Help For 100% Disabled Vet - Is Dr. Pinnamaneni Ethical or Morale?

[ProfessorDave]

Help! I' assisting a 100% disabled veteran in The Villages who has been on a significant pain medication for several years. His Dr. at Lady Lake Pain And Spine Centers of Florida (Dr. Pinnamaneni) won't take the time to do a simple "pre-authorization" which lowers the price by over $200 per month. Publix Pharmacy recently contacted the Dr. and asked twice. This veteran drove to the practice twice this week to ask the receptionist for help - and was promised swift action. The Dr's office has been called three times this week by me - and no response.

I checked with the insurance company - and the story get's worse! The insurance company (Blue Cross Federal) shared two things: 1) they personally put in a request to the Dr. for the preauthorization - and got no response and 2) it would also cost less if the Dr. provided a 90 day refill - but won't, because he bills more money by requiring the patient to come in once a month for a new 30 day prescription - and has been doing that for years. Ethical? Morale? You be the judge.

As a result, the prescription has cost this vet over $500 this year - which he frankly doesn't have! Because of the financial situation - he has been in pain for several days - until I found out about it.

Two requests to consider: 1) Recommendations for a new Pain Doctor to help a 100% disabled vet - with very little money? 2) Please tell friends and family to write to Dr. Pinnamaneni and ask WHY he would leave a war hero in both physical and financial unnecessary pain!!!

[Keefelane66]

If the person is 100% disabled providing it is a disability caused by his military service to his country he should qualify for VA benefits prescriptions are included in his benefits.

[PugMom]

wow, sounds like an awful situation. 1st thing that comes to mind is he needs a new Dr. For the short-term, maybe a walk-in clinic might help him get the pills he needs now. are you able to get a used bottle of his meds with name & info on it? bring it with him to the appt. if he has medicare, i think there's no charge, if he's insurance free, visit is about $120. i hope you get this worked out, there's many good pain dr.'s here, pls keep us updated

[ProfessorDave]

Thanks. His injuries are from the war. Lucky to be alive - he was a "tunnel rat" in Vietnam (most I'm told came home in a body bag). I'll call around for pain Drs on Monday. A few I called Friday are not taking new patients. Any recommendations in the meantime? THANKS!

[hlsboro]

Good grief! Take him to the VA here in the Villages. They will take care of him. Done!!!

[Keefelane66]

Thanks. His injuries are from the war. Lucky to be alive - he was a "tunnel rat" in Vietnam (most I'm told came home in a body bag). I'll call around for pain Drs on Monday. A few I called Friday are not taking new patients. Any recommendations in the meantime? THANKS!
Oh come on.
70 percent disability rating: $1,529.95 per month. 80 percent disability rating: $1,778.43 per month. 90 percent disability rating: $1,998.52 per month. 100 percent disability rating: $3,332.06 per month.

[ProfessorDave]

Unfortunately - the VA sent him to THIS doctor!

[petsetc]

If he has VA coverage and they referred him to an outside doctor , the VA should pay all charges. I have a disabled relative (not 100%) who has been referred to private local doctors for specialty care.

Google it for rules/restrictions

[ProfessorDave]

Thanks for suggestions

[ProfessorDave]

Oh come on.
70 percent disability rating: $1,529.95 per month. 80 percent disability rating: $1,778.43 per month. 90 percent disability rating: $1,998.52 per month. 100 percent disability rating: $3,332.06 per month.

I read this a few times. Helpful? Cruel? Sarcastic? Bored? Missing the point? Educated - or not? But - they can. I'll assume just naive?

[ProfessorDave]

Thanks

[MartinSE]

Help! I' assisting a 100% disabled veteran in The Villages who has been on a significant pain medication for several years. His Dr. at Lady Lake Pain And Spine Centers of Florida (Dr. Pinnamaneni) won't take the time to do a simple "pre-authorization" which lowers the price by over $200 per month. Publix Pharmacy recently contacted the Dr. and asked twice. This veteran drove to the practice twice this week to ask the receptionist for help - and was promised swift action. The Dr's office has been called three times this week by me - and no response.

I checked with the insurance company - and the story get's worse! The insurance company (Blue Cross Federal) shared two things: 1) they personally put in a request to the Dr. for the preauthorization - and got no response and 2) it would also cost less if the Dr. provided a 90 day refill - but won't, because he bills more money by requiring the patient to come in once a month for a new 30 day prescription - and has been doing that for years. Ethical? Morale? You be the judge.

As a result, the prescription has cost this vet over $500 this year - which he frankly doesn't have! Because of the financial situation - he has been in pain for several days - until I found out about it.

Two requests to consider: 1) Recommendations for a new Pain Doctor to help a 100% disabled vet - with very little money? 2) Please tell friends and family to write to Dr. Pinnamaneni and ask WHY he would leave a war hero in both physical and financial unnecessary pain!!!

I don't understand. Why is he n to going to the VA? There is an outpatient clinic in the villages, there is a new clinic in Ocala, and the is Malcom Randell VA hospital (one of the best in the country) in Gainesville.

Unless there is a good reason to not go there, the hospital is Gainesville is better than any civilian healthcare around.

[ProfessorDave]

I don't understand. Why is he n to going to the VA? There is an outpatient clinic in the villages, there is a new clinic in Ocala, and the is Malcom Randell VA hospital (one of the best in the country) in Gainesville.

Unless there is a good reason to not go there, the hospital is Gainesville is better than any civilian healthcare around.
My understanding from him - was that the VA sent him to this specialist. I'll check. Sometimes - this person can be confused. He's had a tough life.

