The NCP3 Framework: Restoring Integrity to Pain Management

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NORMAN J CLEMENT RPH., DDS, NORMAN L. CLEMENT PHARM-TECH, MALACHI F. MACKANDAL PHARMD, BELINDA BROWN-PARKER, IN THE SPIRIT OF JOSEPH SOLVO ESQ., INC., SPIRIT OF REV. IN THE SPIRIT OF WALTER R. CLEMENT BS., MS, MBA. HARVEY JENKINS, MD, PH.D., IN THE SPIRIT OF C.T. VIVIAN, JELANI ZIMBABWE CLEMENT, BS., M.B.A., IN THE SPIRIT OF THE HON. PATRICE LUMUMBA, IN THE SPIRIT OF ERLIN CLEMENT SR., EVELYN J. CLEMENT, IN THE SPIRIT OF WALTER F. WRENN III., MD., JULIE KILLINGSWORTH, RENEE BLARE, RPH, DR. TERENCE SASAKI, MD LESLY POMPY MD., CHRISTOPHER RUSSO, MD., NANCY SEEFELDT, IN THE SPIRIT OF WILLIE GUINYARD BS., JOSEPH WEBSTER MD., MBA, BEVERLY C. PRINCE MD., FACS., NEIL ARNAND, MD., RICHARD KAUL, MD., IN THE SPIRIT OF LEROY BAYLOR, JAY K. JOSHI MD., MBA, AISHA GARDNER, ADRIENNE EDMUNDSON, ESTER HYATT PH.D., WALTER L. SMITH BS., IN THE SPIRIT OF BRAHM FISHER ESQ., MICHELE ALEXANDER MD., CUDJOE WILDING BS, MARTIN NJOKU, BS., RPH., IN THE SPIRIT OF DEBRA LYNN SHEPHERD, BERES E. MUSCHETT, STRATEGIC ADVISORS

Executive Introduction

The Mission of the National Campaign to Protect People in Pain (NCP3)

The National Campaign to Protect People in Pain (NCP3) is a strategic coalition of elite clinicians, researchers, and policy advocates. Its architecture is designed to combat the systemic erosion of medical standards by bridging the disconnect between clinical evidence and federal policy. The NCP3 mission is two-pronged: to restore scientific integrity to the management of chronic pain and to safeguard the patient’s right to individualized, expert-led care.

Vision Statement

“To restore scientific integrity to chronic pain care and protect the sanctity of the doctor-patient relationship from political and legal overreach, ensuring that compassion and evidence remain the cornerstones of medical practice.”

While the NCP3 seeks to uphold the highest standards of clinical pedagogy, this mission is mandated by an unprecedented landscape of “over-federalization” that threatens the very foundation of the medical community.

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The Landscape of “Over-Federalization”: Why Advocacy is Necessary

As NCP3 has highlighted in the case of Dr. Lesly Pompy, MD, a Board-certified interventional anesthesiologist practicing in Monroe, Michigan, the modern landscape of healthcare oversight has shifted from administrative peer review to aggressive criminalization. 

Federal authorities have pivoted from administrative auditing—traditionally focused on civil “clawbacks” (the recovery of overpayments)—to aggressive criminal prosecution. This “over-federalization” effectively converts “garden-variety” billing disagreements into high-stakes criminal indictments.

the three pillars

Advocates have identified and challenged the Three Pillars of Prosecutorial Overreach:

1. The Criminalization of Clinical Subjectivity: Authorities treat the independent medical judgment required for CPT code selection as a fraudulent act rather than a professional determination.
2. The Erasure of the Civil-Criminal Distinction: The boundary between administrative errors and deliberate criminal acts has collapsed, ignoring established civil remedies and the “preponderance of evidence” standard.
3. The Bypass of Professional Governance: Federal agencies explicitly ignore the authority of the American Medical Association (AMA) and the CPT Editorial Panel, choosing instead to rely on “hired-gun” experts to define medical propriety.

Comparison of Medical Oversight Standards

Feature	Traditional Administrative Oversight	Modern Prosecutorial Overreach
Primary Driver	Accuracy in billing and standards.	Criminal indictment and conviction.
Legal Standard	The Correct Standard (Lingle v. Chevron):Focused on Due Process and Takings Clause protections.	The Lower Court Error (Lech Standard): A flawed inquiry process that disregards the Takings Clause.
Governance	Managed by medical experts (AMA/CPT Editorial Panel).	Managed by federal law enforcement (DOJ/DEA).
View of Subjectivity	A clinical determination based on professional training.	Treated as a “fraudulent” or criminal intent.

This shift creates a “lower court error” where the government ignores the constitutional boundaries designed to prevent the state from practicing medicine without a license.

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Legal Foundations and the Protection of Medical Practice

The legal defense of medical practice is anchored in 42 U.S.C. § 1395, which explicitly prohibits any federal officer from exercising “supervision or control over the practice of medicine or the manner in which medical services are provided.” This statutory protection is reinforced by a century of jurisprudence.

“.. FDA guidance document does not apply to permanently implantable pacemakers, hemodialyzers, opened but unused single-use devices, or healthcare settings other than acute-care hospitals. The reuse of single-use medical devices continues to be an evolving area of regulations. For this reason, healthcare workers should refer to the FDA for the latest guidance. ⁹⁹⁶.. see page 81.”

the Supreme Court established that the government must prove “Mens Rea” (a guilty mind)

Ruan v. United States (2022),

In Linder v. United States (1925) and the more recent Ruan v. United States (2022), the Supreme Court established that the government must prove “Mens Rea” (a guilty mind). To convict a clinician, the state must prove the physician subjectively knew a prescription lacked a legitimate medical purpose. If a doctor acts in “Good Faith,” they are practicing medicine, not committing a crime.

