A downstate doctor has filed for a Preliminary Injunction to quash a subpoena from the Illinois Department of Financial and Professional Regulation. The Department sent a subpoena for records to a Hospital at which the doctor had worked in the past. However, the subpoena was part of an ongoing case, and the Department did not sent a copy of the subpoena to the doctor or his attorneys. Also, some of the the Department’s investigative procedures pursue the to 225 ILCS 60/7.5 were ignored. Pursuant toe 68 Ill. Admin. Code 1110.40 the Department must follow the Illinois Code of Civil Procedure with respect to subpoenas.
Addiction to prescription painkillers is an ongoing problem in our society. With addiction and misuse of the drug, comes heavy fatalities. According to a report by the CDC, drug over doses killed a staggering 63,632 Americans in 2016, with more than two thirds (66%) being due to prescription or illicit opioid.
Governor Bruce Rauner, will soon be looking into a bill that has proposed that in order to avoid overuse and overdoses of opioids, certain patients should be allowed temporary access into the states medical marijuana program.
According to Senator Don Harmon, the legislation which passed with bipartisan and supermajorities will be soon placed in front of the republican Governor.
Medical marijuana, being given and allowed in place of prescription painkillers and opioids will not end and subside the endemic of opioid overuse, however it may help to curtail it. Studies and reports have shown reduction in opioid-related fatalities and opioid prescriptions in states that allow the use of marijuana for medical or recreational purposes.
According to Sen. Harmon this bill has a number of benefits as it would do more than just assist pain patients in taking part in what would be called “Opioid Alternative Pilot Program”. It would significantly reduce waits for other patients to get access to one of the state’s approved cannabis dispensaries after their doctors certify that they have one of the 41 qualifying conditions. Patients are waiting 60 to 120 days for documents to be processed by the state so they can receive program membership cards.
According to this proposed bill, patients for the traditional medical cannabis pilot program would almost immediately receive provisional permits to buy less than 2.5 ounces of cannabis from dispensaries every two weeks for up to 90 days after they submit the required forms and certifications from their doctors. The long term applications can then be processed meanwhile.
This bill is manufactured in a way to give legal access to medical marijuana for the same time frame that the pain patients would otherwise be prescribed opioids, which are far more addictive and hazardous.
The bill would also eliminate the previous requirement of fingerprinting and background checks, a process that delays the patient from receiving their membership cards.
The bill also proposes to have the application forms filled by the patients themselves, a process that is being heavily billed by some companies, as they take advantage of the patients and have them fill the form through them. The bill outlaws and dismisses such fees and violators could face charges of class C Misdemeanour.
If approved and accepted, this bill could potentially increase the enrolment of the Medical Cannabis program by almost eight fold.
Medical marijuana is known to help pain patients in various ways. For example, one way medical marijuana could be helpful is in avoiding addiction to prescription painkillers and reduce opioid overdoses. Legislation was passed and Governor Bruce Rauner will be soon weighing in. Allowing people who have been prescribed an opioid, to use marijuana instead could possibly reduce opioid-related fatalities. If the legislation is approved it could increase enrollment in the state’s medical cannabis program dramatically. This bill, if passed, would do more than just assist pain patients who would like to take part in the Opioid Alternative Pilot Program but also drastically reduce wait for other patients to gain access to the one of the cannabis dispensaries. The bill would also eliminate the required fingerprinting and background checks for applications and prohibit physicians from using outside medical and office buildings to examine patients and certify whether or not they would qualify for medical cannabis.
The Department of Healthcare and Family Services has recently proposed amendments regarding long term care and medical payment. This rulemaking will require long term care facilities to inform DHFS of any death or discharge of a resident on Medicaid within fifteen (15) calendar days. Changes in patient credit, third party liability, or requests for change in care rates—all information is to be submitted within forty-five (45) days. The information must be submitted via either of two electronic portals. The two portals are MEDI, Medical Electronic Data Intercharge, or EDI, the Electronic Data Intercharge Service Vendor. These amendements will add self-neglect to actions that are to be investigated by APS, Adult Protective Services. This will establish an APS registry which will record the names of caregivers who were found to have abused, neglected or exploited “adult” patients with disabilities ages 18 or older. The APS agency will review the victim’s case record and concur with a finding and recommend whether or not the said caregiver be placed on the registry or not concur and recommend against placement. Caregivers will be notified on the decision and soon as one has been made. Those who will be affected by this rulemaking include any agency which provide adult protective services, caregivers of older or disabled adults, agencies which hire or supervise caregivers and any and all law enforcement and fire protection agencies. This proposed amendements to the Medical Payment (89 IAC 140; 42 III Reg 9052) implements Public Act 100-449.
