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[image: Your Daily Update] December 14th, 2011 White House: $5.6

billion in fraud recovered - The Federal Eye - The Washington

Post<http://ptmanagerblog.com/white-house-56-billion-in-fraud-recovered-the>

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White House: $5.6 billion in fraud recovered

By Ed

O'Keefe<http://www.washingtonpost.com/ed-okeefe/2011/02/02/ABqNUZE_page.html>

Vice President Biden will chair a Cabinet-level meeting Tuesday on plans to

cut government waste. (n Smialowski - GETTY IMAGES) The White House

says a more aggressive effort to nab deceptive government contractors and

deceitful Medicare recipients is paying off — to the tune of billions of

dollars.

[image: Eye Opener]

The Obama administration plans to announce Tuesday that the Justice

Department <http://www.justice.gov> recovered more than $5.6 billion in

fraud committed against the government in fiscal 2011. Almost $3.4 billion

of the funds came in civil fraud recoveries, with more than $2.2 billion

tied to criminal fraud, according to administration officials familiar with

the announcement who were not authorized to speak publicly on the matter.

The announcement is tied to a Cabinet-level meeting to be held Tuesday

regarding plans to cut wasteful government

spending<http://www.washingtonpost.com/blogs/federal-eye/post/white-house-launch\

ing-new-campaign-to-cut-waste/2011/06/12/AGn3JjSH_blog.html>across

federal agencies and departments.

Among other cases, the Justice Department reached a $15 million settlement

with American

Grocers<http://www.businessweek.com/ap/financialnews/D9JJFNS80.htm>,

a Texas company that was buying cheap expired food, altering expiration

dates on the food and selling it with a steep markup to the federal

government to serve to U.S. troops serving in the Middle East.

But most of the recoveries were tied to health-care fraud and the work of

what officials call Medicare Fraud Strike

Forces<http://www.stopmedicarefraud.gov/>,

or specialized teams of agents and prosecutors from the departments of

Justice and Health and Human Services <http://www.hhs.gov> in nine cities

that are monitoring Medicare spending and quickly bringing cases to court,

the officials said.

Vice President Biden will chair Tuesday’s meeting, which will be attended

by several Cabinet secretaries who plan to share similar examples of how

they are identifying potential savings or cracking down on wasteful

spending and fraud.

At HHS, Secretary Kathleen Sebelius is expected to unveil plans for the

department to urge insurance companies to withhold payments on suspicious

claims by patients who “doctor shop,” or use multiple doctors to obtain

prescriptions for painkillers and narcotics including OxyContin and

Percocet that can easily be abused or resold illegally.

The problem is a growing concern: A Government Accountability Office

report released

in October <http://www.gao.gov/new.items/d12104t.pdf> found that about

170,000 Medicare beneficiaries were receiving prescriptions for painkillers

from five or more doctors at a cost of about $148 million paid by Medicare.

In 2008, GAO said one beneficiary was able to obtain prescriptions for a

total of 3,655 oxycodone pills from 58 different prescribers.

Tuesday’s meeting was also when we were expected to get our first look at

how agencies and departments are cutting back on travel and conference

costs in the wake of a controversial Justice Department watchdog

report<http://www.washingtonpost.com/politics/a-16-muffin-justice-dept-audit-fin\

ds-wasteful-and-extravagant-spending/2011/09/20/gIQAXKyhiK_story.html>that

initially accused the department of spending up to $16 on muffins

served at a breakfast meeting.

The department’s acting inspector general later revised the findings, but

not before the Office of Management and Budget <http://www.omb.gov> ordered

agencies to curtail and revamp their conference spending

plans<http://www.washingtonpost.com/blogs/federal-eye/post/no-more-16-muffins-fo\

r-you/2011/09/22/gIQA2mU8nK_blog.html>in

time for Tuesday’s meeting.

But administration officials said late Monday that the spending reviews are

underway as part of a broader order by President Obama to cut 20 percent of

spending on travel, conference costs, technology and “office

swag.”<http://www.washingtonpost.com/blogs/federal-eye/post/obama-orders-agency-\

spending-cuts-on-travel-technology-and-swag/2011/11/08/gIQAlOXj3M_blog.html>

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washingtonpost.com<http://www.washingtonpost.com/blogs/federal-eye/post/white-ho\

use-56-billion-in-fraud-recovered/2011/12/12/gIQA9IdSqO_blog.html>

Medtronic to Settle Kickback Allegations -

WSJ.com<http://ptmanagerblog.com/medtronic-to-settle-kickback-allegations-wsjc>

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Medtronic to Pay $23.5 Million to Settle Kickback Allegations

By NATHALIE

TADENA<http://online.wsj.com/search/term.html?KEYWORDS=NATHALIE+TADENA & bylinesea\

rch=true>

Medtronic<http://online.wsj.com/public/quotes/main.html?type=djn & symbol=MDT>Inc.

has agreed to pay $23.5 million to resolve allegations that it paid

illegal kickbacks to physicians who participated in its postmarket studies

and device registries to induce doctors to implant the company's pacemakers

and defibrillators, the Department of Justice said Monday.

