Monday, July 11, 2016

Will Kaiser Foundation Health Plan lawsuit against its own investigator reveal more than Kaiser would like?

I'm guessing Quinn told Kaiser what they wanted to hear so they didn't ask questions. I wonder how many Kaiser members were denied health care on the basis of this man's information? How much money did he save Kaiser? I imagine that what Quinn charged Kaiser was a small fraction of the large amount of money he helped Kaiser avoid paying. Will Kaiser reopen those cases and give back to members all such amounts?

Kaiser Foundation Health Plan is not a subsidiary. It's the heart and soul of Kaiser Permanente. It makes about 8 billion tax-free dollars a year. Denying care is a major part of its business plan.
OAKLAND, Calif. (AP) — A subsidiary of health care giant Kaiser Permanente has filed a lawsuit in California accusing an employee responsible for investigating insurance fraud claims of embezzling $7 million, a newspaper reported.

The suit by Kaiser Foundation Health Plan accuses Michael Albert Quinn of submitting invoices for investigative services that were not performed or were not justified over a 16-year span after he joined the company in 1998, the San Francisco Chronicle reported (http://bit.ly/29K2QoA) on Sunday.

Quinn, 45, was responsible for hiring investigators to conduct surveillance on people who were suspected of filing fraudulent claims, He was authorized to approve charges up to $50,000.
The newspaper said Quinn was fired in 2014. Kaiser filed the lawsuit last year...

See more HERE.

Tuesday, September 15, 2015

No lateral moves allowed between health systems: an illegal conspiracy in North Carolina--or the future of medicine that UCSD is aggressively seeking in California?

Is this the future in California if UCSD wins its poaching lawsuit against Dr. Paul Aisen regarding Aisen's decision to transfer his Alzheimer's study to USC? Is it unlawful restraint of trade? Science magazine reports on what happens when health systems collude to stop their employees from moving to other institutions.
“[L]ateral moves of faculty between Duke and UNC are not permitted.”
–UNC's chief of cardiothoracic imaging

An academic 'poaching' lawsuit from a scientist who didn’t move
By Beryl Lieff Benderly
Science
September 10, 2015

In August, we reported on the lawsuit brought by the University of California, San Diego (UCSD), against the University of Southern California (USC) in Los Angeles, in an effort to stop USC’s alleged attempt to bring a multimillion-dollar Alzheimer’s disease research project along with its new recruit, neuroscientist Paul Aisen, from UCSD to USC. We noted that though some observers view universities’ efforts to bring major researchers to their campuses from elsewhere as effective recruiting, others see it as harmful poaching.

In North Carolina, meanwhile, another scientist’s effort to move from Duke University in Durham to the University of North Carolina (UNC), Chapel Hill, has also resulted in a lawsuit, but for an entirely different reason. Danielle Seaman, an assistant professor of radiology at Duke, claims that “an illegal conspiracy” among Duke, UNC, and the two universities’ health systems not to raid each other’s talent barred her from consideration for an advertised opening at UNC, according to the complaint filed with the court.

Allegedly, the institutions’ goal was to “suppress the compensation of their employees,” according to the complaint. “Without the knowledge or consent of their employees, [Duke’s] senior administrators and deans entered into express agreements [with UNC] to eliminate or reduce competition … for skilled medical labor” by not “hir[ing] or attempt[ing] to hire” from each other. This deal, the complaint argues, constitutes an unlawful restraint of trade...

Read more here.

