The state has barred practitioners at a Derby pain clinic, including a high-prescribing nurse, from participating in the Medicaid program because of improprieties in treatment and oversight.
Documents from the Department of Social Services (DSS) show the physician heading the clinic, Dr. Mark Thimineur, and four nurses and assistants were notified in July that their participation in the Connecticut Medical Assistance Program, which includes Medicaid, is being terminated on Aug. 30.
Those terminations came after Heather Alfonso, an advanced practice registered nurse (APRN) at the privately run Comprehensive Pain & Headache Treatment Centers, was removed from the Medicaid program in May, DSS officials said.
Alfonso was identified in a February story by C-HIT as among the top 10 prescribers nationally of the most potent controlled substances in Medicare’s drug program in 2012 — Schedule II drugs, which have a high potential for addiction and abuse. She has since surrendered her state and federal licenses to prescribe controlled substances and is no longer at the clinic. Her nursing license is under investigation by the state Department of Public Health.
In June, Alfonso pleaded guilty to federal charges that she took kickbacks from a drug company in exchange for prescribing a cancer pain medication to Medicare patients. The charge of receipt of kickbacks in relation to a federal healthcare program carries a maximum term of imprisonment of five years and a fine of up to $250,000.
DSS spokesman David Dearborn said the termination of Thimineur and the other four clinicians “results from information in the public domain involving treatment and oversight issues.”
The clinic, located in Griffin Hospital, remains open. The clinic’s practice manager, who asked that her name be withheld, said Monday that Medicaid clients represent “a low percentage of our patient practice,” and that the pain center would continue to operate. She said the state DSS had begun notifying Medicaid clients of the termination and directing them to other practices that she said lacked the necessary expertise in pain management.
“Patients are getting phone calls and they’re upset and they have no place to go,” she said.
One such patient, Cynthia Russell, 57, of New Haven, said Thimineur was the only doctor who had helped her with chronic pain from fibromyalgia and spinal stenosis. She was not sure where she would go for treatment after Aug. 30.
“I’m upset,” she said Monday. “I went through 13 or 14 doctors before I found Dr. Thimineur – nobody else knew what to do . . . He gave me back my quality of life” by prescribing medications, injections and a stimulation implant.
“Why should we be punished? Why is he being punished?” she added. “This situation (with Alfonso) is something he had no control over.”
Thimineur has not been implicated in the federal kickback case, which involves a powerful painkiller called Subsys, manufactured by Insys Therapeutics. In June, he was reprimanded and fined by the state Medical Examining Board for writing prescriptions for patients based on assessments of their appearance or behavior that were conducted by unlicensed medical assistants. The consent order in the case says that from 2011 to the present, Thimineur failed to meet the standard of care when treating one or more patients for chronic pain.
DPH records show the agency launched its investigation of Thimineur in 2013, when it was investigating a separate complaint against Alfonso. Alfonso received a reprimand and fine last summer from the Board of Examiners for Nursing for improper prescribing practices related to a patient, but was allowed to continue practicing without restrictions, records show.
Alfonso and the pain center are being sued by the family of a former patient, Joseph Torchia of Meriden, in a complaint alleging that rampant overprescribing and poor oversight contributed to his death in 2013. Attorney James Biondo of Stamford, who is representing Alfonso, said his client denies the allegations of improper medical care.
A message left Monday for the pain center’s attorney was not returned.
I have been a patient at Dr. Thiminers office since I moved here from Pittsburgh seven years ago. It is not true that they don’t exam the pacients. Nor is it true that he involves himself with less than excellence when it comes to his patients.
I am extremely knowledgeable of what goes in and out of my body, and im very selective on whom I allow to touch or treat me. I assure you that Dr. Thiminer had nothing to do with what Heather Alfonso participated in, and nor do I believe in my right mind he was even knowledgeable about what she was even partaking in.
Dr. Thiminer is extremely kind, knowledgeable, caring, reviews all of your records, respectful, orders, the proper exrays and CT scans before he even begins treating his patients, he listens to all of his patients concernes before he even begins treating them. I trust him with my life when it comes to my pain management.