The government contends that Medtronic, a medical-device maker based in a

Minneapolis suburb, solicited physicians for its studies and registries to

convert their business from a competitor's product and to persuade the

doctors to continue using Medtronic products.

Postmarket studies assess the clinical performance of a medical device or

drug after it has been approved by the Food and Drug Administration.

Registries are collections of data maintained by a device manufacturer

concerning its products that have been sold and implanted in patients.

The Justice Department alleges Medtronic caused false claims to be

submitted to Medicare and Medicaid by using two postmarket studies and two

device registries as the vehicle to pay participating physicians illegal

kickbacks. Although Medtronic collected data and information from

participating physicians, each of the studies and registries required a new

or previous implant of a Medtronic device in each patient and the company

allegedly paid physicians a fee of approximately $1,000 to $2,000 per

patient.

" Patients who rely on their health-care providers to implant vital medical

devices expect that those decisions will be made with the patients' best

interests in mind, " said Tony West, assistant attorney general for the

department's Civil Division. " Kickbacks, like those alleged here, distort

sound medical judgments with financial incentives paid for by the

taxpayers. "

Medtronic made no admission that any studies were improper or unlawful.

" Medtronic is happy to have this investigation behind us, so we can

continue designing and executing clinical trials that generate evidence to

improve patient care, outcomes, and cost effectiveness, " said Marshall

Stanton, vice president of clinical research and reimbursement for

Medtronic's cardiac and vascular group.

The settlement resolves allegations contained in two whistleblower

lawsuits. As part of the settlement, the whistleblowers will receive

payments totaling more than $3.96 million from the federal share of the

recovery.

Medtronic shares fell 1.3% to $35.45 in trading Monday and were little

changed after hours.

via

online.wsj.com<http://online.wsj.com/article/SB100014240529702034304045770952610\

65225318.html>

A good death is a right we must fight

for<http://ptmanagerblog.com/a-good-death-is-a-right-we-must-fight-for>

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A good death is a right we must fight for

by Lickerman,

MD<http://www.kevinmd.com/blog/post-author/alex-lickerman>| in

Physician <http://www.kevinmd.com/blog/category/physician> | 6 responses

The notion that

dying<http://www.kevinmd.com/blog/2010/05/dying-age-era-modern-medicine.html>is

a right seems nonsensical to argue: death is given to all of us

equally

without the need of anyone’s sanction. The right to die well, on the other

hand—well, that’s another matter entirely. A good death is, in many cases,

something our fellow human beings have great power to grant or deny, and is

therefore, sadly, a right for which we must indeed fight.

The notion that we’d even need to fight for the right to die well has only

come to make sense relatively recently, within the last forty years or so.

Prior to that, our ability to prolong dying—meaning, keep extremely ill

people going in hopes that they might overcome whatever health problem

threatens even when the likelihood is vanishingly small—was actually fairly

limited. But with the advent of modern intensive care units and all the

amazing technology that’s emerged in the last four decades, we can now

stretch the quantity of out our last days often to weeks or even months.

Unfortunately, a similar stretching of quality hasn’t yet occurred; if

anything, we see the opposite (to be fair, the same technology also

stretches some lives to years and even decades, meaning it’s enabled some

people to recover from insults that in the past would have undoubtedly

killed them).

Health providers don’t wield this technology to prolong suffering

intentionally. As I argued in a previous post, Knowing When To

Stop<http://www.happinessinthisworld.com/2011/06/05/when-to-stop/#.TpiSFnH2dic>,

it’s quite difficult to predict the timing of death, even in the

terminally ill. In one sense, then, the horrific deaths many patients

experience at the hands of modern medicine reflects our species’ profound

optimism bias. Even when in our hearts we know it’s time to stop, we often

don’t.

Yet as we learn more about our own biases, we begin to have more

responsibility for mastering them and for making decisions from a place of

realistic compassion, not naive hope. If we set aside for purposes of this

discussion those patients I discussed in that previous post who we

genuinely think might have a chance to recover and focus instead on those

who clearly don’t, the need to establish an approach about how to effect

death humanely becomes readily apparent. As a result of technological

advances, we’re now at a point in our history where we must make active

decisions to hasten death, in many instances, in order to prevent suffering

that often results from our ability to prolong it. Which makes it all the

more tragic when we choose not to.