Wednesday, March 25, 2015

Director of Oregon health care group arrested for sexual assault of dog

Director of Oregon health care group arrested for sexual assault of dog


John Williams Ryan
Yamhillmugshots.com

The executive director of a Bend, Oregon health care organization was arrested on Monday on suspicion of sexual abuse in the first degree, sodomy in the first degree, and sexual assault of a dog.
The Bend Bulletin reported today that John Williams Ryan, 47, was arrested after police investigated a co-defendant, Casie Lynn Nelson, 29, who was arrested on Tuesday. According to investigators, the catalyst behind the arrests was the couple's (still unspecified) illegal computer activity.
Oregon State is particularly strong in its animal welfare laws. According to the Animal Legal Defense Fund, Oregon ranked #2 for cracking down on animal abuse in 2013.
In 2014, Oregon's Supreme Court ruled that nonhuman animals can be victims - just like humans can. The landmark ruling, which afforded animals the same basic protection as humans, should enable authorities to help animals in need without obtaining a warrant.
Under Oregon State Law 167.333, sexual assault of an animal is a Class A misdemeanor.
Ryan was placed on leave from his position after his arrest by McMinnville Police detectives. RyanThe organization that Ryan directed, which is comprised of 600 providers and physicians, is currently being helmed by interim executive director Stephen Mann, who stated simply:
Effective Monday, February 23rd, COIPA Executive Director, John Ryan, was placed on administrative leave due to events unrelated to Central Oregon IPA."
According to the Yamhill County jail, Ryan was being held in lieu of $517,000 bail yesterday. Nelson is also in Yamhill County jail, in lieu of $142,500 bail.
McMinnville Police Capt. Dennis Marks stated that the Oregon Department of Justice, McMinnville Police Department, and Bend Police Department are all investigating this case. Updates to this story will be posted as they occur.
...You can also follow along on Facebook and Twitter!

Friday, February 20, 2015

Kaiser forces delay for heart attack patients when every minute counts

Delays in Important Treatment?

Paramedics are supposed to take heart attack patients to the closest, medically appropriate, hospital. But, NBC7 Investigates found this is not always happening.


If you're having a heart attack, cardiologists say getting to the right hospital within 90 minutes is key for survival.
“If you are able to open that artery within 90 minutes, the chances of that patient having a good outcome is excellent,” interventional cardiologist Dr. Vimal Nanavati said.
If you're having the most serious kind of heart attack, called an ST elevation myocardial infarction (STEMI), where your heart artery is completely blocked, getting to a STEMI receiving center is critical.
“Every minute counts,” said Nanavati.
Thirteen San Diego County hospitals have STEMI receiving centers with catheterization labs that can unclog the blocked arteries in a patient's heart.
Robert Quittner has been a paramedic for over 10 years with San Diego Rural/Metro. He said a contractual agreement between two local hospitals is making him question the profession he loves.
"We became paramedics to take care of people," he said. "We're delaying their care. We're causing more damage to the heart."
Quittner is referring to a 30-year cardiovascular partnership between Kaiser Hospital in Grantville and Scripps Memorial Hospital La Jolla.
Kaiser Hospital does not have a STEMI receiving center, so its STEMI patients are transported to Scripps Memorial Hospital La Jolla for treatment.
Seven of the county's 13 STEMI receiving centers are closer to Kaiser Hospital than Scripps La Jolla, including Scripps Mercy, Alvarado, Sharp Memorial and UCSD Medical Center. Naval Medical Center is also included in the 13 facilities and has a STEMI receiving center...

Source: http://www.nbcsandiego.com/news/local/Delays-in-Important-Treatment-292806231.html#ixzz3SLf9id4R
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Wednesday, January 21, 2015

