• General
• HIPAA
• Kickbacks/Conflicts of Interest
• Conflicts of Interest in Research
• Research
• Physician Billing
• Supervising Residents
• Quality of care
• EMTALA
• Hospitals
• Pharmacies
• DME and ambulance companies
• Long-term care
• Pharmaceutical companies and device manufacturers
• Insurers
• Antitrust

• Doctors arrested for drug favors
  Three doctors from the Westchester suburbs of New York City allegedly provided mob figures with erectile dysfunction drugs in exchange for various favors, the FBI said Thursday.
• Health groups' funding faulted
  "The public may be getting hoodwinked because they may think these nonprofits are independent," said Daniel Borochoff, president of the American Institute of Philanthropy, a watchdog group that provides donors with information about nonprofits. "But how can they do it independently if they are paid by the drug companies?"
• Defrauding Medicare - no end to flood of schemes
  Health care fraud has become a multibillion dollar business for a persistent breed of white-collar criminals. Yet, after years of investigations, congressional hearings and government crackdowns, fraud experts say little progress has been made in stemming the tide of federal losses.
• UCLA apologizes for apparent sale of body parts
  The Willed Body Program's director, Henry Reid, was arrested Saturday "for illegal activities involving the commercialization of human remains," that is, selling body parts, Levey said.
• Fraud abroad
  Health Minister Malcolm Chisholm has pledged to do "everything possible" to stop NHS fraud, which is costing up to £100m a year in Scotland. And, in Germany,Schröder Encourages Personal Responsibility.
• Insurers predict $50-billion in health fraud
  The crimes are committed by a small percentage of doctors and other health care providers, but they can cost the average consumer as much as $1,200 a year in higher premiums, said Bill Mahon, president and CEO of the National Health Care Anti-Fraud Association.
• Grassley Investigates Tenet Healthcare's Use of Federal Tax Dollars
  "As general counsel, Ms. Sulzbach zealously defended Tenet against claims of ethical and legal non-compliance, e.g., the April 2001 qui tam suit, while as chief compliance officer, she supposedly ensured compliance by Tenet's officers, directors and employees. It doesn't take a pig farmer from Iowa to smell the stench of conflict in that arrangement."
• Remarks of Senator Grassley
  "I believe we in Congress have a constitutional responsibility to conduct vigilant oversight over the government programs taxpayers support. I take that oversight responsibility personally, and very seriously. Which means most of the time, people are mad at me."
• Fraud, apathy ail Medi-Cal
  Medi-Cal fraud is reaching a staggering level, swallowing as much as a third of the state-federal dollars that flow through the government health program for the poor. That's according to figures released earlier this month that, amazingly, went all but unnoticed in the Capitol.

