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A New DOJ Report

[By Staff Reporters]

According to the Deportment of Justice [DOJ], $9.3 billion was recovered from health care providers accused of defrauding the states and federal government the past decade.

The Study

The department ramped up efforts in the 1990s to combat healthcare fraud by using private citizens with insider knowledge of wrongdoing. They now initiate more than 90 percent of the department’s lawsuits focusing on fraud in health care, and receive between15 percent and 25 percent of the amounts recovered.

The Results

According to an Associated Press report on September 2, of the $9.3 billion recovered between 1996 and 2005, whistle blowers got more than $1 billion. And, while the number of claims dropped in recent years, recovery amounts have soared – jumping from about $10 million a case in 2002 to $50 million by 2005.

Assessment

The reason for this up-tick was the late addition of pharmaceutical manufacturers to the list of defendants.

Conclusion

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54 Responses

  1. Breaking news for dentists who accept Medicaid

    About an hour ago, David Burda posted “Attorney tells audience to brace for a storm of whistle-blower lawsuits” on ModernHealthcare.com.

    http://www.modernhealthcare.com/article/20100623/NEWS/306209989/-1

    Burda reports that healthcare attorney Joanne Judge who is a partner with Stevens & Lee in Reading, Pa. predicts a significant increase in new whistle-blower lawsuits simply because the new law makes it incredibly easy for an unfulfilled employee to file such a lawsuit. No longer is there a requirement for the plaintiff, who stands to win money from the effort, to have directly witnessed the crime.

    What a terrific idea!

    It gets worse as Burda reports: “The new law also converts accidental Medicare overpayments to providers into potential false claims, Judge said. She said the law considers an overpayment as fraud if the overpayment isn’t identified by the provider and returned to the government within 60 days. Judge said that will require providers to beef up their internal billing systems to detect an overpayment as soon as possible and then send Medicare back its money.”

    Do you accept Medicaid now? What about next week?

    D. Kellus Pruitt DDS

    Like

  2. Federal Agency Failed to Report Disciplined Providers to National Database

    The federal agency that administers Medicare and Medicaid contributed to gaps in a national database of disciplined health care providers when it failed to report disciplinary actions as required by law, a new investigation found.

    http://www.propublica.org/blog/item/federal-agency-failed-to-report-disciplined-providers-to-national-database

    Debra

    Like

  3. I hate to say it, but I bet the providers were cost-effective.

    Darrell

    Like

  4. VPMA Sues to Recover Embezzled Funds

    Sometimes the people hired to prevent malfeasance are the very ones up to no good. That seems to be what happened to a local association of physicians.

    The insurer for the Virginia Podiatric Medical Association is trying to recover more than $100,000 the trade group lost as the victim of a two-year embezzlement scheme, according to a lawsuit filed in Richmond Circuit Court on Oct. 13. The scheme, according to the suit, was perpetrated by a former employee of the Keeney Corporation, a Richmond-based association management and lobbying firm that at the time handled VPMA’s financials.

    According to the suit, VPMA hired the Keeney Corp. in July 2007 to provide executive and financial management. That included the collection of membership dues, maintenance of bank accounts, and producing financial reports. But while the money was coming in, a Keeney Corp. employee was lining her own pockets. “From August 2007 through June 2009, Chris Stitler, an employee of the Keeney Corporation, conducted a scheme to defraud the VPMA of its funds,” the suit asserts.

    Source: Michael Schwartz, Richmond BizSense [10/25/10]

    Like

  5. Technically, the Keeney Corp is being sued by Travelers Insurance and Casualty. That suit is not on VPMA’s behalf, however. The association currently has no relationship with Travelers.

    Source: Jean Kirk via Podiatry Management
    Virginia Podiatric Medical Association

    Like

  6. Fun with accountability using Search Engine Optimization

    In the certified letter I received from the Chair of the TDA Council on Ethics and Judicial Affairs informing me that I was on probation (that lasted an hour or so), in addition to accusing me of calling others names which Roy failed to back up with evidence, one of the many unverified complaints against me was: “…attempting to cause the name of TDA members and staff to be recognized by Internet search programs for no apparent purpose other than harassment.”

    We’ve all seen lame evasion before, sports fans: When caught red-handed, irresponsible bureaucrats and politicians often attempt to dodge personal accountability by claiming unfair “harassment.” Roy, Mary Kay and Matt – each one a “properly vetted” TDA leader – are no different than the worst in our current US political system. It’s been proven again and again: Without transparency, rot happens.

    But since the three have been behaving themselves lately, I’ve avoided posting their last names in an effort to encourage them to continue preserving the dignity and honor of my profession without continuing to make a mockery of the TDA’s teetering judicial system. As long as these three leaders in dentistry stay in their humble places, dental patients in Texas will be much better represented before lawmakers – and that’s what the TDA is all about, isn’t it? That means no more threatening suggestions to members that the TDA has illegal influence over the decisions of the Texas State Board of Dental Examiners. Extortion as unwritten TDA policy just has to stop right now.

    In another bureaucratic arena, Dr. Carter Brown, the ADA’s communications expert who refuses to open the ADA Facebook, ignored this former ADA member for months. I simply could not get the social network guru to reply to my messages. How good is that?

    As dentists, it is our Hippocratic obligation to put a halt to our leaders’ rudeness. So let’s have some Tuesday morning fun with Dr. Brown – and why not tinker with Dr. Joshua Austin’s reputation as well? He’s the TDA Delegate from San Antonio who told me (without me learning of it until months later), “@proots She kicked you off facebook grp because you are a nut and a creeper.” And to think I was kicked out of the TDA for calling others names that Roy cannot even share with me. Mine weren’t nearly as clever as the TAGD New Dentist of the Year’s.

    Slow-thinking, anonymous ADA committee chairmen simply don’t understand that transparency is not just another malleable buzzword. Vetted ADA officials who over-step their authority these days unwittingly become easy targets for demands of accountability. Even to this day, a few will still try to deflect the blame for their bad decisions by reflexively labeling a dues-paying member unethical. Silly, silly bureaucrats.

    D. Kellus Pruitt DDS

    Like

  7. NY Podiatrist Avoids Prison Because of Family Circumstances

    A former podiatrist who admitted to defrauding the healthcare system will not go to prison. Michael Akyuz of Greece, NY was sentenced to five years probation for stealing almost three-quarters of a million dollars. U.S District Court Judge Charles Syragusa called it a unique, exceptional family circumstance that led him to impose a lesser sentence today. The recommended sentence for his crimes was 41 to 51 months in prison, but 44-year-old Akyuz will not have to spend a day behind bars.

    Akyuz admitted to healthcare fraud and mail fraud while he was a podiatrist. Over the course of five years, the former foot doctor tended to elderly patients in nursing homes and retirement communities. While he billed Medicare for complex expensive procedures, in reality, he did little more than clip their toenails. Akyuz said he took the money to take care of his family’s healthcare costs. He has four children with varying degrees of autism.

    Source: Brett Davidsen | WHEC.com [11/3/10]

    Like

  8. TX Podiatrist Accused of Tax Evasion Tries to Cancel His Own Hearing

    A federal judge has issued an arrest warrant for an area podiatrist after he failed to show up for a hearing Thursday on charges of cheating on his taxes.

