Part II in Series — “Profiling in America”.
Those Pesky States and their Statutes… That NO ONE Enforces Their Parameters…
If one stops to peruse the state laws on the books regarding PDMPs (prescription drug monitoring programs), there is an abundance of fascinating language buried in our very own state statutes.
For example, many states have what is called “Compacts” with other states.
These are statutes made in state law, usually over roadway or bridge construction, over licensure in nursing or medicine, with other states. They encompass an agreed upon number of states, have rules set governing etc…, have legal language with terms and so forth.
However, in regards to the Opioid Crisis… why would there even need to be a “Compact”?
What a fascinating coincidence.
When I stumbled across this statute it was 2:30 am, and I was in the throes of a horrendous pancreatic flare.
Maybe these people will realize some will stop researching and chasing after their stupid machinations when they are not being harmed directly by them.
If I wasn’t being supposedly punished for idiotic actions of another, I would be able to sleep through a night.
I would have access to the medication appropriate for my condition, at the dose required and not have to worry about this ridiculous, evil, self serving propaganda play.
This crisis is really no more than a cleansing of America, as well as a dressed up profiteering of those in position to do so, at the expense of the seriously ill.
My sense of fury and outrage mounted as I read every sentence of the Kentucky Statute 218A.390 establishing the Prescription Monitoring Program Compact — not program. (This is a crucial difference).
I encourage every single person to read it, twice, at the link provided.
If you have any doubts about what the real motivation of the opioid crisis is after reading it; read it again.
It appears that stakeholder interests have more to do with this crisis than anything else, whoever plays the game the right way will make the most money.
No patients or their privacy was considered, unless it would “embarrass” a member state.
Government Reveals the Lie
When HR 6, the expansive “Opioid Bill”, the Support for Patients and Communities Act, was signed by Pres. Trump on October 24, 2018, few people actually knew its entire contents.
Few realized it actually underfunded addiction treatment, yet again.
It put into place strict guidelines for treatment and how it was to be carried out.
It granted extension of the “bupe” waiver and more freedoms for the drug Suboxone to be used in substance abuse treatment for Medicaid patients, a huge win for the pharmaceutical company Indivior.
As of this writing, there is still no generic for Suboxone (bupe).
It also expanded funding for PDMP (Prescription Drug Monitoring Program) databases.
A very few people understood that last bit.
Appriss Has Been Played
With the passing of HR 6, the company Appriss, Inc., began to feel a little concerned.
This little company, based in Louisville, KY, has enjoyed a secretive monopoly on PDMP algorithm programs utilized in every state system since their inceptions into the state systems.
Beginning in mid 1990’s with the Clinton White House, but helped along by the first Bush White House, with their encouragement of EHRs.
In the first of hundreds of non coincidental coincidences, push turned into hard shove right after President Clinton signed HIPAA into law.
HIPAA being the smoke and mirrors law that pretends to protect patient privacy.
At the rate of a whopping average of 2 whole convictions per year out of 350 million Americans.
Either the American people are extremely respectful of each other’s privacy in regards to medical information or no one is enforcing HIPAA law in any real way.
As much as I would like to believe the former, the truth is the latter.
No doubt Appriss is helped along by their behind the scenes relationship with Representative Hal Rogers, a House of Representatives official from their state of KY, the “Prince of Pork”, who just so happens to be the face man for their National PDMP grant system.
Did someone say coincidence?
His ‘Hal Rogers’ PDMP grants have been the sole reason most states were even able to implement a PDMP database to enroll patients in the first place.
Now… well… the government is moving in. They are going to fund things.
Rep. Rogers would not be able to wield the power he once did… if this were to come to pass.
What to do?
Appriss Inc., executives also heard whispers that D.C. was considering making the PDMP a utility.
With the push toward a National PDMP and the certainty it will happen within the next decade, the government focus is now shifting toward whether or not the PDMP should be a public utility.
Still not a peep out of a single government official about privacy, patient consent, if PDMPs even actually work (not one study has shown a definitive yes on this), or if we need a National PDMP.
The CDC isn’t even able to say they work in stopping addiction and overdose.
A National PDMP utility would spell disaster for Appriss, Inc.
The huge checks would come to an end.
On the verge of receiving the Marconi treatment from the government, it seems.
Appriss, Inc. is worried they will become a white elephant if the government takes over the PDMP.
The company has launched a media campaign to highlight themselves, because, in reality, they do have a strict monopoly on this trade in America.
I read a fascinating analysis of this from a anon hospital insider blog, though the post itself was written by David Finney, a partner at Leap Orbit- a healthcare consulting firm in Maryland.
“Appriss has done what monopolists do, bidding up contract prices and seeking to monetize every aspect of the data it controls. Given the commitment by states and the federal government to “do whatever it takes” to address the opioid epidemic — including supporting PDMPs with ever-increasing grant funds — PDMP administrators may grumble, but otherwise few people have stopped and taken much notice.”…
The article speaks of a National PDMP and then goes on to point out:
“By all indications, the federal omnibus spending bill and subsequent signals from federal officials and lobbyists seem poised to deliver on this new model. Not surprisingly, Appriss is worried. In recent weeks, it has launched a marketing campaign of its own to highlight the benefits of the current state-based approach to PDMPs and the interstate gateway it developed in collaboration with the National Association of Boards of Pharmacy….”
That has to sting.
This is my take on this.
Basically, the government is giving Appriss the middle finger and a good doggie pat on the head.
Appriss Inc., will be another in a long line who has been played by our dear government, developed a program, only to have it stolen and used with no recourse.
I can’t lie and say it isn’t personally satisfying to see Appriss being treated… despicably…(like a patient)… even though it underlines the treachery of our government in spades.
