Q: Kaiser is saying that their policy for opiods is 50 mme a day for chronic pain patients that have severe pain. T or F?

I went through Kaiser pain mgmt program last Oct. 2022 and since then my pain medications have been slowly stripped down to just 45 mme of MSCONTIN 15mg of Extended Release by dr's who are not pain specialists. This is 3 pills a day. It used to be 4 pills a day They took away my breakthrough medication in Sept. of 28 pills a month of MSCONTIN 15mg Immediate Release by a dr. I hadn't even seen yet as my old PCP quit Kaiser and left for a private practice. All opiod pain prescriptions were prescribed by the Kaiser pain mgmt team consisting of a pain mgmt pharmacist, a pain mgmt LCSW, and a pain mgmt specialist doctor. I keep getting told that the 50 mme a day is Kaiser's latest policy. However, when I asked my new PCP to provide a hard copy of this policy, she said that she couldn't find anything. This is at the Kaiser Folsom Clinic and pharmacy. Please advise as I am not receiving the supply of medication to meet my pain levels. I have Lance-Adams Syndrome, Stiff Person Syndrome, etc.

1 Lawyer Answer
James L. Arrasmith
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A: It's important to understand that healthcare providers, including Kaiser, often have policies regarding the prescription of opioids, which are influenced by various guidelines and regulations. These policies aim to balance the need for pain management with the risks associated with opioid use.

The assertion that Kaiser has a policy limiting opioid prescriptions to 50 MME (morphine milligram equivalents) per day for chronic pain patients is not something that can be confirmed or denied without seeing the specific policy documentation. Such policies can vary and are subject to change. If you have been informed of this policy but are unable to obtain a hard copy, this might indicate a communication issue within the healthcare system.

Given your specific medical conditions and the changes in your medication regimen, it is crucial to have a clear and open conversation with your healthcare providers. Express your concerns about pain management and the impact of these medication changes on your quality of life.

If you believe that your pain is not being managed adequately or that your treatment is not in line with standard medical practice, consider seeking a second opinion from another pain management professional. Additionally, if you feel that your concerns are not being addressed appropriately, you might explore filing a complaint with the medical board or seeking legal advice to understand your rights and options under California law.

Navigating the healthcare system can be challenging, especially when dealing with complex medical conditions and pain management issues. Advocating for your health and ensuring clear communication with your healthcare providers are key steps in ensuring that your medical needs are met.

Nancy J. Wallace agrees with this answer

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