Three North Texas Hospitals Among Worst in Nation for Inflating Patients’ Bills

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The Dallas Morning News recently published a shocking story about the billing practices of several local hospitals.

Here are the opening paragraphs:

Tammy Tedford went to Texas General Hospital when she had trouble breathing in April. A month later her husband, James Balter, visited the Grand Prairie hospital for stomach pain.

The Arlington couple came home with new maladies: medical bills high enough to cause a heart attack.

After a CT scan and basic lab tests, Texas General diagnosed Balter with a urinary tract infection and a slightly enlarged prostate.

Hospital staffers gave Tedford respiratory therapy, tested her blood and did a CT scan before releasing her after five hours with a prescription for an antibiotic.

Together the couple’s bills totaled $165,240.

“I thought they made a typo,” said Balter, a 48-year-old limousine dispatcher with no health insurance. “I thought for sure they had moved a decimal point or something.”

A study published this month in a health policy journal found it’s common practice at Texas General and two other for-profit medical centers in North Texas to charge patients upward of nine times the cost of care.

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House Appropriations Bill Would Limit FDA’s Ability to Regulate E-Cigarettes, Other Tobacco Products

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The Cancer Letter reported that “a $20.65 billion agriculture appropriations bill, which cleared a House subcommittee June 18, seeks to limit FDA’s ability to review electronic cigarettes, cigars and other tobacco products already on the market.” The bill would “prevent the FDA Center for Tobacco Products from requiring products already on the market to go through the Premarket Tobacco Review application process under the Federal Food, Drug and Cosmetic Act.”

From the news release of the American Association for Justice.

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Jail Sentence For CEO of Medical Device Company That Sold Surgery Tool Without FDA Approval

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The AP reported that “the former chief executive of a medical device company that admitted to distributing knee replacement surgery tools using a marketing plan rejected by the Food and Drug Administration will go to jail.” On Friday, Charli Chi was sentenced to two years in prison, while his former company, OtisMed Corp., “was fined more than $80 million for the criminal and civil charges for distributing the knee replacement surgery cutting guides.”

From the news release of the American Association for Justice.

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FDA Cracks Down on Online Illegal Medicine, Medical Device Sellers

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Reuters reports that the FDA announced that it sent warning letters to some nine companies and 400 Internet sites and seized unapproved medicines and medical devices from 1,050 websites around the world that were received through international mail facilities in Chicago, Miami, and New York.

According to HealthDay, George Karavetsos, director of the FDA’s Office of Criminal Investigations, said, “Our efforts to protect the health of American patients by preventing the online sale of potentially dangerous illegal medical products will not cease.” Among some of the counterfeit medicines were “antidepressants, hormone replacement therapies, sleep aids and drugs to treat erectile dysfunction, high cholesterol and seizures.” Also seized were “colon hydrotherapy” products and dermal fillers.

From the news release of the American Association for Justice.

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Hundreds Charged in Massive Medicare Fraud Sweep

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A number of national and local outlets cover the government’s nationwide crackdown on Medicare fraud, which resulted in charges brought against 243 people. The sweep was led by the Justice Department, HHS, and the FBI.

The Washington Post reports that in the “single largest crackdown” in an eight-year campaign against healthcare fraud, the Justice Department on Thursday charged 243 people “with $712 million in false billings to Medicare.” The alleged fraud “spanned the country, from Miami — where 73 of the accused worked — to Houston, Dallas, Los Angeles, New York, New Orleans, Detroit and beyond.” According to the Post, a “sizeable number” of those charged allegedly targeted Medicare Part D.

The AP reports that Attorney General Lynch said “the defendants billed for equipment that wasn’t provided, care that wasn’t needed, and services that weren’t rendered.”

USA Today reports that a government “strike force” including the Justice Department, the FBI, and HHS brought cases in 17 districts. The cases include 46 physicians, nurses, and other licensed medical professionals. HHS Secretary Sylvia Burwell “said the agency is being more proactive about rooting out Medicare fraud, including by doing more checking on providers ‘at the front end’ before they can bill Medicare for services.” Burwell also said the Affordable Care Act has bolstered anti-fraud efforts by providing an additional $350 million toward fraud prevention and enforcement efforts.

Reuters reports that the sweep was led by the Medicare Fraud Strike Force and the Centers for Medicare and Medicaid Services, and involved about 900 law enforcement officials.

Bloomberg News reports that task forces from Justice and HHS “since 2007 have charged more than 2,300 defendants with falsely billing the Medicare program for more than $7 billion, federal prosecutors said.”

The Wall Street Journal reports Attorney General Lynch said, “This action represents the largest criminal health-care fraud takedown in the history of the Department of Justice,” adding that the suspects “billed for equipment that wasn’t provided, for care that wasn’t needed, and for services that weren’t rendered.”

Gary Cantrell, top investigator for the HHS Office of Inspector General, said, “For us, the greatest concern looking forward is the prescription drug program,” the AP reports. He explained that such schemes often involve billing for drugs that are never dispensed or billing for opioids that are diverted to street sales.

The Miami Herald describes Miami as “the capital of Medicare fraud,” noting the city accounted “for one-third of all defendants charged this week.”

From the news release of the American Association for Justice.