• Arrest in theft of records
  A former branch manager at a San Jose medical group has been charged with stealing the confidential records of nearly 185,000 patients — mostly South Bay residents, authorities reported.
• Kansas Abortion Clinics Fight Data Request
  The attorney general, Phill Kline, has argued that he is looking for evidence of child rape and violations of a state law restricting abortions performed after 22 weeks of pregnancy. But clinic supporters contend Kline is on a fishing expedition that invades patients' privacy and is making a calculated effort to hamper the clinics from performing abortions.
• Computer theft may expose data on 180,000 patients
  In an statement posted on its Web site today, San Jose Medical Group Management Inc. said the computers were stolen from a locked administrative office during the burglary, which is being investigated by local police. The computers contained names, addresses, confidential medical information and Social Security numbers of some 180,000 current and former patients, according to the health care provider.
• S.F. won't give feds abortion data — Justice Dept. wants General Hospital records on banned late-term method
  "The city will not disclose the medical records of patients who have received abortions" at the hospital, "nor will it disclose the names of physicians who have observed or performed abortions," City Attorney Dennis Herrera's office said in a letter to the U.S. Justice Department. "Wholesale disclosure of this information would result in the gross violation of our patients' privacy rights, and the unjustifiable harassment of our physicians."
• George Harrison's Estate Sues Doc
  The estate also accuses Lederman of violating Harrison's privacy by orchestrating invasive media coverage in the interest of promoting his medical practice.
• Law enforcement: Facing privacy zealots in hospitals
  If Sgt. Joe Friday comes to the hospital looking for "just the facts," it might be in his best interest to get a warrant, too. Especially if the facts involve information on a patient who is part of an investigation in this new HIPAA privacy climate.
• A tough lesson on medical privacy
  A woman in Pakistan doing cut-rate clerical work for UCSF Medical Center threatened to post patients' confidential files on the Internet unless she was paid more money.Pakistani threatened UCSF to get paid, she says.
• Hundreds Of Local Patients' Medical Files Just Tossed In The Dumpster
  It is a doctor's most solemn oath: "Do no harm." Yet a KOMO 4 News investigation has uncovered hundreds of local patients who may have suffered irreparable harm, after their medical charts were tossed in to a dumpster.
• Wal-Mart investigating prescription list's release
  Wal-Mart has launched an investigation into one of its Lubbock pharmacies after personal medication information on clients was inadvertently handed out to a customer last week.
• Patient Privacy Rules Bring Wide Confusion
  The transplant patient was recovering well when doctors discovered that his new heart might have been infected with bacteria before the operation. When the doctors sought more information so they could give the man the right antibiotics, the hospital where the donor had died refused, citing new federal patient privacy rules.
• Gearing Up For July 1, 2003 - Senate Bill 1386 - How Does It Affect You?
  In a nutshell, the law states that any person or company doing business in the state of California is responsible for notifying California residents of security breaches to their non-encrypted information.
• Computer Hacker Leaves Medical Office Scrambling
  It's a doctor's office nightmare: thousands of patients' records compromised all because of a computer-hacker.
• Lawsuit alleges that hospice released private information
  The new suit claims the hospice released the patient information over the last several years as its for-profit subsidiary, Hospice Systems Inc., marketed a software product to other hospices around the nation.
• Searchers may Google your patient records
  In March, Wired.com reported that hackers used Google as a shortcut to infiltrate computer networks that weren't properly secured. Instead of blindly surfing the Web for vulnerable computer networks, hackers can use a search engine to easily identify targets. That's because many databases use templates and canned phrases that Internet search engines pick up as they search and index the content posted on the Web.
• Lawsuit accuses TriWest Healthcare of negligence
  The company's offices were invaded Dec. 14 by thieves who made off with laptop computers containing files on 562,000 military personnel, retirees and family members who have health care through the company. The data included Social Security numbers, birth dates, duty stations, medical records and other information that could be used by identity thieves.
• Rape Crisis Center Won't Release Records
  A rape crisis center plans to refuse a judge's order to release records of a teenage victim's visits to the center, saying the alleged rapist's lawyers wrongfully learned of her counseling by questioning her grandmother.
• Leagues Seek Relief From Privacy Law
  HIPAA could create enormous problems for professional sports teams when compliance is required next year, and lawyers acting in consultation with teams in the National Football League, Major League Baseball and other leagues are seeking regulatory relief.
• Hospital, docs part of Prozac mailing scandal
  About 150 area residents received free samples of a once-weekly version of Prozac through the mail. The mailing came in a Walgreen's envelope and included a letter on Holy Cross Medical Group stationery signed by three physicians.

• Kaiser limits doctors' links to medical firms
  The new policy will likely become a model for conflict of interest policies throughout Kaiser's network, which employs 12,000 physicians in nine states, as well as in other medical groups, predicted Dr. Robert Pearl, executive director and chief executive officer of the medical group.
• Report Faults Scientific Journals on Financial Disclosure
  Several leading medical and science journals fail to enforce their own policies for disclosing financial conflicts of interest among contributing authors, according to a study released today by the nonprofit Center for Science in the Public Interest (CSPI).
• Former Healthsouth officers charged in fraud conspiracy involving Saudi hospitals
  Against the advice of counsel, HealthSouth allegedly agreed to pay the Saudi foundation's director general the sum of $500,000 per year for a five-year period in return for his agreement to execute the contract on behalf of the Saudi foundation.
• Wining and dining potential clients: An ethical dilemma?
  Terms of the multimillion dollar deal have not been disclosed, but the East Meadow, NY-based 1,500-bed health care system has selected Eclipsys' SunriseXA for its new electronic medical record / computerized physician order entry system. Yet as IT execs pop a celebratory cork over the signed contract, hospital officials scramble to build a defense against charges they compromised the competitive bidding process.
• Another Probe Touches Troubled Tenet
  The CEO at one of its hospitals has been indicted for allegedly violating physician recruitment rules. Tenet also said the hospital itself — Alvarado Hospital Medical Center in San Diego County —is facing similar charges. The probe is widening to other Tenet hospitals.Another hospital executive arrested.
• Drug Makers Battle Plan to Curb Rewards for Doctors
  In October, the Department of Health and Human Services said many gifts and gratuities were suspect because they looked like illegal kickbacks. Since then, a few consumer groups, including AARP, have voiced support for the restrictions. But they are outnumbered by the drug makers, doctors and health maintenance organizations that have flooded the government with letters criticizing the proposal.

