Tuesday, July 31, 2012

Accretive Health to exit Minnesota under settlement

Accretive Health to exit Minnesota under settlement
By Zeba Siddiqui
Jul 30, 2012

Medical billing services provider Accretive Health Inc said it would wind down its Minnesota operations to settle a 6-month-old lawsuit by the state that has led to the loss of a contract for the company.

The lawsuit, brought by state Attorney General Lori Swanson in January, followed an investigation into the Chicago-based company's debt collection practices. It alleged that Accretive had violated state and federal health privacy laws through aggressive collection tactics, including having its management "imbedded" into the staff of Minnesota hospitals and managing hospital employees engaged in collections and patient registration.

Accretive must pay $2.5 million and stop all business operations in Minnesota within the next 90 days under the settlement. The money will partly be used to compensate patients, with the rest going to the state treasury.

Accretive said in a statement that it has not yet determined when it will complete the wind down process.

Following the 90-day period, "Accretive will be subject to an outright ban on operating in Minnesota for two years," the office of the Attorney General said in a statement.

The company would not be allowed to reenter the state for six years after that, unless it enters an agreement with the Attorney General Lori Swanson.

"A hospital emergency room is a place of medical trauma and emotional suffering for patients and their families. It should be a solemn place, not a place for a financial shakedown of patients," Minnesota Attorney General Swanson said...

Monday, July 30, 2012

Leon Page v. Tri-City Healthcare: Should public hospital trustees protect the interests of the public--or should they protect the institutions FROM the public?

See minute order.

Tri-City Hospital tried to get Leon Page's public interest lawsuit thrown out, but failed. Page sued after the board prohibited trustees Randy Horton and Kathleen Sterling from voting.

Like so many powerful institutions these days, the hospital abused a law that is supposed to protect free speech and constitutional rights--the anti-SLAPP law. Sadly, the law has been used to stifle complaints from the public.

Judge Timothy Casserly noted in his decision against Tri-City Healthcare on July 25, 2012:

"On October 27, 2011, Larry Anderson presented to the Board a renunciation of Horton and Director Kathleen Sterling in which he accused them of placing the interests of their constituents above those of Defendant.

"...On April 28, 2011, the Board in closed session voted to prohibit Horton from participating and voting in closed sessions meetings of the Board.

"Since then, the Board has excluded Horton from closed sessions conducted on May 26, 2011, June 16, 2011, June 30, 2011, July 28, 2011, August 15,2011, August 23, 2011, August 25, 2011, September 22, 2011, September 27, 2011, September 29, 2011, October 4, 2011, and December 20, 2011.

"Additionally, Defendant announced it would not provide Horton with legal defense or indemnity if he was sued in his official capacity. Defendant denied Horton the stipends provided to attend meetings. Defendant spends money on security personnel to prevent Horton from participating in closed session meetings of the Board. As a result of Horton's exclusion, Plaintiff and similarly situated individuals have been denied meaningful representation on the Board, and the Board's voting rights have been reallocated, disenfranchising a segment of the voting public."

The judge noted this exception to the anti-SLAPP law:

"The Legislature enacted section 425.17 to control the abuse of the anti-SLAPP statute. The statute creates an exception to section 425.16 that protects public interest lawsuits from anti-SLAPP motions.

The statute states in pertinent part:

(b) Section 425.16 does not apply to any action brought solely in the public interest or on behalf of the general public if all of the following conditions exist:

(1) The plaintiff does not seek any relief greater than or different from the relief sought for the general public or a class of which the plaintiff is a member. A claim for attorney's fees, costs, or penalties does not constitute greater or different relief for purposes of this subdivision.

(2) The action, if successful, would enforce an important right affecting the public interest, and would confer a significant benefit, whether pecuniary or nonpecuniary, on the general public or a large class of persons.

(3) Private enforcement is necessary and places a disproportionate financial burden on the plaintiff in relation to the plaintiff's stake in the matter.

Saturday, July 21, 2012

New US Hospital Ratings are out for 2012-2013

U.S. News and World Report does an excellent job, but it's hard to compare hospitals when you can only see one hospital at a time. I've started preparing comparisons of San Diego hospitals.

My first page is the urology comparisons for San Diego. Three local hospitals had better-than-expected survival, and three had worse-than-expected survival

U.S. News Best Hospitals 2012-13

U.S. News surveyed nearly 10,000 specialists and sifted through data for approximately 5,000 hospitals to rank the best in 16 adult specialties, from cancer to urology. Death rates, patient safety, and hospital reputation were a few of the factors considered. Only 148 hospitals were nationally ranked in one or more specialties. The Honor Roll features the 17 that scored near the top in at least six specialties.

Monday, July 16, 2012

Millions in health care district deals involve firms with ties to officials

Washington Hospital Healthcare System is a member of Beta Healthcare. Millions in health care district deals involve firms with ties to officials
July 13, 2012
Jennifer Gollan and Katharine Mieszkowski
California Watch

A financial review of more than 20 health care districts in California found millions of dollars in transactions involving companies and nonprofits with ties to top district officials.

