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She is refusing a televisit. By law. WHAT LAW?

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Do you mean that you are asking a pain management specialist to examine, diagnose and prescribe for a patient by video link, and the specialist is refusing to do so?
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Its part of the CDC guidelines as well as the law in many states. We don’t know where you live so you should consider researching your state laws yourself. If you have an opioid prescription, you can blame the CDC and their ridiculous guidelines that punish those who are in pain.
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nickdean Jun 2020
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Hello Countrymouse
Thanks for the note.
Im a 82 year old city mouse in NYC.
Yes I am asking my pain doctor because of the pandemic - to see me - for the duration of this craziness to prescibe me medication via video link. I have been quarantined for 3 months.
Again. I am 82. If I wanted to OD
I would have done that long ago.
Also I am lucky enough to have to have landed a low income apartment on the 21st floor with a balcony in the middle of Manhattan. If I were a high risk opioid dependent drug addict I could have just stepped off the balcony.
Something should be done to change these stupid laws.
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Nick, have you tried calling 311 to report the issue that you are having?

If the are not helping, please post back here. I'm in Brooklyn.
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nickdean Jun 2020
Hey Barb.
Thank for the note.
But I intend calling my primary care doc on Mon. morning.
He will treat me - I'm sure - like a patient in pain and not a druggie.
Have a great day and stay safe.
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I guess you need to pay your co-pay for an in-person visit if you want your pain pills.
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Nick Dean, how are you going to come up with a retainer to pay an attorney? Just make an appointment and pay your co-pay so that you can get your ridiculously cheap narcotic pain medication.
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nickdean Jun 2020
Hey gems
Thanks for the note. You are so right...especially about the cost of the pills.
But I can't seem to convince my ladyfriend that it is safe for her 82 year old high risk boyfriend to venture out into the world.
Been quarantined for 3 months.
Should be kind of fun... but so Not.
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Nick, is your PCP willing to prescribe your percocet?

I would use them from now on and cut out the pain clinic.

The laws are most likely state laws that are in place to stop unethical doctors from writing scripts for addicts. The really sad thing is that 93% of patients that receive pain management do so with no problems, it's the 7% that misuse the services and meds that make this a problem for everyone trying to have quality of life by reducing their pain.

You can call your state's attorney general and get the laws governing narcotic prescriptions.
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She is refusing to prescribe for you using televisiting. So: what does she propose instead? Given that she presumably wishes to remain your doctor, she'll have to come up with something else.

Being annoyed is not going to solve the problem. Keep your eyes on the prize: which is, continuing your treatment in the light of current restrictions. But this is her problem to solve, how does she get to examine her patients then?
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worriedinCali Jun 2020
CM she examines them in person and it’s the OPs problem to solve. He has to go in person. No more Telehealth visits. Do we all understand how heavily regulated Opioids are? And in this country, we have to advocate for ourselves, we cannot tell a doctor “this is your problem to solve” unless we want the problem to go unsolved.
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https://www.deadiversion.usdoj.gov/coronavirus.html

So, the laws on prescribing opioids are Federal DEA statutes. The above link is a clarification from DEA on prescribing during the pandemic. It clearly seems that prior regs are loosened now.

Have you discussed with your doc your reasons for not venturing out?
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Primary care MD’s don’t like to play candy man these days. You might get 30 or 50 pills, no refills. Please update us and let us know your outcome.
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Isthisrealyreal Jun 2020
There is no reason to imply that this is not about true pain management.

Doctor's don't give refills because it is not allowed on opioids.

Everyone I know that has to take pain management does so because they are crippled with pain, but they would rather not have to take them. Don't be cruel.
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My nephew has had two phone "visits" with his Neurologist and his Endocrinologist in the last month. But he is on no meds.

Normally, Medicare requires the patient to be seen personally to be able to bill Medicare. But I would think under the circumstances, restrictions have been relaxed. If you are an ongoing patient, I don't see where the Dr. can't just give you a new prescription.
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worriedinCali Jun 2020
Joann he can’t just be given a new prescription. He has to be seen monthly and pay his copay. Which is normal.
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That is a good question. I would ask her "what law". I do think that in pain management there is the drawing of blood for narcotic levels, and etc. What occurs in your normal visits that cannot occur on a televisit. Also I do know that pain meds of this level are often those that must be written "in triplicate" meaning they are reportable, and doctors in pain management are scrutinized and managed by MANY laws and many law entities, so there is that. It is a good question for your Doc. What answer were you given?
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I am also a 'chronic' pain patient, but take a very low dose of codeine, which must not be so highly regulated, since my PCP handles it and I see him once every 3 months and he writes a scrip for 1 month with 2 refills.

Prior to the back surgeries which 'fixed' the horrible pain, I was taking Norco and I had to see my PCP monthly. I rehabbed to a point where I am just always going to have some pain--osteoarthritis in most joints and a miserable life w/o something stronger than Ibuprofen (which I can't take much of, stomach issues!)….

Dealing once with a pain management dr I came away in tears and feeling like an utter junky. They are under such scrutiny---and so they prescribe the minimum drugs possible. It's awful. Yet, I know my 'local' drug dealer (everybody has one in their neighborhood) can get his hands on anything. I don't know how and I don't care, but I find it interesting.

My DIL is an anesthesiologist. She said that the worst abusers of narcotics is anesthesiologists. Not the common man in the street.

I'd go to my PCP with this, if your pain dr is unwilling to do a televisit. Things are going to be different for a few more months and drs have to figure out how to treat 'virtually'.
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Pain management centers have begun to see patients in person this month here in Maryland. Prior to this month PM was seeing patients via televisit. My good friend goes monthly for chronic pain.
During the telehealth phone visits my friend needed to show her picture ID during the video to verify who she was.
Her next appt is tomorrow and she was told she must go in person.
These are the facts here. I don’t know where you live.
Yes we had to pay our co-pay for each visit.
I was surprised his appt is in person this month but it is.

PCP’s will not write ongoing pain medication refills. This may actually cause a problem as each patient signs a contract at PM that the patient will not see any other doctor for pain meds else the contract will be voided.
Yes the opioid laws stink but it is what it is these days. Wear a mask and follow CDC guidelines but get there.

Hope this helps.
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I worked at a pharmaceutical wholesaler 17 yrs ago and even then the Opioids were watched. At that time a prescription had to be mailed or sent with the driver. No email or faxes. And that pharmacist better have a prescription for every pill he ordered. And hecshould be aware when a Dr. seems to be prescribing alot of one controlled substance. We had a pharmacist fired and his license taken away because he gave a customer one pill to "carry her over" until her DEA controlled drug could be refilled again.
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Shane, it must be state to state rules, AZ allows 3 months e send to the pharmacy. NV allows the same.

Perhaps it has something to do with the amount of milgrams daily.

There are exceptions to the know it all, some do have compassion and don't think that they are the only ones that know anything. You have never come across that way, so you are an exception. If every nurse cared like you I am sure I would feel differently.
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Shane1124 Jun 2020
I know dear. I was only joking. I too have met those “know it all” nurses. Those are the nurses I would ask to find another profession if their compassion is gone or have developed a cynicism about their professional obligations and need to get out of the field.
However are you sure a pharmacy will send a 3 month RX of narcotics in the mail? I thought it was a federal law.
But you are correct, every state is different.
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