Is Informed Consent Being Used as a Guise for Spreading Misinformation?

Posted on by • Posted in Anti-Vaxx Movement, Coronavirus, Hydroxychloroquine, Infectious Disease Physician, Infectious Virus, Informed Consent, Ivermectin, Misinformation, Misinterpret, Mislead, Misleading, Partisanship, Physicians For Informed Consent (PIC), Vaccination, Vaccine, Vaccine Booster, Vaccine Efficacy, Vaccine Mandate, Vaccine Safety, Vaccine Supply • Leave a comment
https://www.medpagetoday.com/special-reports/exclusives/97258?xid=nl_medpageexclusive_2022-02-21&eun=g885344d0r&utm_source=Sailthru&utm_medium=email&utm_campaign=MPTExclusives_022122&utm_term=NL_Gen_Int_Medpage_Exclusives_Active

The website for the group Physicians for Informed Consent (PIC) reads like an apolitical, educational resource that provides information on vaccines and why they shouldn’t be government-mandated. Its mission is “that doctors and the public are able to evaluate the data on infectious diseases and vaccines objectively, and voluntarily engage in informed decision-making about vaccination.”

The group’s accompanying social media accounts, however, tell a different story. On PIC’s Facebook, Twitter, Instagram, and LinkedIn feeds, you’ll find post after post about reasons to be scared of vaccines – especially for children – often highlighting selective portions of scientific research that contain vaccination risks.

Who’s Behind PIC?

The group was founded in 2015 after California passed a law that prohibited the use of personal belief exemptions from vaccinations required for children to attend any public or private school in the state.

Three years later, the number of waivers issued by doctors to parents seeking medical exemptions for their children tripled. As a result, another law was passed in 2019, cracking down on the inappropriate use of medical exemptions.

The group’s founder, Shira Miller, MD, is a concierge integrative medicine doctor based in Los Angeles, specializing in menopausal care. On her own Twitter profile, she describes herself as “Facebook’s Most Popular Menopause Doctor.”

Miller earned her medical degree in 2002 from Technion-Israel Institute of Technology in Haifa, Israel, and has reportedly been working as a concierge physician since 2010.

PIC’s leadership team also includes 20 physicians from a wide range of specialties, most of whom, like Miller, don’t specialize in infectious diseases.

Among its leaders is Paul Thomas, MD, an Oregon-based pediatrician. Thomas, who is listed as one of PIC’s founding directors, was issued an emergency suspension order of his medical license in 2021 by the state medical board, in which they cited at least eight cases of alleged patient harm. In line with PIC’s philosophy, Thomas maintains that he isn’t “anti-vax” – he’s pro-informed-consent.

Also on the team is Jane Orient, MD, internist and executive director of the Association of American Physicians and Surgeons (AAPS), a group that also opposes vaccine mandates. Orient received her medical degree from Columbia University and currently practices in Arizona. In 2020, the AAPS sued the federal government for withholding its stockpile of hydroxychloroquine from COVID patients, despite research showing that the drug is ineffective. The complaint was dismissed in September 2021.

Doug Mackenzie, MD, a plastic surgeon who graduated from Johns Hopkins University of Medicine, is PIC’s treasurer. He has previously identified himself as an “ex-vaxxer” rather than an anti-vaxxer when speaking on a panel in 2019.

The only RN on the team is Tawny Buettner. After California mandated vaccinations for healthcare workers, Buettner organized a protest outside of her place of work, Rady Children’s Hospital in San Diego; she later sued the hospital after she was dismissed from her job. According to the complaint, Buettner and the 36 other plaintiffs alleged that their requests for religious exemptions from the COVID-19 vaccine were all denied.

Kenneth Stoller, MD, also listed on the leadership team, graduated from the American University of the Caribbean School of Medicine and completed pediatric residency training at the University of California Los Angeles. Stoller was disciplined in 2019 for doling out medical exemptions to children without adequate evidence. According to state records, his license in California has since been revoked; he currently holds a medical license in New Mexico.

What’s PIC?

The most notable physician groups accused of spreading COVID-19 misinformation since the vaccine rollout have been affiliated with right-wing media, if not overtly proclaiming conservative, anti-vaccination beliefs.