...Close ties to nonprofits

Nonprofits with connections to health care district board members also have benefited.

In the Sequoia Healthcare District, which also serves the Peninsula, board member Gerald Shefren voted in April 2011 to approve a $60,000 grant to Pathways Home Health, Hospice and Private Duty, a nonprofit where his wife, Joyce, works part time.

It marked the first time the district had provided a grant to the nonprofit, according to Lee Michelson, the district’s CEO.

Last year, Shefren served on a district committee that recommended Pathways and other groups receive funding from the health care district, documents show. Shefren said he recused himself from that decision. There are no records of the meeting, nor is the district required by the state to keep them, Don Shoecraft, spokesman for the Sequoia district, said in an email.

But soon after, at a full district board meeting, Shefren voted to advance the $60,000 grant for the nonprofit where his wife works, meeting minutes show. He seconded a motion to vote on a package of grants, then joined the 4-to-1 majority in approving it.

Questioned by The Bay Citizen about his vote, Shefren said: “In talking with our CEO and legal counsel, I think that this is an oversight. This probably should have been pulled out separately, so that I could recuse myself from the Pathways grant and vote on the other ones.”

Nancy Farber, CEO of the Washington Hospital Healthcare System, attends a district board meeting in Fremont in May. The district approved payments of $350,000 to a nonprofit now run by Farber’s husband.

By contrast, Nancy Farber, CEO of the Washington Hospital Healthcare System, maintains that she followed the state’s conflict-of-interest rules. With compensation of more than $912,500 in 2010, Farber was one of the highest-paid executives within a health care district in California. As CEO of the health care system, Farber reports to the Washington Township district’s board, which oversees Washington Hospital and various outpatient clinics that serve residents primarily in southern Alameda County.

Since April 2010, Farber’s husband, Peter Farber-Szekrenyi, has played a leading role at the George Mark Children’s House, a nonprofit organization that provides care for children facing serious illnesses.

That was not his first involvement with the San Leandro nonprofit, either. He began volunteering for the organization in January 2009 before joining the nonprofit’s board of directors in May 2009.

In July 2009, the health district board voted to authorize Farber to provide a $100,000 grant to the George Mark Children’s House, documents show. The district board then voted to give the nonprofit an additional grant of $250,000 on March 10, 2010, documents show. Less than a month later, Farber-Szekrenyi became a consultant, earning $12,800 per month as executive director, while the Children’s House closed for roughly six months to reorganize its finances. In April 2011, he became the Children’s House CEO, earning $208,000 a year.

Farber did not vote on either grant because she does not sit on the district board. But she participated in a discussion about the second transaction, telling board members that the $250,000 grant would be awarded in installments based on “agreed upon milestones,” meeting minutes show.

Under state law, public officials are not permitted to participate in a decision in which they have a financial interest.

Despite repeated requests for an interview left at her office and with the district’s public relations staff, Farber declined to respond directly to questions about her role in awarding the grants. However, a written statement from the district’s spokeswoman said that two weeks after the board awarded the second grant, Farber notified board members that her husband had been asked to become the organization’s executive director.

“The matter of the $250,000 grant recently acted upon by this Board can no longer be allocated at my discretion as originally conceived,” Farber wrote in her letter to the board, dated March 24, 2010.

The district in its statement to The Bay Citizen maintains that Farber “stepped away from dealing with matters relating to George Mark Children’s House” after her husband took the job.

However, as CEO, she continued to run the system, which provides ongoing logistical help to the Children’s House, which reopened in fall 2010. The hospital has donated billing services to the small facility, which typically cares for three to four patients at a time, who stay an average of two weeks.

The Washington Hospital Healthcare Foundation provided more than $55,000 between 2009 and January of this year to support the nonprofit’s operating costs, events and fundraisers, documents show. As CEO, Farber approved at least a portion of those payments, according to the district.

Both Farber and her husband also serve on the health care foundation’s board of trustees.

In a promotional video about George Mark Children’s House posted on YouTube, Farber-Szekrenyi said his wife suggested he help the facility because it might close.

“See if you can get on the board and help them,” he said she told him.

Farber-Szekrenyi says his organization did not receive any special treatment.

“Washington Hospital’s and Nancy Farber’s initial assistance predated my role as CEO of George Mark Children’s House,” he wrote in an email to The Bay Citizen, adding that after he became CEO, “Nancy Farber declared her conflict and refrained from further participation in the grant process.”...

Democrats Mock GOP For Protecting Own Health Care In Repeal Vote

This story has a great video that features our own Duncan Hunter, Jr. and other Republicans acting as if they hadn't just voted to give themselves healthcare for life.

Democrats Mock GOP For Protecting Own Health Care In Repeal Vote

Republicans like Rep. Paul Ryan (R-Wis.) are the target of a push by Democrats to show that in voting to repeal the health care law, GOP members also voted to keep their enhanced medical care.