[Number 10 GI]

Due to the opioid problem the government has placed restrictions on what pain meds you can have based on your ailment and limits on how many pills you can get at one time. My wife takes pain meds for her rheumatoid arthritis and has had the strength of the meds reduced and the number she can get at one time. It's not the doctor requiring the patient to come back monthly for another prescription so they can make more money. If the doctor's office isn't doing what they are requested to do and what they are required to do, the VA needs to be notified about the situation. Maybe this doctor needs to be taken off their provider list.

This vet should be able to get his pain meds filled by the VA pharmacy at no expense to him. He is also able to obtain prescriptions from Express Scripts who mail the meds directly to his mailing address. There is a small co-pay but it is very reasonable. A meeting with a VA rep should provide all the answers to your questions.

[tsmall22204]

I feel you are not really taking care of this vet or you would have had him at the VA facility in the Villages. Your story sounds awfully fishy.

[Mrprez]

I feel you are not really taking care of this vet or you would have had him at the VA facility in the Villages. Your story sounds awfully fishy.

Apparently you neglected to read the entire thread. The VA referred this vet to this doctor.

[Eg_cruz]

Is the VA on 42 able to help

[Eg_cruz]

Help! I' assisting a 100% disabled veteran in The Villages who has been on a significant pain medication for several years. His Dr. at Lady Lake Pain And Spine Centers of Florida (Dr. Pinnamaneni) won't take the time to do a simple "pre-authorization" which lowers the price by over $200 per month. Publix Pharmacy recently contacted the Dr. and asked twice. This veteran drove to the practice twice this week to ask the receptionist for help - and was promised swift action. The Dr's office has been called three times this week by me - and no response.

I checked with the insurance company - and the story get's worse! The insurance company (Blue Cross Federal) shared two things: 1) they personally put in a request to the Dr. for the preauthorization - and got no response and 2) it would also cost less if the Dr. provided a 90 day refill - but won't, because he bills more money by requiring the patient to come in once a month for a new 30 day prescription - and has been doing that for years. Ethical? Morale? You be the judge.

As a result, the prescription has cost this vet over $500 this year - which he frankly doesn't have! Because of the financial situation - he has been in pain for several days - until I found out about it.

Two requests to consider: 1) Recommendations for a new Pain Doctor to help a 100% disabled vet - with very little money? 2) Please tell friends and family to write to Dr. Pinnamaneni and ask WHY he would leave a war hero in both physical and financial unnecessary pain!!!
Has he tried medical marijuana or Microdosing
Both work great pain

[Uncle Creepy]

Oh come on.
70 percent disability rating: $1,529.95 per month. 80 percent disability rating: $1,778.43 per month. 90 percent disability rating: $1,998.52 per month. 100 percent disability rating: $3,332.06 per month.

What the hell does this have to do with anything?

[Duppman]

If he has VA coverage and they referred him to an outside doctor , the VA should pay all charges. I have a disabled relative (not 100%) who has been referred to private local doctors for specialty care.

Google it for rules/restrictions
Along with the referral the appointments should be made through the VA's Community Care office. That way the billing goes directly to the VA.

[Marine1974]

This war hero with a disability rating 100% should be getting
free care and prescriptions at the
VA or the VA sends the veteran to a private doctor under what the VA terms it Community Care . The VA pays the provider who accepts VA
insurance ( Tri Care ) for service related injuries .
I have VA healthcare not Tri Care , and make a little bit more money than most veterans and am charged co-pays . $9 or $15 dollars for prescriptions.
$15 for a primary care doctor . $50 for a specialty doctor . Although if you see more than one doctor in the same day the copay covers all VA doctor visits .
Alternatively since turning 65 my Medicare , Medicare part D and supplemental turn out to be less expensive than the VA . I have a $208 deductible for the whole year
I suggest calling or visiting the
the office of Patient Experience. They will make it happen, I guarantee.
Call Florida department of veteran affairs to get a briefing on his benefits.
If the veteran is low income he can apply for a VA pension.
His Primary care VA doctor is the
gatekeeper for prescriptions and specialty doctors .
If the VA sent him to a private doctor they would be paying his bill . Tri Care is a wonderful thing for our war hero’s . Thank him for his
service.

[NotGolfer]

Years ago I had lower back pain and my pcp sent me to that doctor. His office staff were the worst. Bad attitude on one hand. A few months passed after my treatment (that didn't help the issue---but that's not his fault) and we got a bill from our "former" insurance---I think what we had BEFORE we retired and moved here. I personally took it to the office and spoke with the person that handled it. It's been 12 yrs so I can't remember all the details now but I will say I decided "IF" I needed another pain dr. it wouldn't be that one. He's fine but it's his office staff that's lacking. I'm so sorry you're friend is dealing with this!!!

[raynan]

Call Richard Blair Veteran Service Officer 352-689-4400 email va@sumtercountyfl.gov . He is at 7375 Powell Rd in Wildwood (building with the library). He is great and will get this straightened out for your vet.

[Lea N]

Help! I' assisting a 100% disabled veteran in The Villages who has been on a significant pain medication for several years. His Dr. at Lady Lake Pain And Spine Centers of Florida (Dr. Pinnamaneni) won't take the time to do a simple "pre-authorization" which lowers the price by over $200 per month. Publix Pharmacy recently contacted the Dr. and asked twice. This veteran drove to the practice twice this week to ask the receptionist for help - and was promised swift action. The Dr's office has been called three times this week by me - and no response.

I checked with the insurance company - and the story get's worse! The insurance company (Blue Cross Federal) shared two things: 1) they personally put in a request to the Dr. for the preauthorization - and got no response and 2) it would also cost less if the Dr. provided a 90 day refill - but won't, because he bills more money by requiring the patient to come in once a month for a new 30 day prescription - and has been doing that for years. Ethical? Morale? You be the judge.