For example, America’s Frontline Doctors, a group notorious for its support of hydroxychloroquine as a treatment for COVID-19, has made its values well-known. The group’s founder, Simone Gold, MD, JD, was arrested for participating in the Jan. 6 capitol riot and has openly opposed mask-wearing. Similarly, physician leaders of the Front Line COVID-19 Critical Care Alliance, known for promoting the use of ivermectin to treat COVID-19, tout their appearances on the ultra-conservative Newsmax on the website’s homepage.

PIC wants to be different. The group’s focus, according to its general counsel Greg Glaser, JD, of Copperopolis, California, is on the “authoritative citations that show, or calculate, the risks [of vaccines] to the public,” he told MedPage Today.

“We are pro-informed consent, pro-ethics, pro-health. PIC is not anti-vaccine, and PIC is not pro-vaccine – PIC is neutral,” Glaser said on behalf of the group.

In August 2021, Glaser submitted an amicus brief to the Supreme Court PIC’s behalf, arguing against the implementation of vaccine mandates. The document claims that “government statements confirm there is no evidence that COVID-19 vaccines prevent the spread of SARS-CoV-2 or COVID-19,” ignoring the breadth of existing literature that says otherwise.

Nurses Sue Ohio Staffing Firm Over Hefty Quitting Fees

Posted on by • Posted in Fair Labor Standards Act, Indentured Servitude, Lawsuit, Nurse Agency Staffing, Nurse Staffing, Nurse Travelers, Quitting Fee, Racketeering • Leave a comment
https://www.medpagetoday.com/special-reports/exclusives/97289?xid=nl_medpageexclusive_2022-02-21&eun=g885344d0r&utm_source=Sailthru&utm_medium=email&utm_campaign=MPTExclusives_022122&utm_term=NL_Gen_Int_Medpage_Exclusives_Active

Two nurses and a licensed physical therapist (PT) originally from the Philippines have filed a proposed class action lawsuit against an Ohio staffing firm, claiming its contracts and practices amount to trafficking and fraud, among other allegations.

The lawsuit claims that Cincinnati-based Health Carousel, which recruits and hires healthcare workers primarily from the Philippines to work in the U.S., employs its workers in “essentially indentured servitude.”

“Health Carousel mandates that its workers not leave the company for years unless they pay the company tens of thousands of dollars,” a complaint filed on behalf of Novie Carmen, RN, Kersteen Flores, RN, and licensed PT Jerlin Amistoso states. “And the company follows through on its threats by suing workers who dare to leave anyway.”

Earlier this month, a Bloomberg investigation first shed light on the case and Carmen, the original nurse behind it.

“I was basically trapped,” Carmen told Bloomberg. “Duped.”

According to the Bloomberg report, Carmen borrowed money from her boyfriend to help pay the $20,000 “quitting fee” and break ties with Health Carousel.

Carmen, Flores, and Amistoso now claim in their lawsuit that Health Carousel knows its workers must partake in lengthy orientation sessions and work overtime, but that the company doesn’t count those hours toward their required commitment period. The lawsuit adds that, “to make these workers feel even more vulnerable,” Health Carousel isolates them and prohibits them from discussing their pay and working conditions with others.

According to the complaint, Health Carousel maintains its scheme through defrauding the federal government, which approves its visa petitions without knowing it routinely fails to pay workers the wage it promises, and defrauding the workers themselves — who are unexpectedly subject to harsh employment terms, difficult workplace conditions, long work requirements, and stringent rules.

The complaint adds that Health Carousel continues to profit from its alleged scheme because healthcare facilities at which workers are placed pay the company more than what it pays its workers, and the company recoups even more money from workers who leave before the company determines they have completed their commitment period.

The lawsuit seeks to end what it claims are Health Carousel’s illegal practices and to compensate victims through forced labor claims under federal and state law, claims under the Racketeer Influenced and Corrupt Organizations Act and Ohio’s Corrupt Practices Act, and claims under the Fair Labor Standards Act.

Ultimately, Carmen, Flores, and Amistoso allege their circumstances aren’t unique. The Cincinnati Enquirer reported that at least 20 nurses in Pennsylvania alone, where Carmen was placed at a hospital by Health Carousel in 2018, have paid high financial penalties in recent years, according to the lawsuit.

