Despite warnings about abuse, Medicare covered more prescriptions for potent controlled substances in 2012 than it did in 2011. The program’s top prescribers often have faced disciplinary action or criminal charges related to their medical practices.
Despite a national crackdown on prescription drug abuse, doctors churned out an ever-larger number of prescriptions for the most-potent controlled substances to Medicare patients, new data shows.
In addition, ProPublica found, the most prolific prescribers of such drugs as oxycodone, fentanyl, morphine and Ritalin often have worrisome records.
In 2012, the most recent year for which data is available, Medicare covered nearly 27 million prescriptions for powerful narcotic painkillers and stimulants with the highest potential for abuse and dependence. That's up 9 percent over 2011, compared to a 5 percent increase in Medicare prescriptions overall. Even taking into account an increase in the number of Medicare enrollees, the prescribing rate rose slightly for these drugs, which are classified as Schedule 2 controlled substances by the Drug Enforcement Administration.
Twelve of Medicare's top 20 prescribers of Schedule 2 drugs in 2012 have faced disciplinary actions by their state medical boards or criminal charges related to their medical practices, and another had documents seized from his office by federal agents.
The No. 1 prescriber — Dr. Shelinder Aggarwal of Huntsville, Ala., with more than 14,000 Schedule 2 prescriptions in 2012 — had his controlled substances certificate suspended by the state medical board in March 2013. He surrendered his medical license four months later. (Aggarwal could not be reached for comment.)
Prescribing high volumes of Schedule 2 drugs can indicate a doctor is running a pill mill, said Dr. Andrew Kolodny, chief medical officer of Phoenix House, a New York-based drug treatment provider. Government regulators should do more to monitor prescribing patterns and intervene proactively if they appear aberrant, he said.
"We wait 'til these doctors kill people," said Kolodny, founder of Physicians for Responsible Opioid Prescribing, which advocates for tighter regulation of painkillers. "It doesn't make any sense."
Medicare's drug program, known as Part D, now covers about 38 million seniors and disabled people and pays for more than one of every four prescriptions dispensed in this country. Concerns about oversight of controlled substances date back to at least 2011, when the Government Accountability Office highlighted abuse of opioids in Part D and called on Medicare to take action.
Within the past year, Medicare has started to use prescribing data to identify potentially problematic doctors, as have some state medical boards. Beginning in mid-2015, Medicare will have the authority to kick doctors out of the program if they prescribe in abusive ways.
"It's a real area of concern for us," said Dr. Shantanu Agrawal, director of the Center for Program Integrity within the federal Centers for Medicare and Medicaid Services.
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Why has the government allowed an insurance company to get personal details of passport applicants and is subjecting them to promotional content?
Automation in processes certainly has made Passport applications painless. However, with the advancement of technology, it appears that the marketers are willing to obtain your personal information at any cost. And the government is obliging. So, while filing your online application for passport, make sure to read every field and select only those options that are applicable to you.
The case in point is, while filing passport application form on passportIndia.gov.in, under the self-declaration, you are supposed to choose some option for obtaining additional services and facilities. However, you must read the terms and conditions for these additional services. For example, while accepting to get an SMS to know the status of your passport application, you should know that this is a paid service. In addition, you need to agree to accept some promotional content along with the SMS alerts. But more about this later.
What is most shocking, is that the default option under the additional benefit for passport applicant comes checked automatically. The default option is nothing but your consent to share all your personal data with an insurance company, Cholamandalam MS General Insurance (Chola MS). Earlier it was Tata AIG for life insurance. The (default-selected) option says, "YES, share my name, contact details, gender, application type and educational qualification with Chola-MS for Chola Shubh Yatra Travel INSURANCE products/plans."
We asked Tata Consultancy Services (TCS, which manages all the Passport Seva Kendra-PSK across the country) about allowing a third party vendor to access personal details of passport applicants.
In an email reply, an official from TCS said, "Explicit consent is sought from an applicant for sharing personal details. The name of the company (Chola MS for example) and the purpose for which the data will be shared is explicitly stated. In this case, it is for Shubh Yatra Travel Insurance - a product Chola has specifically come up for Passport Applicants. The applicant needs to explicitly select the checkbox marked YES (it is NOT selected by default) in case he would like to share his details (mentioned again-name, contact number etc). If he is not interested, he clicks on the checkbox marked NO. You will appreciate that which data is shared and with whom, is transparently stated and the applicant may choose to click on the checkbox if he has interest in the offer."
Now, coming back to the SMS alerts, you need to pay Rs30 at the Passport Seva Kendra (PSK) as onetime enrolment charges. Unfortunately, despite paying money, there is no guarantee that you would escape from promotional messages.
The portal states: "With enrolment for this service, I agree to receive SMS updates from Passport Seva, which may also contain promotional content. I also agree to pay the charges for the SMS that I would send to Passport Seva as per my mobile service operator tariff norms."
The question is, when the applicant is paying money to obtain services, why should he be subjected to breach of privacy? Why should the applicants share her personal details with a third party? In addition, when you are paying to receive SMS alerts, why you should be subjected to promotional content? Hope the authorities take proper note of this and initiate rectification measure at the earliest.
Taliban terrorists killed atleast 100 children in horrific attack on an Army run school in Peshawar.
The Pakistani Taliban, also known as the Tehreek-e-Taliban Pakistan (TTP), today attacked a Pakistan Army-run school in Peshawar, and killed at least 100 children among 131 total casualties, in retaliation for the Pakistan Army's operation 'Zarb-e-azb'. The attack, which began at mid-day, targetted school children and the Taliban had officially claimed responsibility for the attack.
At the time of the attack, around 500 students and children were said to be inside the school. An estimated five to six terrorists reportedly started firing inside classrooms and took over parts of the building. The terrorists were said to be wearing suicide vests.
TTP spokesman Muhammad Khorasani was quoted by the media as saying, “They include target killers and suicide attackers. They have been ordered to shoot the older students but not the children.”
“It's a revenge attack for the army offensive in North Waziristan," reported Reuters, quoting a TTP spokesperson.
As PM Nawaz Sharif and Pakistani Army Chief rushed to Peshawar, condemnation and condolences also poured in from around the world. Home Minister Rajnath Singh said, “This dastardly & inhuman attack exposes the real face of terrorism. My heart goes out to the families of those children who got killed by the terrorists in Peshawar." PM Modi also expressed condolences after his election rally in Jammu and Kashmir.
Official word on whether the attack had been neutralised was not forthcoming in the 6th hour of the attack.