What constitutes a doctor taking you off of your pain meds?

Right.

So it isn't that your urine showed no evidence that you have been taking your medication as prescribed. It is that your urine has not been tested. Is that correct?

So you missed two drug screenings in a row, on July 20th and August 2nd, is that correct?

Who have you spoken to about this problem? There will be a right of appeal, you won't be left indefinitely without pain relief, but it's a technical tangle that needs sorting out. So either your pain doctor's office or perhaps Medicare themselves need to advise you about what to do.

You won't be the first or last person to have fallen foul of these regulations. You can see what the regulations are for - they're designed to stop people getting px's on false pretences and then selling drugs to abusers - but I agree it's a great pity that there isn't more joined-up thinking about it.

I hope you can get this sorted out quickly. Would it be possible for you to find healthcare that's easier for you to get to?

I read your question as "your urine test did NOT show evidence of opoids as might be expected with prescription use". Yes, doctors do drug screen tests that participate in the Medicare program. Not all doctors do, but the majority are beginning to. Every pain management doctor that I've talked to recently is now doing the drug tests to prevent legal problems for themselves and provide track record for their liability insurance and law enforcement. The drug tests are PAID for by Medicare specifically to combat the financial exploitation of prescriptions, especially opiates. Many of the Blue Cross/Blue Shield programs have in their requirements for pain management doctors to screen patients that have long-term opoid use or high levels of opiate prescriptions to be screened for the drug to be in their bloodstream, hair samples, or urine. If you had 2 screens that didn't show drugs, your doctor under the AMA (American Medical Association) guidelines is not supposed to keep prescribing opiates. Many doctors have gotten in serious legal trouble for opiate prescriptions. If you are in Medicare Advantage plan, some of them have even more stringent rules. Time of day should not affect urine tests - opiates stay in the body at certain levels when you have long term use.

I'm not sure I understand the situation. Did you run out of drugs on July 20, and when you had your appointment on August 2 you hadn't been taking them for several days, so none showed up in your urine?

Certainly all of your appointments should fall within (and near the end) of the prescription's time span. If you need to renew your med in July, not having an appointment until August is not satisfactory. That is something you could work out with the scheduling office.

But missing and having to reschedule appointments is a big problem. And I understand how difficult that is when you have to rely on other people. Is there someone more consistently reliable you could count on? Maybe as a backup when others cancel on you? And what do you mean that Medicaid won't provide free rides because you have Medicare? What is the story there?

Do you have Medicare and Medicaid? Like Jeannie I am having difficulty understanding your question,
I can understand Drs doing a urine screen to be sure you are actually taking the drugs not selling them. What i don't understand is why the drug did not show up after you had taken your medication.
A prescription for a narcotic for the pain of glaucoma is perfectly reasonable because the is no question that glaucoma is very painful. Can you find another Dr whowill be more sympathetic to your condition.
I get the feeling we not getting the whole story.

Yes we need details to help.  There has had to be some further background to this situation as pain management MD's & staff are well aware of what happens when pain meds are discontinued.  Pain Mgmt Centers have to play by very very strict regulations these days, especially in the past year.
Pain Mgmt  doctors do not discontinue pain meds cold turkey. If you want to stop they will  taper you down and give directions on how to do it.
Their rules are stated right there in the contract you sign when you are admitted to their care.
There is no ambiguity in the contract that can't be discussed 
between  you and the staff & the doctor to clarify any issue.
Opioid prescriptions are under very tight scrunity as we speak & new laws are being presented right now.  The Centers will comply to keep their business going and the clients will have to comply too. Otherwise you will be ousted if you don't do your part of the agreement/contract.

If you can or if you want to, ask the Pain Mgmt staff to mail you a copy of the contract you signed at PM office. That will spell out requirements for urine testing and an algorithm to address guidelines for urine testing - like what if your urine was negative for the meds your doctor has prescribed, and twice, & why you are not keeping your appointments.

 You have the responsibility to keep your end of the contract.

Apply for an application for  County transportation services through the Department of Agjng. It's paperwork you need to provide and just try your best to complete it; staff can assist. You can schedule rides through the county bus service weeks in advance so you don't miss appointments and required urine testing.

Pain Mgmt Centers must and will comply with State & Federal laws and if a patient of theirs does not comply, the patient will be discharged and asked to go somewhere else. Pure and simple. Yes we as patients don't like it but these days the attack is on all things Opiod. I quit last January after going 18 months post back surgery. I didn't want to deal with any more of it. Now I take ibuprofen with the same results. 

I hope things work out for you and you get the care you need.

They dont test my mother and she is on 5/325

Wow ,my mom is going to be an unhappy camper. She had a pharmacy once refuse to fill a script , they said they werent filling from that Dr anymore.