Only three states in the U.S. allow assisted suicide: Oregon, Montana, and

Washington. The requirements are that a patient must be of sound mind as

confirmed by a physician and other witnesses and must be diagnosed with a

terminal illness. But what’s fascinating to me about the way people think

about this is the following: though most of the people I’ve asked the

question “Are you afraid to die?” have responded “I’m afraid to die in

pain,” most of them also, while still in a state of good health, have a

difficult time envisioning themselves choosing to swallow poison

(admittedly, I’m referring to anecdotal responses of a small number of

people). And though intellectually we may feel we could certainly be

brought to the point where we could swallow poison, I suspect few of us can

really project how we’d feel about it at the moment we would do it. But

when you listen to people with terminal illnesses who actually do go on to

end their lives, you find what is to me a surprising thing: almost to a

person (of those assisted suicides actually documented) they say they feel

ready, willing, and able. Apparently it is possible to reach a point in

one’s dying where fear evaporates under the onslaught of discomfort.

It may be strange to say it, but I find this comforting. Death may be

inevitable, but fear of death need not. I’d like my death to be as

painless as the next person, but if I see it coming (a possibility that

increases each year with each technological advance), I’d also like to face

it without fear. I don’t know which, in general, causes more suffering in

the end, extreme physical pain or the terror of imminent non-being. But if

extreme pain also has the power to extinguish extreme fear, all the more

reason to think the ability to commit suicide at the time of our own

choosing might represent the crucial difference between a good death and a

bad one.

So my wife and I have discussed it. “You’ll help me take myself out if it

gets to that point, won’t you?” she asks me occasionally. I tell her I

will—and I really will, if it comes to that—but I wonder how. Not just how

I’ll be able to get myself to participate in the death of someone I love

(even seeing her in agony, death is just so final), but even I, as a

doctor, will make it happen in a state in which it’s illegal.

Though it could be argued the laws against assisted suicide in human beings

are largely the product of misguided religious thinking, I suspect there’s

also involved a secular reluctance to allow our fellow human beings to kill

themselves. Even though in many cases it’s hard to argue the prohibition

against assisted suicide is actually humane, it’s also quite a difficult

thing, emotionally, to allow a suicide to happen, much less to view it.

And yet, compassionate action is often hard in general. Tough love

typically doesn’t feel good to anyone involved, the giver or the receiver,

for example, but it is usually, when done appropriately, compassionate and

wise.

From the Nichiren Buddhist—and I think secular humanist—perspective the

alleviation of pointless suffering must be considered the primary aim in

terminal cases. The key concept here, it cannot be overemphasized,

however, is “pointless.” Nichiren Buddhism, at least, is founded on the

principle that suffering has a critical function in many instances as the

catalyst for valuable inner change. Pointless suffering, however, of which

the preventable suffering of the terminally ill is but one example,

remains, from the Buddhist perspective, the great enemy of us all.

Though I’m pledged to prolong life where I can, I’m also pledged to

alleviate pointless suffering. Thus, I very much believe in the right of

people to freely choose the method and time of their own demise when they

find themselves in circumstances where such a choice has become the only

option to relieve their pointless suffering. We remain profoundly

uncomfortable as a society with this position, but our own technological

advances will eventually force us to embrace it. As more and more people

die in needless pain and more and more people sit watching, eventually, I

believe, we will accumulate enough collective experience to make peace with

the notion that what we currently do with our pets is far more humane than

what we mostly do with each other.

* Lickerman is an internal medicine physician at the University of

Chicago who blogs at* Happiness in this

World<http://www.happinessinthisworld.com/>

*.*

*

*

Stop trivializing conflict of

interest<http://ptmanagerblog.com/stop-trivializing-conflict-of-interest>

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Stop trivializing conflict of interest

by Darrell White, MD

<http://www.kevinmd.com/blog/post-author/darrell-white>| in

Physician <http://www.kevinmd.com/blog/category/physician> | one response

-

Embedded media -- click here to see

it.<http://ptmanagerblog.com/stop-trivializing-conflict-of-interest>

-

Embedded media -- click here to see

it.<http://ptmanagerblog.com/stop-trivializing-conflict-of-interest>

- Embedded media -- click here to see

it.<http://ptmanagerblog.com/stop-trivializing-conflict-of-interest>

- inShare9

- Embedded media -- click here to see

it.<http://ptmanagerblog.com/stop-trivializing-conflict-of-interest>

“I’m sorry, Doctor, but we can’t have you give that talk; you have a conflict

of

interest<http://www.kevinmd.com/blog/2010/06/clinical-trial-conflict-interest-do\

ctors.html>since

you’ve been paid to do research on that medicine.”