As a result, the prescription has cost this vet over $500 this year - which he frankly doesn't have! Because of the financial situation - he has been in pain for several days - until I found out about it.

Two requests to consider: 1) Recommendations for a new Pain Doctor to help a 100% disabled vet - with very little money? 2) Please tell friends and family to write to Dr. Pinnamaneni and ask WHY he would leave a war hero in both physical and financial unnecessary pain!!!

How frustrating. This is not as uncommon as one would think. I have a friend who was a caregiver to a loved one and went through the same thing.

I would find another doctor. Quickly.

Has your friend gone to the VA to apply for VA benefits? If not he should give it a try. It takes time and is a process, but in the end worth it. It is not a perfect process but cost of meds is determined by income. If your friend is in a low tax bracket this could be a tremendous help with the cost of prescription meds and more.

If your friend goes this route once he has applied for benefits have him go the local VA to register. Call first to find out if he is in the system yet. Once he is head down to register immediately. This speeds up the process and will get your friend in to see a VA primary care physician quicker.

I am a caregiver to a disabled veteran and am still learning to navigate the VA system. It's not always easy and is time consuming. Sometimes I just don't get answers, ever. I spend a tremendous amount of time and energy getting through the mess. But I did before my loved one applied and was approved for VA benefits too.

Your friend could reach out to the United Way. Within the United Way is a department (volunteer based) that helps veterans.

I wish your friend the best with this.

[Ken D.]

How frustrating. This is not as uncommon as one would think. I have a friend who was a caregiver to a loved one and went through the same thing.

I would find another doctor. Quickly.

Has your friend gone to the VA to apply for VA benefits? If not he should give it a try. It takes time and is a process, but in the end worth it. It is not a perfect process but cost of meds is determined by income. If your friend is in a low tax bracket this could be a tremendous help with the cost of prescription meds and more.

If your friend goes this route once he has applied for benefits have him go the local VA to register. Call first to find out if he is in the system yet. Once he is head down to register immediately. This speeds up the process and will get your friend in to see a VA primary care physician quicker.

I am a caregiver to a disabled veteran and am still learning to navigate the VA system. It's not always easy and is time consuming. Sometimes I just don't get answers, ever. I spend a tremendous amount of time and energy getting through the mess. But I did before my loved one applied and was approved for VA benefits too.

Your friend could reach out to the United Way. Within the United Way is a department (volunteer based) that helps veterans.

I wish your friend the best with this.
Read the thread before responding. He’s already with the VA care.

[DAVES]

Help! I' assisting a 100% disabled veteran in The Villages who has been on a significant pain medication for several years. His Dr. at Lady Lake Pain And Spine Centers of Florida (Dr. Pinnamaneni) won't take the time to do a simple "pre-authorization" which lowers the price by over $200 per month. Publix Pharmacy recently contacted the Dr. and asked twice. This veteran drove to the practice twice this week to ask the receptionist for help - and was promised swift action. The Dr's office has been called three times this week by me - and no response.

I checked with the insurance company - and the story get's worse! The insurance company (Blue Cross Federal) shared two things: 1) they personally put in a request to the Dr. for the preauthorization - and got no response and 2) it would also cost less if the Dr. provided a 90 day refill - but won't, because he bills more money by requiring the patient to come in once a month for a new 30 day prescription - and has been doing that for years. Ethical? Morale? You be the judge.

As a result, the prescription has cost this vet over $500 this year - which he frankly doesn't have! Because of the financial situation - he has been in pain for several days - until I found out about it.

Two requests to consider: 1) Recommendations for a new Pain Doctor to help a 100% disabled vet - with very little money? 2) Please tell friends and family to write to Dr. Pinnamaneni and ask WHY he would leave a war hero in both physical and financial unnecessary pain!!!

As far as doctors and filling out forms, mine is also a pain in the butt on this. I have little patience with needing to constantly follow up. Truth, I stick my wife with this because after 3x I am no longer polite. I've asked around-THEY ALL ARE LIKE THAT.
EXCUSE? Thanks to Medicare etc they are so overworked they cannot spare the time to do a good job.

I of course do not know all the details. Pain meds? In an effort to control FROM excessive use of OPIOIDS, the government has clamped down on pain meds. Prescriptions are for 30 days. The problems with OPIODS is they are habit forming and while they are the most effective pain killers, it takes higher and higher dosages to get the same relief. The mentioned $500 for the year, have it or not, is not much money. ADVICE TO YOUR FRIEND, he should contact VA MEDICAL. My dad did two tours of COMBAT duty in WWII. He got cancer. His prescriptions were like $600 a week. The VA would fill his prescriptions at, it I recall, a flat rate of $20. ASIDE-with cancer, the hidden reality. It is not the cancer that kills you, though it would eventually.
It is the poisons and pain killers they give you that kill you.

TO REPEAT-prescriptions, if they are OPIODS are 30 days and not refillable.

[Lea N]

Read the thread before responding. He’s already with the VA care.

Well, if this is the case then he should contact the VA and let them know he needs a new doctor. They can assign him a new one through community care. I'm not sure if there is a doctor at the VA in Gainesville who can help him but there might very well be. If so it could be worth the trip depending on his pain level for travel.

[Keefelane66]

Well, if this is the case then he should contact the VA and let them know he needs a new doctor. They can assign him a new one through community care. I'm not sure if there is a doctor at the VA in Gainesville who can help him but there might very well be. If so it could be worth the trip depending on his pain level for travel.
Transportation the VA reimburse Veterans portal to portal mileage is determined by address if you like the scenic route no it’s the most direct.

