Feds Sentence Novartis For Drugging Kids

Trileptal is a common drug that was readily prescribed to foster children and other low income children for false claims and false diagnoses.  Novartis paid off doctors to ghostwrite reports to drug kids.

Children in foster care are still being prescribed Trileptal as mood stabilizers and not was it was approved for.  Someone needs to ask Maura Corrigan about this.

Novartis Pharmaceuticals Sentenced For Off-Label Drug Marketing
I cringe when I see the growing list of pharmaceutical corporations that not only drugged kids for cash, but drugged the entire industry of child welfare to believe that it was a good thing for kids.

When you look at the national statistics, you will see a category labeled as " physical neglect".  Physical neglect has 12 codes assigned to break down the different categories for purposes of research studies.

There are two specific codes which address issues of medical neglect:

Refusal to allow or provide needed care for diagnosed condition or impairment.

Unwarranted delay or failure to seek needed care

TRANSLATION: When a parent refuses psychotropic medication to the child, this constitutes medical neglect, a reportable condition to increase the national statistics of child abuse and neglect, and grounds for removal.

This is a classic Title IV-E funding training technique (usually billing at the improper higher rate of 75%) where a Child Welfare Worker will use the tactic of performing an Axis III diagnosis, without medical license, to support the placement of the child in foster care and to automatically classify the child as special needs, accessing Targeted Case Management funding benefits called kiddy kickbacks.

Novartis resolves its own kiddy kickback liabilities, generated from Social Securitydollars while the States child welfare systems continue its pattern of practice of promoting the drugging of children.

Trileptal is a commonly prescribed as a psychotropic drug for foster children.

Wolverine Human Services of Michigan uses this drug liberally with foster children.

Here are two physicians who participated in the illegal and wrongful marketing of Trileptal.

Demitri and Janice Papolos

Trileptal Illegal Marketing Material

States Cry Foul With Health Care Mandate

States Cry Foul With Health Care Mandate

Ever wanted to know why there was so much opposition to the health care reform?  Well here it is.

It's called fraud.  Yes, contained within health care reform is also regulation.  Here is a great little rant from the State of Florida.  Why are they ranting?  It is because they are not compliant.

Florida is so bad, the U.S. Department of Justice teamed up with the U.S. Department of Health and Human Resources to establish the Health Care Fraud Enforcement Task Force (H.E.A.T.)  The worst part of the levels of health care fraud in these states that are crying the unconstitutional foul is that the levels of Medicaid fraud, once the federal moritoria on the suspension of the rules are lifted, will make Medicare pail in comparison to the ugly beast called Medicaid fraud.

U.S. DHHS OIG and DOJ Health Care Fraud Prevention Enforcement Team
The lack of Medicaid and Medicare regulation in the states will substantially cut the federal funding to their programs.  In essence, coming into federally funded, mandated compliance to end Medicaid and Medicare fraud will kill jobs because these fraud scheme, racketeering operations will be shut down.Department of Justice and Department of Health and Human Services response to Senator Grassley's inquiry on...

REINS Drops The Reins On Medicaid Fraud

REINS Drops The Reins On Medicaid Fraud

Oh, this is hilarious.

Here you have a group of individuals who believe regulation is "job killing".  Well, when you are dealing with elected persons who lack administrative sophistication, you must assume their advice comes from their advocates... oops, I mean lobbyists, the same individuals who would significantly benefit from less regulatory mandates.

See, it goes like this, even though all three branches of government have their input into any administrative regulation that comes down, it is actually "job killing" because most of the local governments would not be in operation if they had to be compliant, let alone have to be compliant wtih civil rights policies.  This rings with even more truth when you understand that these "economically significant" new rules that may come down are dealing with privatization, out-sourced by state governments.

Now, let's put this into a more familiar perspective.

States get their Medicaid funding.  Then the contracts to provide child welfare services are privatized.  Even though there is already a moritoria on Medicaid regulation ... oh hell, just watch the video!

Taking aim at federal rules

U.S. Rep. Daniel Webster is among those who want to ease the red tape that often accompanies federal money

In recent weeks, Marion County officials have complained about being hog-tied by the strings that accompany some federal money they receive.

U.S. Rep. Daniel Webster wants to help them by cutting the fiscal ties that bind.

During a recent visit to Ocala, the newly elected Republican said he supports legislation that would empower Congress to approve "major" rules made by federal regulatory agencies deemed to have a significant impact on the overall economy.

The Regulations from the Executive in Need of Scrutiny Act — or REINS Act — defines a "major rule" as one that would have an annual effect on the economy of $100 million or more — or one that causes a "major increase" in costs for consumers, individual industries or government agencies.

Federal grants and awards often have extensive requirements for compliance and reporting that lead local officials to rethink whether they should have even accepted the funding in the first place.

In recent weeks, for example, the County Commission has questioned staff spending under a federal housing grant designed to stabilize neighborhoods with large numbers of foreclosures.

The program, created in 2008 under the $800 billion Housing and Economic Recovery Act, allows the county to buy, refurbish and resell selected properties as a way to slow the spread of blight in emptying communities.

