High numbers of patients on controlled medications may need help connecting to new pain management and/or MAT providers, due to the closure of 29 Lags Medical Centers, which operate high-volume pain management clinics in California.
DHCS encourages MAT providers to consider the use of buprenorphine for pain indications for patients who are opioid-dependent and have difficulty finding providers to continue full-agonist opioid treatment, when medically necessary. These patients are likely to be at risk, if they are unable to connect to ongoing medical care. Please also prescribe naloxone, where appropriate, as a safety measure. The attached resource list could be used by local organizations to share contact information for local resources.
The California Department of Health Care Services (DHCS) is working with health plans and community organizations to create transition plans for the patients. However, because Lags Medical Centers advertises over 30,000 patients served in California, we anticipate that many patients may have difficulty obtaining new pain management providers, given the suddenness of the clinic closures and the high volume of affected patients.
Affected counties: Los Angeles, Ventura, Santa Barbara, San Luis Obispo, Kern, Tulare, Kings, Monterey, Santa Cruz, Fresno, Madera, Merced, Alameda, Stanislaus, San Joaquin, Sacramento
On May 19, DHCS temporarily suspended select Lags Medical Centers locations from participation in the Medi-Cal program because of an ongoing investigation by the California Department of Justice (DOJ), Division of Medi-Cal Fraud and Elder Abuse, involving allegations of fraudulent billing and potential patient harm. On May 25, 2021, DHCS learned that Lags Medical Centers voluntarily closed 29 California locations this month, even though DHCS only suspended seven National Provider Identifier numbers associated with up to 17 locations, potentially impacting about 20,000 beneficiaries access to pain management care.
The centers are spine, sports medicine, and pain management clinics operating in the following counties: Alameda, Fresno, Kern, Kings, Los Angeles, Madera, Merced, Monterey, Sacramento, San Joaquin, San Luis Obispo, Santa Barbara, Santa Cruz, Stanislaus, Tulare, and Ventura. See web archive for city locations: LAGS Medical Centers (archive.org)
DHCS is contacting the Department of Managed Health Care and the involved Medi-Cal managed care plans to ensure they are reaching out to their affected members to connect them to needed services. DHCS also is alerting local partners to ensure they are aware of the clinic closures, and that they know to refer patients to their health plan or Medi-Cal Ombudsman (888) 452-8609 or MMCDOmbudsmanOffice@dhcs.ca.
DHCS anticipates that patients may have difficulty finding new providers, as there is a national shortage of pain management providers. DHCS is particularly concerned about patients dependent on controlled medications, as these patients are at high risk of decompensation and accidental overdose, if this transition is not carefully managed. The attached resource list could be used by local organizations to connect patients to resources.