[Psacc0]

Help! I' assisting a 100% disabled veteran in The Villages who has been on a significant pain medication for several years. His Dr. at Lady Lake Pain And Spine Centers of Florida (Dr. Pinnamaneni) won't take the time to do a simple "pre-authorization" which lowers the price by over $200 per month. Publix Pharmacy recently contacted the Dr. and asked twice. This veteran drove to the practice twice this week to ask the receptionist for help - and was promised swift action. The Dr's office has been called three times this week by me - and no response.

I checked with the insurance company - and the story get's worse! The insurance company (Blue Cross Federal) shared two things: 1) they personally put in a request to the Dr. for the preauthorization - and got no response and 2) it would also cost less if the Dr. provided a 90 day refill - but won't, because he bills more money by requiring the patient to come in once a month for a new 30 day prescription - and has been doing that for years. Ethical? Morale? You be the judge.

As a result, the prescription has cost this vet over $500 this year - which he frankly doesn't have! Because of the financial situation - he has been in pain for several days - until I found out about it.

Two requests to consider: 1) Recommendations for a new Pain Doctor to help a 100% disabled vet - with very little money? 2) Please tell friends and family to write to Dr. Pinnamaneni and ask WHY he would leave a war hero in both physical and financial unnecessary pain!!!

Dr. P. writes my husband’s pain script every month. (Tricare). It is $3.00 at Walgreen’s

[MandoMan]

Help! I' assisting a 100% disabled veteran in The Villages who has been on a significant pain medication for several years. His Dr. at Lady Lake Pain And Spine Centers of Florida (Dr. Pinnamaneni) won't take the time to do a simple "pre-authorization" which lowers the price by over $200 per month. Publix Pharmacy recently contacted the Dr. and asked twice. This veteran drove to the practice twice this week to ask the receptionist for help - and was promised swift action. The Dr's office has been called three times this week by me - and no response.

I checked with the insurance company - and the story get's worse! The insurance company (Blue Cross Federal) shared two things: 1) they personally put in a request to the Dr. for the preauthorization - and got no response and 2) it would also cost less if the Dr. provided a 90 day refill - but won't, because he bills more money by requiring the patient to come in once a month for a new 30 day prescription - and has been doing that for years. Ethical? Morale? You be the judge.

As a result, the prescription has cost this vet over $500 this year - which he frankly doesn't have! Because of the financial situation - he has been in pain for several days - until I found out about it.

Two requests to consider: 1) Recommendations for a new Pain Doctor to help a 100% disabled vet - with very little money? 2) Please tell friends and family to write to Dr. Pinnamaneni and ask WHY he would leave a war hero in both physical and financial unnecessary pain!!!

There are some types of “significant pain medication” that are not supposed to be prescribed in ninety day quantities because they are highly addictive and are often abused or resold. Sometimes doctors are expected to require certain lab tests of the kidneys and liver, too, lest there be damage. Is it possible that you don’t know the rules for this medication? Is it possible that this doctor is following the rules, where some doctors don’t?

I don’t know what the VA pays doctors who agree to work with them, but I do know that my combination of Medicare and the Blue Cross I pay for through my retirement benefits pays doctors, hospitals, and imaging centers around a dime on the dollar and usually doesn’t allow them to charge me anything at all. I don’t know how doctors can pay for office rent, employees, bookkeeping, taxes, and insurance on what may turn out to be a payment of only $6 to $10 for an office call.

Sometime, medications are more expensive because of a new, more convenient formulation or delivery method for which the pharmaceutical company charges a lot of money. For example, an easier way of giving an insulin injection or an epinephrine injection or a slow release capsule. Sometimes, less fancy forms of the same med are much cheaper. Pharmacy fees vary a lot. For example, often CVS is much more expensive, but sometimes it is cheaper. Get the App GoodRX and find out what the various pharmacies around here are charging for the drugs you take. (That doesn’t help you know what your insurer actually pays, however—sometimes they get highly discounted rates.)

[Number 10 GI]

What the hell does this have to do with anything?

The OP implied that the vet was poor. Actually the VA disability payment for a 100% disabled individual is a bit over $3,600 a month which is tax exempt. If the vet is drawing Social Security, he should be receiving about $1,600 a month. By my math that is $5,200 a month income. Now if he is drawing retirement pay for his military service that could be another $1,500 or so a month. How many villagers have that much income?

If the vet is eligible for Tri Care medical coverage, he should not have any out of pocket expense for medical care.

So "what the hell does this have to do with anything"? This vet is not destitute.

[ProfessorDave]

I feel you are not really taking care of this vet or you would have had him at the VA facility in the Villages. Your story sounds awfully fishy.
Insulting at the least - but - you have a right to your opinion. And - your opinion shares what may be within your heat. God knows the various things I've done for this man over the years.

[ProfessorDave]

Has he tried medical marijuana or Microdosing
Both work great pain
Great suggestion. No - he has not tried those approaches. I'll discuss with him this week.

[ProfessorDave]

I feel you are not really taking care of this vet or you would have had him at the VA facility in the Villages. Your story sounds awfully fishy.
Insulting at the least - but - you have a right to your opinion. And - your opinion shares what may be within your heat. God knows the various things I've done for this man over the years.

You clearly did not read the entire thread - including my comments regarding the VA (which he has been to - and they referred him to this Doctor (is my understanding - I plan on confirming tomorrow) - but - that wouldn't stop you from insulting remarks.