WASHINGTON -- Democrats are mocking Republicans in the House of Representatives for voting to repeal the health care reform law and keep their own enhanced medical care.

When Congress passed the health care law, it required members of Congress to get their insurance on exchanges with the rest of the public. But in voting to repeal that law, Republicans and a handful of Democrats were also voting to go back to the old system where the lawmakers get a sweeter deal than most of the rest of the country.

They also voted against a Democratic motion that said members of Congress who support repealing the health care law must also repeal the good stuff they get, such as lifetime care and insurance regardless of pre-existing conditions...

Friday, July 13, 2012

Poorly trained dentists are killing U.S. kids: report

Poorly trained dentists are killing U.S. kids: report
In the last 15 years, 31 children have died during or following dental treatment, according to a recent report by a joint investigation by FRONTLINE and the Center for Public Integrity.
JULY 13, 2012

Some dentists have pushed dangerous procedures for which they haven’t been properly trained on young children.

Poorly trained dentists have been killing American children by administering unnecessary, yet lucrative, sedation. In the last 15 years, 31 children have died during or following dental treatment, according to a recent report by a joint investigation by FRONTLINE and the Center for Public Integrity.

Raven Maria Blanco was 8-years-old when she died in the dentist's chair during a routine procedure. She received three times the average range of sedatives for a child of her weight and health. She had a lethal blood concentration of 24 mg/l of chloral hydrate, as revealed by an autopsy, according to the Daily Mail.

The dentist responsible, Dr. Michael Hechtkopf, only had his license restricted for three months and needed to retrain in risk management and record keeping for a mere seven hours. Dr. Hechtkopf's lawyer said that his client "regretted" what happened.

Raven's parents established the Raven Maria Blanco Foundation to warn others about ill-equipped dentists unnecessarily performing such dangerous procedures. They started a campaign to establish a registry of dental treatment deaths, in hopes to save other families from the same heartbreak.

But other families have endured such tragedy. Five-year-old Diamond Brownridge died from nitrous oxide and an intravenous sedation. 13-year-old Marissa Kingery died from four different types of oral sedatives.

When Dr. Patrick Bamgboye administered the sedatives that killed 3-year-old Juan Quiej earlier this year, he was still on probation for doing the same to 6-year-old Kyneicha Pagan. Kyneicha's mother said, "Two innocent kids die. It can't be a coincidence."

Some of these dentists have merely two days of safe sedation training, but it can increase treatment costs by tens of thousands of dollars, according to ABC. Dr. Indru Punwani, a spokesman for the American Academy of Pediatric Dentistry, said that such weekend courses are inadequate preparation for potential emergencies.

Wednesday, July 11, 2012

Fired Worker Says Kaiser Backed Drug User

See UPDATE to this story.

"...Keefer, Burnett and two union representatives told her to sign a "last chance" agreement which included "false and inaccurate information" about those allegations. She says that when she refused to sign the agreement she was fired, on July 7, 2011. Grotz says Taylor was fired the same day."

Fired Worker Says Kaiser Backed Drug User
Courthouse News (CN)

Kaiser Hospital fired a longtime employee after she complained about her drug-using boss, whom the fired worker says she saw with a rolled-up bill in her nose, "snorting a white powdery substance" at work, the worker claims in a federal lawsuit.

Kristinna Grotz sued Kaiser Foundation Hospitals, the Permanente Medical Group, and SEIU-United Healthcare Workers West, which allegedly failed to stick up for her.

Grotz claims she worked in Kaiser's admitting department from 2002 until she was fired in the summer of 2011.

She says that from early 2008 department manager (nonparty) D. T. used drugs - "in all likelihood methamphetamine" - at work, and that D. T. retaliated against her for reporting it.

Grotz claims that in early 2010 she joined six other employees and wrote a letter complaining to Kaiser about D. T.'s alleged drug use and acts of retaliation and favoritism.

Kaiser then allegedly launched an investigation headed by Taylor's superior and friend Diane Keefer and human resources manager Alan Burnett, neither of whom are parties to the lawsuit.

Grotz say that though Kaiser told her and the other employees that they would be "immune" from retaliation, that "proved to be untrue."

"Thereafter, plaintiff and others were called in one at a time and were interviewed by Ms. Keefer and Mr. Burnett. During her interview, plaintiff informed Ms. Keefer and Mr. Burnett about Ms. Taylor's ongoing substance abuse problem in detail. She informed them that she had personally observed Ms. Taylor and another employee, Terry Caballero, an employee from another Kaiser department, in Ms. Taylor's office, with rolled up bills in their noses snorting a white powdery substance. Plaintiff also said she was aware that Ms. Taylor's apparent drug use had been observed by at least two other individuals who signed the October 15, 2010 letter... Plaintiff stated that she believed that Ms. Taylor received most of her drugs from other employees within the facility," the 14-page complaint states.

Kaiser's "investigation" was bogus, Grotz says, because Keefer helped Taylor cover up her drug use and dismissed the allegations for lack of evidence, despite "contrary eyewitness testimony of Ms. Taylor's drug use from plaintiff and other staff."