    Donald E. Robinson, 66, faxed papers to the federal courthouse in San Antonio stating that his hearing had been “canceled,” and that he had issued a $300 million warrant naming himself as the surety, though he has no authority, Chief U.S. District Judge Fred Biery said at the hearing.

    A federal grand jury indicted Robinson in August on four counts of subscribing to a false income tax return or statement. The indictment said he signed off on tax returns that significantly underreported his income for 2003, 2004, 2005 and 2006. It also alleges he denied having any interest in or signatory authority over financial accounts in foreign countries when he actually did.

    Source: Guillermo Contreras
    Express-News [11/4/10]

    Like

  9. Cutting healthcare waste in dentistry!

    Do our patients want a toothbrush or a coupon for a Spinbrush?

    Today, I found a use for my manual toothbrush that has sat on my sink unused for a year or so. I used it to clean the toothpaste gunk off the handle of my mechanical one.

    Even though we recommend electric toothbrushes for our patients these days, we still give away simple toothbrushes with cleanings. That’s a waste of healthcare dollars. I say it would be better to give the patients a choice between a toothbrush and a discount coupon for an electric one.

    Are you listening, Arm and Hammer? I like your Spinbrush. Can we make a deal?

    D. Kellus Pruitt DDS

    Like

  10. ME Podiatrist Jailed on Drug and Bail Violation Charges

    A Maine podiatrist is being held after federal agents raided his Portland office and seized records in connection with a drug investigation. Dr. John Perry, 59, was charged with possessing cocaine. Agents found a gram of the drug on Perry at the time of his arrest, police said. His car and house were also searched by drug agents.

    Perry was also charged with violating conditions of his bail from a prior charge of operating under the influence. Perry is being held at the Cumberland County Jail.

    Source: WMTW.com [11/17/10]

    Like

  11. ME Podiatrist Pleads Not Guilty to Cocaine Possession Charge

    A podiatrist from Cumberland pleaded not guilty today to a cocaine possession charge, and is expected to be bailed out of jail on $1,000 cash. John Perry, 49, who runs Atlantic Foot & Ankle Center in Portland, was arrested Wednesday. He is the target of an ongoing federal investigation by the U.S. Drug Enforcement Administration.

    Perry was arrested Wednesday morning after a traffic stop in Cumberland. Police say they found a gram of cocaine in the vehicle. Perry has no criminal history except for a drunk driving charge in April, according to state records.

    Source: Trevor Maxwell, Kennebec Journal [11/19/10]

    Like

  12. Medicare Fraud Results in Home Confinement and Probation for SD Podiatrist

    A former Aberdeen podiatrist must spend six months on home confinement and five years on probation because he submitted fraudulent claims to Medicare. Todd Monroe, 46, was sentenced Monday in federal court. Monroe previously pleaded guilty to a federal charge of filing fraudulent paperwork to receive payments from a healthcare benefit program. In addition to home confinement and probation, Monroe must pay a $5,000 fine. He has already paid a required $100 special assessment and $13,427 in restitution.

    Monroe used an improper Medicare code so he could be repaid for clipping the toenails of older patients, a service for which Medicare does not reimburse podiatrists. In court, he apologized for submitting the phony claims. Rich Russman, Monroe’s attorney, said a computer program likely flagged Monroe as a fraud suspect when it determined he was submitting a high number of claims for a rare procedure.

    Source: Scott Waltman, Aberdeen News [12/7/10]

    Like

  13. Judge Orders AZ Podiatrist to go Through Competency Program

    Judge Howard Fell ordered Corina Hollander to participate in the jail’s restoration-to-competency program Monday after learning one of two doctors who evaluated her think she’s incompetent to stand trial. The Tucson podiatrist was charged with prescription fraud charges ranging from conspiracy and participating in a criminal syndicate to fraud, trafficking in the identity of another person, forgery, and acquisition of a narcotic drug by fraud.

    At the time of her indictment, Assistant Attorney General Christina Vejar said Hollander progressed from writing fraudulent prescriptions for a painkiller and anti-anxiety drug for co-workers and roommates to writing fraudulent prescriptions in patients’ and family members’ names.

    Source: Arizona Daily Star [12/13/10]

    Like

  14. What do I want for Christmas? Peace, brotherhood, common-sense from the Texas Dental Association and a $200 refund.

    Six months ago, TDA President Dr. Ronald Rhea spent thousands dollars in postage on 7,000 letters to TDA members to downplay the significance of a $900,000 judgment brought against the Austin, Texas not-for-profit business by the National Labor Review Board. Judge Carson determined that the TDA unjustly fired two employees for petty, vindictive reasons. In Dr. Rhea’s unrepentant letter following the verdict (which I had to type out), he seemed to justify the cost as the customary, unavoidable price of doing business in Texas. (See “NLRB’s $900,000 verdict and TDA’s official response” July 7, 2010)

    https://medicalexecutivepost.com/2010/05/11/become-a-whistle-blower-in-the-healthcare-industrial-complex/#comment-8380

    Not in my neighborhood it isn’t.

    Aside from the fact that such behavior is unlawful even if the TDA can afford the million dollars as suggested by Dr. Rhea, it’s simply unethical for any business entity to intentionally harm any individual – including employees as well as customers.

    By now, even the most traditionally quiet TDA Board members must agree – even if secretly – that the NLRB verdict makes it irresponsible to continue to allow TDA leaders to evade accountability to those who pay for judgments against the organization. The TDA’s current team will already be remembered as having squandered decades of trust in the professional organization on protecting a handful of leaders who to this day, still cannot accept criticism from customers. Elsewhere in this wonderful country, customers are always right.

    Rigid adherence to professional stoicism, along with an attitude reflected by the 2007 ADA/IDM slogan of “Image is everything,” has never been in the best interest of anyone’s dental patients. Decades ago, calculated silence and committee-approved talking points stopped being dignified and honorable outside the ADA and a few other repressive regimes. I know it’s asking a lot, Santa. But it would be wonderful to see a positive sign of change before the end of the year. Quite frankly, the TDA’s efforts to avoid modern Internet communications look silly and are becoming increasingly predictable.

    For example, I predict that by Tuesday morning, I will receive 2 identical letters from Dr. Roy Burk, the Chair of the TDA Council on Ethics and Judicial Affairs. One copy will be a certified letter which when it left Austin, Dr. Burk already knew that my office manager will refuse to sign for it – sending it right back to Austin. As for the other which will arrive by regular mail, I’ll open, read, re-type and share it right here – probably before noon if it’s a short letter. And just to make the slow moving, expensive documents appear even more official than implied by certified mail and genuine TDA stationery, both will sport Dr. Roy N. Burk’s rubber stamped signature. And to think that among other crimes, Dr. Burk accused me of making his Council a mockery of justice. Guess you got to blame someone.

    I expect Dr. Burk to officially inform me that it is his duty to the profession to declare me “unethical” for not cooperating with his Council’s investigation of my written words – evidence which he has access to and I don’t. Both letters will confirm that last week my membership was suspended “indefinitely” starting October 27, 2010.