Kaiser Cost a Man His Penis, He Claims


     NAPA, Calif. (CN) - An elderly patient's penis eroded because Kaiser would not let care providers remove his catheter, he claims in Napa County Superior Court.
     Rupert Collins sued Kaiser Foundation Health Plan, Inc. for elder abuse, negligence and unfair business practices.
     In his lawsuit, Collins says he was a patient at nonparty Napa Valley Care Center when he developed problems with his catheterized penis.
     On July 21, 2013, a nurse sent a fax to Collins' insurer, Kaiser, according to the complaint.
     "The fax stated that Rupert's penis was red and swollen with what was described as a cut. Rupert had a Foley catheter inserted into his penis. Monica's fax said: 'May we have a trial of no Foley to give the area a rest.' Despite this request, Kaiser denied the request to remove the Foley. Despite the fact that Kaiser was notified that Rupert's penis was red and swollen and cut, there is no documentation to show that any physician from Kaiser ever bothered to personally examine Rupert's penis," the complaint states.
     "As a direct result of this reckless neglect by Kaiser, the Foley was left in Rupert's red and swollen and cut penis, and his penis began to erode further and further each day," it continues.
     Two days later, there was a care conference about Rupert Collins' care, but no Kaiser representative showed up, according to the complaint.
     "As a direct result of Kaiser's failure to participate, there was no meaningful communication or ongoing assessment and the dire need to remove the catheter from Rupert's eroding penis continued to be ignored," the complaint states.
     On July 30, another nurse sent another fax to Kaiser requesting permission to remove the catheter, but the request was again denied, according to the complaint.
     The next day, Collins' daughter had a look, according to the complaint.
     "When Diana examined Rupert's penis, she was horrified at what she saw. Rupert's penis was split completely in half from the tip of his penis all the way down to the scrotum sac," the complaint states.
     Collins' daughter had a third nurse contact Kaiser, but Kaiser told the nurse, "The penis erosion is normal and will heal on its own," the complaint states.
     Collins' daughter pressed the issue and got him seen by a Kaiser urologist on Aug. 2. The doctor "stated that if Rupert had been treated earlier, the penis could have been saved but that the penile erosion was now complete, Rupert's penis would never heal and that reconstructive surgery was not a viable option," the complaint states.
     "Rupert's penis and urethra is permanently eroded away and Rupert has suffered permanent genital mutilation," it continues.
     Collins blames Kaiser's business practices for his injuries.
     "The conduct of defendants is part of a general business practice at Kaiser conceived and implemented by Kaiser and Does 1-10, inclusive. This practice exists in part because defendants unreasonably expect few adverse consequences will flow from their mistreatment of their elderly, demented, disabled and vulnerable clientele, and said defendants made a considered decision to promote profit at the expense of their moral, legal and ethical obligations to their resident-patients," the complaint states.
     Rupert Collins seeks general and special damages, treble damages, attorneys' fees and costs, restitution of all funds paid to Kaiser on his behalf and injunctive relief. He is represented by Rebecca J. Freeman of Freeman & Freeman in Santa Rosa. 

Thursday, January 8, 2015

Friday, December 19, 2014

Should you always trust an Ivy-Leage doctor? Will they sometimes lie to you for financial gain?

There's more than one way for doctors to make profits by concealing facts from patients.   Not all the products they promote are sold through the media, as seen in the story of Dr. William Taylor at UCSD.

Real-world doctors fact-check Dr. Oz, and the results aren't pretty
Only one-third of claims made on 'The Dr. Oz Show' can be backed by medical evidence, study says
11% of the recommendations made by Dr. Oz or his guests contradict medical facts, researchers say
Viewers of 'The Dr. Oz Show' should be skeptical about advice given on the program, experts conclude
What do real-world doctors have to say about the advice dispensed on “The Dr. Oz Show”? Less than one-third of it can be backed up by even modest medical evidence.
If that sounds alarming, consider this: Nearly 4 in 10 of the assertions made on the hit show appear to be made on the basis of no evidence at all.
The researchers who took it upon themselves to fact-check Dr. Oz and his on-air guests were able to find legitimate studies related to another 11% of the recommendations made on the show. However, in these cases, the recommendations ran counter to the medical literature.



“Consumers should be skeptical about any recommendations provided on television medical talk shows,” the researchers wrote in a study published this week in BMJ. “Viewers need to realize that the recommendations may not be supported by higher evidence or presented with enough balanced information to adequately inform decision making.”



Critics of Dr. Mehmet Oz, an accomplished cardiac surgeon with degrees from two Ivy League universities, complain that his show is little more than an hour-long infomercial for weight-loss fads like green coffee bean extract. (The Federal Trade Commission has sued the company that hawks this dubious product.) A spokesman for the Center for Inquiry accused him of selling “snake oil.” In June, a Senate subcommittee took him to task for telling his viewers (who number 2.9 million on any given day) things like: “I’ve got the No. 1 miracle in a bottle to burn your fat. It’s raspberry ketones.”

“I don’t get why you need to say this stuff because you know it’s not true," Sen. Claire McCaskill (D-Mo.) said during the hearing...