Grotz claims Kaiser then turned the matter over to an employee assistance counselor. She claims that during a meeting with that counselor, "Debbie Taylor looked plaintiff right in the eye while mouthing the words, 'You f---ing bitch.' The EAP counselor quickly closed the meeting. Only one meeting took place after this aborted meeting and only the admitting staff was in attendance, but not Ms. Taylor.

In fact, none was ever scheduled again with Debbie Taylor present. To plaintiffs' knowledge, employer did nothing further to remedy the hostile working environment or address the illegal use of drugs by Taylor and others in the workplace. Instead, plaintiff and the other employees remained in constant fear of retaliation by Ms. Taylor and Ms. Keefer, which did not take long to materialize."

Beginning in late 2010, Grotz was falsely accused of timecard fraud, threatening Taylor and acting unprofessionally, the complaint says.

Finally, Grotz claims, Keefer, Burnett and two union representatives told her to sign a "last chance" agreement which included "false and inaccurate information" about to those allegations. She says that when she refused to sign the agreement she was fired, on July 7, 2011.

Grotz says Taylor was fired the same day.

Grotz seeks a jury trial and damages for unlawful discharge and breach of the union's duty of fair representation, wrongful termination, intentional infliction of emotional distress, and negligent infliction of emotional distress.

She is represented by George Camerlengo with Camerlengo & Johnson of Redwood City.

Neither Kaiser nor SEIU-United Healthcare workers immediately responded to requests for comment.

Lawsuit against San Diego Kaiser Permanente for problems related to delivery with vacuum device June 2012

UPDATE: I realized why the complaint in this case doesn't talk about malpractice by the doctor. It's becaue Kaiser would simply shift the case to secret, binding arbitration.

I love the new word "mid-evil". It seems perfect, doesn't it? Of course, the teacher in me forces me to admit that the old word "medieval" is also an excellent word, and should probably be used when one is turning in work to a boss or a teacher. But for blogging, I think "mid-evil" will do just fine.

This leaves us with the question, are the actions of Kaiser doctors and administrators too often mid-evil? The sad story below reminds me of the shocking story of Dr. Hamid Safari, who was protected by Kaiser administrators and some Kaiser doctors even after two babies died horribly. In fact, the doctor who complained about Hamid Safari was fired for not keeping his mouth shut!

I am wondering, however, why the complaint does not give more details about the actual events that led up to problems with the birth of Angelina. The deliveries by Dr. Hamid Safari have been described in painful detail, including by the Los Angeles Times. This suit does not name any negligent doctor. Who, exactly, should have warned Plaintiffs about the vacuum device? Was a C-section considered? Who decided against it? I have a sneaking suspicion that not enough education and communication went on in this case. Did the patient speak English? Perhaps the doctor was not at fault, but since Kaiser has falsified so many medical records to cover up problems, we can not know with any certainty what really happened.

See Complaint filed in San Diego Superior Court June 26, 2012.
Complaint can also be seen HERE.

Kaiser Permanente Lawsuit
07/06/2012 10:11:33
by National-Health-Insurance

Soad and Ziad Oraha are suing Kaiser Permanente, they state that Kaiser Permanente used a vacuum device to deliver their baby and caused their baby not only to have a fractured skull but also brain damage.

I am no Doctor but what happened to a C-Section? Using a vacuum device for delivery of a baby sounds down right mid-evil. I wonder if the vacuum device is another one of Kaiser Permanente's money saving devices?