I've learned in the past several years as an MBA Strategy professor (a top business school) - philanthropy (involved in multiple initiatives in Africa and the US) and my career (including currently on the Board of a $ Billion dollar company) that there are CRABS in this world. CRABS try to pull people down who actually strive to be positive and get things done. I'm proud of what I have done with this vet - and the cynicism and insults will not deter me from working to assure that the world is better off because I was here.

[ProfessorDave]

This war hero with a disability rating 100% should be getting
free care and prescriptions at the
VA or the VA sends the veteran to a private doctor under what the VA terms it Community Care . The VA pays the provider who accepts VA
insurance ( Tri Care ) for service related injuries .
I have VA healthcare not Tri Care , and make a little bit more money than most veterans and am charged co-pays . $9 or $15 dollars for prescriptions.
$15 for a primary care doctor . $50 for a specialty doctor . Although if you see more than one doctor in the same day the copay covers all VA doctor visits .
Alternatively since turning 65 my Medicare , Medicare part D and supplemental turn out to be less expensive than the VA . I have a $208 deductible for the whole year
I suggest calling or visiting the
the office of Patient Experience. They will make it happen, I guarantee.
Call Florida department of veteran affairs to get a briefing on his benefits.
If the veteran is low income he can apply for a VA pension.
His Primary care VA doctor is the
gatekeeper for prescriptions and specialty doctors .
If the VA sent him to a private doctor they would be paying his bill . Tri Care is a wonderful thing for our war hero’s . Thank him for his
service.
Very helpful. Will follow this up.

[ProfessorDave]

Call Richard Blair Veteran Service Officer 352-689-4400 email va@sumtercountyfl.gov . He is at 7375 Powell Rd in Wildwood (building with the library). He is great and will get this straightened out for your vet.
Awesome. Thanks so much. First call tomorrow morning!

[ProfessorDave]

The OP implied that the vet was poor. Actually the VA disability payment for a 100% disabled individual is a bit over $3,600 a month which is tax exempt. If the vet is drawing Social Security, he should be receiving about $1,600 a month. By my math that is $5,200 a month income. Now if he is drawing retirement pay for his military service that could be another $1,500 or so a month. How many villagers have that much income?

If the vet is eligible for Tri Care medical coverage, he should not have any out of pocket expense for medical care.

So "what the hell does this have to do with anything"? This vet is not destitute.
Pure ignorance. Do you know what other issues are in this person's life? Do the facts of his personal wealth or lack of it have anything to do with the issue? If a millionaire received poor medical service - would it matter any less that the Dr. is unethical and lack character?

I share with my students (over 1,000 MBA's - Leadership & Strategy): "Some people that are great Devil's Advocates perceive they are always adding value; sometimes they are - and sometimes they are not. They are often driven to enhance their sense of worth by offering alternatives views. Sometimes those views have value - so listen. Often they are driven by only the individual's personal self esteem - and demonstrating their perception of their own intelligence. The solution? Be an "advocate" as a Devil's Advocate if you have that talent - but the world is better off if you just stay quite if your motive is not advocacy but rather self indulgent."

I asked the community for help - with a man I've invested a great deal of time with (mostly financial - which is my wheelhouse) - healthcare just supportive. This situation was new to me - and I've received a great deal of GREAT advice and counsel - so THANKS! I will follow up - and feel better about The Villages overall - (but not entirely).

[Heytubes]

At 100%, he gets a nice pension plus no property tax on his home. ALL medical fees including prescriptions are paid by the VA as well as any procedure done as well as outside doctor care. Seems if he has SS or another retirement income he’s living beyond his means and should see a financial advisor as well as an advocate at DAV. Problem solved. One last thing: there’s lots of posers among us so ask for a copy of his DD 214 and the VA letter of benefits. Just in case.

[ProfessorDave]

At 100%, he gets a nice pension plus no property tax on his home. ALL medical fees including prescriptions are paid by the VA as well as any procedure done as well as outside doctor care. Seems if he has SS or another retirement income he’s living beyond his means and should see a financial advisor as well as an advocate at DAV. Problem solved. One last thing: there’s lots of posers among us so ask for a copy of his DD 214 and the VA letter of benefits. Just in case.
Thanks. Good advice.

[Number 10 GI]

Pure ignorance. Do you know what other issues are in this person's life? Do the facts of his personal wealth or lack of it have anything to do with the issue? If a millionaire received poor medical service - would it matter any less that the Dr. is unethical and lack character?

I share with my students (over 1,000 MBA's - Leadership & Strategy): "Some people that are great Devil's Advocates perceive they are always adding value; sometimes they are - and sometimes they are not. They are often driven to enhance their sense of worth by offering alternatives views. Sometimes those views have value - so listen. Often they are driven by only the individual's personal self esteem - and demonstrating their perception of their own intelligence. The solution? Be an "advocate" as a Devil's Advocate if you have that talent - but the world is better off if you just stay quite if your motive is not advocacy but rather self indulgent."

I asked the community for help - with a man I've invested a great deal of time with (mostly financial - which is my wheelhouse) - healthcare just supportive. This situation was new to me - and I've received a great deal of GREAT advice and counsel - so THANKS! I will follow up - and feel better about The Villages overall - (but not entirely).

The pure ignorance is on your part. You don't even know if he is really a 100% disabled veteran. All you have is his word, that and a couple bucks will get you a cup of coffee. As I pointed out what monetary benefits he is possibly receiving places him far from being financially destitute. Sounds more like poor money management skill. He isn't the only one who has had hardships and heartache in their life so spare me the tears.

It has been pointed out by myself and others that the VA needs of intercede in the problem with the doctor. Again ignorance on your part for not getting the vet to the VA counselors to rectify the situation. I would think some who has taught 1,000 MBA students in Leadership and Strategy would been able to figure that one out.

