Eideard

Whistleblowers earned more than $532 million in 2011 through lawsuits alleging fraud against the U.S. government, a record for such payouts…Private parties suing on the behalf of the government collected $140 million more than they did the previous year, even as the Justice Department’s total civil fraud sanctions remained consistent…

The DOJ recovered some $3.02 billion last year through cases under the False Claims Act – the third-largest recovery ever, just shy of the $3.09 billion it won through cases in 2010.

Golly gee. Anyone think enforcement has changed a little bit since the Bush/Cheney cabal left town.

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Support for the Tea Party — and with it, the Republican Party — has fallen sharply even in places considered Tea Party strongholds, according to a new survey.

In Congressional districts represented by Tea Party lawmakers, the number of people saying they disagree with the Tea Party has risen sharply over the year since the movement powered a Republican sweep in midterm elections, so that almost as many people disagree with the Tea Party as agree with it, according to the poll by the Pew Research Center.

Support for the Republican Party has fallen more sharply in those places than it has in the country as a whole. In the 60 districts represented in Congress by a member of the House Tea Party Caucus, Republicans are viewed about as negatively as Democrats.

The survey suggests that the Tea Party may be dragging down the Republican Party heading into a presidential election year, even as it ushered in a new Republican majority in the House of Representatives just a year ago.

Which shouldn’t surprise anyone. Folks outside the ranks of True Believers looked at who bought and paid for the “movement” and recognized them for what they are – and always have been. The moneybags for rightwing extremists and reactionaries who found a home in the Republican Party decades ago.

Many of those inside the Tea Party were either deluded by their own ignorance – or the agitprop they were fed. Many of those, especially seniors, have realized how truly dumb it would for them to be working to scuttle Social Security or Medicare. How foolish it would be to continue the downward spiral of American education – especially for their own kids and grandkids.

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A federal indictment charges 14 people, including an 88-year-old doctor and two operators of a Los Angeles clinic, with running a scheme to illegally obtain and distribute OxyContin pills, carried out largely through insurance fraud. The indictment stemmed from of a two-year investigation. Ten of the defendants were arrested Thursday morning, officials said.

The distribution ring was allegedly run out of Lake Medical Group, where doctors reportedly wrote prescriptions for the powerful painkiller to uninsured patients who did not need it, federal officials said. Defendants also allegedly obtained the pills from pharmacies by fraudulently billing public insurance programs such as Medicare.

Then members of the organization allegedly resold more than 1 million pills on the street for $23 to $27 a pill, raking in millions of dollars in profits.

The indictment also alleged that in some cases the defendants stole people’s identities and Medicare beneficiary information so they could obtain the OxyContin.

Clinic operators Mike Mikaelian, 43, of East Hollywood and Anjelika Sanamian, 52, of Van Nuys allegedly orchestrated the scheme. Two doctors — Morris Halfon, 88, and Eleanor Santiago, 73 — are accused of prescribing the pills to people who had no medical need for them. The other defendants allegedly assisted in the plot by serving as runners, recruiters or posing as patients.

Throw away the key!

 
The AARP rolled over for the Bush/Cheney corrupt-athon on what’s called the donut hole in drug benefits. They caved on the issue of negotiating drug costs the way the Pentagon and Congress both do. For those reasons and more, thousands of senior citizens left the AARP. Including me.

I belong, now, to the ARA, Alliance of Retired Americans – which gets most of its sponsorship from the AFL-CIO. Another stodgy organization getting off their duff after decades of coasting downstream.

However, I would be a fool if I didn’t compliment and endorse the series of commercials which the AARP is producing to fight against the alliance between the Party of NO and cowardly blue dog Democrats that is trying to cut benefits we worked and paid for over the years while they kiss butt for corporate America.

The commercials are accurate, strong and show some of the spunk missing for a number of years from a once-principled organization.

Bravo!

It will be a profitable Xmas season

The bipartisan congressional supercommittee charged with finding $1.5 trillion in budget savings is leaving Washington lobbying firms in a quandary, seeing their clients pitted against one another in a competition for government cash.

Major defense contractors such as Boeing and Lockheed Martin have a dozen or more lobbying firms working for them, many of whom also represent the health-care industry, another likely target of budget cuts. While firms often deal with conflicts of interest, the supercommittee represents an unusual challenge, said Clyde Wilcox, a government professor at Georgetown University in Washington.

“This actually is going to be much more like a zero sum game,” Wilcox said. “If someone wins, someone loses…”

If all else fails, “I suspect that they’ll be rational businesspersons and make a decision based on their long-term financial interest,” Jeffrey Berry said. “They have a bottom line, just like their clients.”

You do recall, I hope, that principles, ethics, the needs of the people are irrelevant?

