I don't usually pass on just what is posted elsewhere, but in this case the actual owner or reps were participating. It seems YPM, Buydirectrx, and some others are now comtemplating having their patients make a yearly trip to see them. Some comments said it wouldn't be too bad to do that, many from the east coast and saying you can get airfare there for $100-150 (one way or round trip I don't know). I, for one, could maybe afford to do that on occasion (not now though). But if you don't live in a big city and live on the west coast, it would be more like a two to three day ordeal and would cost for the commuter trip to a big airport and the cost of airfare to a big Florida airport with the expense of local transportation to wherever they are and hotel or motel and meal charges. In addition, you know they aren't going to see you for free either. Apparently, you will still have the quarterly consultation charges on top of it.

I realize these places may just be trying to stay ahead of the curve. And the gods at the DEA are pressuring them to have physical face to face interviews despite having records, but that would spell the end for many. It doesn't sound like a requirement as yet and may not have to come into play. It is worrisome though. Anyone who know more or wish to comment, please do.
PB

This message has been edited. Last edited by: pharmboy,

There is absolutely no way I could or would do this for reasons PB listed above, plus, if you had to do this, you might as well just search for a Dr. in your area willing to write the same. May cost a bit in paying for visits to different doctors, but in the end it would be cheaper. Esp if you have insurance.

I sure hope all that is rumor and not truely being considered!!!

Hey All,

If you haven't heard, Avee is NO LONGER filling any scripts for OCS's effective as of the end of business Thursday. That was when we were notified and they are being investigated as we speak.......Their new policy is that they will only fill prescriptions if they know that the doctor has SEEN the patient face-to-face.
I'm not sure what this means for ROP's, but if there are others making noises about face-to-face visits that could be serious.

I am not sure what is going on- we have been caught off guard and are searching for another pharmacy.....
I, personally, have been out of the office the past 2 days (Great timing, huh!!!) So I'm afraid I'm not too sure of things- neither is the owner or the other girl in the office......If I find out anything I will be sure to share with you'all


Sandi

Hey Sandi, I just found this out the hard way. I ordered the refill online on your site yesterday, and didn't get any confirmations back. I called Avee, and heard their recorded message about no refilling anymore??? so I called your office and got VM. Is Avee in trouble? Should I forget about my refill? Plz let me know. Thanks!

[QUOTE]Originally posted by pharmboy:
I don't usually pass on just what is posted elsewhere, but in this case the actual owner or reps were participating. It seems YPM, Buydirectrx, and some others are now comtemplating having their patients make a yearly trip to see them. Some comments said it wouldn't be too bad to do that, many from the east coast and saying you can get airfare there for $100-150 (one way or round trip I don't know). I, for one, could maybe afford to do that on occasion (not now though). But if you don't live in a big city and live on the west coast, it would be more like a two to three day ordeal and would cost for the commuter trip to a big airport and the cost of airfare to a big Florida airport with the expense of local transportation to wherever they are and hotel or motel and meal charges. In addition, you know they aren't going to see you for free either. Apparently, you will still have the quarterly consultation charges on top of it.

I realize these places may just be trying to stay ahead of the curve. And the gods at the DEA are pressuring them to have physical face to face interviews despite having records, but that would spell the end for many. It doesn't sound like a requirement as yet and may not have to come into play. It is worrisome though. Anyone who know more or wish to comment, please do.
PB[/QUOTE

I have also been reading these posts and while the OCS are trying to paint this in a rosie light, I have some serious doubts about it.

Many people will not have the means to travel like that to see a doctor. I looked at fares from my area and even booking 6mo to 1yr out, it is over 300 for the flight alone. Add in motel, meals, transportation and the fact that I would have to find someone to care for my kids and possibly miss work, well....the costs are already high without whatever the price of the doctor visit and tests may be.

The other issue is the DEA. I do not think this will stop the scrutiny. If face to face was all that was required to make them happy, then local doctors would not be so afraid to prescribe meds and ROPs would never have been needed in the first place. I think that flying to a clinic to meet a doc face to face will just cause the DEA to look more closely at what is being scripted and create more hoops for doctors and patients to jump thru. The clinic will just make it easier for the DEA to have everything it wants to investigate in one place.

While I wish there was a perfect solution, I don't think what these OCS's are proposing is it.

