With the opioid epidemic both an ongoing public health crisis and a hot topic extending well beyond the health care industry, Congress continues stepping up to the plate. Case in point: H.R. 5722, the Dr. Todd Graham Pain Management Improvement Act of 2018, one of a number of bills packaged under the MOST (Medicare and Opioid Safe Treatment) Act, legislation designed to fill coverage gaps for individuals at risk for or suffering from opioid use disorder.
Named in honor of Dr. Todd Graham, and Indiana physician murdered by the husband of a patient whom Dr. Graham refused to prescribe pain medication after he determined her condition was chronic, H.R. 5722 "[directs] the Secretary of Health and Human Services to conduct a study and submit to Congress a report containing recommendation on how to improve the use of non-opioid treatments for acute and chronic pain management for individuals entitled to benefits under part A or enrolled under part B of the Medicare program, and for other purposes."
In formulating the report, the HHS secretary is required to consult with various health care agencies organizations and providers, including "licensed health care providers who furnish alternative pain management services." The report is also required to include an evaluation of barriers to Medicare recipients receiving nondrug pain management; the "[potential legislative and administrative changes under such title to improve individuals' access to items and services currently covered under such title and used for the treatment of pain, such as cognitive behavioral interventions, physical therapy, occupational therapy, physical medicine, biofeedback therapy, and chiropractic therapy, and other pain treatments services furnished in a hospital or post-acute care setting" [our emphasis in italics]; and a cost / benefit analysis associated with expanding coverage to include non-opioid pain management options.
To learn more about the Medicare and Opioid Safe Treatment Act, and review the stipulations in H.R. 5722 and the other bills packaged under the MOST Act, click here. As of press time, the act is under review by the House Committee on Ways and Means.
Many relevant diagnostic signs are not performed deliberately by the examiner or by the patient at the examiner’s direction. They are observed as the patient reacts to their condition. Fortin’s finger sign, Minor’s sign, and Vanzetti’s sign are three examples of this principle.
Spearheaded by burgeoning scientific and clinical research literature, psychedelics have reached a level of media coverage and popular interest that has not been seen for over half a century. By “psychedelics,” we are referring to the unique class of substances that includes psilocybin (the active compound found in so-called “magic mushrooms”), LSD, dimethyltryptamine (DMT), ayahuasca, 5-MeO-DMT, and mescaline – each of which occurs in the natural world (except for LSD, which is a semi-synthetic compound).
While working at the Lovelace Medical Center in Albuquerque, N.M., one of the primary care physicians stated that imaging every patient prior to receiving chiropractic was not medically necessary. It was at that point I reconsidered the need for the imaging of every patient to avoid malpractice.
