U.S. charges hundreds in healthcare fraud, opioid crackdown

https://www.reuters.com/article/us-usa-justice-healthcare/u-s-charges-hundreds-in-healthcare-fraud-opioid-crackdown-idUSKBN1JO26B

The U.S. Justice Department on Thursday announced charges against 601 people including doctors for taking part in healthcare frauds that resulted in over $2 billion in losses and contributed to the nation’s opioid epidemic in some cases.

The arrests came in dozens of unrelated prosecutions the Justice Department announced together as part of an annual healthcare fraud takedown.

The hundreds of suspects charged included 162 doctors and other suspects charged for their roles in prescribing and distributing addictive opioid painkillers.

Though many of the cases also involved a variety of schemes to fraudulently bill government healthcare programs, officials sought in the latest crackdown to emphasize their efforts to combat the nation’s opioid epidemic.

According to the U.S. Centers for Disease Control and Prevention, the epidemic caused more than 42,000 deaths from opioid overdoses in the United States in 2016.

While the Justice Department has been conducting investigations into some opioid manufacturers like OxyContin maker Purdue Pharma LP, the cases stemming from the sweep did not focus on wrongdoing by major corporations.

Many of the criminal cases announced on Thursday involved charges against medical professionals who authorities said had contributed to the country’s opioid epidemic by participating in the unlawful distribution of prescription painkillers.

Those charged included a Florida anesthesiologist accused of running a “pill mill;” a Pennsylvania doctor alleged to have billed an insurer for illegally prescribed opioids; and a Texas pharmacy chain owner and two other people accused of improperly filling orders for opioids that were sold to drug couriers.

The Justice Department also announced other cases unrelated to opioids, including schemes to bill the government healthcare programs Medicare, Medicaid and Tricare as well as private insurers for medically unnecessary prescription drugs and compounded medications.

Recently Medicare announced that they are going to increase what they pay for Epidural Spinal Injections (ESI) to encourage pain docs to use these ESI more than prescribing opiates.  There is an estimated 10 million ESI procedures done very year in this country and studies suggests that 5% of those procedures will cause the pt to have Arachnoiditis     a IRREVERSIBLE/INCURABLE painful condition… causing the pt to become a intractable chronic pain pt.   The medication often used is Methylprednisolone… that neither the founder of the medication ( UpJohn) nor the FDA recommends that this medication being used in ESI.

So if this increase in what Medicare pays for this procedures works – instead of following the FDA’s recommendation to NOT USE IT… will cause in excess of 500,000 new intractable chronic pain pts… while at the same time… our bureaucracy is attempting to cause fewer opiate prescriptions to be prescribed/dispensed.

OR force these pts to partake in non-opiate therapies that most insurance don’t pay for and pts can’t afford, don’t have the time or be able to have transportation to participate in all of these non-opiate therapies … not to mention that they don’t work for a lot of pts.

Is this the way a bureaucracy is suppose to work ?… one part causes a problem and another part try to solve the problem that the other part is causing. Of course, we know how successful our bureaucracy has been fighting the war on drugs over the last nearly 50 yrs…  what could go wrong ?

Filed under: General Problems