“Well, Senator, it’s a conflict of interest for a doctor to sell those

crutches in his office.”

“It is the opinion of this newspaper that physicians should declare to each

patient any ownership interest they might have in a surgery center so that

the patient is aware of any conflict of interest.”

And on and on the drums beat, droning incessantly and insistently about the

dreaded conflict of interest.

In a world now run by the terminally attention deficited, with

multi-tasking and synergy-seeking all the rage, we apparently have one

domain in which nothing but the purest, most antiseptic, monastic and

single-minded devotion to a single task and goal is acceptable: the

provision of health care in America. Think about it … the simple existence

of other interests is de facto evidence of some nefarious conflict of

interest.

The underlying assumption appears to be that it is impossible to have any

additional interest–ownership of a business, a consulting agreement, stock

or stock options–without the ability to devote your primary attention to

the best interests of your patient. Any other interest is automatically

bad, and every physician is guilty and can’t be proven innocent. How did we

come to this?

There are issues and examples both substantial and trivial, and yet each of

them is addressed as if they are one and the same. I bought pens last month

for the first time in my professional career (I graduated from med school

in 1986). It was weird. Who knew that there was a place called OfficeMax

and that this huge store had not one but two aisles of pens to peruse?!I

think it was Bics in a Kmart the last time I bought a pen. Somehow this

fact means that I have been making decisions for my patients based on all

those pens I didn’t buy all these years. There’s only one problem with

that: I don’t remember a single thing about even one of those pens.

And yet somehow accepting those pens is a conflict of interest. Seriously.

Why is it that if I somehow get something from someone, big or small, even

if I perform some service or even buy something from them, that it’s a

conflict of interest if some company or other might make money from what I

do for my patient? Why is every peripheral interest that exists around the

little silo in which I practice medicine–a space occupied by me, my staff,

and my patient–why is that automatically a conflict of interest with some

sort of negative connotation? That I must be doing something bad? Why not

just another interest? Why can’t these things be a “convergence of

interests” between what is best for my patient and any of the other stuff

that might be going on around us?

Listen, I get it. There have been instances where docs have pushed inferior

products on their patients because they had a significant financial

incentive to do so. I’m reviewing a med-mal case right now where the

plaintiff had an eye problem which resulted in cataract surgery. The

cataract surgeons are not being sued, but I looked over the surgical record

and saw that they put an inferior lens implant in this guy’s eye, and I

know they did that because they own the surgery center and that lens is

dirt cheap. That’s a conflict of interest. But for every surgery center

owner like this putz I know 50 who put in state-of-the-art implants because

that’s what’s best for their patients. Those docs still make a profit, but

it’s smaller because they are putting the patient first. Why is that a

conflict of interest?

It’s not.

Three different companies make 3 versions of the same kind of medicine, all

of which have identical efficacy and safety, and all of which sell within

pennies of each other. How does one choose among them if one needs to be

prescribed? Is it such a heinous insult to humanity to choose to prescribe

the product from the company that pays the doc to consult on some other

project? Or the company that brought in lunch? Or the one that left a

couple pen lights in the office? Tell me, how and why is this a conflict of

interest?

This trivialization of the concept of conflict of interest is actually

weakening the protections that we should have against real conflicts that

cause real harm. Pushing unproven technology (artificial spinal discs,

anyone?) on unsuspecting patients prior to definitive proof in return for

obscene consulting agreements, for example. Applying the same degree of

moral outrage to a ham sandwich as we do to conflicts which truly pit the

best interests of our patients against some profound interest on the part

of the physician that prevents him/her from centralizing the patient is

farcical moral equivalence. I think it is actually harming our patients.

Our most renowned medical editors, innovators, inventors, and teachers are

withdrawing from public positions that require a monk-like aversion to

these conflicts of interest. Who will replace them? Will the ascete

cocooned in the conflict-free zone and unaware of what developments are on

the way contribute? How about the teachers? Will we be taught by

specialists who put together the purest power-points from the latest

scrubbed articles, priests who are not stained by the sins of the those who

are touched by the commerce of medicine by actually touching, you know,

patients?

Here’s my bid: a true conflict of interest is one in which there is an

essential tension between what is best for a patient, and some other

ancillary benefit that might accrue to the physician. Something that makes

the doc think about that other benefit first, before the patient.

Everything else is an “additional” benefit. We should stop this silliness;

stop trivializing the concept of conflict of interest through the dumping

together of all other interests in the same gutter. We should all be

allowed to ignore all but the truest of conflicts as we continue to put our

patients’ interests first.

We should be allowed to seek a convergence of interests.

via

kevinmd.com<http://www.kevinmd.com/blog/2011/12/stop-trivializing-conflict-inter\

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