    I base my predictions on (1) a similar matching set of letters dated Nov 15 in which Dr. Burk informed me: “You have a right to appeal to the Board of Directors of the Texas Dental Association and have an in-person hearing in Austin, Texas. Both the Association and you may procure the services of legal counsel. In order to exercise this right of appeal, you must give written notice by certified, return receipt requested mail to the Texas Dental Association… This notice of your request to appeal to the Board of Directors must be received by TDA within thirty (30) days from the date of this letter,” and (2) Dr. Burk’s proven determination to stick to a rigid timeline as defined in untested laws found in a dusty section of an obsolete TDA manual.

    I wonder how much money legal interpretations of never-used pages in that Board-approved manual have cost TDA members so far – just to shame one customer. Want to know what this struggle to clear my name has cost me in attorney’s fees? Zero. God bless America.

    For being such a determined promoter of paperless dental practices, the TDA certainly supports using certified mail and paper receipts that can be filed in a shoe box. And this is the second time Dr. Burk has spontaneously mentioned “attorneys” to me. Not once have I suggested that it will take more than simple conversation to clear up our misunderstanding…. plus the refund that is already owed me for unfair denial of advertised benefits I purchased in good faith. That’s all.

    Who fears whom?

    D. Kellus Pruitt DDS

    Like

  15. The BBB and the FOIA bring transparency to organized dentistry in Texas

    About the time I confidently shared that I have the quirky habits of the TDA figured out, the Council on Ethics Chairman Dr. Roy Burk unexpectedly changed his routine – leaving me with egg on my face. Compared to other kinds of yucky stuff found in nature, egg isn’t so bad.

    A week ago, when I made foolhardy predictions concerning the progress of Dr. Burk’s TDA Case No. 12- 2010-3 against me, I was certain that he had already mailed me the final set of identical letters – one certified and the other regular 1st class mail – concerning the passage of the December 15 deadline to appeal my suspension from membership. Having picked up the TDA’s resolute and unstoppable committee-approved cadence from his first four certified letters, I was also expecting to be informed of the final level of disgrace I’m to suffer for refusing to cooperate with an untrustworthy judicial system – irrevocable, indefinite suspension from the TDA (for undisclosed reasons).

    According to Dr. Burk’s November 15 matching letters, had I followed his precise instructions and responded in time via certified letter of my own notifying the Council that I intended to appeal the suspension, he would have arranged a special, in-person hearing in front of the TDA Board of Directors in Austin – who have probably already read the evidence that I have yet to see.

    He also made it a point to mention that both the TDA and I are permitted to have legal representation present at the Austin hearing. I suppose if I had the intention of meeting with the TDA Board, and decided to hire an attorney to help defend my reputation on a state level, we would have both spent a good deal of the time in front of the Board members reading the evidence of my alleged unprofessional conduct, which allegedly consists of complaints about my long-forgotten written words from as long as 3 years ago.

    I no longer think Dr. Burk’s letters are delayed by the Christmas holiday mail rush. I think my boastful prediction was in fact wrong. I now wonder if Dr. Roy Burk, Dr. Matthew Roberts, TDA Executive Director Mary Kay Linn or any other official from the TDA will ever respond to me again. It’s a break, I guess. But not a clean one for any of us.

    For TDA officials, employees and members, there are two snags which appeared just today. The first concerns my November 5 complaint I filed against the TDA with the Austin Better Business Bureau over $200 of prorated dues that is owed me. I received the following email this afternoon, notifying me that BBB Case No. 90189714 against the TDA is closed as of today, and defined as “UNRESOLVED.” The TDA’s failure to cooperate with the BBB will leave an ugly scar visible to the Austin business community – all because of a silly $200 refund. Yet Dr. Burk accuses me of not upholding the dignity and honor of the profession by refusing to help with his Council’s investigation of my written words that he has access to, but I don’t.

    From: Better Business Bureau

    Sent: Monday, December 27, 2010 3:05 PM

    To: Dr Darrell Pruitt

    Subject: BBB Complaint

    Complaint ID#: 90189714

    Business Name: Texas Dental Association

    We have received your most recent correspondence in the above-mentioned complaint case indicating that you do not feel this matter is resolved.

    At this time, the business has not made any further additions or altered their response.

    Unfortunately, the BBB cannot pursue the matter further. This complaint case is now considered closed UNRESOLVED.

    The Better Business Bureau develops and maintains Reliability Reports on companies in our service area. This information is available to the public and is frequently used by potential customers. The company’s level of cooperation in resolving this complaint becomes a part of their file with the Better Business Bureau.

    Sincerely,

    Dispute Resolution Specialist

    ————

    TDA leadership may not be aware that the Austin BBB features a report card for those companies it contacts pursuant to consumer complaints. The TDA’s grade for their handling of their first disgruntled customer will be no better than the Fs that numerous Castle Dental franchises in Austin have earned from ignoring disgruntled dental patients.

    Then there’s the second, potentially more painful snag: Over a week ago, I requested through the Freedom of Information Act TDA emails from 2006 that were subpoenaed in the TDA’s National Labor Relations Board case that the TDA lost this summer for unjustly firing employees. Minutes ago, I received a call from Sharon at the NLRB, asking which of Mary Kay Linn’s emails I wanted. Evidently, when the TDA’s foot-dragging caused Judge Carson to become frustrated, he subpoenaed lots of the TDA Executive Director’s emails – making them all available through the FOIA. Collecting all of them could cost me hundreds of dollars. I told Sharon that I’d start with the emails that are relevant to the NLRB case for under $25. She promised to get on it right away, and said to please let her know if she can be of any further help. Sharon is very helpful. If the employees of the not-for-profit TDA were as consumer-friendly as federal employees, I wouldn’t have to even use the Freedom of Information Act or the BBB to clear up the TDA’s prideful blunder.

    Personally, it is my hope that the TDA employee’s emails I intend to share on the Internet will help to ameliorate the damage to my own reputation caused by her tyranny. From personal experience with the TDA, I’m confident the Executive Director’s emails will reveal an “us against them” atmosphere that fosters costly and unfair treatment of not only TDA employees, but dues-paying members as well. That’s no way to run a business.

    D. Kellus Pruitt DDS

    Like

  16. Darrell,

    Is the State of New York soft on “Bad” Dentists?

    http://www.syracuse.com/news/index.ssf/2010/12/critic_new_york_lax_about_disc.html

    What do you think?

    Mary

    Like

  17. As a dentist, I can assure you that the article linked, “Critic: New York state lax about disciplining dentists” by James T. Mulder, that appeared in the Post-Standard last week, is an embarrassment to the profession. Unfortunately, I’m afraid the article more than likely accurately describes a growing problem in quality of care throughout the nation: Dentists are not being adequately policed by either dentists or the state.

    New York’s failure is probably similar to Texas’. Greed combined with sloppy, harmful dentistry are natural consequences of inadequate funding of state boards, and I don’t see the effectiveness of government oversight improving even with HITECH, digital solutions that lean on “meaningful use” and stimulus money. That will just never get off the ground in dentistry.

    Perhaps we should accept that we can no longer count on our state governments to adequately protect us from those who would prey on our ignorance concerning dental and medical problems. My only immediate answer would be for people to put their trust recommendations from co-workers, friends and loved ones – not advertisements.