The 12-member panel, whose work has taken on greater urgency since Standard & Poor’s downgraded the U.S. credit rating in August, will be the central focus of political and lobbying activity for the next few months…

“It’s akin to working with congressional leadership, which we — as most firms — do all the time,” Stewart Verdery [whose clients include clients Boeing, General Dynamics, Eli Lilly & Co. and the Pharmaceutical Research and Manufacturers of America] said…

The politicians will have their hands out – and will find them filled.

A 65-year-old doctor has been convicted of performing unnecessary and dangerous surgeries on more than 160 people in a $154-million medical insurance scam that lured patients by promising them cash or low-cost cosmetic surgeries.

Dr. Michael Chan of Cerritos, one of 19 defendants accused of fraudulently billing medical insurance companies, pleaded guilty in Orange County Superior Court to 40 felony counts, including conspiracy to commit insurance fraud and insurance fraud. He faces up to 28 years in state prison.

Nearly 3,000 people across the U.S. allegedly agreed to undergo unnecessary procedures such as sweaty palm surgeries and colonoscopies at the Unity Outpatient Surgery Center, a Buena Park facility which is now closed.

Recruiters, known as “cappers,” targeted employees from businesses in 39 states who were covered by PPO insurance plans. Prosecutors likened them to “body snatchers.”

Patients, who typically received between $300 and $1,000 per surgery, were allegedly coached on how to describe their symptoms by the cappers who then scheduled their surgeries, assisted them with paperwork and arranged their travel…

Along with Dr. William Hampton Jr. of Seal Beach and Dr. Mario Rosenberg of Beverly Hills, Chan was accused of ignoring basic medical protocol, such as failing to obtain medical information, not meeting with patients beforehand and neglecting to follow up.

The surgeries were mainly performed on weekends. All three doctors were arrested in 2007.

Nine defendants pleaded guilty and have been sentenced, including Hampton, who was sentenced to 16 years in state prison. In addition to doctors and cappers, the defendants include an attorney, an accountant and administrators.

What a delightful crew of all-American crooks. I’m especially outraged because like a number of folks on Medicare, my best option [so far] is a Medicare Advantage PPO – that’s a preferred provider organization. My somewhat mediocre coverage is via Humana – since United Healthcare, yes, that AARP-sponsored wonder, pulled Medicare Advantage coverage from New Mexico last year. Another big-hearted savior.

No surprises here other than the fact that one of these criminal fronts was shut down.

DaVita’s new planned world headquarters in Denver

One of the nation’s largest providers of kidney dialysis deliberately wasted medicine in order to reap hundreds of millions of dollars in extra payments from Medicare, a former clinic nurse and a doctor are charging in a whistle-blower lawsuit.

The lawsuit says that the company, DaVita, used larger than necessary vials of medicine knowing that Medicare would pay for the unused portion of each vial if it were deemed unavoidable waste. DaVita, which treats nearly a third of the nation’s dialysis patients, denies the accusations.

The accusations are the latest related to how financial incentives may have driven overuse of pharmaceuticals in the dialysis business. In January, Medicare began a payment system that pays for the overall treatment and does not pay separately for the drugs accompanying it. Many practices, including the size of some vials used, suddenly changed, providing an instant case study of how financial incentives can influence treatment choices.

The lawsuit says that until January, for example, DaVita required nurses to use one 10-microgram vial of Zemplar, a vitamin D drug, instead of a six-microgram dose in three two-microgram vials,. It then billed Medicare for all 10 micrograms even though four went unused.

Instead of giving an entire 100-milligram vial of Venofer, an iron drug, once or twice a month, the clinics gave 25-milligram doses more frequently, the suit says. But since the drug came only in a 100-milligram vial, Medicare was billed for 100 milligrams for each dose, even though 75 milligrams were wasted, the lawsuit says…

This so-called bundled payment system has instantly turned drugs from a source of profit to a cost to be avoided. And dialysis clinics have responded.

Not especially different from the ever-popular cost-plus billing often used in the military-industrial complex. My least favorite form of welfare for capitalists producing non-consumable goods. If you have a guaranteed profit of any size – and can inflate the legitimate costs 100% – you double your profit.

New Republican legislation in the House and Senate would force the U.S. government to reroute huge amounts of money to China and other creditors in the event that Congress fails to raise its debt ceiling…

If passed, Pat Toomey’s (R-PA) plan would require the government to cut large checks to foreign countries, and major financial institutions, before paying off its obligations to Social Security beneficiaries and other citizens owed money by the Treasury…

That’s where Toomey’s idea supposedly comes in. And yet, according to the Treasury Department, his plan wouldn’t actually avoid a default, or its catastrophic consequences.

