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What Kmart ’s Settlement Says About Health Care Fraud
This reportedly violated regulations requiring pharmacies to apply their usual and customary charges when billing government payers.
The DOJ claims that “[t]he government’s resolution of this matter illustrates the government’s emphasis on combating health care fraud,” It might more accurately have said that the settlement adds to the mountain of evidence showing that the government cannot control even the most obvious forms of health care fraud, a point we make at length in our forthcoming book, Overcharged: Why Americans Pay Too Much For Health Care.
For one thing, at the very same time government payers were hon...
Source: The Health Care Blog - February 1, 2018 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Charles Silver David Hyman K-Mart Lisinopril Source Type: blogs
Rethinking Medication and Information Technology
Previous articles in this series looked at barriers to taking medication and possible solutions, including special conditions that produce challenges. This final article in the series turns the question on its head. Can patients get better without the medications?
Dr. Omar Manejwala, CMO of DarioHealth, goes so far as to use the terms “paternalistic” and “infantilizing” to label claims that people fail to take medication solely out of ignorance or forgetfulness. To all the other factors that hold people back from taking their meds, he adds social and religious factors, concerns about side effects an...
Source: EMR and HIPAA - April 6, 2023 Category: Information Technology Authors: Andy Oram Tags: Ambulatory Clinical Communication and Patient Experience EMR-EHR Health IT Company Healthcare IT Hospital - Health System LTPAC AdhereHealth Bryan Hill Carium Caroline E. Ortiz Charles Lee Cognizant DarioHealth FDB fee-for- Source Type: blogs
Why Bad News Is Not Always Bad
Last month, the cover of BusinessWeek featured an article, How Big Pharma Uses Charity Programs to Cover for Drug Price Hikes, focused on co-pay charities for Medicare patients. I of course had heard about such co-pay charities before, and even had the opportunity to meet with a representative of one a few years ago, but frankly I had no idea what they did. So when the article came out, outlining the "evils" of this practice, it caught my attention. By catching my attention, it actually saved my elderly parents significant amounts of money.
My father and mother are both retired, living on a small pension and Social Secur...
Source: Policy and Medicine - August 4, 2016 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs
ProPublica Publishes Medicare Part D Prescriber Data
In 2010, the "investigative journalist organization" known as ProPubilca, through donations from the Pew Foundation and several other organizations geared towards attacking industry, began the "Dollars for Docs" campaign. As we have covered extensively since the launch of that campaign, ProPublica aggregated the payment reporting data of approximately 15 manufacturers who were reporting their payments publicly—either as a requirement of a corporate integrity agreement (CIA) with HHS-OIG, or voluntarily—and then created a searchable, aggregated website.
Additionally, ProPublica teamed up with national and local medi...
Source: Policy and Medicine - June 13, 2013 Category: Health Medicine and Bioethics Commentators Authors: Thomas Sullivan Source Type: blogs
Obama’s Foreign Policy Is Linked to a Healthy, Restrained Immune System
With 58% of Americans disapproving of Obama’s foreign policy, mounting Ebola virus deaths, and flu season around the corner, I think it is important to synthesize an overlapping theme between how our country fights perceived threats, and how our bodies successfully or unsuccessfully fight disease. In short, I think Obama’s continued restraint and use of soft power is evidence of a good prognosis for the country.
In this analogy, our bombs and military are the most caustic weapons of the country’s immune system, akin to a fever of 105 degrees and impending sepsis. Does “nuke them all” work?
Diplomacy, espionage, s...
Source: The Examining Room of Dr. Charles - August 16, 2014 Category: Primary Care Authors: drcharles Tags: Uncategorized Source Type: blogs
Trust in science and medical experts
This week is a good time to talk about trust in expert opinion and science.
For the past forty years, nutrition experts in the US have warned us about cholesterol and fat. Eat too much of it and it will block your arteries, was the proclamation. Americans did what the scientists and experts said. They ate low-fat foods. You see how that worked out.
Now, the Dietary Guidelines Advisory Committee will soon tell the American people that they were wrong about saturated fat and cholesterol. Experts, who had based their recommendations on scientific evidence, will reverse course and say…oops. Our bad. The science was not t...