    Darrell K. Pruitt DDS

    Like

  18. Medical Residents Must Pay Social Security Taxes: Supreme Court

    The U.S. Supreme Court ruled that full-time medical residents should pay Social Security taxes because they are workers who happen to be studying, upholding Internal Revenue Service rules that have been in litigation since they were published in 2004. Mayo Clinic in Rochester, MN, lost the case.

    The clinic had argued that the IRS regulations requiring students to pay Social Security taxes contradicted congressional intent to exempt full-time students from the Federal Insurance Contributions Act, or FICA. Mayo medical residents work between 50 and 80 hours a week and earn stipends of as much as $56,000 a year plus benefits. Mayo argued that residents have not yet begun their “working lives” because they are not fully trained.

    Source: Joe Carlson, Modern Healthcare [1/11/11]

    I say, shame on you Mayo Clinic. Every intern, resident and fellow that I know paid their taxes while in training, including me!

    Donna C.

    Like

  19. BBB rating of the TDA continues to drop
    [Consumers are warned to use caution when dealing with the Austin-based business]

    If you recall, a couple of weeks ago the Austin Better Business Bureau downgraded the Texas Dental Association’s reliability rating from perfect to A- because the TDA Executive Director refused to join me in a voluntary, inexpensive attempt to quickly resolve our business dispute over a $200 refund. In her favor, she did respond, but only to inform the BBB Dispute Resolution Specialist that her not-for-profit professional organization actually has complaints against me, a dues-paying member. But after gaining our attention, the Executive Director failed to offer any further description of the alleged complaints. Since the dispute resolution platform was the Austin BBB and not the Fort Worth BBB, her response appeared not just petty, but 170 miles off-topic.

    I think most agree that the Executive Director’s silly behavior over $200 looks far from dignified and honorable doesn’t it? But then, Austin BBB officials cannot possibly comprehend the importance TDA Delegates place on maintaining a perfect image of “professionalism,” even while maligning the customers they serve over two hundred stinking dollars.

    Yesterday, I revisited the BBB Website and discovered that the TDA’s reliability rating has been further lowered to a B+.

    http://www.bbb.org/central-texas/business-reviews/dentist-information-bureaus/texas-dental-association-in-austin-tx-90020165#complaint

    Here is the report:

    BBB Rating for Texas Dental Association

    Based on BBB files, Texas Dental Association has a BBB Rating of B+ on a scale from A+ to F.

    Factors that lowered this business’ rating include:

    • One complaint filed against business that was not resolved.

    • BBB does not have sufficient background information on this business. BBB made at least two requests for background information from the business. BBB has not received a response from the business and/or has not been able to verify information received from business.

    [It didn’t take the Austin BBB long to discover that the TDA has a problem with transparency, conveniently making accountability difficult for even the Better Business Bureau to trace. Where’s the TDA President?]

    Factors that raised this business’ rating include:

    • Length of time business has been operating.

    • Complaint volume filed with BBB for business of this size.

    • Response to 1 complaint(s) filed against business.

    [Only one complaint in all those years! I guess that makes me the TDA’s biggest (recognized) troublemaker ever for those keeping such records. Let’s be honest with each other, fellow TDA members: If I hadn’t resisted TDA leadership’s worn out attempts at intimidation – one arguably approaching illegal – how much longer would we have continued to secretly talk among ourselves about the widely-known, horrible directions the Executive Director is taking our professional organization? Please don’t pretend you don’t know what I’m talking about.]

    The BBB develops a full report on a firm based on inquiry or complaint activity. This company first came to our attention in January 2007. We are attempting to develop more information on the company. At the present time we do not have enough information to issue a full report. The BBB suggests you read and understand company promotional materials and contracts and check company references and licensing, where applicable.

    ———-

    In other words, the Austin Better Business Bureau is telling consumers to be wary of my professional organization. How good is that for our image? Don’t even think about blaming me for this…. but if you must, please file your complaint with the Fort Worth BBB.

    At the end of the report, the BBB further advises: “If you choose to do business with Texas Dental Association, please let them know that you contacted BBB for a BBB Reliability Report.”

    All for $200 worth of executive pride. If I were a TDA member, I’d be pissed.

    D. Kellus Pruitt DDS

    Like

  20. Fraud Plagues Global Health Fund?

    A $21.7 billion development fund backed by celebrities and hailed as an alternative to the bureaucracy of the United Nations sees as much as two-thirds of some grants eaten up by corruption, according to the Associated Press.

    http://www.msnbc.msn.com/id/41221202/ns/health-health_care

    Becky

    Like

  21. Too “Mature” [i.e., old] Doctors

    One-third of the nation’s physicians are over 65, and that proportion is expected to rise. As doctors in the baby boom generation reach 65, many are under increasing financial pressures that make them reluctant to retire.

    http://www.nytimes.com/2011/01/25/health/25doctors.html?_r=1

    Experts warn that there are too few safeguards to protect patients against those who should no longer be practicing.

    Becky

    Like

  22. Are whistleblowers paid too much?

    A former U.S. attorney thinks so. Michael Loucks, a former prosecutor in Boston, is advocating for a cap of $2 million, the Wall Street Journal reports.

    http://www.fiercepharma.com/story/gsk-pay-750m-over-adulterated-drugs/2010-10-26?utm_medium=nl&utm_source=internal

    That’s far less than the record-setting $96 million awarded a former GlaxoSmithKline staffer who raised the red flag on manufacturing problems there.

    Craig

    Like

  23. A message for TDA President Dr. Ron Rhea and the Board of Directors
    [Ease up. It’s only dentistry]

    “For what it’s worth, as the annual convention in San Antonio approaches, I think it would be extremely beneficial for TDA members, staff, patients and the profession to discuss responsiveness with TDA President Dr. Ronald Rhea – but he won’t respond. Maybe he’ll respond here on TDA Perks.” TDA Perks Facebook, February 20, 2011.

    It’s long been obvious that ADA leadership has never been forthcoming with critically important information regarding the costs and dangers that electronic health records bring to dentists as well as patients. In fact, over the last several years I have documented hundreds of instances where ADA officials, including the past 4 presidents, have ignored this member’s questions about EDRs and HIPAA. Even as they evaded me, dentistry’s elected leaders joined BCBSTX and Delta Dental in pushing members to quickly volunteer for permanent NPI numbers. Now that ADA-guided quality control in the nation’s dentistry is becoming a reality through HITECH – based on dentists’ NPI numbers – do you think ADA leaders are proud of their influence?

    To witness the effects of the information vacuum left by the ADA’s rapidly-failing policy of non-interactive, committee-approved talking points and press releases in the internet age of transparency, simply google any of the presidents’ names along with mine, and my unanswered questions will likely appear within their first 20 hits simply because ADA officials have very limited internet presence. Even the cheap, repetitive vitriol I write is more popular than Dr. Raymond Gist’s expensive press releases.

    The vetted ADA officials we chose to represent our patients’ interests are being left behind by the networked and non-vetted community they serve. Naturally, any policy of non-interaction will increasingly isolate increasingly clueless ADA leaders, and they will continue to make increasingly costly bad decisions based on limited and often biased information from vetted sources.