Tuesday, July 10, 2012

Taking A Risk To Secure Health Insurance

Taking A Risk To Secure Health Insurance By Randy Dotinga KaiserHealthNews.org Henry J. Kaiser Family Foundation JUN 12, 2012 When it comes to medicine, I usually do as I'm told. Take a pill? Sure. Blood test? Absolutely. Surgery? If you think so, doc. But I've been acting against medical advice since January, and I'll keep on ignoring it until July. Let me explain. Last January, I cancelled my existing, very expensive individual coverage through California's state-run high risk plan and became insurance-free to gain eligibility for the federal alternative. That means that if I get a cancer diagnosis tomorrow, I'll end up with huge medical bills. I did this because I want to take advantage of the federal government's efforts to help people like me who have pre-existing conditions and no access to a group plan. Those two words -- pre-existing condition -- explain why I find myself in this circumstance. Back in 1996, when I was 27, my heart started to beat funny. The diagnosis was lone atrial fibrillation, a kind of irregular heartbeat that appeared for no apparent reason and, in my case, couldn't be fixed. Even getting "cardioverted" didn't help. A daily beta blocker keeps my heart from pumping too fast, and my risk of any complications is low. Even so, no one will insure me on the individual market. And since I'm single and self-employed as a freelance writer, I don't have access to guaranteed group coverage, except for a plan for artists and writers that would cost me at least $31,226 a year. That's why, for the last few years, I have made do with the state's high-risk insurance plan. California, where I live, is one of 35 states that offer health insurance to people with pre-existing conditions who otherwise wouldn't be able to get individual coverage. But for me, access to California's high-risk plan is expensive -- the PPO plan would cost me $748 a month this year, close to $9,000 a year -- and the coverage is thin. The annual spending limit is just $75,000, hardly enough to cover a major health crisis. And the lifetime benefit limit is a paltry $750,000. As a result of the 2010 federal health law, I now have another possibility: The federal high-risk plan would cost me just $265 a month -- $3,180 a year -- and offers unlimited annual and lifetime benefits. That sounds like a great deal cost-wise, and the lack of coverage limits is much better for me in the long run if I get diagnosed with an expensive disease. But there's a rub: I'm not eligible for the federal plan unless I go six months without any coverage at all. That's just what I decided to do. To me, the prospect of affordable and unlimited coverage -- at least from July 2012-December 2013 -- is worth the risk of going without coverage for the allotted time. "You're responding in an understandable way," said Harold Pollack, a University of Chicago professor who studies health care. "Any program that requires people to be actively uninsured creates a very paradoxical and painful set of incentives and encourages people to do what you're doing." But I'm taking a major risk by going without insurance for so long. This would be the absolute wrong time to get hit by the proverbial bus. Or, as happened a few weeks ago, hear a dermatologist ask "Have you had that looked at?" while I lounge at a hotel pool. (Don't worry. I'd previously had it looked at, and it's nothing to worry about.) My decision to go coverage-free did not go over well up in Sacramento when I mentioned it to staffers at the California Managed Risk Medical Insurance Board, which oversees the state and federal high-risk plans here. A spokeswoman told me that the agency wouldn't cooperate with me on this story if I planned to embolden other people to make the same decision. Janette Casillas, the agency's executive director, put it this way: going without insurance in order to get insurance "is not something that we would encourage." The federal government could change everything by getting rid of that six-months-without-coverage rule. But if it did, it would need to find another way to limit coverage for high-risk patients so it doesn't cost more than the budgeted amount, Pollack said. "They'd have to have some other rationing requirement that would also create problems, since it's such a small program for such a huge need," he said. "Almost every deficit of this program comes down to the fact that Congress has not appropriated enough money to meet the need that is there." Even if I do land in the federal high-risk plan as of July 1 -- if space is available -- it's not a long-term fix for me or anyone else. The good news, for me at least: In 2014, the federal health law is scheduled to take full effect, including provisions that protect consumers who have pre-existing conditions from being denied coverage. The high-risk pool coverage won't be needed anymore.

Do you want to know if you're going to live or die? Some doctors keep unique ocular melanoma test secret

"Some doctors do not offer the test, reasoning that there is little to be gained. But other doctors, including J. William Harbour of Washington University, who developed the test (but does not profit from its use), encourage patients to have it. And probably because of the way he describes it, Dr. Harbour says his patients almost always want it."

I believe that far too many doctors keep secrets from patients, including, or perhaps especially, when they believe the issue is unimportant. Perhaps they don't want to be bothered, but they shouldn't be substituting their own subjective decisions for the patient's.

A Life-Death Predictor Adds to a Cancer’s Strain
New York Times
July 9, 2012

In May 2011, Cassandra Caton, an 18-year-old with honey-colored hair and the soft features of a child, suddenly went blind in her right eye. Five months later, an ophthalmologist noticed something disturbing. A large growth in the back of her eye had ripped her retina, destroying her vision.

Cassandra Caton’s right eye was marked with a “yes” before it was surgically removed in December at Barnes-Jewish Hospital in St. Louis.

He sent her to Washington University in St. Louis, a three-hour drive from her sparsely furnished apartment in the working-class town of Sedalia, Mo.

And there, Ms. Caton, mother of a 2-year-old daughter, wife of a chicken factory worker, got almost incomprehensibly bad news. The growth was cancer, a melanoma, and it was so huge it filled her eyeball.

“Am I going to die?” Ms. Caton asked. “Is my baby going to have a mommy in five years?”

It is a question that plagues cancer patients. Doctors try to give survival odds based on a tumor’s appearance and size, but often that is just an educated guess.

But Ms. Caton had a new option, something that became possible only in this new genetic age. She could have a genetic test of her tumor that could reveal her prognosis with uncanny precision. The test identifies one of two gene patterns in eye melanomas. Almost everyone in Class 1 — roughly half of patients — is cured when the tumor is removed. As for those in Class 2, 70 to 80 percent will die within five years. Their cancers will re-emerge as growths in the liver. For them, there is no cure and no way to slow the disease.

No test has ever been so accurate in predicting cancer outcomes, researchers said.

The data from studies of the test are “unbelievably impressive,” said Dr. Michael Birrer, an ovarian cancer specialist at Massachusetts General Hospital. “I would die to have something like that in ovarian cancer.”

While for now the ocular melanoma test is in a class by itself, cancer researchers say it is a taste of what may be coming as they continue to investigate the genes of cancer cells. Similar tests, not always as definitive but nonetheless able to give prognostic information, are under development or starting to be used for other cancers, like cancers of the blood.