Of Health Carousel, the Enquirer reported that the staffing firm has made the Deloitte Cincinnati 100 list of the region’s largest privately held companies for the past 5 years. “In the latest ranking, the company dropped from 39 to 45 on the list, reporting a revenue of $288 million in 2020,” the Enquirer wrote. “It hauled in $301 million in 2019.”

Legal counsel for Carmen, Flores, and Amistoso did not immediately provide additional comment on the case.

A spokesperson for Health Carousel, which has denied the allegations against it in court documents, told MedPage Today in an email that, “Unfortunately, we cannot comment on the specifics of ongoing litigation, but we are confident we will be successful in this matter.”

The spokesperson also pointed to a statement posted on the company’s website that includes the following: “For our part, ensuring the health, safety and well-being of every one of our nurses is the core of our business. To imply otherwise, based on activists intent on exploiting and twisting the experiences of a few, is disheartening and damaging. But more than that, it is simply inaccurate and a grave insult to the millions of people worldwide who continue to be victimized by traffickers.”

The company also posted a list of answers to frequently asked questions, one of which includes information on why nurses have to reimburse expenses when they break a contract. To that end, Health Carousel states in part that, “Requiring repayment of invested expenses and other damages if an employee does not fulfill a service obligation is not a ‘quitting fee’ or a penalty. Rather, it is a customary, reasonable and fair practice that many employers use in a range of industries and occupations to recoup investment in tuition reimbursement, relocation expenses, signing bonuses and more.”

Health Carousel added that the expenses it expects healthcare professionals to reimburse should they not complete their contracts “approximates or underestimates” its upfront investment on their behalf. “For example, when healthcare professionals do not complete the commitment period in the contract, the nurse retains his or her permanent resident visa to work in the United States, but Health Carousel suffers a financial loss because it cannot earn back the money it had advanced for their recruitment, credentialing, sponsorship, relocation and resettlement, and employment,” the company stated.

Ambulance rides are getting a lot more expensive

Posted on by • Posted in Ambulance, Health Insurance Coverage Adequacy, Health Policy, High Deductible Health Plans, High Prices, Out of Pocket Expenses, Surprise Bills • Leave a comment

https://www.axios.com/ambulance-rides-are-getting-a-lot-more-expensive-cee897fe-63b7-4412-aa67-718109773e79.html

The cost of an ambulance ride has soared over the past five years, according to a report from FAIR Health, shared first with Axios.

Why it matters: Patients typically have little ability to choose their ambulance provider, and often find themselves on the hook for hundreds, if not thousands of dollars.

The details: Most ambulance trips billed insurers for “advanced life support,” according to FAIR Health’s analysis.

  • Private insurers’ average payment for those rides jumped by 56% between 2017 and 2020 — from $486 to $758.
  • Ambulance operators’ sticker prices, before accounting for discounts negotiated with insurers, have risen 22% over the same period, and are now over $1,200.

Medicare, however, kept its payments in check: Its average reimbursement for advanced life support ambulance rides increased by just 5%, from $441 to $463.

Between the lines: Ambulances aren’t covered by the new law that bans most surprise medical bills, meaning patients are still on the hook in payment disputes between insurers and ambulance operators.

State of play: Ground ambulances are operated by local fire departments, private companies, hospitals and other providers and paid for in a variety of ways, which makes this a tricky issue to address, according to the Commonwealth Fund.

  • Some states — such as Colorado, Delaware, Florida, Illinois, Maine, Maryland, New York, Ohio, Vermont and West Virginia — have protections against surprise ground ambulance billing, a columnist in the Deseret News pointed out earlier this year.
  • But in California, Florida, Colorado, Texas, Illinois, Washington state and Wisconsin, more than two-thirds of emergency ambulance rides included an out-of-network charge for ambulance-related services that posed a surprise bill risk in 2018, according to a Peterson-KFF Health System Tracker brief.
  • The Biden administration has said it’s working on the problem.

The bottom line: Costs for ground ambulance care are on the rise and, with few balance billing protections, that means patients could still be hit with some big surprises if they wind up needing a ride in an ambulance.