• Association of funding and conclusions in randomized drug trials
  Conclusions in trials funded by for-profit organizations may be more positive due to biased interpretation of trial results.
• Pharmaceutical industry sponsorship and research outcome and quality: systematic review
  Systematic bias favors products which are made by the company funding the research. Explanations include the selection of an inappropriate comparator to the product being investigated and publication bias.
• Scope and Impact of Financial Conflicts of Interest in Biomedical Research: A Systematic Review
  A new Yale University study finds that when businesses, rather than other groups, sponsor medical research at hospitals and colleges, the outcomes are 3.6 times more likely to favor the company involved.
• A National Survey of Provisions in Clinical-Trial Agreements between Medical Schools and Industry Sponsors
  Academic institutions routinely engage in industry-sponsored research that fails to adhere to International Committee of Medical Journal Editors guidelines regarding trial design, access to data, and publication rights.

• Calif. lawmakers want stop to human pesticide testing
  Sen. Barbara Boxer and Rep. Henry Waxman, two California Democrats, issued a 38-page report yesterday alleging that pesticide industry-sponsored studies on humans nationwide are improperly putting participants at risk. "In violation of ethical standards, the experiments appear to have inflicted harm on human subjects, failed to obtain informed consent, dismissed adverse outcomes and lacked scientific validity," the report says.
• Former UVM professor charged with research fraud
  Poehlman faces up to five years in prison on the criminal charges. He's also barred from receiving Public Health Research funds and must retract or correct 10 articles.
• Clone doctor took parents' cash for experiments
  The maverick fertility scientist Panos Zavos yesterday admitted that he had taken money from the parents of a dead infant and of an 11-year-old girl in order to carry out cloning experiments on their remains.
• Trial to open in deaths of cancer patients at Hutch
  The lawsuits were filed after The Seattle Times published a series of articles three years ago called "Uninformed Consent: What patients at ‘The Hutch' weren't told about the experiments in which they died." The series raised questions about whether patients were adequately informed in two controversial medical trials in which the Hutch or its doctors had financial ties.
• Nigerians in drug trial take their case to US court
  A counsel for the children, Lukman Ishola, says that Pfizer conducted the trial test of trovafloxacin on paediatric patients in a secretive manner without consent of their parents and guardians. He also claimed that the children's families were not told that they were taking part in a drug test.
• Northwestern University to pay $5.5M to resolve effort reporting allegations
  For example, the government alleged that in completing applications for the National Institutes of Health and other federal agencies grants, Northwestern overstated the percentage of its researchers' work effort that they were able to devote to the grant. The United States also alleged that the university knowingly failed to comply with federal government requirements that a specified percentage of the researchers' effort be devoted to the grant.
• Physician reprimanded for research fraud
  The professional conduct committee of the GMC found Dr Jamal, aged 49, guilty of serious professional misconduct for falsifying his results in a multicentre trial of the drug Tarabetic, also known as Efamol. Having played a major role in the preliminary work on the drug, Dr Jamal had been promised 0.5% of Tarabetic's profits should it come to market.
• Scientists under the microscope — Researchers grapple with cause, effect of recent frauds
  A Chronicle survey of the Bay Area's three most prominent academic institutions — UCSF, UC Berkeley and Stanford University — found that a total of 38 charges of research misconduct have been filed since 1994 — an average of about five charges a year.
• Artificial Heart Implant Leads to Suit Over Consent Process
  Quinn's lawsuit, filed last month in Philadelphia's Common Pleas Court, puts the spotlight on the informed-consent process in clinical trials, and raises questions about whether patients who are near death and perhaps in extreme emotional states can make good choices about taking chances with a new medical procedure or treatment.
• Internal investigation leads to suspension of surgeon's clinical research privileges
  The University of Michigan has suspended the clinical research privileges of one of its leading cancer surgeons. IRB breaches included: inadequate documentation of informed consent, deviations from the approved protocol, patient enrollment after the study was closed, and failure to report adverse events.