Critical Takeaways for Students of Law and Medicine

• The Biological vs. Behavioral State: Physical dependency is a predictable, biological side effect of long-term treatment. It is a clinical error and a violation of medical ethics to label a physiologically dependent patient as an “addict.”
• The Primacy of “Good Faith”: A physician’s decision to treat a patient’s documented pain in good faith is legally protected regardless of dosage or duration; the government lacks the authority to regulate general medical practice through rigid, one-size-fits-all mandates.
• The Danger of Flawed Monitoring Tools (UDS): Urine drug screens are strictly monitoring tools with high rates of false results. Using a UDS as “diagnostic proof” of addiction or as the sole reason to discharge a patient is a betrayal of the ethical duty to treat.

These legal protections are currently circumvented by a “Public Health Emergency” declaration. The NCP3 asserts this declaration is based on the “false assertion” that medical prescriptions are the primary driver of the overdose crisis, necessitating the Six Pillars of reform.

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The Six Pillars of the NCP3 Framework

The NCP3 framework provides a strategic roadmap for restoring clinical autonomy and scientific rigor.

1. Remove Political Interference: Policy must be driven by peer-reviewed medical literature rather than political pressure. So What? This ensures that patient treatment is dictated by clinical science rather than the shifting winds of election cycles.
2. Correct Misinformation: Clarifying that the overdose crisis is driven by illicit street drugs, not legal medical prescriptions. So What? This stops the victimization of legitimate patients and doctors for a crisis driven by non-medical, illicit substances.
3. End Stigma & Discrimination: Protecting vulnerable populations, such as those with Sickle Cell Disease, who face systemic bias. So What? This upholds the core ethical duty to treat all patients with dignity, regardless of their condition.
4. Restore Compassionate Care: Re-establishing patient-centered treatment as the primary goal. So What? This re-humanizes medicine, moving away from a culture that views chronic pain patients as legal liabilities.
5. Challenge Restrictive Guidelines: Actively opposing flawed CDC/VA guidelines and advocating for the ASIPP 2023 Consensus Guidelines. So What? The ASIPP guidelines represent the expert-backed alternative grounded in actual clinical consensus rather than law enforcement metrics.
6. Professional Education & Advocacy: Providing CME and CLE to clinicians and attorneys. So What? This education serves as a defensive strategy to establish a “legally defensible standard of care” that can withstand prosecutorial scrutiny.

Key Insight: The Overdose Crisis vs. The Opioid Crisis The NCP3 distinguishes between the “overdose crisis”—overwhelmingly driven by illicit, non-medical substances like illicit fentanyl—and “opioid policy,” which currently targets the legal, regulated prescriptions required by patients with intractable pain.

The implementation of these pillars is hindered by a systematic failure to track the actual outcomes of restrictive federal policies.

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The Human Cost of Data Gaps and “Junk Science”

A catastrophic failure of scientific integrity is the “Absence of Official Tracking.” Federal agencies have enforced a restrictive prescribing agenda while intentionally ignoring secondary harms. This reliance on “junk science” prioritizes law enforcement “wins” over human survival, leaving a massive data void in patient safety.

The Uncounted Metrics:

• [ ] Suicides: Deaths directly linked to forced tapers or the publication of the 2016 CDC Guidelines.
• [ ] Loss of Functionality: Patients who can no longer perform basic activities of daily living due to untreated pain.
• [ ] Loss of Employment: Patients forced out of the workforce and onto disability benefits because their medical stability was stripped.
• [ ] Medical Complications: Deaths from heart attacks, strokes, or uncontrolled blood pressure resulting from the physiological stress of “forced tapers.”

Because the government fails to track these physical and human costs, advocates must pivot to constitutional protections to halt the damage.

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Conclusion:

Reclaiming the Sanctuary of Care

The NCP3 framework argues that current federal overreach constitutes a violation of the Takings Clause of the Fifth Amendment. This clause prohibits the government from seizing private property for public use without just compensation. Importantly, this protection extends to intangible property, including intellectual property, contract rights, and—crucially—a doctor’s independent medical judgment.

When the government engages in the “outright confiscation” of clinical autonomy, it is not merely regulating; it is “taking” the physician’s intangible property and the patient’s established care plan. We have a profound ethical and legal duty to differentiate between a patient in pain and a person misusing drugs. By reclaiming the sanctuary of the doctor-patient relationship, we ensure that the treatment of human suffering remains a protected medical mission rather than a criminal liability.

Learner’s Summary: Three Actionable Principles

1. Demand Data Integrity: Future advocates must insist the government track the “Uncounted Metrics,” such as suicides and loss of functionality, to expose the failure of restrictive policies.
2. Assert the Linder/Ruan Standard: Legal and medical practitioners must prioritize “Mens Rea” (Good Faith intent) over rigid dosage guidelines in every professional and courtroom setting.
3. Defend Intangible Property: Utilize the Takings Clause to argue that the confiscation of medical judgment and individualized care plans is an unconstitutional seizure of property.

THE CRIMINALIZATION OF CAREGIVERS

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