Rules on Medicine Very Restrictive
As one of Ohio Valley’s foremost interventional pain practices, I feel the need to educate our public regarding the current insurance insanity that we are all facing.
The public’s perspective is that all a doctor does after seeing them is write out a couple of Rx’s and they will see you back in a couple of weeks.
The reality is far from the truth.
The type of insurance you carry will determine what type of long-acting pain medication you may be allowed to receive unless of course you want to pay more “out of pocket.”
Generics are always first line. If you are covered under Medicare, you need to fail MSContin before I can give you a tamper proof Opioid like Opana. If you’re covered with Molina (an Ohio Medicaid plan), you have to fail MSContin and Methadone, (two very non-tamper proof meds that are highly addicting) before I can give you Opana. If you have West Virginia Medicaid, you have to fail two of three meds which include MS Contin, Methadone, or Fentanyl, before I can Rx a safer, cleaner drug like Opana. We can write for all the short acting (non-tamperproof meds) without any problems but that is exactly why many patients get “hooked” on Opioids. I do not see how these Insurance guidelines really helping alleviate and deal with our current opioid epidemic.
I just wanted the public to get a better look at what is happening and voice your concerns to the Insurance companies and legislators.
Roland Chalifoux Jr., DO
Valley Pain Management