• Health Insurers Allege ‘Rent-a-Patient' Fraud
  Twelve Blue Cross and Blue Shield plans from across the United States charged that a group of California-based surgery centers and medical management companies paid people as young as 12 to have unnecessary medical procedures.
• Trigger point injections trigger prison sentence
  A federal judge sentenced a surgeon to 41 months in prison yesterday for fraudulently billing TennCare and other health insurers more than $3.1 million.

• Couple Charged in $40-Million Health Fraud
  The two are charged with stealing the identities of doctors and patients so they could bill the programs for lab tests, medical supplies and drugs that were not provided and for services that were exaggerated or were provided by unlicensed personnel.
• Allstate NJ, Encompass Lawsuit Seeks $22 Million in Fraud Damages from North Jersey MDs
  According to the suit, the fraud operation involved the misrepresentation and fraudulent documentation of injuries and complaints of injuries in more than one thousand Allstate New Jersey and Encompass insureds and others.
• Eye doctor found guilty of $1M fraud
  An eye surgeon from Coral Gables was sentenced Monday to 57 months in prison on 90 counts of Medicare fraud, the government said.
• Support for physician deception of insurance companies among a sample of Philadelphia residents
  Participants were asked whether, in response to restriction of health care, a physician should 1) accept restriction, 2) appeal restriction, or 3) misrepresent a patient's condition to obtain the desired service. Sanctioning of deception was substantial in this sample of prospective jurors.
• Doctor faces 108 charges
  The indictment alleges Hassman filed claims on patients to get payments she was not entitled to, specifically chiropractor services not covered by TRICARE. She allegedly employed chiropractors and others to perform the services on patients and then submitted the claims under her own name or, earlier, that of her previous employer.
• Hospital fined $1 million in fraud case
  The case centered on the work of Jeffrey Askanazi, the pain doctor who treated patients at United Memorial. He was sent to prison for three years after a fraud conviction in 1998. The government contended that Askanazi ran a "surgical mill" at United Memorial and treated patients like "cash cows."
• FBI targets 2 heart doctors
  Heart patients who may have undergone unnecessary surgery at the hands of two prominent Redding doctors sought lawyers Thursday as federal agents continued poring over mounds of medical records generated by the two, including those of 167 Medicare patients who died under their care. Comparing the number of heart procedures at Redding Medical to the number at another Redding hospital, one doctor told investigators that he estimated half of the Redding Medical heart procedures were unnecessary.The probe spotlights broader questionsabout care in Redding.One of the doctors responds.Lawyers pursue clients on Web.In the aftermath, Redding hospital lays off 12.5% of workforce.Redding hospital halts cardiac surgery.Doctor is formally accused.
• Physician sentenced to five years in prison for health care fraud and money laundering
  Baluch claimed that he performed 150 to 180 of a particular allergy test when in fact he performed no more than 50 of another allergy test for which Medicaid and Medicare did not provide any benefits. To further his scheme, Baluch prepared phony progress notes regarding the false allergy tests in case Medicaid or Medicare requested supporting documentation when reviewing the respective false claims.

