🎙️ Episode 56

Scored. Flagged. Medically Abandoned. Forgotten.
Unveiling NarxCare: The Hidden Scoring System in Your Medical Records

This is a rerelease of a 2022 podcast episode featuring attorney Jennifer D. Oliva.

In this powerful conversation, Bev Schechtman and Claudia Merandi of The Doctor Patient Forum sit down with Professor Oliva to expose the implications of NarxCare and Prescription Drug Monitoring Programs (PDMPs) on patient care — particularly for those living with chronic pain.

They explore the secretive nature of risk-scoring algorithms, the lack of transparency in PDMP data, and the systemic discrimination embedded in these tools — especially for marginalized and disabled populations. Together, they make the case for regulatory oversight, algorithmic accountability, and why advocacy is essential to protect patient rights and restore ethical care.

NarxCare is a secret risk-scoring algorithm embedded in electronic health records.
Most patients cannot access or correct their PDMP data.
These scores disproportionately flag patients with complex conditions as “high risk.”
Errors in PDMP data can result in abrupt care abandonment and harm.
Providers face pressure to under-prescribe due to fear of red flags.
The opioid crisis has redefined pain care around liability, not compassion.
There is little to no regulatory oversight of NarxCare or PDMP systems.
Legislative action and public advocacy are urgently needed to protect patient safety and autonomy.

Professor Oliva’s research and teaching interests include health law and policy, privacy law, evidence, torts, and complex litigation. She has served as a peer reviewer for the American Journal of Public Health, Yale Journal of Health Policy, Law, and Ethics, American Journal of Law & Medicine, Journal of Law and the Biosciences, and Big Data & Society.

Her scholarship has been published by or is forthcoming in the Virginia Law Review, California Law Review, Duke Law Journal, Northwestern University Law Review, UCLA Law Review, North Carolina Law Review, Ohio State Law Journal, and online companions to the University of Chicago Law Review and New York University Law Review.

She lives in Bloomington, Indiana.

The Doctor Patient Forum has joined advocates nationwide in filing a citizen petition demanding that the FDA regulate NarxCare and all clinical algorithm software that scores patients.

🛑 This affects patients with pain, addiction, and complex conditions.
🗣️ Your voice matters. Help us hold the system accountable.

👉 Submit your public comment today:
🔗 https://www.regulations.gov/document/FDA-2025-P-0701-0001
📅 Deadline to comment: May 10, 2025

Clips taken from:

NPR 1A – “Against the Pain: The Opioid Crisis and Medication Access”
https://the1a.org/segments/against-the-pain-the-opioid-crisis-and-medication-access/
Cato Institute – “Patients, Privacy, and PDMPs” (Dr. Jeffrey Singer & Kate Nicholson)
https://www.youtube.com/watch?v=YXVXShMASJ4&t=4357s
Duke Margolis – “Strategies for Promoting the Safe Use of Prescription Opioids”
https://www.youtube.com/watch?v=AFUkAi8Coyw
NPR – “To End Addiction Epidemic” (Kolodny quote)
https://www.npr.org/2014/05/09/311119395/to-end-addiction-epidemic-states-focus-on-stopping-doctor-shoppers
Cover 2 Resources – Gary Mendell (Podcast)
https://open.spotify.com/episode/33OosEC2hutlE9y6Cogmne
Jennifer Oliva’s Paper – “Dosing Discrimination: Regulating PDMP Risk Scores”
https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3768774

Pediatric Patients Made to Suffer - One Mom's Story - Beth Steckler - Episode 24