What I warned about in my comments on the new state laws in Oregon has happened, but Washington State is the first. Laws took effect in 2012 in Washington which require doctors to incorporate safeguards into their practices, including close supervision, to minimize the potential for abuse and diversion of controlled substances. A copy of that law is available on the page http://doctorsofcourage.org/index.php/state-law/washington-states-standard-of-care-law/
On July 14, 2016, the Washington State Medical Commission suspended the license of Dr. Frank Li, 48, a pain management specialist, and revoked the agreement for 5 physician assistants to practice under his authority because of “poor standards” at his pain centers, accusing him of “consistent violations of the standard of care.” So now the attacks on physicians criminally with “standard of care” charges has begun. As many as 60 doctors or other health care providers who have worked for Dr. Li’s Seattle Pain Centers since 2013 are under investigation.
The attack based on standard of care is very generic, as I predicted it would be. The charges allege Li
- committed unprofessional conduct in violation of state regulations for chronic, non-cancer pain management, including rules designed to prevent opiate abuse, overdose and death,
- failed to conduct proper patient evaluation,
- failed to provide informed consent to patients or their families,
- failed to conduct proper reviews and consultations for opiate therapy,
- exposed chronic pain patients to risk of harm for addiction or overdose,
- failed to properly monitor drug use and evaluate patients to determine whether opiates were needed,
- failed to consider patients’ other risk factors,
- and didn’t investigate patient deaths.
Basically those charges could be filed on any doctor’s practice in America. In the standard phrasing of the Controlled Substance Act to justify this illegal action, Micah Matthews, deputy director of the Washington state Medical Quality Assurance Commission stated “I guess what I would call it is classic ‘pill mill’ behavior.” Nothing in the above listed charges would substantiate that comparison. But once these “standard of care” laws are passed by Congress, the Feds are going to jump all over this gravy train.
As is standard with any pain management practice, thirteen complaints had been filed with the medical commission since 2010. These type of complaints are usually from disgruntled patients that have been discharged. The records show eleven of the complaints were closed after no violations could be verified. Two complaints filed in 2015 remain open: one from the Health Care Authority and one from the state Attorney General’s Office’s Medicaid Fraud Control Unit. This is standard action when a doctor is targeted—the government works with the Medical Board to raise issues for review. And when they have nothing substantial to base it on, they always go for insurance fraud.
Supposedly the investigation of the deaths of 18 patients between 2010 and 2015 showed “an egregious pattern of substandard medical care and disregard by Dr. Li and his providers for patient health and safety.” Sixteen of the patients supposedly had “acute drug intoxication” listed as a possible cause of death. That cause of death is listed on anyone with controlled drugs in their system at the time of death, whether at a toxic level or not. Two others supposedly had serious health conditions that the pain treatment center disregarded. In reality, one patient died in a car accident and another died from a stroke, but both received opiates from Seattle Pain Centers. These “multiple, serious health conditions” could again, apply to any patient of any physician.
Li is the medical director and owner of Seattle Pain Center which has 8 pain treatment centers in the state, with locations in Seattle, Renton, Everett, Tacoma, Olympia, Spokane, Poulsbo and Vancouver. He also operates a clinic in Beverly Hills, California that might also be affected. 25,000 patients will be affected by this action. They were simply told by the state Department of Health to contact their health insurance company and primary care provider to minimize disruptions in their care. You can bet their care is going to be disrupted big time. But Micah Matthews, deputy director of the Washington state Medical Quality Assurance Commission (MQAC) was quoted as saying “There shouldn’t be an immediate disruption,” One patient suffering from chronic back pain said “I’m scared wondering where am I going to go now.”
When they have nothing else to go in, the government always uses insurance fraud to attack anyone they target. In this case, they bring up issues including
- using minimally trained staff and allowing them to bill under the names of established providers
- excessive use of urine drug screens to maximize profit, and
- seeking out Medicaid patients to maximize billing for excessive or unnecessary tests or visits.
Give me a break! You don’t even make enough to pay the bills with Medicaid reimbursement. When a doctor takes care of Medicaid patients, it is because he has a heart, not because he is financially motivated.
But Matthews makes the standard inflammatory comment “It seems clear that this business practices was to generate billings and maximize profits over patient safety.”
My evaluation of this is that we have a good, caring physician basically being attacked on trumped up charges per the plan of the government when the “standard of care” laws were written in order to confiscate assets. Oh, and if chronic pain patients die as a result, they’ll cover it up as part of the “heroin epidemic”.
UPDATE Nov 18, 2016
Dr. Li is fighting his suspension, and has a court date in December. Also, a Dr. Burkie (sp.?) has purchased assets from Dr. Li, and has re-opened the Renton office, although it is not called the Seattle Pain Center. Word is that Dr. Burkie used to work for Dr. Li at the Renton office and that he has re-hired some of the other doctors who used to work there. The understanding is that Dr. Burkie is a neurologist. They are opening on 11/28/16, and are making appointments now. Phone number is: 206-538-6300. They are now credentialed for regular Medicare, as well as Regence and Aetna, and are working on getting credentialed for the other insurances. For further information you can contact “firstname.lastname@example.org” to stay informed about Dr. Li and the former Seattle Pain Centers.