Articles Posted in Insurance

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:

calvtexascspancapture-300x151Although it’s risky to read too much into justices’ comments about cases argued before the U.S. Supreme Court, legal analysts found strong suggestions in such remarks to assert that the latest GOP challenge to the Affordable Care Act may have exceeded the legal validity of its extreme contentions.

This could mean that Republicans — state attorneys general as well as the Trump Administration — may find failure in California v. Texas. This is political partisans’ legal push to get the high court to strike down Obamacare, focusing on the individual mandate that imposed financial penalties to ensure that Americans obtain health insurance.

The mandate originally was portrayed by supporters as integral to Obamacare, ensuring its insurance markets did not get swamped with only the poorest and sickest Americans and dooming federal efforts to provide affordable health coverage to poorer and middle-class Americans. The high court, in an earlier and important case, upheld the ACA, arguing its use of the mandate was a legitimate exercise of government taxing powers.

covimask-300x159While Americans have been riveted for days about incremental shifts in election results, other confounding numbers raced ever higher and into worrisome places. Just consider these numbers: 128,000, 9.6 million plus, and 235,000 and more.

“Covid, covid, covid. By the way, on Nov. 4 you won’t hear about it anymore,” President Trump asserted during his closing re-election campaign rallies.

If only. The nation’s coronavirus pandemic is unchecked and showing signs of worsening, bigly, with records shattering on consecutive days for infections diagnosed: 100,000 on Nov. 4, 120,000 on Nov. 5, and 128,000 on Nov. 6.

benfrankbuck-200x300The expected surge in coronavirus cases is slamming hospitals across the country, and they and the entire U.S. health care system will need major public support in difficult days ahead. Still, important markers also have gone down, so pillars of the medical establishment eventually may have to account for billions of taxpayer dollars they have been all but gifted already and why they charge sky-high prices for their medical services.

Noam Levey of the Los Angeles Times deserves credit for his reporting about the public largesse that already has benefited parties in the health care system. As he wrote:

“The Trump administration has pumped billions of dollars into the health care industry during the Covid-19 crisis, padding bottom lines at some of the country’s most profitable businesses even as millions of Americans have been left struggling with mounting medical bills. And although taxpayer money has poured into drug makers, hospital systems and medical distributors, administration officials have put few requirements on the businesses that took public assistance. Pharmaceutical companies could charge more for vaccines and treatments developed with public money. Medical distributors that received government assistance to air-lift supplies from China this spring were able to sell the material at undiscounted prices. And hospitals sustained with bailout money will be free to raise prices on patients for years to come.”

votebanner-300x150As coronavirus infections rage unchecked from coast-to-coast, Americans may need to redouble the attention they pay to their health and safeguarding it.

To deal in optimal ways with what threatens to be a tough November, we all may wish to:

Vote as safely as possible.

buildingpurdue-300x200Christmas arrived before Halloween for a notorious Big Pharma firm. Federal prosecutors effectively gave its family founders and its executives gilded skates, so they can slide away for now from major criminal charges and severe financial penalties for their part in fostering the opioid abuse and drug overdose crisis that has killed hundreds of thousands of Americans and cost the nation more than $1 trillion.

The devil is in the details in the announced settlement by the U.S. Justice Department with Purdue Pharmaceutical, the maker of the powerful painkiller OxyContin.

Federal prosecutors painted a picture of their planned deal with Purdue as an historic, $8.3 billion knock-out for a company that critics say played a major role in the opioid crisis, with the firm creating a template for hyping falsehoods about the safety and effectiveness of prescription painkillers. As the Washington Post reported, the first glance at the multibillion-dollar Purdue settlement seems tough:

javaid-300x169A Virginia criminal case, while focusing on claims of fraud against the federal government, also has exposed a long-running and nightmarish pattern of what prosecutors assert has been a Chesapeake gynecologist’s rampant mistreatment of his patients, many of them women of color and poor.

Dr. Javaid Perwaiz is on trial because authorities say he “manipulated records to cover crimes that enriched him but endangered pregnancies, sterilized women unnecessarily, and pressured them into needless procedures to finance his lavish lifestyle,” the Washington Post reported.

The newspaper’s articles, as well as the efforts by the FBI and federal prosecutors to develop the charges against the jailed specialist, raise disturbing questions about not only Virginia medical regulators but also the hospitals where the gynecologist practiced and colleagues who have described a “frenzied environment in which hospital staff struggled to keep pace with Perwaiz as he rushed from procedure to procedure.”

costsrisinghealthinsurancekff20-300x225The Covid-19 pandemic has forced many Americans to reconsider their transportation options, what with fears of infection and the slashing of public transit systems’ routes and schedules. That has made used cars, motorcycles, and bicycles hot commodities.

Those who are working and considering how their finances might stretch may take little comfort in another reality of the U.S. health care system — the relentlessly increasing cost of employer-provided coverage. Who can afford a second car while also footing the rising bill for health coverage?

As the nonpartisan Kaiser Family Foundation said in its annual report on this issue:

bar-150x150Taxpayers have put billions of dollars into long-term care rescue. Congress and the White House have deadlocked over further assistance, with a key stumbling block — as expressed by the foot-dragging Senate Majority Leader Mitch McConnell — focused on demands for greater protections for health care workers and enterprises, as well as business in general, from legal accountability for their work during the pandemic.

This is sham reasoning to stall desperately needed aid, for example, for schools and the jobless.

Small businesses, including the mom-and-pop long-term care facilities, put a demonstrably low priority on needing protection from liability lawsuits, according to a new study by Emily Gottlieb and Joanne Doroshow at the Center for Justice and Democracy at New York Law School. The researchers based their findings of multiple surveys of small business operators, with many of those questions posed by business groups themselves.

debtcomsurvey-300x254Americans have made health care a central concern of the upcoming elections with excellent reasons. Their nightmares about this issue are getting worse, not better:

Patrick Malone & Associates, P.C. listed in Best Lawyers Rated by Super Lawyers Patrick A. Malone
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