• UW medical billing needs watchdog, committee says
  Speaking for the committee, Seattle attorney William Van Ness Jr. and Orin Smith, former chief executive officer of Starbucks Coffee, said complacency, arrogance and inconsistent management were at the root of the university's problems.
• Feds accused UW doctors of overbilling $100 million
  The University of Washington overbilled Medicare and Medicaid by at least $100 million over 10 years, despite an "abundance of evidence" that it knew the rules for proper billing, according to a newly disclosed slide show used by federal attorneys to make their case against the medical school.
• Regents reject deal in UW billing case
  University of Washington regents have angrily rejected a proposed $35 million settlement in a 5-year-old civil lawsuit over Medicare and Medicaid overbilling, according to sources close to the case.
• UW professor sentenced for role in billing case
  Dr. William Couser, a leading kidney specialist and professor of medicine at the University of Washington, was sentenced to 1,000 hours of community service and five years probation yesterday for having falsely claimed to have been present during dialysis procedures.
• Surgeon guilty in UW case
  An internationally known Seattle brain surgeon admitted yesterday that he obstructed a criminal investigation into Medicare and Medicaid overbilling by "creating an atmosphere of fear and intimidation" at the University of Washington Academic Medical Center.
• Phantom of the Operating Room
  In a verdict that could have far-reaching implications for the Oregon Health Sciences University, a federal jury last month awarded $382,000 in damages to a former plastic surgery resident who was fired for raising questions about his boss's billing practices—practices that may involve Medicare fraud.

• U.S. seizes state prison health care Judge cites preventable deaths of inmates, ‘depravity' of system
  A federal judge, saying he was acting urgently to stop the needless deaths of inmates because of medical malfeasance, ordered Thursday that a receiver take control of California's prison health care system and correct what he called deplorable conditions.
• The Troubles at King/Drew
  This series, in five parts, covers the severity of the hospital's recurring medical lapses, its managerial shortcomings and the political conditions that have thwarted effective reform.
• Man dies in nursing home after "DNR" order accidentally placed in his file
  Frances Daniel is suing Doctors Lake of Orange Park for more than $75,000 dollars in the death of her 81-year-old husband. Daniel says the do-not-resuscitate order was meant for her husband's roommate.
• Indicted oncologist loses some privileges
  Late last month, the U.S. attorney's office in Nashville charged that the 52-year-old oncologist had either shortchanged her patients on their chemotherapy doses or, in other cases, overbilled TennCare and Medicare by falsely claiming that she had administered full doses of the powerful anti-cancer medications
• Ex-nurse's shady past never followed him - System allowed man accused of killing patients to move from hospital to hospital
  The most sustained look at Cullen, when his suspected killing spree might have been stopped, was in the middle of last year. Yet the hospitals and public agencies that looked into him then, like those that encountered him throughout his career, said they were defeated by a system that lacks a way to spread the word about medical professionals suspected of misdeeds, and by hospitals and government agencies unwilling to do so.
• LA Hospital Neglects Patients; Five Patients Die
  A report compiled by federal officials said nurses at Martin Luther King Jr.-Drew Medical Center left critically ill patients unattended for hours at a time and were ordered to lie about patients' conditions.
• 2nd physician sues Magee over Paps
  A second physician has filed suit against Magee-Womens Hospital and the UPMC Health System, accusing the hospital of falsifying hundreds of thousands of Pap smear reports and practicing poor quality control.
• The Cost of Courage: Centre County hospital critics soon unwanted
  The hospital, in fact, seemed more concerned with Powers than with correcting the problems she was pointing out.
• Dismissal is retaliation by hospital, doctor says
  A Marysville heart surgeon has accused Rideout Memorial Hospital officials of punishing him for objecting to questionable medical practices and billings. Hospital officials had canceled Richman's hospital privileges on May 22 after he pleaded no contest on May 7 to drug charges and entered a treatment program.
• State fines six doctors for online prescriptions
  in an unprecedented move that could affect medical practice nationwide, the Medical Board of California has levied millions in fines against six out-of-state doctors for prescribing drugs to state residents over the Internet.
• SLA Pursuer Loses MD License
  Opsahl became the first doctor in the state to have his license revoked for prescribing medicine over the Internet without conducting a physical examination, a spokeswoman for the Medical Board of California said. The revocation is effective Feb. 21.
• Doctor Charged With Diluting Cancer Drugs
  A Pompano Beach urologist was indicted Wednesday on charges that he diluted expensive cancer-treatment drugs given to more than 30 patients. Dr. Victor Souaid, 40, is charged with 60 counts including health care fraud, product tampering and the wholesale distribution of prescription drugs without a license.
• Doctor Defends Branding Woman's Uterus
  A surgeon being sued for branding a patient's uterus with the initials of his alma mater — the University of Kentucky — defended his actions as a routine part of a hysterectomy.
• Infection-related lawsuits swamp Sacramento hospitals
  More than two dozen lawsuits have been filed against local hospitals in the last six months claiming that patients caught infections during their hospital stays, worsening their health and increasing costs by thousands of dollars.
• Kaiser Will Pay $1-Million Fine for Death
  The state alleged that Kaiser failed to deliver urgently needed care to 74-year-old Margaret Utterback, who died in 1996 of an abdominal aortic aneurysm. The state also claimed that Kaiser had "systemic" problems treating patients in a timely manner.