Remy

quote:

Hey Sandi, I just found this out the hard way. I ordered the refill online on your site yesterday, and didn't get any confirmations back. I called Avee, and heard their recorded message about no refilling anymore??? so I called your office and got VM. Is Avee in trouble? Should I forget about my refill? Plz let me know. Thanks!

Venus- I apologize, but we are currently looking for another pharmacy and then we should be able to get scripts and refills transferred- But this seems the be the beginning of the end, I think that ALL the other pharmacies are going to be hit sooner or later, so please try to find a pm doctor that can help you out.......I hate to be chicken little, but my personal opinion as an office worker is that the sky is falling and it's time to get outta dodge....

Hi all:

I have to pipe in with my 2 cents on this issue of course. I am also concerned about where we are heading as far as OCS's are involved and I don't think we are going to have these sources available to us for a whole lot longer. I do think that for a while, there are still some who will find a way around the new rules that seem to be hitting us all of a sudden here in Florida.

I recently consulted and was prescribed a compounded medication from a pharmacy here in the State of Florida. The Doctor signed off on the script and sent it to the pharmacy. The pharmacy then informed the Doctor that they needed to have a copy of a recent progress note for me in their file in order to fill the prescription.

I forwarded the progress note to them (the Doctor already had it on hand) and as soon as they had the document, the medication was sent out. This leaves more paper trails in more places which I hate, but I think that for a while we may need to search out other sources and try to keep some details under wraps.

I will keep everyone posted when I learn more about AVEE as they are pretty close to home.

Have a safe and pain free weekend everyone and enjoy the Superbowl.

Gonefishin!!

Thanks Gonefishin for your input. Plz keep us posted about Avee. I had my VERY FIRST online fill EVER last mont through OSS & Avee, and didn't even make it to a refill. Now I am thinking, hopefully, Avee is not in trouble since they have my records and consulted me. Is anyone esle sweating it out there?

This looks like REAL trouble. The DEA has made it very clear to all of the OCSs that the only acceptable way to prescribe a controlled substance is through a face to face examination with THE PRESCRIBING PHYSICIAN - not a PA, not a nurse, not anyone else.

While there are going to be a lot of attempts at having patients fly into Florida for a face to face visit, the days of ROPs are over soon. There is no way to make the current ROP business model practicable and profitable if every patient must be seen in person, even if it is only once a year. The DEA has dropped the big one, and even the leaders in the industry are quietly (not out loud yet, but quietly) acknowleding that this is it - telemedicine as we know it is through.

You are wrong about PA's not being able to rx controlled substances. Many PAs and Nurse Practitioners (NPs) have DEA numbers and can prescribe controlled substances. In a few states, they cannot, but the DEA does allow it. As I said, they are eligible to apply for DEA numbers.

WKL, you are correct about PA's in general, but apparently (and this could be rumor and incorrect) DEA has told several of the OCSs that FOR THEM and their practice of medicine that the physician, and only the physician themselves, are acceptable for the face to face visit requirement. Now, with that said, I got a lot of this information from DB.com (which is bordering on hysteria over all of this and has always been a tad unreliable) and I may have completely misunderstood what was said. It does make sense though.
Either way it is clear that DEA's ultimate goal is simply to restrict access to narcotic pain medication to terminal patients and a few others, and deny access to, and the prescribing of, narcotic pain medication to anyone that, in their view, does not absolutely need it. While they won't say it officially, they seem to feel that the vast majority of all those taking hydrocodone, oxycodone and other therapies are simply abusers whose pain, if they have any at all, is minimal. They seem to tihnk that those patients should just toughen up, live in pain and be treated with NSAIDs, physical therapy and other treatments of that type. (It smacks of the macho insanity of the current administration in my opinion, but I don't run the DEA). The bottom line is simple - DEA's mission is to shut off access to narcotic pain therapies to everyone except the few that they feel are legitimate. DEA is now, whether they admit it or not, practicing medicine and are undermining the many legitimate and important things they do by this obsessively misguided war on legal, effecascious therapies because those therapies are "narcotics". DEA does many good things - in this effort I feel that they are both wrong and lazy. They are wrong because they are not qualified to practice medicine and yet make decisions about what is, and is not, legitimate medical practice every day. They are lazy because, it seems to me, that going after doctors is much easier and safer than going after the true scoundrels, the importers and sellers of the many street drugs that have no medical use what so ever. Then again, doctors don't shoot back. This misguided war on prescription narcotics is a stain on the DEA's generally excellent reputation, and in trying to save people from themselves taking narcotics and ruining their lives, DEA is ruining their lives by keeping them in intractable pain.
At the end of the day however, the OCSs need to realize that they cannot negotiate with DEA or take what they say under advisement as a possibility - DEA is the law, and they do not make suggestions, they issue orders which everyone who holds a DEA registration to prescribe narcotic pain medication must follow completely and fully. Remember, a DEA registration is a privilege, not a right. They do not HAVE to let anyone prescribe anything if they do not want to. They are the authority of the Executive Branch of the government - period. It seems that DEA has let it be known that the days of operating safely because of the legal "grey" areas are over. OCSs in particular are being ordered to follow the complete, exact letter of the law or face the consequences, and the requirements for a face to face visit are only the start. DEA will shut down telemedicine within the next few months. And hundreds of thousands of people will live in indescribable pain simply so that they are safe from the "dangers" of narcotics. The tail is, at least for now, clearly wagging the dog.