I will waste no more time reflecting on Appriss’s potential loss here.
When you deal in deceit- you will have it dealt to you in the future.
When you get too greedy- it never works out.
Since the others in the game, Brandeis and Yale, have day jobs, it shouldn’t hit them too hard.
Besides this site and a few other knowledgeable people, no one has said much about their connections to the PDMPs or the Opioid Crisis at all.
They haven’t been connected in the public eye.
Furthermore, the Kentucky Compact will be a moot point if a national PDMP is created.
Bye bye to that huge money generator for all the states involved, and stakeholders- of which I am certain Appriss, Inc., is the biggest one.
Of course, the yearly reports that are required by the statute written in Kentucky law are no where to be found.
There is no public list of the members or stakeholders involved in the Kentucky Prescription Monitoring Program Compact or any reports existing for review.
The Right to Know
Do we, as the patients who exist as members of the very lists involved in these databases, have a right to know who is viewing our protected, sensitive patient information?
What about informed consent?
Who asked us?
Is it right that our information is being traded to other states and stakeholders and profited off of — all without our informed consent?
Make no mistake- this has gone on for years. The Compact was created in 2012.
I wonder how much money has been made off this information in seven years already.
What will become of all the algorithm programs tailored to sell to all the states?
Does the average American understand what has happened in this power play around the Opioid Crisis?
The insurers have copycat algorithm programs now.
Appriss, Inc., has opened Pandora’s box.
There are algorithm programs to tell your physician you need to lose weight, based on your BMI- a flawed system that has no clue of your bone density or muscle mass.
A bodybuilder will be flagged for obesity even with a body fat of 8%, if their weight to height ratio is too high.
There is NO INPUT mechanism on these programs.
This is what happens when you allow computers to practice medicine- and allow the companies to use them without disclosing the fields they use for inputs.
It Takes One
In the patient community, we have tried for years to find just one.
One politician to stand up for us. One lawyer.
We have been unsuccessful.
Isn’t that astonishing?
No one is willing to stand up for patients being harmed by legislation in this opioid hysteria madness in a court of law.
It defies logic.
No one is willing to say in a court of law that privacy is being breached and invaded by these programs.
They are all too afraid.
That, more than anything, should speak to the American public.
Who is in charge? Are we?
The ACLU National has repeatedly turned down requests to represent patients, to include cancer patients, being denied compassionate pain care.
Yet, they will represent all groups of others being denied medications they require for health.
We have reams of documents, proof, laws, contradictions, and evidence already gathered to ease the process.
For example, Robert D. Rose Jr. has attempted for years to get someone to assist him in his battle.
No one in a position of importance will defend a single patient who is suffering.
That should make any American pause, make any American question who really is in charge of this country.
No one will care when you are suffering and in need of help, except other people who are also suffering and in need of help.
The agencies charged with helping those who are disabled, suffering, and in need of help will let you know how they cannot help you.
You will be gaslighted to death, told to accept your lot, look on the bright side, and be mindful.
Oh, and here is a list of places who offer services.
A list of the cottage industry’s finest that sprung up around the “Opioid Crisis”.
Line the Pockets of Crony Capitalists
- In this district, a politician’s BFF has a company that manufactures drug testing kits.
How interesting that he introduces a bill requiring that every patient be drug tested before they ever receive an opioid prescription? No exception.
And they award the contract for the state to his buddies firm.
- In this district, a woman owns a share in yoga franchises.
Patients in this medical network are highly pressured to attend yoga before they receive an opioid prescription, and they have to go to this place, contracted by the medical network. If it doesn’t work, they are shamed heavily.
- This politician has invested heavily in CBD.
Patients are pressured heavily to try CBD, and refused an opioid prescription. His CDB is the only kind in the area.
A politician with pain psychology.
A politician with mindfulness.
A politician with acupuncture.
Do you understand?
This is all true, how the politics has become around the opioid crisis and state legislation. The sharks moved in and have been having a field day.
A drug screen, which costs under $50 over the counter at Rite Aid, now costs upwards of $500 at a doctor’s office visit and is rarely covered by insurance.
An out of pocket cost to a patient who can ill afford it and who should not have to bear the humiliation of having one in the first place.
That patient did nothing to deserve a drug screen. It is a waste of money, period.
When will the American public speak out for the patients who are suffering beside them?
Those of us who are fighting for ALL of us, not just ourselves.
We are fighting so that all of us can be treated with dignity and compassion.
If we don’t fight together, it will soon be too late to do anything at all.
We must force consent to be obtained for all patients to be entered into any PDMP or state tracking system- to include all the Appriss Inc., add on programs.
We must also push our politicians to fight for transparency in the algorithms used in all healthcare system programs.
Why so secretive? Competition is a great excuse to use for being discriminatory.
Is it because of racist and sexist field inputs?
We don’t know.
Until we require transparency in the algorithms, we won’t know.
Until we compel the statutes to be actually adhered to, we won’t even know what they have done the last 7 years with the patient information they collected in the PMDC- as the statute said they were to annually report.
Where are the reports?
Until America comes together and demands transparency, we will remain in the dark, allowing injustice and harm to happen to those who have done nothing wrong.
The only crime in America where you have zero, and I do mean zero, recourse…
Where no one, NOT ONE, will stand for you…
Is the crime of having the misfortune to fall ill with a incurable painful disease.
Thank you for reading!
This is Part II in a groundbreaking series on the algorithm data science and lack of informed consent surrounding the opioid crisis in 2019 America.
Please check back for coverage on this groundbreaking, vital issue!
The Profiling System In Every State You Never Signed Up For
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