• Death 50 feet from ER costs hospital $12 mil.
  Advocate Ravenswood Hospital has agreed to pay $12.5 million to the family of Christopher Sercye, the 15-year-old boy whom hospital workers refused to help as he lay dying outside.
• Botsford Pays $5M For Patient's Death
  A Detroit federal jury awarded $5 million to the family of Kelly Snider-Smith, 33, who died while being transferred from Botsford General Hospital to University of Michigan Hospital, according to reports.

• Tenet Faces SEC Music
  The Securities and Exchange Commission has indicated it may file civil charges against Tenet and the executives who once led the company when it profited handsomely from an aggressive pricing scheme. Until 2002, Tenet relied on outsized outlier reimbursements from Medicare and stop-loss payments from commercial insurance to achieve the profitability that made it a Wall Street darling. After UBS analyst Kenneth Weakley exposed the scheme late that year, however, the company saw its stock collapse.
• Hospital's ex-chief gets jail
  Boettcher said he believed lying to regulators was the only way the hospital would gain timely approval for a new birthing center, emergency room, ambulatory-care center, surgical suites, and modern facilities for both obstetrics and pediatrics, all of which Fletcher Allen badly needed and are now being built at the hospital.
• OIG and Tenet Healthcare Corporation Reach Divestiture Agreement To Address Exclusion of Redding Medical Center
  The OIG had initiated proceedings to exclude Redding from Medicare, Medicaid and other Federal health care programs based on allegedly unnecessary invasive cardiology services provided to patients of the hospital over a four year period.
• Tenet hit by more charges
  In a fresh set of legal problems for its beleaguered Redding hospital, Tenet Healthcare Corp. was accused by state officials Monday of overbilling the Medi-Cal program by $12 million over two years.
• Tenet is being sued for overcoding inpatient stays. 

• State: Pharmacy sold fake meds
  "It's unconscionable that somebody would do what these people are alleged to have done," Florida Attorney General Charlie Crist said Friday. "The sheer greed factor here is just astounding."
• OIG settles largest ever kickback civil monetary action against PharMerica
  OIG brought an administrative action under the CMPL against PharMerica on June 17, 2004, alleging that PharMerica paid an excessive amount of money for a small Virginia pharmacy in return for a commitment from the seller to refer its Medicaid and Medicare pharmacy business for the next 7 years.
• Suit accuses Caremark of improprieties
  Two Caremark Rx Inc. employees are accusing their Nashville-based employer of fraudulently reshipping prescription drug orders that were returned to the company, without testing the medications for possible tampering or paying back clients who were first sent the prescriptions.
• Lax System Allows Criminals To Invade the Supply Chain
  At a time when more Americans are relying on medication, their chances of receiving a drug that is fake, diluted or mislabeled have never been so great.
• Federal prosecutors accuse pharmacy benefit company of shortchanging customers
  The suits say Medco routinely induced physicians to switch patients to Merck drugs, even if a patient had been doing well on another medication that cost less. They say the company tried to avoid penalties for delays in filling mail orders by destroying prescriptions on days when the order volume was heavy.
• Owners of Brooklyn Pharmacy and Clinic charged in $2.4M fraud
  In carrying out their scheme, prosecutors charge that the defendants Rivkin, Boim, Erlich, and Lachter set up a bogus in-house pharmacy at Brooklyn Medical Arts, through which prescriptions for AIDS medications, including Serostim, were funneled to Bridge Total Health Corp., which does business as Echo Drugs. The drugstore, in turn, would make regular deliveries of the medications to the clinic. However, instead of dispensing the medications, clinic owners Erlich and Lachter would often tell recipients that the drugs were either missing or stolen.

