The Cost of Dignity: A deep dive into the 'personal needs allowance' with THV11

People need help as they age. We look closer at the “personal needs allowance” and how it affects those living in Arkansas nursing homes. THV11 sits down with Darren O'Quinn for an interview.

Does your pharmacy or medical practice receive unsolicited faxes?

We are currently investigating a class action lawsuit under the Telephone Consumer Protection Act of 1991 (TCPA) — which limits marketing via fax transmissions. These abuses have risen significantly in recent years, but we now have advantages to stop these disruptive and expensive faxes with heightened enforcement of the TCPA; rules that make TCPA cases relatively easy for individuals to file; a requirement that plaintiffs show only that they received unsolicited faxes, not that they were damaged; and a U.S. Supreme Court decision allowing TCPA class actions to be brought in federal as well as state courts.

Virtually any business that contacts consumers using the technologies that fall under TCPA can be held accountable, regardless of industry or jurisdiction. Each call, text or fax deemed to be in violation translates to damages of $500 to $1,500.

When you receive an unsolicited fax, have your staff put it in a box and at the end of the month send it to Darren. He will then review it and let you know if you can be compensated. Again, this can amount to $500 to $1,500 per fax and we provide this service at no cost to you.

Darren, as a pharmacist and attorney, has taught pharmacy at the UAMS and Harding University Colleges of Pharmacy for over 30 years.

This year, with the pandemic and legislative session, pharmacy has undergone many regulatory changes. For an excellent summary of these changes, click here

HIPAA Access to Medical Records

Under HIPAA a patient has the right to request and receive a copy of their medical, payment, and other records—Protected Health Information (PHI)—that providers and health plans use to make decisions about the patient. It doesn’t matter how old the PHI is, where it is kept, or where it originated. This includes clinical lab test reports and underlying information (
Ultimately, the patient is now in charge of their health records. Their records are still protected for privacy and security. But now the patient has increased transparency and immediate access to their information, and they can choose how and when they want to access this information. They have the right to receive the information electronically and in their preferred form and format if the entity has the ability to readily do so.
There have been many new updates in this area under the federal HITECH and CURES acts allowing a patient to obtain their records for little to no cost. The old days of charging people a dollar a page for copying under State law are long gone.
If you need information on these news laws, feel free to call Darren.

The Great Vacation

As summer ends, I would like to reflect on what turned out to be a unique family vacation during a unique pandemic year. The key word for us was adapt. So, we adapted with “The Wheels of Justice” above.

And man were those wheels big! We are talking about a 44-foot beast with all the bells and whistles that is similar to driving a 5-story building. With planning books in hand, we headed west along the Main Street of America - Route 66.

And man were those wheels big! We are talking about a 44-foot beast with all the bells and whistles that is similar to driving a 5-story building. With planning books in hand, we headed west along the Main Street of America - Route 66.

We next stopped in Sante Fe for a rest at a scenic RV park. I think it was there I was appointed Sheriff of the trip. I was honored to receive my badge. What I didn’t know was I was the only employee and my other job duties included food services, sanitation, recreation, and maintenance in addition to my bus driving responsibilities.

We shopped around and ate in the arts district and then headed to the Grand Canyon for a day. The only problem getting there was you felt like the wind gusts were going to blow you over the side, but it was a sight to see.

Next up was Las Vegas – Griswold style. After viewing the Hoover Dam, Las Vegas was a sight to see pulling up at night. Our RV slot was not a “pull thru” that night, so it was up to me to back the Beast into the slot. With a lot of help from our RV neighbors (I overheard one of them say, “Do you think he got too much rig for him?”), we dodged a tree and got er' done. Of course, we then headed to the strip (luckily in an Uber with all the traffic).

The kids weren’t too impressed, so our next stop was San Diego, a favorite. We stayed at a RV park right on the ocean. There was the San Diego Zoo, La Jolla, and many nice restaurants.

We stayed there for three days (two extra) because the weather was great and there were many things to do. Of course, that also meant I had to drive 19 hours straight the last day to get home on time. Along the way back, we visited Phoenix, Yuma (whose high school mascot is the “Criminals” due to the large federal prison there and is also “The Lettuce Capital of the World”), and Albuquerque (missed the hot air balloon rides due to wind). We saw a lot of beautiful scenery along the way and got to spend quality time together as a family. We also met a lot of nice “RV park” people, became experienced at Love’s Truckstop (the real Love’s – the backside where all us big rig drivers hang out), and learned a lot (e.g., when you are the biggest thing on the road, unless it is an 18-wheeler, you are the traffic rules – so just put the blinker on and go).

Would I do it again? No. Well, probably in a few years Melanie and I would like to go along the top of the United States and see some national parks, but right now I am still recovering from what amounted to driving a house 5,000 miles.