    How can the TDA policy of slow-moving stoicism at all costs possibly be consistent with the tenets of the Hippocratic Oath?

    It appears to me that our leaders are hopelessly bogged down with the TDA’s latest mind-numbing slogan. Who would have guessed that admonishing vetted officials to “speak with one voice” would paralyze the organization’s leaders? For reasons based on common sense, nobody in leadership is willing to accept ownership of bad decisions made by misguided committee members just to appear to get along with each other. Face it. We’ve got problems similar to other dysfunctional families. The fear of unjust retribution for speaking the truth about EDRs leaves TDA leaders with no voice at all. Regardless of the mysterious agreements otherwise intelligent dentists must make in order to become properly “vetted” TDA officials, it’s only dentistry for crying out loud!

    At this point in my long, politically-incorrect struggle for openness in the TDA, I am left with only one way to put this question to Dr. Ron Rhea: As TDA President, what has the TDA Board asked that you keep hidden from membership concerning EDRs and HIPAA? The TDA’s unresponsiveness is costing the TDA more credibility daily. Further complicating the promotion of paperless practices to uninformed Texas dentists, this week HHS fined covered-entities for HIPAA violators for the first time, and it was millions of dollars.

    Time is running out before dentists you and I know in Texas needlessly go bankrupt over the loss of unencrypted Protected Health Information (PHI). We need to talk, dentist-to-dentist, about protecting the profession as well patients’ privacy.

    It was a week ago that I posted my invitation to discuss “responsiveness.” You know that if you continue to ignore my civil invitation it will only force me to eventually post one or more civil follow-ups. And if you choose to kick me off the TDA Perks Facebook over nothing more than an invitation to discuss “responsiveness,” how will that possibly promote the dignity and honor of the profession? Even if you once again come up with a good spin for a TDA policy of capricious bureaucratic aggression, who in the community will you choose to tell your side of the story? Here, outside your protective walls, I have the TDA outnumbered in voices by one.

    D. Kellus Pruitt DDS

    (Since the last message I attempted to email to the President and cc’d to each of the TDA Board members was sent back as “undeliverable,” I will no longer bother my internet provider with such a long list. Besides, it was an unappreciated favor anyway).

    Like

  24. I’ve given up on my $200 refund, so the TDA leaders won. Or did they?

    This story is about my goal to bring unwelcome transparency to the Texas Dental Association despite entrenched and comfortable leaders’ understandable resistance to unprecedented personal accountability.

    Remember my fight for a refund from the TDA for wrongfully suspending my membership in October? A dozen or so unnamed high-level TDA officials – dentists in Texas that I have never met – simply stole my TDA membership to make an example of me to deter future troublemakers from speaking up I suppose. I suspect their intention to harm me for criticizing the organization began as a favor to one or more indignant TDA members who lack the courage to confront me themselves. After all, that’s what they pay TDA dues for.

    Harming this TDA member turned out to be as easy as ignoring my repeated requests for a reasonable, adult discussion rather than the TDA’s childish and notoriously biased bureaucracy games. The majority of the TDA Board members, who probably learned professional subservience in dental school, unwisely voted to play games that even powerful, protected niche institutions can no longer win.

    Even though those who accuse me of “failing to uphold the dignity and honor of the profession” never shared with me even the links to the rumored “pages and pages” of internet-based evidence – much of it secretly collected years before I was even told that “TDA members and/or staff” had complained about my behavior (?) – an unnamed influential and highly-respected official convincingly presented the mysterious complaints to a Board that was eager to please. As an example of the official’s power in dentistry in Texas, he or she somehow persuaded 20 or so intelligent men and women with post-graduate degrees to go along with a bonehead plan out of the 1950s to somehow protect the profession from evil by censoring a dues-paying member’s opinions. Here’s what I find entertaining: At least a few clueless high-ranking TDA officials still don’t seem to be the least bit aware that others have been watching them act like children from the very first certified form letter with a rubber-stamped signature.

    Last summer, when solutions were still cheap, I repeatedly suggested to misled, and as it turns out, ill-equipped TDA officials that they just walk away from this fight that they will never win. Nobody ever responded. I suppose overconfidence naturally develops when chosen leaders are never held personally accountable for their harmful, aggressive decisions. So when a pile of smoldering vengeance that at least two of the officials had been keeping warm for as long as 3 years was dumped on the Board, the intense team spirit caused rogue officials to bet the TDA’s dignity and honor on their ability to still command-and-control troublemakers even in the internet age.. or something like that.

    I really don’t mean to rub it in, but I must say that I find it amusing that the same TDA officials who would conspire to secretly cause me harm, appear to be oblivious to the fact that unlike ever before in the history of the TDA Council on Ethics and Judicial Affairs, OTHERS ARE WATCHING. From the very start, I said it is the TDA Council that is ultimately on trial. Not me.

    In summary, other than the default $200 donation to the TDA, how have I served my profession in Texas lately? I can confidently claim that those following this adventure witnessed the last time TDA officials will ever use aggression on any dues-paying TDA member to marginalize complaints against the organization. The baby-boomers never want to go through this again, and younger, networked dentists know better than to try such foolishness.

    Transparency has arrived. The pure excitement I’ve enjoyed from bringing it in a year or two before it would have arrived anyway is well worth $200 to me. The TDA might have stolen my money, but it was far from a clean getaway. I’ve got a tight grip on its tender issues and I intend to publicly domesticate the insensitive, slow-moving fat dinosaur. Just sit back and watch the squeeze. I’m not leaving.

    For other anonymous ladies and gentlemen in traditional leadership positions inside and outside dentistry, whose greatest fear is that your names will be mentioned on the internet by a not-anonymous dissatisfied customer, beware that the rules of the game changed when you lost control of the flow of information. If as a leader you must be inaccessible, why even bother?

    D. Kellus Pruitt DDS

    Like

  25. As a member of the community who enjoys doing such things anyway, I feel it’s my obligation to expose deceptive advertisements such as the March 3rd, HealthcareITNews.com’s “Americans want docs to be online.”

    http://www.healthcareitnews.com/news/americans-want-docs-be-online

    It is morally wrong to disguise advertisements as journalism in order to fool naïve healthcare consumers, including lawmakers. Here is the comment I posted following Mike Milliard’s deceptive article.

    ———-

    “Seventy-three percent of Americans surveyed would use a secure online communication solution to make it easier to get lab results, request appointments, pay medical bills, and communicate with their doctor’s office, the poll finds.” – Mike Miliard, HealthcareITnews.

    What a deal! Why not 100%? Until I read Milliard’s article, I was unaware that HealthcareITNews had become a press release portal for HIT vendors like Intuit Health which funded the study. I admit I was momentarily fooled by the presence of a byline.

    One doesn’t have to read very far into Milliard’s statement to uncover stakeholder bias: As long as patients’ unencrypted health information is being increasingly shared on the internet using the tools Intuit sells, there are no “secure online communication solutions” that Milliard seems to take for granted. What’s more, since most breaches are reportedly caused by malicious intent, it’s easy to see that even encryption won’t completely stop reportable data breaches of PHI.