DME and ambulance companies

• U.S. seizes hospital beds from city firm
  The agency stated that Vail Products failed or refused to furnish material to the FDA as required by federal law, and said Vail has continually not followed FDA regulations. Vail has been issued two FDA warning letters - one in 1997 and one in 2003 - outlining unacceptable practices. The agency says Vail was given a chance to correct violations but failed to do so.
• Pacemaker sale on eBay spotlights dangers
  A pacemaker stolen from a Sacramento hospital, sold on eBay and implanted in an Arizona man exposed a potentially fatal flaw in the nation's system for tracking lifesaving medical devices, regulators and doctors say.
• Medicare stung by wheelchair scam
  Fifty separate investigations under way in nearly two-dozen states have identified $167 million in fraudulent Medicare claims for power wheelchairs, officials told The Associated Press, a fast-growing new swindle of the government's main health care assistance program.

• PA nursing home owner gets 4-12 years in prison
  "We have a special responsibility to protect our more defenseless citizens from the greed of unscrupulous nursing home owners who callously fail to deliver needed health services," said Spitzer. "The sentence imposed today sends a clear message: nursing home owners who abandon and neglect their patients for personal gain will go to jail."

• 150 cases of drug pricing fraud?
  The Wall Street Journal reported Monday that the investigations could produce more than $1 billion in criminal and civil penalties this year. The paper said the probes are looking at allegations that drug companies cheat state and federal health-care programs by inflating prices and offer undisclosed rebates to distributors.
• Bayer agrees to biggest Medicaid fraud settlement
  Germany's Bayer will plead guilty to a criminal charge and pay $257 million in fines and civil damages in what U.S. prosecutors Wednesday called the biggest Medicaid fraud recovery in U.S. history.
• Judge Says Maker of OxyContin Misled Officials to Win Patents
  To win its patents, Purdue told the patent office that OxyContin was unique because 90 percent of patients taking the medicine got pain relief by taking very little medicine - from 10 milligrams to 40 milligrams. But during the course of the trial, Dr. Robert F. Kaiko, OxyContin's inventor, acknowledged that he had done no clinical studies and had no evidence to support this claim.
• Whistleblower charges drug company with deceptive practices
  Pfizer is accused of having a marketing strategy for off-label use of Neurontin that included ghostwriting journal articles for doctors and rewarding potential prescribers with beach trips. Dateline NBC has a special on this:drug giant accused of false claims.
• Guilty plea in medical fraud — 12 patients die
  A Menlo Park maker of medical devices hid the fact that its product had malfunctioned thousands of times and that 12 people had died during or after its implantation, a senior company official admitted in San Francisco federal court Thursday.
• Largest independent contract health care manufacturer in world has entire product line recalled
  The suspension follows audits of the company's manufacturing premises, which revealed widespread and serious deficiencies and failures in the company's manufacturing and quality control procedures, including the systematic and deliberate manipulation of quality control test data.
• Schering-Plough target of criminal investigation
  Allegations include giving items of value to physicians to induce purchase of Schering-Plough products, promoting off-label use, providing false pricing information, and obstruction of justice.
• New York Will Sue 3 Big Drug Makers on Doctor Discount
  The drug companies establish a price for the drug that the government and insurance companies use to determine how much to reimburse the doctors and pharmacies for the drugs they buy. The companies then allow the doctors and pharmacies to buy their drugs at much lower prices than the ones reported to the government. The doctors and pharmacies then pocket the difference.
• Bristol-Myers Squibb to Pay $670 Million to Settle Lawsuits
  Bristol-Myers Squibb said yesterday that it had agreed to pay $670 million to settle numerous lawsuits by states, consumers and competitors charging it with using illegal tactics to keep lower-priced versions of its medicines Taxol and BuSpar out of the market
• Documents Show Effort to Promote Unproven Drug
  Mr. Greene also filed another memorandum with the court that details how Warner-Lambert tracked prescriptions written by doctors after they attended dinner meetings paid for by the drug company at which Neurontin was discussed. The memo, dated June 26, 1995, said that in the Northeast, doctors attending the dinners wrote 70 percent more prescriptions for Neurontin than doctors who did not attend.