– Darren

Ask Your Legislator to Stand for Your Rights

The citizens of Arkansas need to ensure that our rights are defended - preventing a change in the rules to rig the system and preventing a one-size-fits-all government-mandated price tag on human life.

Our state should not allow corporate lobbyists and special interests to place a government-mandated value on human life or have an influence on the rules of our courts- but that’s exactly what special interests have pushed our legislature to do in the Arkansas legislative session currently taking place.

Big tech, special interests, and corporate lobbyists want to take the rules of our courts that have been established to safeguard our constitutional rights and move them to the political arena where politicians and lobbyists can constantly rewrite them to suit their needs, not ours. 

A regular person in Arkansas could lose his or her rights in court when seeking justice against a bad nursing home, a distracted driver, a greedy Pharmacy Benefit Manager, or a corrupt employer. Our right to have a citizen jury determine for themselves what value human life has, what justice would be, and what is right in court cases involving death or injury is being threatened by the efforts of these corporate, special interest groups. 

Our rights – like the 7th Amendment right to trial by a citizen jury free from government mandates – must be defended. Write your legislator today. Here is how you can easily do that:

Is your home fire-safe? Follow these home fire protection recommendations

Home fires are a major problem in America, and especially during the colder months of the year, causing tremendous property loss, injuries, and even deaths.

Most people consider their home to be their sanctuary from the dangers of the world. It’s the place to find comfort and security. It provides shelter, and a refuge from worry. Unfortunately, this peace can be shattered by a home fire.

Home fires are a major problem in America, and especially during the colder months of the year, causing tremendous property loss, injuries, and even deaths. According to the U.S. Fire Administration, residential fires are the leading property type for fire deaths (75%), fire injuries (77.1%) and fire dollar loss (43.3%). The National Fire Protection Association reported from 2014-2018 more than one quarter of all reported fires occurred in homes. During this period, U.S. fire departments responded to an estimated average of 353,100 home structure fires per year. These fires caused an annual average of 2,620 civilian deaths; 11,030 civilian fire injuries; and $7.2 billion in direct property damage.

The American Red Cross recommends these simple things to better protect your home from fires:

Dryers are responsible for about 9 out of 10 appliance fires. Check yours – in fact, check all your appliances – for testing labels that indicate you purchased them in safe working order. You may not find them on some older appliances, so consider whether it’s time to replace them or have them checked by a professional. Make it a habit to clean out the lint screen every time you use your dryer. It may be an annoyance, but this simple action can save you a lot more pain and aggravation later.

All those appliance and electronic cords have to plug in somewhere, so your electrical outlets should be next on your home inspection list. That list should include the following:

Your garage, basement and yard can present hazards as well – in fact, they have the potential to be even more dangerous.

Despite your best efforts, something may go unexpectedly wrong, so you and your family should have a plan for what to do in case of emergency. That plan should include:

Smoke alarms double the chance of your family surviving a fire, so it goes without saying that you should have several.

Source: Beasley Allen

Darren Files Suit in Circuit Court Against Pharmacy Benefit Managers

Darren has a lawsuit filed in circuit court against Pharmacy Benefit Managers (PBMs) claiming they are violating Arkansas law by withholding information to pharmacies and reimbursing their own pharmacies more than they reimburse independent ones.

The suit says pharmacists have been forced to routinely sell prescriptions to consumers at a loss and alleges that the pharmacists are entitled to their actual financial losses and reasonable attorneys’ fees. It seeks a “disgorgement,” or a return of profits gained from the PBMs’ wrongful activities. It also seeks civil penalties of $10,000 per violation, along with injunctions to end actions in violation of Arkansas law.

PBMs serve as middlemen between pharmacies and insurance companies, reimbursing pharmacies for the drugs they buy wholesale through a methodology based on “maximum allowable cost.” Their stated purpose is to incentivize pharmacies to reduce costs. But pharmacies say that some reimbursements fall below their wholesale cost of the drug, and they accuse PBMs of unequal reimbursements. The largest PBM, CVS Caremark, is owned by the same company that owns CVS Pharmacy.

The 17-page complaint accuses PBMs of failing to abide by an Arkansas law requiring pharmacies to know reimbursement rates before filling prescriptions, and for PBMs to update their lists so pharmacies know current pricing. It says the process forces pharmacists to fill prescriptions without knowing what the reimbursement will be, and then to accept whatever money it receives.

And it says PBMs are doing this deliberately, with bigger profit spreads for pharmacies like Darren represents and narrower profit margins for their own affiliates. It called Arkansas CVS Pharmacy an “active co-conspirator” acting in violation of the Arkansas Deceptive Trade Practice Act. Under Arkansas law, PBMs are required to reimburse other pharmacies the same amount they reimburse their affiliates.

