydro soon enough.


But even if there was this centralized database--- it does not take a genius to commit identity theft and order away. All you need to get a mailbox at the UPS store (that's who bought up Mailboxes Etc., on a side note, stuff is actually cheaper now at the storesince UPSbought it) are 2 forms of photo ID. Steal a person's wallet, anda newlicense starring youis easy to make, and a college ID is ridiculously easy.Have a bunch of stuff sent there via money order or register for some creditcards, then close up the mailbox and repeat. My point is, a centralized database will discourage the people who were not really addicts, but an addict will find a way to get what he wants regardless. Without the centralized database, now he can get it by doctor shopping; take that away and he has to resort to buying from dealers which supports organized crime, or he can resort to identity theft. I will bet anyone $100 the number of reported cases of identity theft goes up if there ever is this big-brother-styled database. Sure, supporting such a system makes us OP owners seem like we care and may score brownie points with the DEA, but I see so many problems with it flying- both in implementation and application.


To me, we just need am answer from the DEA if medical records and a phone consult are what is neccessary to be legit. These type of OP's are already in place, and if I ever get a clear answer, I think I will start my own OP of this type. I've ordered from them before and know whatthe patients wantand how to goabout itm all I need is the legal go-ahead. If a physical and diagnosis are already established, it doesn't make sense you would need a new one. These OP's are kinda like telemedicine pain management specialists, and for a lot of people they do really serve a legit purpose to the underprescribed.


-daverx

[icollect]

In this scenarioyou've stated, several crimes have already been committed including fraud and theft, prior to defrauding a doctor to obtain a controled substance. It would beeasier to buy fake identification and medical records, and walk into a doctors office, doing your best hunchback of Notre Dame routine,and get Percosets or oxycotin. Why mess with baby drugslike hydrocodone or darvoset. Plus in you scenario ourcriminal is very sophisticated, and is going to defeat any checkreguardless of face ro face or internet.


We can't stop professional criminals, but we can stop the folks that hang out at drugbuyers.com, they register there, leave ip addresses, and lot's of other info we could use. In addition these folks continuely post about double dipping and op hopping and all sorts of damaging and illegal activity. That's the kind of behavior we can stop. If someone persist in trying to defeat the system you do what real world pharmacies do and have them locked up.


Law enforcement does not hold doctors or pharmiciesacountablethathave antifraud protection in place. The criminal is the one that gets arrested and goes to jail in the real world not the pharmacist or doctor.


There will be no compromise with the feds, the dye is cast. You've been labeled as the slime of the earth in the papers, and to back down now for them would be to lose face. Read the article about lifeline. There will be no reprieve.


We have to use our intellect to apply real world solutions to our industry. Artificial intellegence has been around for 20 years and is super at even spotting abstract patterns. We're not dealing with abstracts here we're dealing with laws already on the books and we sure as hell don't them to write new laws just for us. Letsuse innovation not hesitation.


I completely disagree with letting the other shoe fall, let me just say I've already hedged my bet.

[redex]

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<TD class=text> We can't stop professional criminals, but we can stop the folks that hang out at drugbuyers.com, they register there, leave ip addresses, and lot's of other info we could use. In addition these folks continuely post about double dipping and op hopping and all sorts of damaging and illegal activity. That's the kind of behavior we can stop.</TD></TR></T></TABLE></TD></TR></T></TABLE></TD></TR></T></TABLE>


Double dipping and OP hopping is not acceptable behavior, but is it illegal? Laws and statutes please? jk http://www.rxaffiliateforum.com/smileys/smiley4.gif


Points to ponder:


If all those affiliates that moved their sites from EVA to IMS, thereby offering their customers another source for their meds, is that illegal too? EVA will still send out the refill notices, so will IMS? What then?


What about pharmacy comparison sites, we all think that this may be the safest approach in the future so as to not tie us into one OP, BUT now we are offering a plethora of sources for the med buyer to choose from. Choose from???... or will they buy from all of them? Will we face chargesfor promoting multiple sources for prescription medications. Should we only be promoting one OP so we do not offer double dipping opportunities?


May the best attorney win. I know which one I am hiring http://www.rxaffiliateforum.com/smileys/smiley4.gif

[icollect]

Supplying false information to obtain a controled substance is aganist the law. That's in any context. The only question that arises was the doctor or the pharmacy careless.


You made my point for me beautifully, a central database would prevent double dipping by preventing the script from being transfered for certain drugs and only once for others. That is law. You don't track by pharmacy except who is the owner pharmacyof the current presciption for that patient, you track patient behavior. Any attempt at any behavior that suggest a drug problem results in a permanent ban. Another attempt results in arrest.


We are marketers not pharmacies. We have no obligation other than not to misrepresent our product as we don't prescribe or dispense. Unless you knowningly enter into an agreement with a doctor and a pharmacy to dispense controled substances illegally you are basically immune from prosecution. We are not required even to have a working knowledge of the medications we dispense. If we were every television station and newspaper that had ever carried an ad for any medication would be as liable as the manufacture in civil actions. I have seen some ops that try to put me in the position of a customer service rep in which case I promptly remove links and replace them with ones that provide customer service.


As far as what products we market from who and where, that is a matter of choice on our part. You startgetting to areas of free speach there. We are advertisers and nothing more. If you make you or your site more than that, your opening up a legal can of worm, both civil and criminal. If you are approached with such a proposal run like hell, because you will be left holding the ball when the defication hits the oscolater.


Last but not least, I'm not a lawyer, but I've worked in the corp world for 30 years. The law for the biggest part is common sense. The one thing that is for sure in any business you can be sued for anything. So you try to prevent this by being prepared. The worse possible defense is I knew but did nothing.