Having a prognosis allows people to plan their lives, but most do not want to know if they have a gene for an incurable, fatal illness, like Huntington’s disease or early onset Alzheimer’s.

The eye test raises a similar choice, with an added twist. This is not a test offered to healthy people, but to patients who have just gotten the news that they have cancer. The results will either give them reassurance that they will survive the cancer — or near certainty that they will die from it.

Can patients in the throes of getting this terrifying news really make an informed choice about whether they want the test? Are they able to understand at such a fraught time that, for now at least, there is nothing that can save them if they get the bad prognosis?

Some doctors do not offer the test, reasoning that there is little to be gained.

But other doctors, including J. William Harbour of Washington University, who developed the test (but does not profit from its use), encourage patients to have it. And probably because of the way he describes it, Dr. Harbour says his patients almost always want it.

Ms. Caton was no exception. Without the test, doctors would have had to guess her outcome based on the size of her tumor. And the conventional wisdom is that people with growths as large as hers have a slim chance of surviving. But perhaps, her doctors hoped, the genetic test would come up with a different answer.

Heralding the Future

Dr. Harbour, a genial and burly man with salt-and-pepper hair, has a way about him that relaxes patients, makes them feel everything will be O.K.

“I give them as much information as I think they can handle,” Dr. Harbour says...

Monday, July 9, 2012

Scripps and Kaiser Permanente Physicians Among First in United States to Give Irregular Heart Rhythms the Deep Freeze

If you survive Kaiser's cardiologists, and they are nice enough give you a referral to Scripps, you're likely to do very well. Of course, Kaiser doctors are discouraged by their bosses from making referrals.

Scripps and Kaiser Permanente Physicians Among First in United States to Give Irregular Heart Rhythms the Deep Freeze
July 9, 2012

Innovative cryoablation technology used to treat common atrial fibrillation Physicians from Scripps Health and Kaiser Permanente have teamed up to be the first in San Diego to use a cryoablation system to treat atrial fibrillation, a serious heart rhythm disorder that affects millions of Americans.

Unlike traditional ablation treatments that use radiofrequency, or heat, to destroy faulty electrical circuits in the heart, this newly FDA approved freezing technology allows the catheter to adhere to the tissue during ablation, allowing for greater catheter stability.

Dr. Doug Gibson, Scripps Clinic, and Dr. Brant Liu, Kaiser Permanente, recently led the effort that resulted in the first successful procedure in San Diego at Scripps Memorial Hospital La Jolla using Medtronic’s Arctic Front Cardiac CryoAblation Catheter System. Scripps is the exclusive provider of cardiac surgery, interventional cardiology and electrophysiology to the more than 515,000 Kaiser Permanente members across San Diego County.

“We have found that using cold, rather than heat, may minimize the risk of damaging healthy heart tissue and other structures surrounding the heart,” said Dr. Gibson. “The potential advantages of cryoablation are fewer complications, less radiation exposure, and less discomfort for the patient.”

About Cryoablation

During the minimally invasive procedure, a thin flexible tube with a balloon on the end, called a balloon catheter, is inserted into a vein in the groin and then threaded up to the location of the damaged heart tissue that is triggering an irregular heartbeat. The balloon is filled with liquid coolant that expands with gas and causes it to become very cold. The balloon freezes the nearby heart tissue, which neutralizes the abnormal heart muscle that causes atrial fibrillation. This procedure is an alternative to radiofrequency catheter ablation, which uses heat to burn the tissue that is causing the irregular beat.

To date, Arctic Front has been used to successfully treat more than 10,000 patients in 150 centers outside of the United States.

“Cryoablation gives patients peace of mind that their heart may be restored to an appropriate rhythm and they can resume their normal, daily activity following the treatment,” said Dr. Steven Higgins, director of electrophysiology and chairman of cardiology at Scripps Memorial Hospital La Jolla. “This technology is an extension of Scripps’ leadership in heart care and research as best exemplified by the Prebys Cardiovascular Institute currently under construction.”

The $456 million Prebys Cardiovascular Institute will be a center for innovation that will bring together top researchers, physicians and staff. The Institute will incorporate leading-edge wireless technologies and individualized medicine for the best in patient care when it opens in 2015. Annually, more than 55,000 patients receive their cardiovascular care from Scripps, making it San Diego County’s largest heart care provider. Scripps is the region’s only cardiovascular program consistently recognized by U.S. News & World Report as one of the best in the country. About Atrial Fibrillation

Atrial fibrillation is the most common and one of the most undertreated heart rhythm disorders in America. Approximately 3 million Americans are estimated to have the disease, and about 40 percent don’t exhibit symptoms and may be under-diagnosed.

Half of all diagnosed atrial fibrillation patients fail drug therapy, and if left untreated patients have up to a five times higher risk of stroke and an increased chance of developing heart failure. Additionally, since atrial fibrillation is often age-related, as the U.S. population continues to grow older, the need for more effective treatment options is escalating.