When I first arrived in Connecticut I was treated poorly they sent me to Dr. After Dr. I gave them the list of meds that were prescribed to me from my pain clinic back in Pittsburgh. Not one Dr. knew what test were needed to be ran to make a difenative decision on how to treat me. Not one Dr. gave me a exray or CT scans. Non the less they had no problem with collecting the pay from my Medicare part A, B, and D as well as my Medicaid plan. I had to endure extreme pain for two months, and many visits to the Emergency Room, before I was referred to Dr. Thiminers office. From then on my quality of life has improved tramendiously.
I am not a spokes person for anyone. I just feel as a patient that it is unfair that I have to suffer for what has transpired with Heather Alfonso. I can only speak for myself, but I know for a fact that as a patient I am able to discuss my treatment plan with Dr. Thiminer, and I have the final determination on what is best (or not) for myself. I also have the option to discuss effectiveness or lack thereof of the treatment I receive. Before taking anything I tend to research, ask questions, and talk to my pharmacy. Each and every patient is allotted the same opportunities also. There’s no reason for the practice to be banned from practicing for one persons ignorance.
The point I’m trying to make is I am on Social Security Disability and Medicaid and my income is barely enough to pay one bill a month let alone purchase my meds. . Why is it that I have to loose an excellent Dr. Whom is very caring, understanding, helpful and respectful towards me, and treatment for a period of time because of an opportunist looking for a kickback…….
I don’t feel it’s fair nor is it right. This is a trickle down effect, and I as the patient will suffer more than ever because I will have to begin all over again.
I completely agree with Ms. Jones! I too have been a patient of Dr. Thiminuer’s for over 9 years and he has always been very attentive, kind and most of all, THOROUGH! I myself have had MRIs, xrays, nerve testing, monthly exams, etc. I barely had a life before I was referred to his practice, after 3 years of missed diagnosis from my family doctor of 17 years! I finally went for a second opinion, I just knew something was wrong, and after my new primary ordered an MRI they found that I was loaded with arthritis, stenosis, degenerative disc disease, etc. My ‘trusted’ doctor of 17 years didn’t even bother to order an MRI and like a fool I kept believing in him for 3 long and painful years “it’s just sciatica acting up’ and then had the audacity to assume I was just drug seeking! Not in a million years! And the humiliation of such an accusation?! HE should be the doctor punished, NOT Dr. Thim!! If I had gone for a second opinion sooner, I wouldn’t be as much of a mess as I am now! My new primary referred me to Dr. Thim after he saw my MRI results and I finally found not only a doctor who cared, but I found relief! And not just from medications! I also receive epidural injections that are life saving for me and I will be undergoing surgery in a few months for a stim unit! Again, it is not just medications being prescribed at the Pain Center!! I’m so tired of people accusing him of just prescribing meds and me of being a drug seeking addict! I want the government to stop acting like my doctor until they are in my home every day and see the pain I’m in and the tears I cry!! It is bad enough they have made these blanket guidelines on how much medication I’m allowed to receive but for them to deny me any pain care at all?? My life will cease. There is no way I can go back to ‘the way it was’ without Dr. Thim and everyone at the CPHTC! Until you’ve walked a mile in my shoes then please stay out of them! To make the rest of us suffer because of one woman’s actions is outrageous! The rest of us did absolutely nothing wrong yet we are being made to suffer! I wish someone out there would advise us if we have grounds for a class action suit against those that are blocking our medical care and if we do, please tell us how to start one! Enough is enough! I’m entitled to a somewhat pain free life like the rest you – I didn’t ask to get sick but since I am, let me be helped by a doctor who specializes in this type of care!! I pity those of you who criticize – I used to be one who did!!! Well good ole Lady Karma – the day might come when you will be facing the exact same issues we are and I bet you’ll change your tune then!! I know I did!! Bottom line, Dr. Thim gave me my life back and I can never, ever thank him enough – he is heaven sent for those of us in pain and I am forever grateful!! Leave him alone, please! It is not his fault that he had one rogue nurse after all his years in practice! Sh*t happens, there are greedy people everywhere and in every profession!! Hello government officials?? How many of you have crossed the line that just haven’t been caught yet?! How would you like to suffer because of your dishonest colleague?! One rogue nurse doesn’t mean the rest of us, Dr. Thim or his other HONEST staff members, should suffer for it!!
