Articles Posted in Ethics

documentsigning-300x156Wealthy investors want to enrich themselves yet more, partly by pushing doctors to oust patients from their practices unless they sign away invaluable constitutional rights. These rights can protect them if they are harmed while receiving medical services.

Patients’ safeguards, however, too often vanish when businesses compel customers to sign on to “forced arbitration,” Bloomberg Businessweek reported, noting that this consumer menace is rising in medicine as hedge funds buy up physician groups. Rich investors see lucrative profits in these practices, particularly in specialties like dermatology, gastroenterology, and obstetrics.

It seems that doctors like practicing medicine and dislike the billing, managing, paper shuffling, and other bureaucratic aspects of their profession, the story reported. Some aren’t good at it. Many are struggling, especially as the coronavirus pandemic has slashed patient demand for all kinds of medical procedures, sending doctors’ revenues plummeting. As Bloomberg reported:

walmartlogo-300x117The stain of the nation’s opioid abuse and drug overdose crisis has spread now to Bentonville, Ark., as federal prosecutors have sued Walmart, accusing the nation’s largest retailer of improperly allowing its pharmacists to fill millions of suspicious prescriptions for potent painkillers.

The pharmacists themselves complained to their corporate bosses that they were delivering opioids in far too great quantities to too few customers in out-of-the-way places, prosecutors contend. The warnings were ignored.

Instead, Walmart operated too lax a system both to monitor its outlets’ dispensing of drugs and to provide legally required warning information to federal watchdogs about potentially problematic sales, the New York Times reported, quoting Jeffrey Bossert Clark, acting assistant attorney general of the U.S. Justice Department’s civil division:

christmaswish-300x200These may be some of the most somber holidays in many Americans’ recent memory. They also may challenge the faithful to translate seasonal religious messages about hope, joy, compassion, and caring for others into practical action, particularly in how the nation treats people who have been battered by the coronavirus pandemic.

While reaching out, past the confines of our homes and health safety measures, and while feasting and enjoying gifts and the merriment of the year’s end, can we also express our gratitude to those whose toil has sustained us through an awful 2020?

Can we say thanks to essential workers — the folks who made the groceries run, who kept big stores humming, who grew, raised, and harvested what we eat, and who made the magic, so endless boxes of needed and desired stuff magically showed up on doorsteps?

A key component of the American legal system, in the criminal and civil systems, is the opportunity afforded to those most harmed to see those implicated in awful situations take responsibility for their conduct. It can be a key moment for the aggrieved to find closure and a measure of justice.

countylahospicegrafic-300x139With coronavirus infections and deaths rising anew in worrisome fashion from coast to coast, matters could not get worse with the nation’s long-term care, right? Guess again. Profit-mongering and “audacious, widespread fraud” apparently has run amok in hospice care in the Golden State.

Because California, alas, too often serves as a trend-setting locale, patients, their loved ones, clinicians, regulators, and politicians may wish to take heed of an investigation published by the Los Angeles Times. The newspaper reported that too many older, sick, and injured patients have been gulled into signing up for unneeded and undelivered services meant for folks at the end of their lives:

“[M]any [hospice patients] are unwitting recruits [of] unscrupulous providers who bill Medicare for hospice services and equipment for ‘terminally ill’ patients who aren’t dying. Intense competition for new patients — who generate $154 to $1,432 a day each in Medicare payments — has spawned a cottage industry of illegal practices, including kickbacks to crooked doctors and recruiters who zero in on prospective patients at retirement homes and other venues … The exponential boom in providers has transformed end-of-life care that was once the realm of charities and religious groups into a multibillion-dollar business dominated by profit-driven operators. Nowhere has that growth been more explosive, and its harmful side effects more evident, than in Los Angeles County. The county’s hospices have multiplied sixfold in the last decade and now account for more than half of the state’s roughly 1,200 Medicare-certified providers, according to a Times analysis of federal health care data.”

mckinseylogo-300x169Heaps of ignominy are not in short order for parties that played sketchy roles in fostering the nation’s deadly opioid abuse and drug overdose crisis. The stain has spread now to one of corporate America’s most-favored advisors — the giant McKinsey consulting group.

The firm has issued a rare public mea culpa for its work with Purdue Pharmaceuticals, a family-run drug maker that has gained notoriety, even among Big Pharma companies, for how it hyped its powerful painkiller OxyContin. The relentless push to sell that drug, officials have asserted, provided a ghastly template for peddling opioids, triggering abuse, addiction, debilitation, and death for hundreds of thousands of Americans in recent times.

