[ProfessorDave]

Originally Posted by Number 10 GI

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]

Originally Posted by 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 !

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]

Originally Posted by Keefelane66

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

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...esentation.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

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]

Originally Posted by 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!!!

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.

Originally Posted by 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!!!

[fdpaq0580]

Originally Posted by 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!!!

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]

Originally Posted by ProfessorDave

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]

Originally Posted by 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

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...esentation.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?