Your "accomplishments" in your life you brag about apparently impresses you but I find it quite arrogant and condescending.

There are too many holes in this vet's story for me to give him any credence.

Did you read the posts about prescribing opioids? The government has cracked down quite hard on what strength levels can be prescribed and a patient can only obtain 30 days worth at a time. Hence the required visit to the doctor for a new prescription, not that the doctor is trying to fleece the government and patient for personal financial gain. Did you actually talk to the pharmacy to see if this claim that the doctor wasn't providing a form that could save the patient money or is it what he is saying?

[GOLFER54]

For twelve years I have been going to Dr. Sastry, and she accommodated me on my prescriptions thought those years. She is professional, sweet and personable and will spend time to help you so you don’t feel like you’re just in a revolving door and rushed , ignored and left feeling you just wasted your time.
741 Summet Park
Highway 466
United States
352-728-2110
Good Luck !

[Curtisbwp]

No! You are incorrect, the VA does NOT provide medication for chronic and sever pain. I am a combat injured vet. Broken hip, lower spine, shattered sacrolliak mended 1/2 inch out of place, every rib on right side broken, rib cage crushed and cracked skull.
After 40 years the pain is unbearable, I have to pay a private dr for monthly visits and for meds.

[Number 10 GI]

No! You are incorrect, the VA does NOT provide medication for chronic and sever pain. I am a combat injured vet. Broken hip, lower spine, shattered sacrolliak mended 1/2 inch out of place, every rib on right side broken, rib cage crushed and cracked skull.
After 40 years the pain is unbearable, I have to pay a private dr for monthly visits and for meds.

Do you have a disability rating from the VA?

[Twostars]

Amen!

[Nanabarb42#]

Unfortunately - the VA sent him to THIS doctor!
This canNOT be true! The VA would not send a 100% disabled veteran to an outside pain clinic for pain meds...sounds fishy to me.

[ProfessorDave]

The pure ignorance is on your part. You don't even know if he is really a 100% disabled veteran. All you have is his word, that and a couple bucks will get you a cup of coffee. As I pointed out what monetary benefits he is possibly receiving places him far from being financially destitute. Sounds more like poor money management skill. He isn't the only one who has had hardships and heartache in their life so spare me the tears.

It has been pointed out by myself and others that the VA needs of intercede in the problem with the doctor. Again ignorance on your part for not getting the vet to the VA counselors to rectify the situation. I would think some who has taught 1,000 MBA students in Leadership and Strategy would been able to figure that one out.

Your "accomplishments" in your life you brag about apparently impresses you but I find it quite arrogant and condescending.

There are too many holes in this vet's story for me to give him any credence.

Did you read the posts about prescribing opioids? The government has cracked down quite hard on what strength levels can be prescribed and a patient can only obtain 30 days worth at a time. Hence the required visit to the doctor for a new prescription, not that the doctor is trying to fleece the government and patient for personal financial gain. Did you actually talk to the pharmacy to see if this claim that the doctor wasn't providing a form that could save the patient money or is it what he is saying?
Your message says it all. He is a 100% disabled vet - why would you doubt him - or me? We both know why. You ASS U ME lots of things - and assumptions can describe you. Yes - there were lots of helpful comments. I now know more about what the VA can do; that was my intent of the original post. Yes - I read opinions on opiods. They are opinions; helpful, but not all opinions are facts.

I shared my background - to give others the courage to stand up to fake assumptions - with no positive intent - and only to tear down. I'm forever fortunate not to have that trait - and have been able to keep focussed on what's important - trying - and making the world a better place because I am here.

I will pray for you. I honestly - feel sorry for you. It is so easy to be cynical - but isn't it unfulfilling?

[ProfessorDave]

For twelve years I have been going to Dr. Sastry, and she accommodated me on my prescriptions thought those years. She is professional, sweet and personable and will spend time to help you so you don’t feel like you’re just in a revolving door and rushed , ignored and left feeling you just wasted your time.
741 Summet Park
Highway 466
United States
352-728-2110
Good Luck !
Awesome. One of my calls tomorrow morning! Appreciate your good heart - and help.

[conman5652@aol.com]

Take him over to va clinic and meet with compensation people. If he is a veteran the va has to help him as long as he was honorably discharged

[Riversong]

Oh come on.
70 percent disability rating: $1,529.95 per month. 80 percent disability rating: $1,778.43 per month. 90 percent disability rating: $1,998.52 per month. 100 percent disability rating: $3,332.06 per month.

If not already done, he should apply for Social Security benefits. If he was in Vietnam, he will be in favorable age category for benefits. He could then have Medicare as well as VA to assist with medical expenses.

[teamC]

Two parts to this issue with solutions:
#1) re: New Dr.
Since 2014 The VA can refer pts to outside physicians (called CHOICE Program). The VA sent him to this Doctor. The veteran could request another physician at the VA
Local VA Spending $70M To Send Vets To Private Docs (https://www.keywhitman.com/about/blog/2014/september/local-va-spending-70m-to-send-vets-to-private-do/)

BUT
that may not solve the problem because of

#2) Opioid prescribing laws:
See attached rules for chronic pain treatment:
https://www.cdc.gov/opioids/patients/pdf/Opioid-Prescribing-Guideline-Overview-Presentation.pdf

These prescribing changes were made b/c of the opioid crisis in this country. It is not just Veterans or the VA who are affected. Ask anyone who had a hip or knee replacement 10 years ago who had to get a 2nd knee or hip surgery in the last 7-8 years!
So writing letters will not help. Pharmacists are not even allowed by law to fill scripts for >30 days (or even refill them early). Paper/written prescriptions are required-no calling in scripts for pain meds that are classified as restricted.

