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Posted 4/4/2013 6:07 AM (GMT 0)
I've been going to a pain clinic for a few months now. They said after this last visit/prescription I will then have to wait 90 days b4 getting a new script. They say it's TN law and it's bc they are "interventional pain management" and that is why the 90 day gap.
My concern is they have me on 15mg of Oct and my PvP will not write any narcotics.....what will I do??
Posted 4/4/2013 6:18 AM (GMT 0)
Well Im not sure whats going on with that as I have never heard anything like it. Can see how they can call their selves a pain clinic of any kind and leave you 90 days with no meds? Thats ridiculous! Interventional pain management? I dont get that one!!

I would be finding me a new Dr and real soon. I know some of the folks here are really good at digging around and finding laws and regs and stuff and I know onw of them are sure going to take a look for this nonsense when they get a chance.

Not much help for you but if you can find another Dr as quick as you can or your going to have to stretch those oxy's to the limit.

Like I said others with better search skills then me will find out whats the deal so hang in there.

Vickie
Posted 4/4/2013 7:50 AM (GMT 0)
The only new law in TN that I could find that went into effect on April 1st is that doctors and pharmacies must check the new database that was set up at the beginning of the year before writing or dispensing narcotic pain medications to make sure that patients are not getting these medications from multiple doctors and/or having them filled at multiple pharmacies.

Also pharmacies in TN are now required to update this database every 7 days instead of 20.

I could find nothing in the law about having to wait 90 days, so unless I missed something this is seems to be something your pain clinic is doing.
Posted 4/4/2013 9:03 AM (GMT 0)
Thats what I gathered as well Jim. What in the world is "interventional pain management"? Thats a new one on me. It sounds more like they treat acute pain more then chronic if they expect you to take meds for a few months and then not for 90 days!

Thats about ridiculous to think chronic pain treatment could work that way. Has to be something more about that.

Thanks for checking out and I am just not real good at using this thing to search.

p.s. Jim and RJ nice to see you all here trolling with me tonight but that must mean you both are having sleep problems?

Vickie
Posted 4/4/2013 10:36 AM (GMT 0)
Hey AngMichelle,

It seems more and more... people here are being told something about "the law being so-and-so"... and most of it is nonsense! It's frustrating that so many are being given false information.

As Jim stated - there's the new law pertaining to the Controlled Substance Monitoring Database Program (CSMDP). That's really all I can find related to laws in TN.

Re: "interventional pain management" - that makes no sense. Most of us go to interventional pain management clinics. All that this means is that.... in addition to medications - the pain clinic uses a multi-faceted approach - such as trigger point injections, facet/nerve blocks, implanting pain pumps/SCSs, epidurals, ablations and so forth. This is nothing new... and there's no certain "wait period" because of going to a multi-approach pain clinic??

So... I'm just confused a little bit.... you've been going to this particular pain clinic... they've been scripting you pain meds.... and, now, they are asking you to go 90 days because of a new law?? I'm not getting it. For one, because no law exists.... and, second, did you ask them what you are supposed to do for 90 days??

If this were me - I'd be on the phone tomorrow and figuring this out. Hang in there --Tina
Posted 4/4/2013 4:10 PM (GMT 0)
There is a difference in the types of pain clinics that are out there. Interventional simply means that they offer procedures, rather than medical management. Injections, radiofrequency ablations, spinal cord stimulation, physical therapy , TENS , etc.....most of these no longer deal with medical management only cases.
Conventional pain management clinics seem to be the ones that also do all of those things but also offer medical management after all of those other techniques are exhausted.
Posted 4/4/2013 4:14 PM (GMT 0)
Oh, and the 90 day rule that we are hearing so much about something  if I recall correctly, in that if a patient is going to be prescribed narcotics for longer than a 90 day period, they must see a board certified pain management doctor, not their primary or other type of doctor, unless that doctor has taken the extra education credits to prescribe narcotics long term.

There was also a petition sent into the FDA regarding changing the language of what opiods can be prescribed for- instead of moderate to severe pain, they wanted it changed to "severe" and for long term treatment of cancer pain, not necessarily for chronic pain. It was done by the Physicians for Proper Prescribing of Opiates or something like that......they are behind the proponents of the 90 day thing......not sure if that was ever approved or not....

Post Edited (mrsm123) : 4/4/2013 10:25:18 AM (GMT-6)

Posted 4/4/2013 6:44 PM (GMT 0)
My insurance covers NO Lon term chronic pain clinic anywhere near. I believe since they may not be a long tern clinic that is why they are telling me this gap is needed when I bet it's really that they can't prescribe more than 3 months and I'll probably have to this every 3 months...I asked them what someone with CHRONIC pain is to do and just isn't an answer, especially being on Medicaid...
Thanks guys for the replies!
Posted 4/4/2013 9:24 PM (GMT 0)
I find it so aggravating to hear stories like this! What are we suppose to do, when we have conditions that they will not do anything for, but supposedly keep you comfortable? I know I have tried most of the "interventional" pain treatments, TENS, Guided Imagery, BioFeed back, and a host of other things, none of them worked! Now they are having "supposedly people, and Doctors that are well versed in pain" trying to take away the medications that do work!  I get frustrated because, although I have an excellent PM here in Illinois, I really want to move away from here, ideally I would like to move to Kentucky where my sister and all her family live.  But I am having problems finding a PM clinic that is willing to continue with my present Pain Management regiment. So far they have said they will not continue with my current prescriptions, and they will only do "interventional"  pain treatment. It seems this is the new thing in PM treatment! I can empathize with you AngMichelle, you seem to be stuck between a rock and a hard place!  I have said this before and I will say it again, if only these "people in the know" had to suffer and experience the pain that we do, then maybe, just maybe they would not be so quick in wanting to institute "interventional pain management"  as the sole treatment for those of us suffering from chronic pain!