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Senator Investigates Retailers for “Dubious” Memory Loss Supplements

The AP reports that Sen. Claire McCaskill (D-MO) “is probing retailers and online companies about sales of dubious dietary supplements, especially those promising seniors protection from memory loss, dementia and other age-related problems.” McCaskill, the ranking Democrat on the Senate Aging Committee, wrote letters to 15 companies, “including Wal-Mart, Target Corp., Amazon, Google and Walgreen’s,” asking executives “to explain how they vet dietary supplements and weed out products making false claims.”

From the news release of the American Association for Justice.

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Lawsuit Charges Surgeons and Hospitals with Healthcare Fraud for Using Fake Spinal Implants

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The Las Vegas Review-Journal reported a recently unsealed lawsuit filed in February in California claims two surgeons and four hospitals in Las Vegas operated a large healthcare fraud scheme by allegedly implanting counterfeit spinal hardware into patients undergoing surgery. The lawsuit claims the California company Spinal Solutions manufactured the counterfeit parts and mixed them with legitimate products to avoid detection. Spinal Solutions then paid kickbacks to Las Vegas surgeons, Jaswinder Grover and Patrick S. McNutty, that used the fake products.

From the news release of the American Association for Justice.

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Study: Tobacco Industry Adds Chemicals to Products to Make Them Harder to Quit

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Medscape reports new research published online in Tobacco Control suggests the tobacco industry “adds chemicals to its products to make them more irresistible to consumers and thwart smokers’ efforts to quit.” The study led by Hillel R. Alpert, ScD, Harvard School of Public Health concludes “pyrazine additives to low tar, or ‘light,’ cigarettes and e-cigarettes are reinforcing the addictive qualities of nicotine and should be regulated by” the FDA. Alpert said, “Pyrazine compounds used as additives in tobacco products appear to enhance addiction by increasing product appeal and making it easier for nonsmokers to initiate smoking, more difficult for current smokers to quit, and much easier for former smokers to relapse into smoking.” The research was supported by the National Cancer Institute.

The Medical Daily adds that “pyrazines are said to characterize the flavor and aroma of tobacco smoke, contributing what industry execs refer to as the brown notes and in some cases, cocoa, nutty, and popcorn type flavors. While each manufacturer has its own (undisclosed) recipe, e-cigarettes are said to include some of the same additives approved for regular cigarettes (though less of them), with additional flavorings to jazz up the taste of the vapor.” Scientists are concerned that “while a flavoring may be safe to eat, the effects on the body could be vastly different when burned and inhaled.”

From the news release of the American Association for Justice.

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NHTSA Confirms Additional Takata Airbag-Related Death

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Bloomberg News reports that NHTSA administrator Mark Rosekind in an emailed statement said that a seventh death has been linked to faulty airbags. Rosekind said, “After examination of the vehicle and other evidence, NHTSA has concluded that a ruptured Takata air-bag inflator is likely to have been involved.” The case involves Kylan Rae Langlinais, 22, who died in April after her 2005 Honda Civic hit a utility pole. Rosekind said of the accident, “This tragedy underscores the necessity of the actions NHTSA is taking to ensure that every vehicle on America’s roads has a safe air bag.”

Reuters notes that this week Langlinais’ family filed suit in US District Court alleging that the Takata airbag caused Langlinais’ death. So far the seven deaths linked to flawed Takata airbag inflators have all been in Honda-manufactured vehicles.

Honda adds $363m to costs of Takata airbag recalls. The AP reports that Honda has announced it will set aside an additional $363 million to fund more recalls of Takata airbags. Last month Takata “gave in to pressure from U.S. safety regulators and agreed to double the size of an air bag inflator recall to a record 33.8 million,” the AP notes. So far Honda has been involved in about 20 million of those recalls. CFO Magazine also reports.

Honda expands recall over Takata airbags. The AP reports that Honda said it is expanding its recall of Takata “passenger air bag inflators from high-humidity states to the entire nation,” a move that will “add just over a million 2001 to 2005 Civics and 2003 to 2007 Accords to the recall.” Honda took the step at the insistence of the National Highway Traffic Safety Administration, says the AP.

The Detroit News reports that Honda’s announcement comes just days after it “confirmed a seventh death in one of its vehicles linked to air bags rupturing and sending deadly metal fragments flying.” In a statement commenting on the April 5 death of 22-year-old Kylan Langlinais, NHTSA Administrator Mark Rosekind said that it was “‘likely’ because of a faulty Takata inflator.” The piece quotes him as saying, “This tragedy underscores the necessity of the actions NHTSA is taking to ensure that every vehicle on America’s roads has a safe air bag.”

From the news release of the American Association for Justice.

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Insurers Seek to Link Drug Costs to Performance

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I don’t often agree with insurance companies, but this idea makes sense to me.

The Boston Globe reports that the health insurance industry is pressing to tie the cost of specialty medicines to performance, in “a bid to contain prescription drug prices.” For example, Express Scripts is “advancing a plan that would offer different reimbursement rates for drugs that treat more than one type of cancer based on how long the drugs extend lives.” The new payment criteria is expected to “emerge slowly and vary widely based on types of medications and payers, which include insurance companies and some government plans such as Medicaid.

But proponents agree they need to rein in prices of specialty drugs, which can run up to tens of thousands or hundreds of thousands of dollars a year.” The Globe says that while the pharmaceutical industry is “bracing” for payment changes, they are also “hoping to capitalize on the…pay for performance trend with a new generation of targeted therapies that can effectively treat a higher share of patients with specific genetic mutations.”

From the news release of the American Association for Justice.

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