Monday Morning Update 12/23/13

From Kris Crinkle: “Re: Epic. The bells rang for a new contract signing. Southcoast Health System (MA). Replacing Meditech Magic, eClinicalWorks, athenahealth, and Cerner homecare. I’m an avid reader and love the format, especially Dr. Jayne.”

From JG: “Re: musical stocking stuffers, best of 2013. The Growlers, Dean Wareham, The Men. Thank you for everything you do!” I listened to all three bands and liked all three.

From The PACS Designer: “Re: all-digital solutions. A truly remarkable event took place at this year’s RSNA. Philips Healthcare introduced the world’s first all-digital diagnostic treatment solution in the form of a CT/PET Scanner. This event should be of great interest to Doctor Dalai as he’s been contemplating the purchase of such a system for quite some time.”

A ProPublica investigation uses the federal government’s own Medicare databases to find evidence of rampant Medicare drug plan fraud, with organized groups either stealing the identity of doctors or bribing them to write prescriptions. Medicare’s process is so poorly managed that they rarely catch anyone. Example: Medicare paid $3.8 million in one year to fill the prescriptions of a psychiatrist, most of them for drugs unrelated to his specialty, when someone stole his identity. Pharmacies and insurers say they’re reporting suspicious behavior to Medicare but are being ignored. The series of articles concludes that newspaper reporters can easily detect fraud from Medicare’s databases, but the agency itself isn’t doing it.

Fraud rings use an ever-evolving variety of schemes to plunder the program. In one of the most popular, elderly, broke, disgraced or foreign-trained doctors are recruited for jobs at small clinics. Their provider IDs are used to write thousands of Medicare prescriptions for patients whose identities also may have been bought or stolen. Once dispensed, the drugs are then resold, sometimes with new labels, to pharmacies or drug wholesalers. In other schemes, investigators say, pharmacies are active participants, billing Medicare multiple times for prescriptions they never fill. Doctors can readily disavow the prescriptions as forged, investigators say. And because the schemes don’t always involve painkillers, a law enforcement focus, they can escape notice.

Weird News Andy delivers this story, which he titles “Yes C-Section, No C-Baby.” Doctors in Brazil perform an emergency C-section delivery after failing to hear the baby’s heartbeat, only to find that their patient wasn’t pregnant. The woman showed up with proof of her prenatal care and a protruding abdomen, but she was having a false pregnancy, her second of the year. The hospital suggested she seek mental care instead.

Contacts

Mr. H, Inga, Dr. Jayne, Dr. Gregg, Lt. Dan, Dr. Travis, Lorre

More news: HIStalk Practice, HIStalk Connect.