    In spite of increased enforcement and recent million dollar HIPAA fines, breach incidents continue to increase – not decrease. In addition, even though a link to the Intuit-funded survey isn’t offered, it’s obviously unlikely that the respondents were asked how much more they would be willing to pay for healthcare to enjoy the high-tech luxuries Intuit appears to be selling to doctors through misinformed patients – a cheap, old school PR trick that is traditionally resented by healthcare providers because of ethics.

    In fairness, what if in addition to the HIT stakeholder’s favorite parts about high-tech, the respondents in the survey had also been provided the frightening results of Redspin’s “Breach Report 2010 – Protected Health Information”?

    http://www.redspin.com/docs/WP_Redspin_2010_Protected_Health_Information_Breach_Report.pdf

    “A total of 225 breaches of protected health information affecting 6,067,751 individuals have been recorded since the interim final breach notification regulation was issued in August 2009 as part of the Health Information Technology for Economic and Clinical Health (HITECH) Act” (Executive Summary). And as mentioned earlier, according to the study, 61% of breaches stem from malicious intent. I think the 27% of the respondents in the survey that aren’t so crazy about slippery digital products may be about the same percentage of Americans who have suffered identity thefts Probably a coincidence.

    Just before hinting (but not actually stating) that EHRs will save patients money on doctors’ bills, Mike Milliard enthusiastically writes: “Significantly, that ‘anytime, anywhere’ access is so important that nearly half of patients would consider switching doctors for a practice that offered online services such as those.”

    Steve Malik, president and general manager of Intuit Health is apparently not as concerned as Milliard about understating the cost of interoperability: “[O]nline solutions, like a patient portal, have proven to improve staff and patient satisfaction levels, while positively impacting the physician’s bottom line by reducing patient no-shows and increasing the speed at which payments are received.”

    Before anyone gets upset about the vendor’s additional unprecedented and unsupported claims about the benefits of Intuit’s products, remember, it’s just a press release.

    D. Kellus Pruitt

    Like

  26. Darrell

    I bet Mike Milliard never treated a single patient in his life.

    Dave Marcinko

    Like

  27. Contaminated Hospital Alcohol Wipes?

    It took fast-acting doctors at a Colorado hospital to flag problems with tainted alcohol wipes now tied to a massive recall and growing reports of potentially deadly infections, including the case of a 10-year-old boy already battling leukemia.

    http://www.msnbc.msn.com/id/41914778/ns/health-infectious_diseases?GT1=43001

    Hope

    Like

  28. IL Podiatrist Still On Death Row Despite State Law Repeal

    Gov. Quinn’s landmark decisions to repeal the death penalty and commute death sentences to life in prison may have cleared out Illinois’ Death Row — but they did little to help a one-time Chicago doctor who remains condemned to death. Ronald Mikos, 62, still awaits execution after a 2005 conviction.

    That’s because the death penalty is still legal in the federal court system where he was tried. Mikos, a former podiatrist, was sentenced to death after he killed a disabled patient of his who was about to testify against him in a Medicare-fraud investigation in 2002.

    Source: Natasha Korecki, Chicago Sun-Times [3/9/11]

    Like

  29. Lawsuit Against New Orleans Hospital Settles Shortly After Trial Begins

    Tenet Healthcare just settled a class-action lawsuit brought on behalf of people trapped in Memorial Medical Center in New Orleans after Hurricane Katrina. The amount was not immediately announced.

    http://www.propublica.org/article/lawsuit-against-new-orleans-hospital-settles-shortly-after-trial-begins

    Ann Miller RN MHA

    Like

  30. Aetna Insurance Company Sues Physicians

    Aetna is suing six New Jersey doctors over “unconscionable” and “excessive” medical bills in a lawsuit that could help determine what pricing limits insurers can impose on out-of-network doctors.

    http://www.bloomberg.com/news/2011-03-24/ultrasound-at-59-490-is-outrage-in-aetna-claim-against-doctors.html

    Linda

    Like

  31. Ameriprise Financial (NYSE: AMP) plans to sell its independent broker/dealer unit Securities America, according to the company’s first quarter earnings report released today.

    http://registeredrep.com/advisorland/compliance/ameriprise_to_shed_securities_america_amid_pending_settlement_0425/

    Meanwhile, the firm is still in the process of finalizing a settlement with investors claiming SAI sold allegedly fraudulent private placements from Medical Capital Holdings and Provident Royalties.

    Ann Miller RN MHA

    Like

  32. New Report Blasts Problem-Plagued Cancer Research Grid

    $350 million caBIG technology program is too complex and its business model is unsustainable, says National Cancer Institute working group.

    http://www.informationweek.com/news/government/enterprise-architecture/229401221?queryText=cancer

    Ann Miller RN MHA
    [Executive Director]

    Like

  33. More Medical Licenses Taken Away – Fewer Disciplinary Actions in 2010

    Although the number of medical licenses taken away in 2010 was up 4.5% over 2009, the total number of disciplinary actions taken by state medical boards fell 1.2%, according to the Federation of State Medical Board’s (FSMB) annual summary of state board actions.

    According to the report, which compiles the disciplinary actions taken by 70 state medical and osteopathic boards, 1,815 physicians and other medical professionals had their licenses revoked, suspended, or mandatorily retired in 2010, compared with 1,736 in 2009.

    State boards took 5,652 total disciplinary actions—including probations ordered, licenses modified, or penalties and reprimands issued—in 2010, compared with 5,721 in 2009, according to the Federation’s summary.

    Source: Andis Robeznieks, Modern Healthcare [5/11/11]

    Like

  34. States Eye Public Access to More Doctor Disciplinary Records

    A long-running push for increased transparency in the medical profession has led medical boards nationwide to release more information about physicians’ professional and disciplinary history online during the last 15 years. Even so, exactly what is publicly available — both to consumers seeking information online and families inquiring about a specific physician or complaint — varies greatly. States are hearing from consumers that not enough information is available or easily accessible.

    So at least five states have recently passed or are considering legislation that would create more transparency, particularly regarding physician disciplinary records and procedures. The measures would release more physician information, make that information easier for consumers to get, and provide quicker responses on requests to investigate physicians.

    Source: Carolyne Krupa, AMNews [5/9/11]

    Like

  35. My First Interview

    I’m preparing for my first interview. It is scheduled to take place on Tuesday, May 31, at 7PM Fort Worth time on The Whole Tooth Blogtalkradio.

    http://www.blogtalkradio.com/thewholetooth

    If you recall, a few months ago I was approached about being interviewed by Richard Train and the co-founder of Get Results marketing and Business Coaching, Hogan Allen, on their talk show. This morning, Richard said he recognizes that I’m “very passionate about the good, bad and ugly of dentistry,” and that “it could be a fun show to do.” I think he’s right.

    In January, I warned that when I hear myself in a recording, my West Texas way of speaking shocks me as much as anyone else. I’m pretty sure you have no clue about the depth of the drawl regardless how slowly I type. I need 30 minutes of material… no problem.

    The topic I’ve chosen is, “Dentistry’s Low Hanging Fruit – What We Fix First.”

    I told Richard that it is my wish to keep the discussion positive, including a few common sense solutions to future problems in dentistry. There are so many directions I can go with this even without poking fun at the usual suspects in the dental industry.