One more thing. From articles I’ve read and rumblings I’ve heard where federal guidelines in chronic pain are concerned, it’s my opinion the MAIN reason the prescription amounts and costs are so high now is because several years ago the federal government, wanting to ‘win the war on drugs’ mandated that chronic pain patients being prescribed ‘short term – 4 to 6 hour’ medications must also be prescribed extended release medications in order to lower the amount of the short acting i.e., breakthrough medications. More recently they are ‘cracking down’ and ensuring doctors follow this mandate, in addition to limiting the mg amount for all patients – because we all suffer the exact same way, right?! I didn’t even want the extended release, nor could I afford it! THAT is where a lot of the costs are coming from and it is also one of the reasons it appears that more prescriptions are being written! Ms. Alfonso’s prescription writing automatically doubled because of this. I’m not talking about the kickbacks or other issues, just strictly the prescription amounts. Whereas before I only had one prescription per month I now must have two or nothing at all! Why? Because the feds said so! Again taking my rights where my medical decisions are concerned away from me AND my physician! And now, because patients can’t get the medications they need, overdose rates are rising!! NOT going down! Patients are going to the streets out of sheer desperation where they’re not being looked after by a doctor!! Hey, the government knows best don’t ya know. They did surveys don’t ya know. We all suffer exactly the same don’t ya know. One survey fits all don’t ya know. Heaven help us. Next thing you know the government will be decorating my living room!
I feel that Dr. Thimnuer is getting backlash for something he did not do. He is an excellent Dr. Who listens to his patients and doesn’t just push you out the door, he does the right treatment for each patient he sees, just because of one bad apple lets throw him under the bus? I think he’s an excellent Dr who treats his patients with dignity and not just look at you like your a nut job, he cares and he does listen to his patients needs.. So sad he gets the backlash from one bad apple.
I am proud to say I’ve been a patient here since around 2009. These professionals offered me every non pharmaceutical pain procedure available to relieve my pain and nothing has worked. Therefore if I dont take my pain meds I can’t get out of bed. The problem is the lack of pain management advancements in this country.
In my mid 20s I was hurt working as a nurse in the ER and I never fully recovered. Now at 35 my body moves like a 70 year old. My spine from the next to mid back hurts daily. I have list of conditions that equal PAIN. I do not get total relief from my meds (which was doses got cut in half when all bs began so i suffer) but I’m able to function and raise my family. Heather Alfonso was not the monster you speak of. She listened to me, was down to earth and helped me. I am greatful to her. The policy there was one month you see her or another practitioner for meds and the next you do a nursing visit. Someone was always there if I needed to see doctor of APRN for concerns. So I saw her or another prescriber every other month. Thats MUCH MORE then I see my primary doctor! They gave me my urine tests and blood test to ensure I dont use street drugs and to ensure Um taking my meds, as they should. I’ve never been given meds without taking such tests either. I think DEA and the state are using them for their bigger agenda. ..
Hello. I have been a patient of this pain center for 3 months. They gave me a full exam. They are ver professional and curtious. Explain everything to you. I am on meds. So if you terminate them. What do we do. Its not our fault of others mistakes. Why should we be punished. This practice is within driving distance from my home. If your going to terminate a good place of practice. Give us more to choose from. I have bad arthritis in my neck and a bad back. Cant work or lift anything. They are helping me . They moniter to make sure the meds are in my system which i think is a great idea. Please dont take them away. I have nowhere else to go. Unless you are going to provide me a place
If you are on both medicare and medicaid there is Dr Sood s office in trumbull. Good luck all i know how scary it is when coming off or switching pain meds.