• General
• Privacy and Security
• Kickbacks/Conflicts of Interest
• Research
• Physician Billing
• EMTALA
• Hospitals
• Pharmacies
• DME and ambulance companies
• Pharmaceutical companies and device manufacturers
• Insurers
• Antitrust/Red Flags

• Mayo Clinic CEO fires two employees for privacy violation 
• Hospital privacy leaks could harm patients
  Private information about accident victims treated at University Medical Center has apparently been leaking for months, the Sun has learned, allegedly so ambulance-chasing attorneys could mine for clients.
• Doctor and two former hospital employees sentenced for HIPAA violations
  
• Time to check dangers of social networking 
  While many popular Web sites have strong privacy practices in place, there is no better time to analyze where, when, how, and if your personal health information (PHI) is circulating through these types of web sites.
• New Stark law regulations loom over healthcare professionals 
• IA medical center settles false claims case for $4.5 million
  Covenant Medical Center in Waterloo, IA, agreed to pay $4.5 million to settle claims that it had improper financial relationships with five physicians, according to a Department of Justice (DOJ) release.
• Detroit physical therapist admits to falsifying Medicare claims worth $1.68M
  On August 26, Jay Jha, a Detroit-area physical therapist, admitted his involvement in a conspiracy that defrauded Medicare of approximately $18.6 million, according to a Department of Justice (DOJ) release.
• Ira Davenport owes $255K to Medicaid
  Ira Davenport Memorial Hospital in Bath was recently cited for mistakes in applying for Medicaid reimbursement for its dental clinic, according to the Attorney General’s Medicaid Fraud Control Unit representative Jerry Solomon.
• 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.

• Kaiser patient data stolen 
  Information regarding approximately 15,000 Kaiser Permanente patients, including about 4,000 people in the Sacramento area, was stolen in December, the organization said Tuesday.
• Former UCLA health worker pleads guilty to accessing celebrities' medical records 
• Octomom Nadya Suleman's hospital, Kaiser Permanente's Bellflower, fined again over privacy breach
  The Southern California hospital where Nadya Suleman's octuplets were born has been fined $187,500 for failing to protect their medical privacy, state health officials said Thursday.
• CVS Pays $2.25 Million and Toughens Practices to Settle HIPAA Privacy Case
  The U.S. Department of Health and Human Services (HHS) and the Federal Trade Commission (FTC) today announced that CVS, the nation’s largest retail pharmacy chain, will pay the U.S. government a $2.25 million settlement and take corrective action to ensure it does not violate the privacy of its millions of patients when disposing of patient information such as identifying information on pill bottle labels.
• Virginia DHP Urges Caution After Hacker Claims of Data Breach
  As Virginia DHP officials await the completion of an investigation into reports of a massive data breach affecting 8 million records from the Virginia Prescription Monitoring Program, people are urged to be vigilant for signs of identity theft. On April 30, a message demanding a $10 million ransom for the data was posted on the Prescription Monitoring Program's Website.
• 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.
• 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.

• 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.

• 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.



Conflicts of Interest in Research

• 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.
• 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.

• 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.
  
  

  Supervising Residents

• 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.

• 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.

• Pharmacy owner defrauds Medicaid of $3 million 
• Walgreens seeks to settle case over dumped documents
  New developments suggest another drug store giant may face punishment for trashing your privacy. Now, Walgreens wants to settle its case - whether the state wants to or not.
• 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.

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.

• 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.

• 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.
• 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.
• 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.

• 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."