“The Defendant PBMs and the Defendant PBM Affiliates are knowledgeable and, in fact, intend for Lackie Drug to lose substantial sums of money in this blind reimbursement process in order to remove [pharmacists] and other Arkansas independent pharmacies like [them] and that compete against Arkansas CVS Pharmacy and other PBM Affiliates, from the marketplace or force them to sell their business to a big brand PBM Affiliate’s pharmacy controlled, operated, and preferred by a PBM,”

the complaint says.

The complaint says the defendants’ actions are “intentionally designed to prevent honest competition and perpetuate monopolies by the owners of big brand stores, which control the PBMs and are treated much more favorably by the PBMs.”

This action comes a week after the U.S. Supreme Court unanimously ruled in favor of the state in Rutledge v. Pharmaceutical Care Management Association. That case centered around Act 900, which was passed in Arkansas in 2015. The Arkansas law requires PBMs to increase reimbursements for generic drugs if they are below wholesale costs, and it created an appeals process for pharmacies to challenge the reimbursements.

When the law went into effect in September 2015, the PCMA immediately sued. The industry argued that state laws can’t preempt payments made for voluntarily created employee benefit plans in private industry under the Employee Retirement Income Security Act of 1974, otherwise known as ERISA.

PCMA lost and now huge PBM corporations must face the legal consequences inflicted on small, independently owned pharmacies.


5 steps to Help During Uncertain Times

Human beings like certainty. We are hard-wired to want to know what is happening when and to notice things that feel threatening to us. When things feel uncertain or when we don’t generally feel safe, it’s normal to feel stressed. This very reaction, while there to protect us, can cause all sorts of havoc when there is a sense of uncertainty and conflicting information around us.

A large part of anxiety comes from a sense of what we think we should be able to control but can’t. Right now, many of us are worried about COVID-19, known as the “Coronavirus.” We may feel helpless about what will happen or what we can do to prevent further stress. The uncertainty might also connect to our uncertainty about other aspects of our lives, or remind us of past times when we didn’t feel safe and the immediate future was uncertain.

In times like these, our mental health can suffer. We don’t always know it’s happening. You might feel more on edge than usual, angry, helpless, or sad. It’s important to note that we are not helpless in light of current news events. We can always choose our response. If you are struggling, here are some things you can do to take care of your mental health in the face of uncertainty:

  1. Separate what is in your control from what is not. There are things you can do, and it’s helpful to focus on those. Wash your hands. Remind others to wash theirs. Take your vitamins. Limit your consumption of news (Do you really need to know what is happening on a cruise ship you aren’t on?).
  2. Do what helps you feel a sense of safety. This will be different for everyone, and it’s important not to compare yourself to others. It’s ok if you’ve decided what makes you feel safe is to limit attendance at large social events, but make sure you separate when you are isolating based on the potential for sickness versus isolating because it’s part of depression.
  3. Get outside in nature–even if you are avoiding crowds. I took a walk yesterday afternoon in my neighborhood with my daughter. The sun was shining, we got our dose of vitamin D, and it felt good to both get some fresh air and quality time together.  Exercise also helps both your physical and mental health.
  4. Challenge yourself to stay in the present. Perhaps your worry is compounding—you are not only thinking about what is currently happening but also projecting into the future. When you find yourself worrying about something that hasn’t happened, gently bring yourself back to the present moment. Notice the sights, sounds, tastes, and other sensory experiences in your immediate moment and name them. Engaging in mindfulness activities is one way to help stay grounded when things feel beyond your control.
  5. Stay connected and reach out if you need more support. Talk to trusted friends about what you are feeling. If you are feeling particularly anxious or if you are struggling with your mental health, it’s ok to reach out to a mental health professional for support. You don’t have to be alone with your worry and it can be comforting to share what you are experiencing with those trained to help.

We are in this together, and we are here to help. All you have to do is call. If we can’t help you, we will refer you to someone that can.

Healthcare Providers and the OIG Exclusion List


The federal Office of Inspector General (OIG) has the authority to exclude individuals and entities from federally funded health care programs pursuant to section 1128 of the Social Security Act (and from Medicare and State health care programs under section 1156 of the Act) and maintains a list of all currently excluded individuals and entities called the List of Excluded Individuals/Entities (LEIE).

Anyone who hires an individual or entity on the LEIE may be subject to civil monetary penalties. As a consequence, to avoid liability, healthcare entities need to routinely check the LEIE to ensure that new hires and current employees are not on the excluded list.