• Insurer Agrees to Pay Doctors $198 Million
  Filed yesterday in U.S. District Court in Miami, the agreement is the fifth to emerge from a massive class-action suit, consolidated in 2000, targeting 10 large managed-care providers. The doctors and about a dozen state medical associations accused the health plans of using a host of techniques to wrongly reduce physician payments. The physicians complained that by refusing to cover certain tests and treatments or underpaying for services, the practices had a detrimental effect on patient care.
• Blue Cross could face joint state, federal trial
  The suits accuse the state's largest health insurer of among other things deceiving and bilking subscribers by failing to pass along discounts that it secretly negotiated for medical services and pharmaceutical drugs.
• Attorney General Sues Unlicensed Health Insurer
  The joint investigation found that Jaravata and her associates falsely represented Metro Health had a network or doctors and hospitals to provide care and would pay 100% of a member's medical expenses after the member paid premiums, deductibles and co-payments. It was also revealed that Jaravata and her associates engaged in "claims avoidance" by failing to pay legitimate claims, discouraging members from using benefits, and terminating members to avoid payment of claims.
• Cigna settles docs' suit with $700M agreement
  The Philadelphia-based health care company faced doctors' charges it violated federal statutes against conspiracy, aiding and abetting claims, breach of contract, unjust enrichment and violations of various state prompt pay statutes.
• U.S. Probing CareFirst Over Attempted Sale
  Top CareFirst executives would have received tens of million dollars in additional bonuses if the WellPoint deal had been approved. Terry Newmyer, who heads the Fair Care Foundation, an advocacy group, called the federal probe "an overdue step toward uncovering the truth" about "the unprecedented compensation schemes."
• Aetna agrees to settle doctors' payment suit for $470M
  Aetna has agreed to a $470 million settlement with more than 700,000 doctors who alleged in a class-action lawsuit that insurers wrongly cut payments to them and interfered with their recommended treatment for patients.
• Cigna Pays to Settle Medicare Charges
  Cigna Corp., one of the nation's largest health insurers, paid the federal government $24.5 million to resolve allegations that its hospital in New Mexico submitted a decade's worth of false cost reports to increase Medicare reimbursements, federal officials said Wednesday.

• FTC Challenges Hospital Merger That Allegedly Led to Anticompetitive Price Increases
  According to the FTC, Evanston Northwestern Healthcare Corporation's (ENH) acquisition of Highland Park Hospital (Highland Park) resulted in significantly higher prices charged to health insurers and therefore in higher costs to purchasers of insurance and consumers of hospital services.
• Federal Trade Commission Settles Price-fixing Charges Against Washington University Physician Network
  "This group of St. Louis-area physicians engaged in overt price-fixing," said Joe Simons, Director of the FTC's Bureau of Competition. "Its conduct was plainly anticompetitive and harmful to consumers, by forcing up prices in the area. It is a straightforward violation of the FTC Act."
• FTC accuses group of price-fixing
  The Federal Trade Commission on Wednesday filed a complaint against Brown & Toland, accusing the large San Francisco doctors group of price-fixing certain health plan contracts. See the FTC chargehere.
• Doctor's group settles charges of price fixing
  The consent order calls for the physicians group, CPA, to be dissolved. "CPA served no function other than to jointly fix prices on behalf of its members during the health plan contracting process," said Joe Simons, director of the FTC's Bureau of Competition.
• U.S. to Step Up Antitrust Effort on Health Care
  The chairman of the Federal Trade Commission, concerned about rising medical costs, said yesterday that his agency planned to step up scrutiny of past hospital mergers and groups of doctors to make sure they had not joined forces simply to fix prices.
• FTC investigating Nevada ob-gyns for price collusion
  In July, the FTC sent a letter to the president of the Clark County OB-GYN Society telling him that the 100-member group was under investigation to see if it violated antitrust laws by collectively negotiating health insurance contract prices or by collectively refusing to deal with plans.