    I’m considering discussing de-identification of electronic dental records as a way around the ever-expanding obligations and liabilities of being a HIPAA-covered dentist. It’s perfect timing. Yesterday, even the long-silent ADA News acknowledged that HIPAA is increasingly bad news for American dentists (who volunteered for NPI numbers as recommended by the ADA).

    http://www.ada.org/news/5807.aspx

    Did anyone else notice ADA News reporter Kelly Soderlund’s unusual approach to the serious topic of HIPAA in her article? It starts with the title: “Stronger enforcement of HIPAA, thanks to new law.”

    Why did she choose to say “thanks to new law” rather than the more professionally acceptable, unbiased, “according to new law”? Better yet, why didn’t she choose to say “Stronger enforcement of HIPAA because of increase in data breaches from dental offices”?

    I’m also considering discussing hybrid EHRs – just because a fax machine is used in communications doesn’t mean the message has to terminate in paper… but it can.

    Any thoughts from anyone? I promise I won’t bite. What would you like to fix?

    Darrell

    Like

  36. Preparing my interview questions

    I’m filling in the blanks on an information sheet for my May 31st interview on The Whole Tooth blogtalkradio.

    http://www.blogtalkradio.com/thewholetooth

    Here’s what I came up with:

    ———————-

    Get Results Marketing and Business Coaching

    The Whole Tooth™ Interview Information

    Interviewee Name: Darrell K. Pruitt DDS

    Topic Title: Dentistry’s Low Hanging Fruit – What We Fix First

    Description: Dentistry has long been an obscure niche in healthcare. As a consequence, the needs of dentists and patients have been virtually ignored by those who set national HIT standards and goals. In 2004, President Bush hastily committed tremendous government resources to developing a national system of interoperable digital health records for all providers by 2014. As it turns out, 2014 was overly ambitious for hospitals and physicians who need EHRs much more than dentists.

    Paperless interoperability with dentists is nothing more than a dead politically-correct fantasy. If dental patients are ever to reap the latent benefits of Evidence Based miracles divined from data mining dental patients’ treatment histories on an internet platform (in real time) – with permission from dentists and patients of course – it’s time for dentists to ignore committee solutions that don’t fit our patients’ needs. It’s time to distance dentistry from the bi-partisan HIPAA blunder. Think laterally.

    Please list the top five-eight questions/points you’d like to discuss during your interview.

    1. What went wrong? – Why didn’t dentists jump on board as planned?

    2. Do dental patients prefer their dentists to be paperless or not? – Does it matter?

    3. If no progress is made towards interoperable dental records, what will we miss?

    4. How important is security to dental patients today versus tomorrow?

    5. How important is security to dentists today versus tomorrow?

    6. Is encryption the answer to the increasing liability of data breaches from dental offices?

    7. Is de-identification of dental records a possible solution to the liability of data breaches?

    8. Is a “hybrid,”computer/fax system a possible solution to interoperability with almost all dentists?

    ———

    So what do you think? Anything else you’d like me to address?

    Darrell

    Like

  37. TX Podiatrist Pleads Guilty ot Healthcare Fraud

    A 52-year-old Paris, Texas podiatrist has pleaded guilty to federal healthcare fraud charges in the Eastern District of Texas announced U.S. Attorney John M. Bales today. Dr. William Goldman pleaded guilty to healthcare fraud before U.S. Magistrate Judge Don Bush.

    According to information presented in court, Goldman submitted false claims to Medicare and Medicaid from 2003 to 2008 for surgeries he never performed. Goldman was indicted by a federal grand jury on Apr. 15, 2010. Goldman faces up to two years in federal prison. He also faces forfeiture of $350,000.00, along with his podiatry license.

    Source: Department of Justice [5/18/11]

    Like

  38. Intent To Harm

    The new doctor in town was friendly, popular—and dangerous. Especially to the nurses who reported his bizarre treatments.

    http://www.texasobserver.org/cover-story/intent-to-harm

    Ann Miller RN MHA

    Like

  39. Tips for investigating health professionals from the AHCJ

    It’s likely you’ve read some of the stories about health professionals gone wrong in recent months.

    They include reports by Blythe Bernhard and Jeremy Kohler of the St. Louis Post-Dispatch that patients are kept in the dark about problems with their doctors and hospitals and that Missouri’s disciplinary system seems geared toward protecting doctors’ livelihoods; a series of articles from Charles Ornstein and Tracy Weber of ProPublica showing that patients suffered as problem nurses were kept on the job in California and state agencies have failed to report disciplined caregivers to a federal database; and Bill Heisel’s chronicles of “Doctors Behaving Badly” at ReportingOnHealth.org.

    We have gathered some tips from those reporters and other AHCJ members who have checked up on the medical professionals in their area – and the boards that regulate them. Find out what documents to look for and who you need should be talking to.

    Source: http://www.healthjournalism.org/resources-tips.php

    Like

  40. Data Breach at WellPoint?

    WellPoint (NYSE: WLP) will pay a $100,000 fine because it waited months before notifying Indiana officials of a security breach that may have exposed personal information of 32,000 members. It also will reimburse each affected member up to $50,000 for any breach-related losses as part of the settlement reached with the Indiana Attorney General.

    http://www.in.gov/portal/news_events/files/7_5_11_WellPoint_settlement_MTD_and_Order.pdf

    Ann Miller RN MHA

    Like

  41. The Stent Doctors [Midei and McLean]

    The criminal trial begins for a Maryland Eastern Shore doctor accused of unnecessary stent procedures. And, a Towson Maryland doctor is accused of similar infractions and awaits word on whether he can keep his medical license.

    http://articles.baltimoresun.com/2011-07-12/health/bs-md-stent-fraud-trial-20110712_1_unnecessary-stent-procedures-mark-midei-eastern-shore-doctor

    Blake

    Like

  42. PPO kickback scheme uncovered

    What appears to be grossly unethical business practices in the PPO medical insurance industry were revealed today on Bill Rusteberg’s RiskManagers.us Blog in an article titled, “Molly Mulebriar Exposes PPO Kickback Scheme.”

    http://blog.riskmanagers.us/?p=6342#more-6342

    Mr. Rusteberg writes: “Molly Mulebriar, forensic auditor and ace investigative reporterette, obtains actual PPO contract that confirms that consumers do not always fully benefit from PPO ‘discounts.’ Are 100% of PPO discounts passed on to the consumer? In this case, the answer is no.”

    Copied below is part of a PPO contract Mulebriar uncovered which describes how providers must agree to pay insurer’s “administrative costs” in order for the policy to appear more competitive to employers – who are kept uninformed about such financial agreements which ultimately cheat clueless patients most of all:

    “In addition, Client hereby acknowledges that, as a part of PPOs contractual arrangement with certain participating network providers, PPO and its Affiliates may receive compensation for administrative services performed for the benefit of Participating Providers during the term of this Agreement. Such fees may be in the form of direct payment by the Participating Provider to the PPO or in the form of a differential in reimbursement amounts (the ‘Differential Model’).

    In a Differential Model scenario, the reimbursement amount paid for a claim under this Agreement may not be identical to the amount of compensation a Participating Provider receives or retains in connection with providing health care services.”