 

Here in the United States even the pain treatment for allot of terminally ill cancer patients, is minimal at best. There are better medications available, and used in other countries (but illegal here) that are better suited to treat the pain of the terminally ill cancer patient and gives them a much better quality of life in there last days! But they are highly addictive, but I ask you? does it matter how addictive the medication is, if your terminally ill?..... I personally think  that for being so medically advanced in this country, we  are also so far behind in the humane treatment of chronic pain!

 

White Beard

Posted 4/5/2013 11:09 AM (GMT 0)
I guess this is kind of related here. I talked to my pharmacist yesterday because I had an issue with a new script and we contacted the prescribing NP at the PM for clarification and correction. So while we were waiting I asked him some questions....he explained that they no longer take ANY new patients with the opiate scripts and that, although they do have some issues getting meds in, iris basically that they know the clients and who is doctor shopping. If the client is not legit, they don't fill the med anymore. I even had to go get a hard copy of my script and take it ther and then they would cross out the other mscontin and fill the newly written one.

Basically my issue was that we are increasing my mscontin by 15 mg, but I take 30's twice a day. We are changing them all to 15's, but giving me 5 a day to space however I need. This should give me a little more to take when I need it and I can stay on the same on the "good days".

Anyway, the issue here was the pharmacist and how a new patient would get meds filled. Basically, they wouldn't at my pharmacy. It's a mom and pop, but a great one!
Posted 4/5/2013 5:28 PM (GMT 0)
My current Pm doctor works in a clinic called "Interventional Pain Specialists", he does do injections, implanted medtronic stims, emg's and more ect...I think the term Interventional is just that a term, If your having a probelm with your current doctor then you do need to look for another one, There was talk and it was in the newspapers about the Federal government stepping in and limiting controlled substances to monthly, I don't know if or will it go thru, if that happens we all will have to see our doctor's every Month and if that passess I will send Uncle Sam my bill for the $50. co-pay to see a specialists once a month. It was on the front page here of the Houston Chronicle and I wondered if there was going to be talk about it on here.
Posted 6/7/2013 8:26 PM (GMT 0)
AngMichelle, Doesn't Tenn have Medicaid Managed Care ? What Health Plan are you a member of ?
Posted 6/7/2013 9:21 PM (GMT 0)
Mercy&Grace, just to let you know AngMichelle has not been to the forum in quite a while.

Susie
Posted 6/7/2013 9:30 PM (GMT 0)
straydog, Thank You ! I'm new and was just trying to help.
Posted 6/14/2013 6:06 PM (GMT 0)
I heard that this is happening with PCP Dr.'s but no PM Dr.'s... what part of Tn do u live in? I ask because I live in Mt. Juliet and my PM Dr. hasn't said a word about this...
Posted 6/14/2013 6:23 PM (GMT 0)
uniquelyme,
I believe alot of the problem is because she is on Medicaid. The problem is very common if your pain is Not cancer related and you have chronic pain and Medicaid is your only insurance.
Posted 6/14/2013 7:40 PM (GMT 0)
I was on TennCare for years (that's Tennessee Medicaid) and went to a PM Dr. That was before all of these new rules started up... Now I am on Medicare due to Disability as of January this year... I haven't had any problems yet, but don't know if I will. My PM Doc isn't as generous with the pain meds as my old PM was, but that's not a big issue. I know that the rules are changing and I hope like hell that mine doesn't change the way he does business... I live in Tennessee and that's why I was asking....
Posted 6/14/2013 8:31 PM (GMT 0)
If you're receiving Medicare, that is different than Medicaid only. Even if you're dual eligible, receiving Medicare and Medicaid, that is much better than Medicaid only.

But the states have received letters from Washington D.C. politicians inquiring about the providers that rx alot of pain and certain other types of medication to those on Medicaid and to those on Medicare. The links below explain it.

The majority of States were sent letter by Senator Charles Grassley in 2010- http://s3.documentcloud.org/documents/259291/grassley-letter-to-states.pdf

Grassley Probes High-Volume Medicaid Prescribers-
http://www.medpagetoday.com/PublicHealthPolicy/Medicaid/30857?utm_medium=email&utm_campaign=DailyHeadlines&utm_source=

Medicare Drug Program Fails to Monitor Prescribers, Putting Seniors and Disabled at Risk-
http://www.propublica.org/article/part-d-prescriber-checkup-mainbar
Posted 6/14/2013 10:12 PM (GMT 0)
I am due to have a neurostimulator transplant done on July 11; did great on the trial. Briefly considered spinal fusion to repair the train wreck that is my spine, but fear of that amount of surgery with rods and pins and cages freaked me out so I am opting for the least invasive treatment that will help my leg pain. Has anyone had this procedure recently and can you give me any updates and encouragement?
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