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By R Carter
An option I don’t see discussed often, likely because it’s considered to have no teeth, is filing an ethics complaint with state medical boards and federal DHHS. Many are concerned that doing so may make them a target, not so. Ethics complaints are protected under both state and federal guidelines, the information can’t be released to a prescriber so there’s no way anyone could retaliate.
Don’t confuse filing a grievance with a State Medical Board with filing a complaint with a State Attorney General, with the later any complaint is public record and can be released to anyone.
Given the frequency and wide occurrence of ethics violations, if everyone did, state and federal authorities would be compelled by law to investigate and eventually take action. If nothing else, enough of them create data points in the system which compel policy makers at state and federal levels to also investigate.
With regards to healthcare, we live in a data driven, evidence based world. Everything is converted to digital data and stored some place. Eventually that data feeds onto reports which get before decision makers.
It’s easy for policy makers to tune us out when they’re under no obligation to here us. But imagine 50 million chronic pain patients filling complaints at a state and federal level. That’s right, there are 50 million of us, or 20.4% of the population. That’s a number which can’t be ignored, it’s large enough to change the outcome of an election and with one on the horizon, we need to start thinking in those terms.
So why can’t we organize ourselves to use the system that’s in place? Apathy, so many of us have been beat down by our medical problems, we’ve become so accustom to being turned away and told no, we give up.
Rather than give up we need to get angry. I’m mean mad as hell, I’m not going to take this anymore, angry!
Then we need to pass that anger on to others in the CPP community and get them to file complaints as well. My friend over at PharmacistSteve has posted on this topic as well. He recommends the following:
- If your insurance is Medicare/Medicaid/Medicare Advantage:
- You need to file a GRIEVANCE with www.cms.gov (800-MEDICARE) against anyone involved with you being denied care for any reason.
- Read Full Post
Appealing Insurance Denials
Policy makers will only take notice when we force them to do so. So let the squeaky wheel get the grease by doing yourself and the community a favor. Next time your prescriber doesn’t follow traditional standards of care and I’m not talking of the one’s the CDC has put out there, but the ones we’ve lived with for the last twenty years, file a complaint.
Not sure what to put on it? If so you can ask for help here. Simply go the Contact Us menu at the top and follow it to leave a message and contact info, I’ll be glad to do what I can in answering your questions.
Here are some attachments for filing a grievance at a federal level, which will get you started and answer most basic questions.
Here are some guidelines which will help you understand what an ethics violation is.
Finally, to file a grievance at a state level, go to the website for you State Medical Board. There you can obtain the appropriate form, some even allow filing your grievance online.
One last thought to keep in mind. Unless you have a medical background it’s not always easy to spot the difference between how a doctor manages your care because of his/her personal preferences and how they do it because they are operating by policy and regulation set out at a state level. The second thing to keep in mind is that as private practitioners, prescribers can choose to run their business just about anyway they want. So filing a grievance because your doctor is rude and dismissive is not enough.
If you have questions you can always post your questions here in the Contact Us section of the website.