    My mind goes a little fuzzy when I read terms like “Differential Model scenarios,” but nevertheless, I’m going to bet that the amount a doctor is actually paid for a claim by the PPO is not only NEVER identical to the reported “compensation,” but is always LESS than the amount advertised to employers who purchase the plans.

    Bill Rusteberg, owner of Rusteberg & Associates insurance advisory group in Harlingen, Texas, adds as an Editor’s Note:

    “An innovative TPA [Third Party Administrator] could compete for business with a $3 monthly PEPM administration fee easily using this methodology. Since the TPA’s share of the PPO discount never shows up on the fixed cost side of the ledger but is hidden in the claim cost side, an unsuspecting Plan Sponsor would believe that the TPA was really competitive. Yet, in reality, the TPA would be making a killing.”

    So how about Delta Dental, UnitedConcordia, UnitedHealth and other members of the National Association of Dental Plans {NADP)?

    My question of course is whether such deception is also occurring in the notoriously sleazy dental PPO industry while the American Dental Association is furiously trying to prevent dentists from abandoning their electronic dental records for safer and cheaper paper dental records. Like the ADA, the NADP also pushes for quick EDR adoption by ADA members regardless of the risks to dentists and their patients.

    Instead of connecting with those he serves, someone persuaded ADA President Dr. Raymond Gist to sign a letter to HHS suggesting that dental patients don’t need to know who has access to their Protected Healthcare Information. Dr. Gist said such transparency with those whose privacy is at risk would be just too much trouble. (See “ADA urges withdrawal of ‘access report’ proposal” by Craig Palmer for ADA News).

    http://www.ada.org/news/6075.aspx

    For a healthcare leader fighting to preserve the tenets of the Hippocratic Oath, someone has Dr. Raymond Gist facing the wrong direction.

    D. Kellus Pruitt DDS

    Like

  43. Dangerous Docs Go Undiscplined in California

    As a side-effect of fiscal constraints, more than 700 California doctors, sanctioned for wrongdoing by hospitals and other health care organizations, have not faced any disciplinary action from the state medical board.

    http://www.propublica.org/blog/item/side-effect-of-fiscal-constraints-dangerous-docs-undiscplined-in-california

    Debra

    Like

  44. Medical oversight fines often go unpaid

    California dental regulators have collected only about 20 percent of the fines they have levied against dentists in the last four years, a far weaker record than licensing authorities that oversee registered and vocational nurses and psychiatric technicians.

    http://californiawatch.org/dailyreport/medical-oversight-fines-often-go-unpaid-12073

    Mary

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  45. Sliding scale

    As dentists as well as physicians become harder for constituents to find, I think we can expect to see a sliding scale for government fines – especially in the rural areas.

    Politicians may talk about getting tough when they have to, but in the end, they must deliver access to medical care.

    For example, how many doctors have been fined for HIPAA violations in the last 14 years? I’m pretty sure it’s in the single digits … Like zero.

    Darrell

    Like

  46. Doctor charged with killing longtime partner, and child

    One victim stabbed more than 100 times; boy’s body found in bathtub. Two counts of aggravated first-degree murder were filed against Dr. Louis C. Chen, 39, in the stabbing deaths of Eric Cooper, 29, and their son, Cooper Chen.

    http://www.msnbc.msn.com/id/44163322/ns/us_news-crime_and_courts/

    Penny

    Like

  47. Florida Dentist Surrenders License Over Patient Death

    A dentist whose patient died after having a tool dropped down his throat during a dental-implant procedure surrendered his license to practice dentistry, according to Florida Board of Dentistry officials.

    Wesley Meyers officially surrendered his license to the Board on Friday, almost four years after his patient, 90-year-old Charles K. Gaal Jr., died following surgery to remove a dentistry tool from his lung.

    On two occasions within a two-year span, Meyers dropped a tool down Gaal’s throat. Surgery was required to remove the first tool from Gaal’s large intestine, officials said. Gaal died following the second surgery in 2007 to remove a tool from his lung. His doctors say Gaal never recovered from the surgery.

    In 2008, Myers was issued a $17,000 fine by the Board of Dentistry and prohibited from performing dental-implant procedures without receiving additional training.

    Myers stopped practicing dentistry in 2010 after Gaal’s family filed a wrongful death lawsuit.

    Source: http://www.johnsonvorhees.com/content/article/embed/article/1555/

    Like

  48. Healthcare Fraud and Abuse

    Miami-Area Doctor Pleads Guilty in $25 Million Health Care Fraud Scheme
    http://www.justice.gov/opa/pr/2011/August/11-crm-1075.html

    Owner of Miami-Area Mental Health Care Corporation Convicted on All Counts for Orchestrating $205 Million Medicare Fraud Scheme
    http://www.justice.gov/opa/pr/2011/August/11-crm-1074.html

    Miami-Area Medical Equipment Company Owners Sentenced to Prison for Medicare Fraud Scheme
    http://www.justice.gov/opa/pr/2011/August/11-crm-1073.html

    Mary

    Like

  49. Agency declines to restore public data

    http://www.healthjournalism.org/uploads/NPDB-HRSA-response.pdf

    The U.S. Health Resources and Services Administration resisted demands by three major journalism organizations for the immediate restoration of a Public Use File of the National Practitioner Data Bank, a tool that reporters have used to expose lapses in oversight of troubled physicians.

    http://www.healthjournalism.org/blog/2011/09/agency-declines-to-restore-public-data/

    Ruth

    Like

  50. Mental health worker who reported child porn fired

    ‘We’re not allowed to go to police’ unless actual child abuse is observed, supervisor says.

    http://www.msnbc.msn.com/id/45222798/ns/us_news-life

    Is this article not shameful; or what?

    Doris

    Like

  51. VA Nurses Scrutinized After Patient Deaths in Two States

    After a patient died last year at a Veterans Affairs hospital in Manhattan, federal inspectors discovered nurses in his unit had a startling gap in their skills:

    http://www.propublica.org/article/va-nurses-scrutinized-after-patient-deaths-in-two-states

    They didn’t understand how the monitors tracking vital signs worked.

    Hope Hetico RN MHA

    Like

  52. Whistleblower suit

    Georgia hospitals defrauded Medicaid?

    http://onlineathens.com/breaking-news/2013-07-31/whistleblower-suit-hospitals-defrauded-medicaid

    Hope Hetico RN MHA

    Like

  53. Doctors Found Sanctioned for Negligence by the New York State Department of Health Allowed to Continue to Practice

    According to The New York Public Interest Research Group, over three-quarters of doctors found sanctioned for negligence by the New York State Department of Health are allowed to continue to practice. Nearly 60% of New York State actions against doctors were based on sanctions taken by other states, the federal government, or the courts, not directly as the result of an Office of Professional Medical Conduct (OPMC)-initiated investigation.

    One of the arguments as to why New York State does not revoke questionable doctors’ licenses is that they are an important resource. However, over the past ten years, New York’s population has grown by about 2%. Its doctor population has swelled by 36%.

    Source: The New York Public Interest Research Group

    Like

  54. DentaQuest?

    This Tennessean reporter investigated complaints over a Medicaid dental provider.

    http://healthjournalism.org/blog/2014/07/tennessean-reporter-investigates-complaints-over-medicaid-dental-provider/

    Mary

    Like

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