Sunday, July 8, 2012

Former Harbor-UCLA medical chief files lawsuit

Former Harbor-UCLA medical chief files lawsuit
CLAIM: Gail Anderson says officials damaged his reputation.
By Kristin S. Agostoni
Daily Breeze

The former chief medical officer at County Harbor-UCLA Medical Center alleges two county health officials damaged his reputation and exposed him to negative publicity after his abrupt exit last year from the Torrance-area hospital.

Gail Anderson, who had led Harbor-UCLA for 13 years, says in a lawsuit that he was escorted to the hospital exit "in full view of fellow physicians" and others after he was "wrongfully and without due cause" placed on administrative leave.

In the complaint filed June 6 in Los Angeles Superior Court, Anderson takes aim at Mitchell Katz, director of the county Department of Health Services, and Hal Yee, the agency's chief medical officer, alleging they leaked a news story about his departure to the Los Angeles Times and, later, the Daily Breeze, leading to coverage in other outlets.

"Local television stations picked up the story and ran spots repeating the same defamatory statements and innuendo," according to Anderson's complaint, which seeks $50 million in damages.

It alleges Katz and Yee invaded his professional and personal privacy, caused him emotional distress and destroyed his reputation in medical and other circles.

Anderson, a Manhattan Beach resident, graduated in 1976 from the USC Keck School of Medicine, according to the Medical Board of California. Before working at Harbor-UCLA, he was senior vice president of medical affairs and chief of the medical staff at Grady Health System in Atlanta,the complaint states.

The reasons for Anderson's departure from Harbor-UCLA - which surprised staff members and doctors - have not been publicly explained. Both papers had reported that Anderson was placed on leave amid an investigation. The Times, citing unnamed sources in a follow-up article, reported that authorities were probing the hospital's process of credentialing doctors and aspects of Anderson's own credential to treat patients.

His exit also came a couple weeks before a Sept. 13 inspection report found patient care problems at Harbor-UCLA that prompted the Centers for Medicare and Medicaid Services to threaten cutting off Medicare funding. Harbor-UCLA responded by instituting new policies and other changes, and CMS in March alerted the hospital that its Medicare status had been restored.

Hospital spokeswoman Julie Rees referred questions about Anderson's complaint and his status with the county to the Department of Health Services.

Michael Wilson, that department's spokesman, said Katz and Yee declined to comment on the suit. Wilson did not answer questions about Anderson, writing in an email message that "the status of personnel matters is confidential."

Richard Carroll, Anderson's Long Beach attorney, said his client has been on paid leave since last year, and has been required to remain at home during work hours.

He said he believes Anderson will soon receive word that he is terminated. He characterized a recent administrative meeting during which Anderson could respond to the actions against him as "an abomination."

Asked whether Anderson had received an explanation for his departure, Carroll said the "primary feature" offered in a notice his client received last year was insubordination. He said implications that his departure was tied to credentialing issues are "false."

Carroll said Anderson could choose to file a wrongful termination lawsuit against the county once he exhausts the administrative appeal process.

The complaint against Katz and Yee alleges defamation, libel, slander and intentional infliction of emotional distress, among other claims.

While Anderson had received a letter advising him of a pending administrative investigation at the time he was led out of the hospital, it also said his leave was not a disciplinary action, according to the complaint.

While the action constituted a "confidential personnel matter," Katz and Yee "deliberately" and "maliciously" leaked a story to the Los Angeles Times concerning his departure, along with a second story to the Breeze, the complaint says.

Anderson's attorneys argue both officials portrayed him "as a criminal actor and exposed him to scorn and strong public criticism" from the medical community, patients and the public at large.

"I'm blaming these guys basically for going to the press," Carroll said. "There's an assumption of privacy ... until the employee waves it." Anderson earned more than $420,000 in 2009, the Times reported last year.

Wednesday, July 4, 2012

Dr. Drew Pinsky responds to allegations he received GlaxoSmithKline payments

Dr. Drew Pinsky responds to allegations he received GlaxoSmithKline payments
By Michelle Castillo
July 4, 2012
(CBS News)

After being accused of taking payments from GlaxoSmithKline to promote the antidepressant Wellbutrin, Dr. Drew Pinksy told CBS News everything he said was in accordance with the law and accurate according to his medical experience.

"In the late 90s I was hired to participate in a 2-year initiative discussing intimacy and depression which was funded by an educational grant by Glaxo Wellcome," Pinksy told HealthPop in a statement. "Services for the non-branded campaign included town hall meetings, writings and multimedia activities in conjunction with the patient advocacy group the National Depresive and Manic Depressive Association (NDMDA). My comments were consistent with my clinical experience."

Pinsky - a board-certified internist, addiction medicine specialist, and radio and television personality - was mentioned in a complaint filed by the U.S. government against the pharmaceutical company, according to the Forbes.

