番茄社区

Welcome to the latest edition of Investigative Roundup, highlighting some of the best investigative reporting on healthcare each week.

Doc's $670K Telemedicine Racket?

A Kansas anesthesiologist has been indicted on charges of taking hundreds of thousands of dollars in kickbacks in exchange for signing off on unnecessary prescriptions and device orders, .

Scott Taggart Roethle, MD, was allegedly paid $30 per prescription or order that he signed, racking up some $674,000 since 2017. These orders were usually for orthopedic devices, genetic tests, and topical creams, DOJ said.

The fraud cost Medicare Part B some $26 million, U.S. prosecutors said.

Roethle held medical licenses in 22 states, signing orders for thousands of patients in those states, DOJ said. The telemedicine and marketing companies who paid him allegedly solicited patients through the media and cold calls, then passed along their information to Roethle via an electronic portal.

Prosecutors said Roethle had no contact with the patients in almost all instances, and didn't independently determine if they needed the items or services before signing off.

Patients often complained that they didn't want or need the things he ordered for them, DOJ said.

An Unlikely COVID Origins Provocateur

The New York Times , a postdoctoral fellow at the Broad Institute who has long been a visible presence in the debate over COVID-19 origins.

Chan and her colleagues initially raised concerns about the virus' origins in a May 2020 paper charging that SARS-CoV-2 was suspiciously well adapted for humans. They speculated that perhaps it had spilled over into humans and was circulating undetected for months, picking up favorable mutations -- or perhaps it became better adapted to humans in a lab and accidentally escaped.

Some of her virology colleagues dismissed her out of hand, saying she lacked expertise; some called her a conspiracy theorist.

"There were days and weeks when I was extremely afraid, and many days I didn't sleep," Chan told the Times. She said she's often worried for her safety.

The Times described the 32-year-old Chan as an "unlikely provocateur." She studied biochemistry and molecular biology at the University of British Columbia and earned a PhD in medical genetics. Then she moved on to a postdoctoral fellowship at Harvard, finally landing at the Broad Institute.

Still, she maintains an active Twitter presence on the origins of SARS-CoV-2, and she inked a book deal with Harper Collins. Her co-author will be Matt Ridley, a controversial science writer who's been criticized for downplaying climate change, according to the Times.

Chan said she's currently on the fence about the origins of SARS-CoV-2. On days when she thinks that it could indeed be due to natural spillover, she feels "mostly really, really sorry for the scientists who are implicated as possible sources for the virus."

A highly anticipated U.S. intelligence report issued late Tuesday about the virus' origins.

'How Deeply Ignorant We Are' About Healthcare Pricing

The New York Times has to make pricing information released under new U.S. transparency rules easier to use, and along the way revealed how hospitals charge vastly different prices for the same services.

Not all hospitals are complying with the new rule to publish the rates they negotiated with insurers, but the reporters compiled information from more than 60 hospitals that did publish, partnering with researchers from the University of Maryland-Baltimore County to turn the pricing files into a database.

They found that hospitals charge patients "wildly different amounts for the same basic services" like an x-ray or a pregnancy test.

They also found that insurers aren't always negotiating favorable rates for their customers: "In many cases, insured patients were getting prices that are higher than they would if they pretended to have no coverage at all," they wrote.

More patients have a reason to care when their insurance makes a bad deal, as high-deductible plans become increasingly popular, the Times reported. With these plans, patients could have to pay thousands of dollars before their coverage kicks in.

The reporters used patient bills involving rabies vaccine as examples. At Intermountain Medical Center in Utah, a child's dose of the two drugs to prevent rabies -- along with administration fees and ED usage charges -- cost $4,198 with Cigna; $3,704 for patients paying cash; $3,457 with Regence BlueCross BlueShield; and $1,284 for SelectHealth, which is owned by Intermountain.

In Florida, an adult dose of a rabies shot at AdventHealth Orlando ranged from $17,000 to $37,000, not including ED usage fees.

"It's not just individual patients who are in the dark," Martin Gaynor, PhD, a healthcare economist from Carnegie Mellon, told the Times. "Employers are in the dark. Governments are in the dark. It's just astonishing how deeply ignorant we are about these prices."

Comment