Source: Dr John M - February 12, 2015 Category: Cardiology Authors: Dr John Source Type: blogs
On THCB
The Mess That is MACRA by Kip Sullivan
Is Pornography Creating a Public Health Crisis? by Steve Findlay
Why I Left My Pharma-Sponsored Academic Research Gig by Brad Flansbaum
The Joint Commission Pain Standards: Five Misconceptions by David W Baker, MD
The Pharma = Evil Narrative by David Shaywitz, MD
Stephen Curry’s Health Care Plan by Charles Gross
What Is Patient-Centered Care? What Isn’t Patient-Centered Care? by Rob Lamberts, MD
All Providers Are Not Equal by Steven Findlay
The C Word by Jeff Goldsmith
Trump’s Healthcare Plan: Right Diagnosis, Wrong Prescription by Sally C. Pipes
The Prescription for High Drug C...
Source: The Health Care Blog - April 23, 2016 Category: Consumer Health News Authors: John Irvine Tags: Featured THCB Source Type: blogs
Homme Fatale
By SAURABH JHA, MD
Halfway through the “Bell Curve,” which is an analysis of differences in intelligence between races, I realized what had been bothering me about Charles Murray’s thesis. It wasn’t the accuracy of his analysis, which concerned me, too. It was that he analyzed. The truth, I used to believe, was always beautiful, whether it was what happened in the multiverse at T equals zero, or the historical counterfactual if Neville Chamberlain hadn’t signed the peace accord with Adolph Hitler. After reading Murray’s book, I realized that the truth can be irrelevant, ugly, and utterly useless. Even if the av...
Source: The Health Care Blog - December 22, 2016 Category: Consumer Health News Authors: at RogueRad Tags: OP-ED Physicians Source Type: blogs
Should you ever not listen to your doctor?
Since I got married seven years ago and had two kids, I’ve had to shed parts of my life, like the hockey package, going to the movies, and slow-pitch softball. None were hard sacrifices, but the casualty that hurt the most was giving up my doctor of over 20 years. I met him soon after I got out of college and he was early in his career, and while I never needed him for much, I knew he was on top of everything.
Even after my wife and I moved north of Boston, I wanted to believe that I could keep him, that an hour-long drive into town without traffic was possible, because how often did I ever have an emergency? Well, in 20...
Source: Harvard Health Blog - December 26, 2017 Category: Consumer Health News Authors: Steve Calechman Tags: Health Health care Managing your health care Source Type: blogs
Fight Aging! Newsletter, May 27th 2019
In this study, we found that cofilin competes with tau for direct microtubule binding in vitro, in cells, and in vivo, which inhibits tau-induced microtubule assembly. Genetic reduction of cofilin mitigates tauopathy and synaptic defects in Tau-P301S mice and movement deficits in tau transgenic C. elegans. The pathogenic effects of cofilin are selectively mediated by activated cofilin, as active but not inactive cofilin selectively interacts with tubulin, destabilizes microtubules, and promotes tauopathy. These results therefore indicate that activated cofilin plays an essential intermediary role in neurotoxic signaling th...
Source: Fight Aging! - May 26, 2019 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs
How to Navigate Life with a Chronic Disease Like T1D and High-Deductible Insurance Plans
Conclusion:So, this is a method to survive a high-deductible insurance plan without breaking the bank. I have done it, so I know it works. Keep in mind: insurance companies feel entitled to screw patients (you are not their customer, your employer is). Don ' t let them do it to you!
Source: Scott's Web Log - February 8, 2021 Category: Endocrinology Tags: 2021 high-deductible insurance plans insulin rebates test strips Source Type: blogs
Like Don Quixote Chasing Windmills, I Aim to See Financial Remediation for Patients Still Suffering in a Predatory U.S Healthcare System
Sometimes, I feel (if you pardon the metaphor) a bit like Don Quixote chasing windmills with my efforts to see true financial remediation introduced in the predatory U.S. healthcare " system " (and I am glad to see that the term " predatory " is now being used by a growing number of medical doctors, which I think is great). I envision a type of financial remediation whereby patients will be able to get access to the care they need without having to face financial predators trying to pick their pockets with illegal discount bribes standing in the way of their getting access to things they need like insulin, CGM senors ...
Source: Scott's Web Log - June 25, 2023 Category: Endocrinology Tags: 2023 CGM Formulary Exclusion insulin PBM Source Type: blogs