The document states that Pinksy allegedly received two payments in March 2009 and April 2009 from GlaxoSmithKline totaling $275,000 to promote Wellbutrin SR. The Wall Street Journal reported in June 1999, he made statements on "Loveline," a television and radio show he co-hosted, saying that he prescribed Wellbutrin to depressed patients because it "may enhance or at least not suppress sexual arousal" as much as other antidepressants are known to do. Pinsky was also reported to have made comments on other media, including another national radio program called "David Essel - Alive!," Forbes added. In both instances, he did not disclose that he was paid by the company to do so, and he promote uses of Wellbutrin that had not been approved by the Food and Drug Administration.

GlaxoSmithKline recently plead guilty and had to pay $3 billion in the largest settlement of health care fraud in U.S. history, HealthPop reported. The company was charged with unlawful promotion of certain prescription drugs.

California doctors sue Aetna for coverage denials

Is it possible that both the doctors and the insurance companies are ripping off patients? Doctors are apparently getting kickbacks for referring patients.

California doctors sue Aetna for coverage denials
Jul 3, 2012
By Toni Clarke

Thousands of doctors in California are suing the health insurance company Aetna Inc claiming the company routinely denies patients access to out-of-network doctors even when the patient has purchased a policy giving them the right to choose providers.

The lawsuit, filed in the Los Angeles County Superior Court, accuses Aetna of threatening patients with denial of coverage if their members visit doctors outside the Aetna network of providers, and of threatening doctors with having their Aetna contracts terminated if they refer patients outside the network.

The lawsuit was brought by the Los Angeles County Medical Association, California Medical Association and a coalition of health care organizations and providers.

Aetna claims the suit is in retaliation for a suit filed by Aetna in February claiming several California providers, including Bay Area Surgical Management (BASM)and seven ancillary facilities, sent Aetna members to BASM without revealing that physicians had an ownership interest in the facility or were getting paid by BASM for their referrals.

"We have sued some of these same doctors and surgery centers named in the suit for their egregious billing practices in February of this year," Cynthia Michener, a spokeswoman for Aetna, said in an email. "This is a countersuit disguised as a class action lawsuit."

Michener said Aetna would "continue to pursue medical providers whose charges are so grossly out of line."

She cited as examples facilities and doctors who have charged $73,536 for a kidney stone fragmentation when an average in-network charge would be around $7,612. Or those that have charged $37,572 for a knee procedure that would cost about $10,500 with an in-network physician.

Michener was not immediately able to say what the average cost of these procedures would have been in out-of-network facilities that are not being sued by Aetna.

The lawsuit brought by the physicians accuses Aetna of false advertising, breach of contract, unfair business practices, and both intentional and negligent interference with healthcare providers.

The lawsuit seeks an end to the practices, an immediate injunction, compensation for patients and physicians and punitive damages.

"Despite making tens of millions of dollars selling policies with out-of-network benefits, Aetna has engaged in a campaign to retaliate against its members who attempt to use their out-of-network benefits, and the physicians who refer these members to out-of-network providers," the lawsuit states.

Monday, July 2, 2012

GlaxoSmithKline Drug giant pleads guilty, fined $3B for drug marketing

Drug giant pleads guilty, fined $3B for drug marketing
By Staff and wire reports
USA Today July 2, 2012

Prescription drug giant GlaxoSmithKline will plead guilty and pay $3 billion to resolve federal criminal and civil inquiries arising from the company's illegal promotion of some of its products, its failure to report safety data and alleged false price reporting as part of the largest health care fraud settlement in U.S. history, the Justice Department announced Monday.

The company agreed to plead guilty to three criminal counts, including two counts of introducing misbranded drugs — Paxil and Wellbutrin — and one count of failing to report safety data about the drug Avandia to the Food and Drug Administration.

Under the terms of the plea agreement, GSK(GSK) will pay a total of $1 billion, including a criminal fine of $956,814,400. The company also will pay $2 billion to resolve civil claims under the federal government's False Claims Act.

"Today's multibillion-dollar settlement is unprecedented in both size and scope,'' Deputy Attorney General James Cole said. "At every level, we are determined to stop practices that jeopardize patients' health, harm taxpayers, and violate the public trust - and this historic action is a clear warning to any company that chooses to break the law."

Prosecutors say GSK encouraged use of Paxil for children although it was not approved for anyone under 18. The company also promoted Wellbutrin for uses besides major depressive disorder, its only approved use. They say that between 2001 and 2007 GSK failed to report on two studies of the cardiovascular safety of Avandia, a diabetes drug.

Glaxo is pleading guilty to these violations of FDA regulations, which are misdemeanors. It has set aside $3.5 billion to cover the cost of the fines and other penalties related to the government's seven-year probe of the company's marketing practices for Paxil, Wellbutrin and Avandia, three of its blockbuster drugs.

The company earlier set aisde $3 billion for legal costs tied to health problems that people taking Avandia and the other medicines are at risk of suffering.

Glaxo has already paid more than $700 million to resolve patient lawsuits, alleging Avandia caused heart attacks and strokes. Many of the Avandia cases have been consolidated before a federal judge in Philadelphia.