Purpose of List

The LEIE is a tool to keep track of individuals who have been excluded from participation in federal healthcare programs due to crimes or convictions like fraud or patient neglect. But individuals who are placed on the list by the OIG don't stay there forever. Each exclusion comes with a different term, and when that term is up, individuals may apply for reinstatement (and removal from the LEIE database).
Reinstatement, however, doesn't occur automatically when the term ends. OIG-excluded individuals who wish to be removed from the Medicaid and Medicare exclusion list must go through a process to become employable in healthcare programs again.

How Do You Get on the List?

There are a number of ways a person can end up on the LEIE list ranging from student loan defaults to misdemeanor criminal convictions (even ones unrelated to healthcare) to out-and-out healthcare fraud, and everything in between. You can even end up on the list through a request of another federal agency.

The Problem Then Becomes, How Do You Get Yourself Off the List?

There are a number of ways a person can end up on the LEIE list ranging from student loan defaults to misdemeanor criminal convictions (even ones unrelated to healthcare) to out-and-out healthcare fraud, and everything in between. You can even end up on the list through a request of another federal agency.

Knowledge is Power

Knowing exactly when you are eligible for removal is not as easy a question as the OIG would have you believe. In the simplest of cases, it just means serving out the time of exclusion that was initially imposed. Unfortunately, it is becoming increasingly common for providers to be placed on the list without actually receiving notice. This means that you may not even know when, or for how long, you were placed on the list. It is very often the case that providers do not even know they are on the list until a prospective employer tells them they are not hireable because they are excluded.

More Roadblocks

Another serious problem is that removal from the list is often tied to the OIG getting some form of notice of eligibility from another federal agency. Which federal agency the notice comes from is not always easy to find out. Student loans are a great example of this. Unless you have settled your student loans with the Department of Justice, and notice of the settlement is sent to the OIG in a form the OIG deems sufficient (which it will not tell you), you are not eligible for removal.

The Bottom Line

The OIG exclusion list is a complicated regulatory program which requires experience and perseverance to navigate. It is highly recommended that you do not attempt to handle removal without qualified assistance. If your application is denied, even for hyper-technical reasons, you may be barred from reapplying for one full calendar year. Therefore, it is crucial that your application is complete and correct, and you are fully eligible for removal.


If the OIG is attempting to place you on the exclusion list, or you need help in determining if you are already on the list or in getting off the list, call Darren. He has experience with the OIG list and can help in this complex area of the law.

COVID-19 Update

Dear Friends,

The Law Offices of Darren O'Quinn remain open and fully functional during these uncertain times. As I'm sure all of you are, we are listening to local and federal officials with regards to face-to-face meetings, and will provide relevant updates through this letter and on our social channels in the weeks and months to come. 

If you or someone you know needs our services, please feel free to contact us at 501-817-3124. We are here to help and accepting all calls and emails.

Please leave a voicemail as all messages are delivered to us personally. We will get right back to you.

2019 Hospital Safety Rankings

Up To 440,000 People Die Every Year Due to Preventable Medical Errors

Eight Arkansas hospitals earned a “D” or “F” in the recently released 2019 “Hospital Safety Grade Rankings,” which are released twice a year by a nonprofit watchdog organization called “Leapfrog Hospital Safety Grade.”

The rankings can be found at

Of the 29 Arkansas hospitals included in the rankings, 4 received an “A” Grade, 1 received a “B,” and 16 received a “C.”

The rankings focus on patient safety, and how well the hospital protects patients from preventable harm and medical errors. The ranking use a scoring methodology that includes 28 national performance measures gleaned from the Centers for Medicare & Medicaid Services (CMS), the Leapfrog Hospital Survey, and other supplemental data sources.

Arkansas hospitals receiving a "D" Grade:

The only Arkansas hospital to receive an “F” Grade was Jefferson Regional Medical Center in Pine Bluff:

Think about the last time you purchased a car or a major appliance. Did you do your homework? Did you compare features, warranties, and costs? 

Now think about the last time you or a family member went to the hospital. You probably didn't even know you might have a choice. And it's unlikely that you compared services or quality, because few resources exist to help you choose the best care. 

We are changing that. By publicly reporting critical safety and quality information, we can help you find the best care for you and your family. And by making transparency the norm in health care, we're helping hospitals achieve the best care possible for their patients.

Aren't all hospitals the same?

In short, no. In some hospitals, patient safety and high quality are top priorities. Strong healthcare teams reduce infection rates, put checks in place to prevent mistakes, and ensure strong lines of communication between hospital staff, patients, and families. But some hospitals trail behind. In fact, medical errors are the third-leading cause of death in this country, surpassing the number of deaths caused by car accidents, breast cancer, and HIV/AIDS. 

That means that it's critically important that you choose a hospital with a good track record of keeping its patients safe from harm. Make an informed decision for your care. Ready to compare hospitals?