6 Michigan physicians charged in $464M billing fraud scheme

https://www.beckershospitalreview.com/legal-regulatory-issues/6-michigan-physicians-charged-in-464m-billing-fraud-scheme.html?origin=rcme&utm_source=rcme

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A grand jury in Michigan returned a 56-count indictment Dec. 4 that charges six physicians in a $464 million healthcare fraud scheme, according to the Department of Justice.

Rajendra Bothra, MD, owner and operator of a pain clinic in Warren, Mich., and five physicians who worked at the clinic are accused of prescribing patients opioid pain medication to get them to come in for office visits. During the office visits, the physicians allegedly subjected the patients to unnecessary treatment, including facet joint injections. The physicians “sought to bill insurance companies for the maximum number of services and procedures possible with no regard to the patients’ needs,” the Justice Department said in a press release.

The fraud scheme, which occurred between 2013 and November 2018, allegedly involved more than 13 million unlawfully prescribed opioid prescription drugs.

“The damage that opioid distribution has done to our community and to the United States as a whole has been devastating,” said U.S. Attorney Matthew Schneider. “Healthcare professionals who prey on patients who are addicted to opioids in order to line their pockets is particularly egregious. We will continue to prosecute such individuals who choose to violate federal law and their ethical oaths.

 

Geisinger slashes opioid prescriptions by 50% since 2014, saving $1M per year

https://www.beckershospitalreview.com/opioids/geisinger-slashes-opioid-prescriptions-by-50-since-2014-saving-1m-per-year.html

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Danville, Pa.-based Geisinger Health System has cut opioid prescriptions in half since 2014, saving the health system an average of about $1 million annually, according to The Sentinel.

Here are four things to know:

1. Geisinger told The Sentinel it has managed to slash opioid prescriptions from 60,000 to 31,000 on average per month since 2014, in part by focusing on a pain reducing regimen consisting of physical therapy and changes in patients’ diet and behavior. Exceptions are made for some patients, such as those in oncology, according to the report. Patients who do receive opioid prescriptions receive a seven-day maximum supply.

2. The reduction also stemmed from the health system’s shift to electronic prescribing, which began in August 2017. Geisinger’s analytics and IT teams developed an electronic provider dashboard to identify and track the highest prescribing physicians and discuss the latest research in prescribing practices with them before addressing clinicians systemwide.

“As we put [the data] in front of [clinicians], the typical response we received was, ‘Wow, I didn’t know I was prescribing that much,'” Mike Evans, vice president and chief pharmacy officer for Geisinger, told The Sentinel.

3. Mr. Evans said the health system plans to end paper prescribing of opioids this summer. He also acknowledged the importance of cybersecurity measures to prevent potential hacking.

4. John Kravitz, CIO of Geisinger, told The Sentinel the health system’s efforts to curb opioid prescribing have cost less than $500,000 but have saved the system an estimated $1 million annually.

To access the full report, click here.

 

 

Healthcare Triage Special: The Science of Opioids

Healthcare Triage Special: The Science of Opioids

Opioid Science

The Science of Opioids – How do opioids work? We look at the physiological processes that let opioids produce their effects in human bodies.

Drug officials worried about doctors’ eagerness to prescribe heroin withdrawal drug for cash

http://www.post-gazette.com/local/region/2016/02/15/Drug-officials-worried-about-doctors-eagerness-to-prescribe-heroin-withdrawal-drug-for-cash/stories/201602150012

 

As epidemic grows, the cost of drug addiction weighs on hospital finances

http://www.healthcarefinancenews.com/news/epidemic-grows-cost-drug-addiction-weighs-hospital-finances?mkt_tok=3RkMMJWWfF9wsRous6XJZKXonjHpfsX57u4rUa6zlMI%2F0ER3fOvrPUfGjI4IScRqI%2BSLDwEYGJlv6SgFQ7LHMbpszbgPUhM%3D

Systems test out pilot programs that help keep addicts from ending up in the emergency room.