Messages and awareness campaigns regarding mental health and the extreme importance of a healthy work life balance inundate our culture. However ironically, doctors are rarely the focal point of these enterprises. This is the sad and unfortunate truth of our healthcare system. Doctors are afraid and reluctant to seek help for mental health, and those who do, are always nervous about losing their careers. According to a study done at the Mayo clinic, medical licensure questions inquiring physicians about their mental health or a prior diagnosis, discourages physicians’ from seeking the help they need. Doctors in some states are expected to answer questions likes these in order to renew their license and some of them are withholding information, and in some instances, failing to get the help they desperately need.
The report concluded that a staggering 40% of the physicians stated that they would be very hesitant to reach out and seek help, out of dread. Therefore, clearly there are many physicians masking their mental health problems out of fear of jeopardizing their careers, and they need all the support they can get to recover from physical and emotional burnout because of the intensity of their job descriptions.
The concern with asking doctors about their mental health on licensing applications is that the questions tend to be overly broad. Some state licensures ask about current mental conditions, previous mental health conditions and/or impairment from a mental health condition.
For most doctors, the overtaxing requirements of medical school mark the commencement of their mental health problems. A study carried out in 2016 highlighted that almost 30% of medical students were depressed or showed signs and symptoms of depression, but only 15% actually sought help for psychiatric care. These numbers increase during residency as it is a very tough and demanding period in their lives. This distress only worsens with time as the emotional burden keeps piling on.
Suicidal ideation is very high and prevalent amongst physicians, many physicians end up self-prescribing antidepressants and some may even reach out to their coworkers for a prescription as a favor.
Michael Meyers, a psychiatrist and a professor of clinical psychiatry at State University of New York-Downstate Medical Center, acknowledges that physicians under these circumstances often feel like they’re capable of handling their own treatment because they’re so knowledgeable in medicine. But Myers says, “Under no circumstances should doctors be treating themselves or their family members unless it is an emergency.”
There is a common myth and misconception that if a physician suffers from a mental health problem, they are unfit or incapable of taking care of the patients under their care. However the American Psychiatric Association says that there is absolutely no parallel and connection between this theory. This barrier that has been created in the mind of the general population regarding a physician seeking help for mental health and preforming their duties as a healthcare provider needs to explained and removed if we are to receive top notch medical help.
In fact a physician receiving mental health treatment helps both the doctor and the patient. The easier you make it for a symptomatic physician to go for a treatment that works, the better off the physician is and the better off his or her patients are.
Based on how the licensing questions are asked, they may actually be violating federal law. The Federation of State Medical Boards advises against asking physicians about their mental health treatment because doing so might infringe the Americans with Disabilities Act, yet almost two thirds of state medical boards ask physicians questions about their mental health.
As a result contrary to the common belief that there is a stigma attached to physicians and healthcare workers seeking help for mental health because there is a constant looming fear of losing their license, or being judged and questioned over their capabilities, it is in fact the lack of sought help and treatment that puts their careers, jobs and their patients at risk.
Illinois House passes a measure that requires hospitals to have Sexual Assault Nurse Examiners (SANEs). SANEs will be able to treat and examine victims of sexual assault. Currently, hospitals have nurses complete a ‘rape kit examination’. Sexual assault survivor, Lindsey Ross, completed a rape kit examination at a hospital outside of the city of Chicago. Ross believes the nurse who went through a rape kit examination with her was not fully trained to handle sexual assault cases. Ross explains that her experience would have been completely different had she been seen by a Sexual Assault Nurse Examiner.