FTC sues to block Rhode Island’s largest health systems from merging

Posted on by • Posted in Antitrust, Competition, Dept of Justice (DOJ), Federal Trade Commission (FTC), Market Consolidation, Market Power, Mergers & Acquisitions, Monopoly, Monopoly Behavior • Leave a comment
https://www.healthcaredive.com/news/ftc-sues-block-rhode-island-hospital-merger/619091/?utm_source=Sailthru&utm_medium=email&utm_campaign=Issue:%202022-02-18%20Healthcare%20Dive%20%5Bissue:39885%5D&utm_term=Healthcare%20Dive

Dive Brief:

  • The Federal Trade Commission is suing to block Rhode Island’s two largest health systems from merging, alleging the tie-up between Lifespan and Care New England would increase prices and diminish the quality of care.
  • In the state’s own review, Rhode Island’s attorney general said the union would result in “extraordinary market power” and denied the merger application under state law that requires a review of such tie-ups. Rhode Island’s attorney general will join FTC’s federal lawsuit seeking to block the deal.
  • The FTC alleges that, together, Lifespan and Care New England would control at least 70% of Rhode Island’s market for inpatient hospital services and also reduce competition in several nearby Massachusetts communities.

Dive Insight:

The union between Lifespan, the state’s largest health system, and Care New England, the second largest, quickly raised alarms in Rhode Island.

A 25-page report from the state’s insurance department found that the merger would “significantly alter” the state’s healthcare market, which currently enjoys a “relatively competitive” market. State regulators were also concerned about the control the new system would have over physician services. Given these risks, the state insurance commissioner proposed a set of conditions on the deal including price caps. Health system executives were open to working under certain conditions.

However, executives seemed surprise by Thursday’s announcement that the deal to create an integrated academic medical system with Brown University at the forefront would be blocked.

“On four separate occasions in prior years, the FTC reviewed the same proposed merger and allowed it to proceed,” a joint statement released Thursday said. The management teams said they offered up 30 conditions to regulators to satisfy antitrust concerns about the merger, “but neither the FTC or the AG ever discussed these conditions or others with the two systems prior to today’s decisions,” according to the statement.

After flirting with the idea of combining the systems for years, Lifespan and Care New England inked a deal to merge last February after the coronavirus pandemic revived talks.

The two touted the deal as a way to create an integrated academic health system with Brown University’s medical school in a central role. Brown University committed $125 million to the creation of the new system.

However, FTC commissioners voted unanimously to block the union over concerns it would extinguish competition between the two.

And although regulators have long leaned on the argument that hospital mergers lead to higher prices, a joint letter from FTC Chair Lina Khan and Commissioner Rebecca Kelly Slaughter points to the harmful effects consolidation has on labor markets, an argument growing in importance within the agency. 

“Just as we want firms to compete with each other to sell goods and services to their customers, we want employers to compete with each other to attract and retain workers,” the letter states. “Indeed, there is a growing body of empirical research about the potential for competitive harm to labor markets from consolidation and concentration.”

The news follows reports that the Department of Justice is preparing to sue to stop UnitedHealth Group’s blockbuster acquisition of Change Healthcare, a healthcare technology firm. Concerned about the “massive consolidation” of healthcare data, the American Hospital Association urged antitrust regulators to thoroughly examine the proposed transaction in a letter sent to DOJ last spring.

After taking office, President Joe Biden has signaled his administration would take an aggressive antitrust stance, including getting tough on hospital mergers. Last summer, the president issued an executive order that called on antitrust regulators to “review and revise” merger guidelines to ensure patients are not harmed by proposed deals.

Biden specifically called out the healthcare industry, rife with consolidation and accompanying research that shows hospital unions lead to higher prices.

“Thanks to unchecked mergers, the ten largest healthcare systems now control a quarter of the market,” the release from the White House said.

Still, the FTC has become overwhelmed by the sheer number of proposed transactions. In August, the agency said it was hit by a “tidal wave” of merger filings and warned applicants it may not vet all submissions before the applicable deadlines. But in letters sent to merging companies, the FTC warned the delay should not be interpreted as a green light for any deal.

“Companies that choose to proceed with transactions that have not been fully investigated are doing so at their own risk,” the regulator said in a statement.