“[T]his idea is unworkable,” said Deputy Treasury Secretary Neal Wolin in a statement. “It would not actually prevent default, since it would seek to protect only principal and interest payments, and not other legal obligations of the U.S., from non-payment. Adopting a policy that payments to investors should take precedence over other U.S. legal obligations would merely be default by another name, since the world would recognize it as a failure by the U.S. to stand behind its commitments.”

The full impact of an actual default is unclear, but Treasury, and independent experts have warned that it would among other consequences, cause an enormous loss of wealth among U.S. citizens. Under the circumstances, one would think that the government’s top priority would be ensuring that citizens owed money by the Treasury would take precedence over, say, foreign governments. But that wouldn’t be the case if Toomey and some House Republicans, including Republican Study Committee Chairman Jim Jordan (R-OH), get their way.

The Administration thinks such a policy would be tone deaf. “Such a policy would also be unacceptable to American servicemen and women, retirees, and all other Americans, who would rightly reject the notion that their payment has been deemed a lower priority by their government,” Wolin added…

“I think it is a dreadful idea,” Sen. Kent Conrad (D-ND) told National Journal. “Basically what they are saying is, pay China first. Are we going to forget about the American public and the things that they need? Somehow they are secondary? And paying the Chinese and the Japanese is the first priority of this country..?

You have to be wearing blinders made of boiler plate to ignore how committed the Republican Party is to Big Oil and Big Money. Still, blatant butt-kissing like this is so contemptible. Couple it with Republican willingness to crap on the needs of ordinary citizens — rejecting any priority for social security or medicare payments, funding for veterans administration hospitals — puts their display of ethical corruption down lower than a snake’s belly.

Cripes. Rattlers in my neck of the prairie would be offended by being compared to Republicans.

Women still outlive men, but the gender gap among U.S. seniors is narrowing.

New 2010 census figures, released Thursday, show men are narrowing the female population advantage, primarily in the 65-plus age group. It’s a change in the social dynamics of a country in which longevity, widowhood and health care for seniors often have been seen as issues more important to women.

In all, the numbers highlight a nation that is rapidly aging even as Congress debates cuts in Medicare, an issue with ramifications for the growing ranks of older men…

Over the past decade, the number of men in the U.S. increased by 9.9 percent, faster than the 9.5 percent growth rate for women. As a result, women outnumbered men by just 5.18 million, compared with 2000, when there were 5.3 million more women than men.

The male-female ratio in the U.S. also increased to 96.7 from 96.3 in 2000, reflecting the narrowing of the female advantage in overall population…There hasn’t been such a sustained resurgence in the U.S. male population since 1910, when medical advances started to increase women’s life expectancies by reducing deaths during pregnancy…

The latest census figures come amid a graying baby boomer demographic of 78 million people — now between the ages of 46 and 65 and looking ahead to retirement — who will have a major voice in the 2012 elections as federal spending and the spiraling costs of Medicare rise to the forefront.

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A former president of the Maryland State Medical Society, Dr. Sroka has practiced family medicine for 32 years in a small, red-brick building just six miles from his childhood home, treating fishing buddies, neighbors and even his elementary school principal much the way doctors have practiced medicine for centuries. He likes to chat, but with costs going up and reimbursements down, that extra time has hurt his income. So Dr. Sroka, 62, thought about retiring.

He tried to sell his once highly profitable practice. No luck. He tried giving it away. No luck.

Dr. Sroka’s fate is emblematic of a transformation in American medicine. He once provided for nearly all of his patients’ medical needs — stitching up the injured, directing care for the hospitalized and keeping vigil for the dying. But doctors like him are increasingly being replaced by teams of rotating doctors and nurses who do not know their patients nearly as well. A centuries-old intimacy between doctor and patient is being lost, and patients who visit the doctor are often kept guessing about who will appear in the white coat…

Yup. Let’s address law and healthcare legislation and ignore the number of greedy buggers whose choice to enter medicine is grounded almost exclusively on income vs. effort.

Indeed, younger doctors — half of whom are now women — are refusing to take over these small practices. They want better lifestyles, shorter work days, and weekends free of the beepers, cellphones and patient emergencies that have long defined doctors’ lives. Weighed down with debt, they want regular paychecks instead of shopkeeper risks. And even if they wanted such practices, banks — attuned to the growing uncertainties — are far less likely to lend the money needed…

Of course “fewer unnecessary tests” is also a crock as anyone who has investigated rising medical costs should know. Cripes, I’ll even include an anecdote. In a good deal of pain on a weekend, I went to a private emergency clinic. After batteries of tests including a skull X-ray they gave me painkillers and suggested I see my regular doctor on Monday. The bill to Medicare, my supplemental insurance and me was over $800.

My doctor resolved the cause as a previously unexperienced allergy – treated with OTC medication, by the way. He chuckled over the private emergency clinic as “they certainly know how to manage their profit centers”.

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