Purdue was a McKinsey client, and the consultants now are re-examining their advice to the drug maker on how to fire up OxyContin sales and whether these suggestions fell short of the firm’s own standards. The New York Times, to its credit, dug into records to detail the consultants’ unacceptable conduct, reporting:

cpsctoypolice-300x158As rough holidays rumble into Americans’ lives, federal lawmakers and regulators seem to be going out of their way to be of disservice to constituents — by quietly skipping crucial inspections of imported toys and other consumer goods or noisily promoting corporate legal immunity while blocking pandemic relief for tens of millions of jobless workers and others desperate for help.

Let’s start with the peril that untold numbers of tiny tots and others may be subject to, due to little-publicized decisions by the Consumer Product Safety Commission (CPSC). As USA Today reported:

“The federal safety inspectors who protect kids from dangerous and deadly toys were not standing guard for nearly six months while this year’s holiday gifts entered the U.S. by the shipload.  Princess palaces and playhouses, water guns and tricycles landed on store shelves and front doorsteps without the usual security checks for lead, chemicals or choking hazards. Government leaders had secretly sent home the nation’s toy police. The Consumer Product Safety Commission pulled its inspectors from ports around the country in mid-March because of the threat of Covid-19. Leaders of the federal agency made the decision in private, without a warning to consumers or full disclosure to Congress, then continued the shutdown at the ports and a government testing laboratory until September, USA TODAY has found. That included spring and summer months that were their inspectors’ busiest last year.”

oighhslogo-150x150Buh-bye? Arrivederci? Sayonara? Can it be that the coronavirus pandemic puts an end to one of the disgraceful ways that Big Pharma and medical device makers push their wares on all-too malleable doctors — with big-money speaker programs?

The inspector general’s office of the giant federal Health and Human Services (HHS) agency has warned drug- and medical device-makers that these pandemic-paused marketing shams should not resume. The $2 billion that industry players have forked out for the in-person gab fests in the last three years looks sketchy at best to federal watchdogs and prosecutors, the HHS inspector general warned in a rarely issued “special fraud alert.” It reported this:

“The Office of Inspector General (OIG) and Department of Justice (DOJ) have investigated and resolved numerous fraud cases involving allegations that remuneration offered and paid in connection with speaker programs violated the anti-kickback statute. The Federal government has pursued civil and criminal cases against companies and individual [health care providers] involving speaker programs … Our enforcement experience demonstrates that some companies expend significant resources on speaker programs and that some [health care providers] receive substantial remuneration from companies. This Special Fraud Alert highlights some of the inherent fraud and abuse risks associated with the offer, payment, solicitation, or receipt of remuneration related to company-sponsored speaker programs.”

srabuse-150x150The coronavirus pandemic’s terrible toll on nursing homes and other long-term care facilities may be much worse than now estimated, as resident advocates, watchdog groups, and experts  tally “excess deaths” in the facilities — perhaps one additional casualty beyond any two formally attributed to Covid-19.

These fatalities are unacceptable, resulting from frantic and low-paid health workers’ inability to care for the aged, injured, and chronically ill infected with the coronavirus while also dealing with the needs of people so frail they require institutionalization. It’s tough reading, but here is what the Associated Press reported:

“As more than 90,000 of the nation’s long-term care residents have died in a pandemic that has pushed staffs to the limit, advocates for the elderly say a tandem wave of death separate from the virus has quietly claimed tens of thousands more, often because overburdened workers haven’t been able to give them the care they need. Nursing home watchdogs are being flooded with reports of residents kept in soiled diapers so long their skin peeled off, left with bedsores that cut to the bone, and allowed to wither away in starvation or thirst.

docofficegoogle-300x188A federal criminal case concluded with felony convictions for a Virginia gynecologist. But the questions are only now beginning as to how a doctor could have caused so many women so much harm for so long without other clinicians, hospitals, administrators, insurers, and regulators stepping in to stop him.

As the Washington Post reported, jurors took 2½ days to convict Dr. Javaid Perwaiz on 52 counts in what prosecutors alleged was his years of defrauding insurance companies by performing life-altering hysterectomies and other unneeded surgeries on women patients. He is scheduled to be sentenced in March, facing a maximum sentence of 465 years imprisonment.

His conduct, condemned and proven by prosecutors in a trial that ran for weeks, included “performing diagnostic procedures with broken equipment and scaring patients into surgery by falsely claiming they had cancer,” the newspaper reported, adding:

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