As of now, sexual assault victims are treated the same regardless of age — SANEs will be able to recognize the difference in need between a child and an adult victim. The Illinois Health and Hospital Association supports this measure and the objectives it wishes to fulfill. After passing the House, this bill is to be considered by the Senate. This will be a monumental for sexual assault victims; allowing them to get the appropriate care for their traumatic experiences.
Since its inception a decade ago, the Medicare Fraud Strike Force has charged more than 3,500 people with ‘ripping off’ Medicare as of early 2017. These are nine teams (made up of agents, investigators, prosecutors, auditors, etc) based in fraud hot spots such as Miami, Los Angeles, Detroit, Southern Texas, New York City, Southern Louisiana, Chicago and Tampa.
Here are some examples of the type of cases that the Medicare Fraud Strike Force goes after:
1.) Using Fake Patients for Payment.
Miami based agents investigating Medicare Fraud heard of suspicious practices of a psychiatric medical facilities recruiting patients, and so they started investigating. Here is what they found: medical facilities were paying recruiters to scare patients. Many of those people were drug addicts who were not in need of psychiatric services, but were looking for case or substance-abuse treatment. They were coached to say that they were suicidal to generate bogus Medicare claims. The CEO of the facility was convicted and sentenced to serious jail time.
2.) False Billing by Healthcare Providers.
These health care companies were billing Medicare for bogus home health services. The task force carefully checked patient records and compared them for billing records and found instances where patients were not care for, but the health care providers were billing anyways. Some patients were given expensive treatments that they did not need, and Medicare was even billed for services that did not happen at all.
3.) The Opioid Medicare Connection.
Medicare numbers are worth more on the black market than credit card numbers, since Medicare numbers can be used to bogus opioid prescriptions. The pills are then sold on the street for big profit. Monitoring opioid prescriptions is difficult because they are so frequently given to patients in pain. One in three Medicare Part D beneficiaries received at least one opioid prescription in 2016. One case in Detroit involved a doctor who used recruiters to find patients whose Medicare numbers he could steal. He would then use those numbers to give patients painkillers for cash. This particular doctor was sentenced to 23 years in prison.
Women who have vaginal mesh implants to support their bladders often have discomfort. These women sometimes find themselves falling prey to a burgeoning industry that makes money by coaxing women into have surgery – sometimes unnecessarily — so that they are more lucrative plaintiffs in a lawsuit against medical device manufacturers. Court records suggest that perhaps thousands of women have been sucked into unnecessary surgeries, which may have horrendous complications.
The litigation surrounding mesh implants is lucrative. Millions of women, world wide, have received them,and many women do in fact complain that they cause bleeding and/or pain during sexual intercourse. But, surgery is not always, or even often, the answer.
The Illinois Department of Financial and Professional Regulation will prosecute doctors for performing unnecessary procedures, and rightfully so, as it is a violation of state and federal criminal law to perform and bill for a procedure that is not medically necessary. Charges of Medicare and Medicaid fraud are also likely.
Doctors must be wary of arrangements with lawyers and or third parties who are arranging to find patients for them. It is illegal to pay a referral for patients.
“I’d rather see a female doctor.” In a male-dominated profession, this request is not common, unless we are speaking about gynecology. From 1970 to today, the percentage of women gynecologists jumped from 7 percent to 59 percent. Male physicians fear that due to the decline in number of male gynecologists, their gender may eventually be excluded from the speciality altogether. The Chicago Tribune article, Male OB-GYNs are in the decline by Soumya Karlamangla mentions an instance of this gender preference. Brooke Hamel, a 19 year old girl from Virginia, recently went to the gynecologist to get a intrauterine device inserted. “He touched me and I immediately lost it… As soon as I had to spread my legs, I was in a really vulnerable place, and I did not want to be in that position with a male.” Outside of this speciality, fewer than a third of physicians are females. Men are now less likely than ever to try and become an OB-GYN due to this controversy. If the drop in number of male gynecologists continues, this could weaken the field overall. In terms of care, male and female OB-GYNs have the same education and practice. Preference in gender is only a matter of what the patient feels most comfortable with. On the other hand, there are women who prefer male OB-GYNs stating they are more gentle and better listeners. Perhaps this is due to the need to overcome this uprising stereotype.