I agree with just about everything beachbum has said. I have been a member of this board and DB for many years (although I don't post often there). And sometimes there are breakouts that do border on hysteria and rumors feed upon themselves. I believe there are legitmate concerns that are being addressed, but with so many people with so many different personal agendas piping in, things are easily blown out of proportion. Take some deep breaths and let's see what "the facts" are. I do know some of what has been discussed is a new business model being floated by a group of OCSs that many think are credible. They may have other things on their agenda too. And too many easily pick up the ball and run with it in too many directions. Let's see what actually shakes out.
Take care all
PB

I haven't verified anything yet and if anyone has any better info please post it, but I saw this on two other boards.

On February 2, 2007, an Order to Show Cause and Immediate Suspension Order was issued to Avee Pharmacy, Inc. (DEA Certificate of Registration BA8622284).

On February 5, 2077 an Order to Show Cause and Immediate Suspension Order’s were issued to CRJ Pharmacy, Inc., (DEA Certificate of Registration BC9458539) and YPM Total Care Pharmacy (DEA Certificate of Registration BY9713276). As of these dates, these pharmacies authorities to dispense controlled substances were suspended.

Such suspension will remain in effect until a final determination is reached in these proceedings. During the duration of the suspension, DEA registrants may not sell to or purchase from these pharmacies any controlled substances.

The Deputy Administrator of DEA issued a preliminary finding that Avee, CRJ, and YPM had failed to maintain effective controls against diversion and that the continued registration of these pharmacies would be inconsistent with the public health and safety.
Specifically, Avee, CRJ, and YPM dispensed controlled substances based on prescriptions that are written for other than a legitimate medical purpose and based on orders placed by customers using various Internet websites. In many instances, the prescribing and/or dispensing of controlled substances violated state laws.

Avee, CRJ, and YPM are given an opportunity for an administrative hearing within 60 days from the issuance of the Order to Show Cause and Immediate Suspension Order.

After the hearing, the Deputy Administrator will make a final decision on whether these pharmacies DEA Certificate of Registration should be permanently revoked. The decision will be published in the Federal Register.

Avee Pharmacy
Clearwater, Florida
www.avee.com

CRJ Pharmacy
Lakeland, Florida

YPM Total Care Pharmacy
Lakeland, Florida

If this is wrong or anyone have any better info, please post it. I hate to just pass on unsubstantiated rumor. So I am taking a chance here.

Chris Larson himself confirmed it on the YPM forum a few minutes ago. This is the most serious blow to telemedicine so far. This really could be the clarion call of the end of OCSs and telemedicine as we know it. I guess the Government wants us to embrace the new technology - of the early years of the 20th Century!

Yes, beachbum, it is sad.

This is a quote from the YPM forum as I understand it:

Well,

Today the DEA came in to YPM total care and served us with an Order of Show Cause and suspended YPM pharmacies DEA license.

What does this mean to you?

We are figuring out where to get refills done. We will get you taken care of. We have suspended new consults until we get our current fills taken care of. We will start consulting as soon as we are sure that we can move ahead with out this type of problem happening again.

I am very concerned with the DEA's ability to come in and shut down companies with out any criminal charges. YPMs attorney is flying in and helping us sort out what we can do in the near future.

What do I think happened?

I think that by me being up front with the DEA, Talking out loud on DB, basically being out front with everything has caused YPM to be targeted. Everyone hold tight, I will have more info soon.

I will not be posting on DB, It seems that most everything I posted has been used against me in one way or the other.

-Chris