To save $$-the veteran should fill prescriptions at the VA (the VA can only fill non-VA doctor prescriptions if the VA referred him to them)

Thank you for taking this veteran under your wing!
Please thank this veteran for their service!!

[ProfessorDave]

[QUOTE=teamC;2075278]Two parts to this issue with solutions:
#1) re: New Dr.
Since 2014 The VA can refer pts to outside physicians (called CHOICE Program). The VA sent him to this Doctor. The veteran could request another physician at the VA
Local VA Spending $70M To Send Vets To Private Docs (https://www.keywhitman.com/about/blog/2014/september/local-va-spending-70m-to-send-vets-to-private-do/)

Thanks for your response post. Received lots of helpful information. Visiting the VA in the Villages later today.

The information you shared is VERY HELPFUL!

The VA didn't occur to me. With hindsight, the VA does have an awesome reputation locally.

Thanks again.

[BayLady57]

Help! I' assisting a 100% disabled veteran in The Villages who has been on a significant pain medication for several years. His Dr. at Lady Lake Pain And Spine Centers of Florida (Dr. Pinnamaneni) won't take the time to do a simple "pre-authorization" which lowers the price by over $200 per month. Publix Pharmacy recently contacted the Dr. and asked twice. This veteran drove to the practice twice this week to ask the receptionist for help - and was promised swift action. The Dr's office has been called three times this week by me - and no response.

I checked with the insurance company - and the story get's worse! The insurance company (Blue Cross Federal) shared two things: 1) they personally put in a request to the Dr. for the preauthorization - and got no response and 2) it would also cost less if the Dr. provided a 90 day refill - but won't, because he bills more money by requiring the patient to come in once a month for a new 30 day prescription - and has been doing that for years. Ethical? Morale? You be the judge.

As a result, the prescription has cost this vet over $500 this year - which he frankly doesn't have! Because of the financial situation - he has been in pain for several days - until I found out about it.

Two requests to consider: 1) Recommendations for a new Pain Doctor to help a 100% disabled vet - with very little money? 2) Please tell friends and family to write to Dr. Pinnamaneni and ask WHY he would leave a war hero in both physical and financial unnecessary pain!!!

I am a recently retired R.N. of 44 years and the last 21 of those year was employed as a primary care R.N. case manager at my local VA Hospital in R.I. You posted multiple issues regarding this Veteran which I will try to address from my professional experience and perspective.

If this Veteran is 100% SC, regardless of income he is exempt from payment for all medications and copays for all tests and services done within and without the VA as long at the VA authorized this Veteran to receive care outside the VA. You note that this Veteran's insurance is Federal BC/BS which is a completely different entity than VA coverage. Likely at some point this Veteran worked for a Federal Government agency non military service related and was able to keep this coverage if he is now retired. I have Federal BC/BS and I never served, it was a benefit I earned working for the Federal Government which I continue to pay premiums to retain this coverage in retirement which the Federal Government subsidizes. That being said, if this Veteran is using his Federal BC/BS as the payer source for the community pain management doctor he is seeing, than the VA did not authorize this service because they are not the payer source. And the VA will not preauthorize for services that they had no input in coordinating and have ongoing oversight.

With regards to pain management which includes the prescribing of opioids, on occasion if a Veteran does not feel the VA is managing his/her pain appropriately, and if they have health insurance coverage outside the VA which seems to be the case with this Veteran they will and have every right to do so seek care outside the VA. If a Veteran chooses to do this and are not happy with the community care services they sought on their own the VA has absolutely nothing to do with these negative outcomes because they had no part in the coordinating of and overseeing this care.

I can not assume what were the motives of why this patient sought pain management care outside the VA, but I can tell you from 1st hand experience if it is medication related the VA has gotten very strict with prescribing of opioids. And I can't think of one patient and I case managed many which includes end of life cancer patients receiving hospice level of care that received a 90 supply of opioids. Although most of these hospice patients are exempt from random drug tests, most patients prescribed ongoing opioids are required sometimes monthly to be drug tested prior to getting a refill, and a computer search is done to see if a patient has received or is receiving an opioid from another pharmacy. These checks are done for several reasons. If a patient is prescribed daily use of opioids and are taking them as prescribed we want to see them test positive for the prescribed opioids in their drug screen because if it does not show up there is a suspicion that the opioid is being sold by the patient or a family member for significant $$ on the street which happens more than you think. And the suspicion of this is increased if a patient or family member consistently requests an early refill with more excuses for this than I can count. Secondly, if non prescribed med such as Fentanyl, Benzos, etc. show up in patient's drug screens, adding a prescribed opioid to this drug cocktail can literally end a patient's life from an OD and it will be the prescriber who will be held accountable.

To be honest, as a former VA R.N. I very much resent your assumption that the VA is responsible for leaving this Veteran in pain and financially burdened with the costs of his pain medication prescribed by a non VA provider which it is more than highly suspicious this Veteran sought this care without VA authorization. Yes, I will be the 1st to admit the VA has it's ongoing issues and there are bad apple providers that work for this agency. But, the majority of those that provide care to Veterans which included myself jump through every hoop possible to relieve the pain and suffering of Veterans which more often than not puts us at odds with a dictatorship VA administration that sadly cares more about the bottom line than the Veterans they are supposed to be serving.

If you truly want to help this Veteran put him in touch with the DAV or other Veteran advocacy groups that have the expertise to assist him that you do not.

[Paul1934]

Get a written script and use Good Rx, the discount is truly obscene.

