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Valued Social Butterfly
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Re: CVS's war on drugs and how it effects us.

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Yes, CVS did begin their own initiative back in September 2017 - but now the rules being made by Medicare / Medicaid by CMS as described by the CDC are in their favor and scrutiny will begin in earnest by ALL Medicare Part D plans.  

 

The word has also gone out to doctors - unless in one of those exception categories - hopefully, they will think before prescribing opioids in the number they have previously been doing.

 

There is a limit on how many will be prescribed after some procedure.

Chronic pain users will be reviewed more often - by the doctor, care team or even the insurer.  

 

This is is a good thing - a lot of elderly people go to multiple doctors, they get their scripts filled here and there - it is even hard to keep up with all the meds they are taking, much less trying to determine if one med does not work well with another Rx or even an OTC supplement.

 

You will just have to wait and see how much problem this creates for you - after the initIal review, it may not be a problem at all or the doctor may want to reevaluate you again to see if something else could help your chronic pain.  Either thing will have to be repeated periodically.

 

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MY SIGNATURE: "It’s Always something" - Roseanne Rosannadanna
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Re: CVS's war on drugs and how it effects us.

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CVS was not mandated by the goverment. This is something they came up with themselves. The last time they tried to do this, the goverment came down on them as well as AARP and groups for the eldery. 

Okieboi50
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Valued Social Butterfly
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Re: CVS's war on drugs and how it effects us.

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@Okieboi

Medicare / Medicaid doctors are not in overall control in how they treat a particular condition - they have to abide by what is defined as best practices.

 

It is true that in the past, many of these doctors were overprescribing opioids - now the use of them is going to go through extra scrutiny -Yours and everybody else's unless in one of the exempt categories which was covered in my previous post.  

 

All I know is that these government agencies are cracking down on why, when, how, how much and for how long and with what other medicine - so just remember, when you are put through this wringer by whomever, they have been mandated by the government to apply this scrutiny and have to do it - just like approving any other treatment and its medical neccessities - medicine or treatment.

 

 

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Re: CVS's war on drugs and how it effects us.

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Thanks for replying. I understand what you are saying. But the main thing I am trying to say is that not everyone is a drug addict or hooked on drugs. There are some of us who know how to be responsible with their meds and should not be lumped into the ones that are not responsible. What if you went to the Doctor and you have an illness. And the Doctor, just gave everyone the same thing because others have it. Each person, meds work differant. I hope you would want the Dr. to do things to find out how to treat YOU, Ive been on the same meds for many years. And for some place, to think they know whats better for me, than the Dr. is insane! Because so many place are afraid of being sued. Theu punish those who need it and are responsible.It makes me so mad, they do a band-aid approach, instead of fixing the real probem.

Okieboi50
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Re: CVS's war on drugs and how it effects us.

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The reason for controls being put into place:

 

AARP 03/08/2018 - Opioid Overdoses Up Among Older Americans

 

Kind of staggering how these scripts have been written so freely for this age group.

 

 

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Re: CVS's war on drugs and how it effects us.

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@Okieboi

I think you might be surprised about what seems to be in-store for Medicare chronic/urgent pain suffers in 2019 -

 

Prescribing rules were issued by the CDC a few years ago and then revised and on April 02, 2018, CMS (Center for Medicare and Medicaid Services) issued new rules for Medicare/Medicaid on opioid use - Norco contains hydrocodone so it is included..

 

CMS Press Release 04/02/2018 - 2019 Final Call Letter - Improving Drug Utilization Review Controls (...

 

2019 Final Call Letter

Improving Drug Utilization Review Controls (Opioids)

. . . . Given the urgency and scope of the continuing national prescription opioid epidemic, CMS is finalizing a number of new policies for 2019 to further help Medicare plan sponsors prevent and combat prescription opioid overuse. While the strategies collectively work towards the same goal, an overall reduction in opioid overuse and overdoses, we have tailored each approach to address the distinct populations of Medicare Part D prescription opioid users (e.g., new opioid users; chronic users; those with uncoordinated care; those that concurrently use opioids with benzodiazepines, etc.).

 

. . . . The care coordination edit and other opioid-related strategies implemented for Part D beneficiaries discussed in this Call Letter support adoption of the CDC Guideline for Prescribing Opioids for Chronic Pain. CMS believes it is important that MA-PDs set expectations for prescribers to implement the CDC’s recommendations as a best practice through their provider contracts. PDPs should also reinforce these messages through interactions with prescribers as an integral component of sponsors’ drug utilization management program.

 

more at the link above

Yes, checking meds against each other is also part of the new procedure.

 

and a news report in more plain language about it with the controversy.

NYT 03/27/2018 - Medicare Is Cracking Down on Opioids. Doctors Fear Pain Patients Will Suffer.

 

So it really isn't going to matter where you actually get your meds under Part D - all providers are gonna be doing more scrutiny about useage, other meds also being taken at the same time.  Many doctors are getting ready with some non-opioid treatments which hopefully will work.

 

There are a few that will have easy access because of their condition - per the CMS Press Release which agrees with the CDC guideline:

We also recommend that beneficiaries who are residents of a long-term care facility, in hospice care or receiving palliative or end-of-life care, or being treated for active cancer-related pain are excluded from these interventions. In addition, it is also very important that beneficiaries’ access to medication-assisted treatment (MAT), such as buprenorphine, is not impacted.

 

 

 

 

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CVS's war on drugs and how it effects us.

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If you have Medicare-D. You know every year we have to pick a policy. This year, most of the policies offered to me was only using CVS for my meds. I been using Walgreens for yrs and was very upset that I would have to change.to CVS. Later I found out I could have stayed with Walgreens. I go to a pain clinic for chronic pain and I'm on a set amount of meds for pain that I have been on for more than 10yrs.Yesterday, I took My Norco script to CVS and they told me it would be 30mins when they will be ready. An hour later I get a called from the pharmacist, that they can't fill my meds due to the fact that they think I am on to many meds and need to come back and get my script. I was so mad I just hung the phone on Him. This policy is going to effect a lot of people and I don't think a company should be able to over ride what a Dr. wants for me. I told them I will no longer be using them and took it to Walgreens(who I just found out I could use them) and that they don't have a policy like CVS.It made me fell like I was a drug addict. I just want others to know, that they need to find out what policies of your pharmacy.Heart

Okieboi50
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