[VICAR OF DIBLEY]

We use Dr. Alger. He has helped my husband and my self.
Does your friend have a neurotransmitter? For some individuals it relieves nearly all their pain.
We wish both of you success in resolving this.

Winn Dixie has special rates for people who do not have medical coverage. Perhaps you can get a lower price for his meds there.


Help! I' assisting a 100% disabled veteran in The Villages who has been on a significant pain medication for several years. His Dr. at Lady Lake Pain And Spine Centers of Florida (Dr. Pinnamaneni) won't take the time to do a simple "pre-authorization" which lowers the price by over $200 per month. Publix Pharmacy recently contacted the Dr. and asked twice. This veteran drove to the practice twice this week to ask the receptionist for help - and was promised swift action. The Dr's office has been called three times this week by me - and no response.

I checked with the insurance company - and the story get's worse! The insurance company (Blue Cross Federal) shared two things: 1) they personally put in a request to the Dr. for the preauthorization - and got no response and 2) it would also cost less if the Dr. provided a 90 day refill - but won't, because he bills more money by requiring the patient to come in once a month for a new 30 day prescription - and has been doing that for years. Ethical? Morale? You be the judge.

As a result, the prescription has cost this vet over $500 this year - which he frankly doesn't have! Because of the financial situation - he has been in pain for several days - until I found out about it.

Two requests to consider: 1) Recommendations for a new Pain Doctor to help a 100% disabled vet - with very little money? 2) Please tell friends and family to write to Dr. Pinnamaneni and ask WHY he would leave a war hero in both physical and financial unnecessary pain!!!

[fdpaq0580]

Help! I' assisting a 100% disabled veteran in The Villages who has been on a significant pain medication for several years. His Dr. at Lady Lake Pain And Spine Centers of Florida (Dr. Pinnamaneni) won't take the time to do a simple "pre-authorization" which lowers the price by over $200 per month. Publix Pharmacy recently contacted the Dr. and asked twice. This veteran drove to the practice twice this week to ask the receptionist for help - and was promised swift action. The Dr's office has been called three times this week by me - and no response.

I checked with the insurance company - and the story get's worse! The insurance company (Blue Cross Federal) shared two things: 1) they personally put in a request to the Dr. for the preauthorization - and got no response and 2) it would also cost less if the Dr. provided a 90 day refill - but won't, because he bills more money by requiring the patient to come in once a month for a new 30 day prescription - and has been doing that for years. Ethical? Morale? You be the judge.

As a result, the prescription has cost this vet over $500 this year - which he frankly doesn't have! Because of the financial situation - he has been in pain for several days - until I found out about it.

Two requests to consider: 1) Recommendations for a new Pain Doctor to help a 100% disabled vet - with very little money? 2) Please tell friends and family to write to Dr. Pinnamaneni and ask WHY he would leave a war hero in both physical and financial unnecessary pain!!!

Seems to me Dr. P. needs to be reported to the VA and the insurance co for failure to respond to repeated requests from them and patient for help or explanation. Maybe the BBB or an atty might get the Dr's attention. In any case, I would dump that doctor like he had the plague. Definitely visit the VA for assistance. Assuming your friend is the 100% disabled vet/hero you say he is, he deserves far better than a doctor who can't be bothered by patients who actually need care. Dr P., is responsible for his practice. If his staff is failing, the doctor is still responsible. He needs a wake-up call and fire the ones not doing their jobs. If he is the problem, then he deserves to lose his practice, and maybe even his license. I would rather be helped by anyone who actually cares then a guy with a diploma who doesn't give a damn about me. Lord, deliver us from doctors who are only in it for the money.

[OrangeBlossomBaby]

Great suggestion. No - he has not tried those approaches. I'll discuss with him this week.

It will cost him a LOT more than $500/year. Medical cannabis is /not/ covered by any insurance at all in the state of Florida. It's available, but you have to pay whatever you're charged at the shop.

[OrangeBlossomBaby]

Two parts to this issue with solutions:
#1) re: New Dr.
Since 2014 The VA can refer pts to outside physicians (called CHOICE Program). The VA sent him to this Doctor. The veteran could request another physician at the VA
Local VA Spending $70M To Send Vets To Private Docs (https://www.keywhitman.com/about/blog/2014/september/local-va-spending-70m-to-send-vets-to-private-do/)

BUT
that may not solve the problem because of

#2) Opioid prescribing laws:
See attached rules for chronic pain treatment:
https://www.cdc.gov/opioids/patients/pdf/Opioid-Prescribing-Guideline-Overview-Presentation.pdf

These prescribing changes were made b/c of the opioid crisis in this country. It is not just Veterans or the VA who are affected. Ask anyone who had a hip or knee replacement 10 years ago who had to get a 2nd knee or hip surgery in the last 7-8 years!
So writing letters will not help. Pharmacists are not even allowed by law to fill scripts for >30 days (or even refill them early). Paper/written prescriptions are required-no calling in scripts for pain meds that are classified as restricted.

To save $$-the veteran should fill prescriptions at the VA (the VA can only fill non-VA doctor prescriptions if the VA referred him to them)

Thank you for taking this veteran under your wing!
Please thank this veteran for their service!!

When I had my knee repair (not replacement) surgery several years ago the surgeon's office would only give me 12 Vikoden. If you take 4 a day (as directed), that's 3 days worth of pain meds. Thankfully, I respond to just half a dose, and didn't need 4 doses every day. So I was able to stretch that 3 day dose to jjuuuuuust about the full 8 days I actually benefited from them. The 8th day I ran out in the afternoon and had a double shot of kahlua instead.

[asianthree]

So OP, did contacting the VA fix issues?