The county initially received $6.3 million toward the effort and is considering whether to take an additional $4.6 million.

Last week, the commission agreed to approach the Federal Aviation Administration to find out whether a ban on aerobatic planes and pilots at the Dunnellon-Marion County Airport would force the county to forfeit at least $2.5 million in federal grants that fund improvements at the facility.

Marion County Public Schools, meanwhile, once devoted an entire department tomonitoring federally funded programs and the attached requirements to ensure compliance with Washington's demands.

Webster, in a recent interview, said there must be a way to give local governments more latitude in deciding how those funds can be spent and still comply with the goals set by federal regulators.

He noted that President Barack Obama has even said as much.

In mid January, Obama issued an executive order calling for a "government-wide" review of federal regulations that hamper job creation and adversely affect economic growth.

"We can aid our communities by getting rid of federal strings," said Webster, whose district includes much of eastern Marion, including parts of Ocala and Silver Springs Shores.

Describing these requirements as often "duplicative and oppressive," the freshman congressman, who is also a 28-year veteran of the Florida Legislature, indicated that he believes these regulations eventually catch up to local governments as they do local businesses.

"These are the items I want to dispose of," he added. "Part of Congress' duty is to oversee, and they have not done that."

He also thought Congress should start to write more specific laws to curtail the ambiguity that executive-branch agencies exploit in the absence of concrete direction from lawmakers.

"People and states have had it with the federal government telling them what to do. This just balances what's there," Webster said.

The REINS Act was introduced in January by Rep. Geoff Davis, a Kentucky Republican. The two other Republican congressmen who represent parts of Marion County — Cliff Stearns of Ocala and Richard Nugent of Brooskville — support the measure. In fact, Stearns is a cosponsor and Nugent has asked to be one.

The fourth member of Marion's congressional delegation, Democrat Corrine Brown, is still studying the legislation and has not taken a formal stand.

Not everyone thinks the bill is so great. "While the legislation...may be well-intentioned, it simply misses the mark," U.S. Rep. John Conyers (D-Mich.) told a House subcommittee last month.

He went on to summarize the critics' position:

For starters, the bill overreaches. Congress may make laws, he said, but the REINS Act "unduly trammels on executive authority."

Second, the REINS cure does not target the disease of over regulation.

"Some might argue that there is a legitimate need to strike a balance between protecting the safety and health of all Americans (through federal rules and requirements) and fostering economic growth, job creation and competitiveness," Conyers said.

But REINS "will distort the rulemaking process" and "hamper the implementation of evert single law on the books!" he said.

"By changing the presumption in the Congressional Review Act, and requiring affirmative congressional approval (as opposed to disapproval) for all major rules, this act will serve as a chokehold, and stifle regulatory review, which I am afraid is the real intent of this legislation."

Finally, he said, REINS is based on incomplete economic analysis and "solely addresses the costs of regulation, while failing to account for the tremendous cost benefits that regulations yield."
Regulations From the Executive in Need of Scrutiny (REINS) Act of 2009

Stop Medicare Fraud

Health Care: End the 'Perverse Incentives'

In most of the U.S., health care can be confusing, uncoordinated, and expensive. What if we were to emphasize cooperation, communication, and prevention?

Imagine you were a diabetic whose doctor developed a customized plan to help keep the condition in check. Imagine a team that monitored blood sugars remotely and called you periodically to see how you felt. Imagine your doctor knowing when you experience a diabetic episode, with an appointment automatically scheduled to address it that day. Imagine seeking more intense treatment at a hospital whose staff already knew your history and could discuss follow-up care with your doctor. Here's the best part: Imagine getting all this for less than you pay today.

Sound unbelievable? With health-care costs rising every day, consumers—and even providers—have reason to be skeptical that a utopian world of good care at a good price could ever exist. But this is the future promised in Accountable Care Organizations (ACOs), a new model designed to reduce spending by improving health, eliminating inefficiencies, and preventing costly complications.

There are two premises underlying ACOs that make them unique and unlike past efforts to contain costs, including Health Maintenance Organizations (HMOs). First is the need to change the way we pay for health care. Today's health-care providers are paid by the number of office visits, tests ordered, and procedures performed, regardless of whether these services yield a better outcome. The system rewards volume: the more services consumed, the higher the payments. This approach has had disastrous effects, including runaway spending and insurance premium increases that reached an estimated 17.3 percent of U.S. gross domestic product in 2009, the largest one-year increase in history.

ACOs propose to fix this system of perverse incentives. Rather than paying for treatments when people get sick, caregivers in an ACO would be held accountable for keeping patients well. Their reward is a portion of the funds that are saved when people improve their health and require less care.

CHEAPER TO PREVENT THAN TO AMPUTATE

Diabetic care today costs insurers an average of about $30,000 a year, most of which goes toward treating expensive complications. An oft-cited example of today's absurdist approach to health care is that many insurers will not reimburse $150 for someone to get a routine foot checkup, but nearly all will pay $30,000 for a foot amputation, an all-too-common remedy in advanced cases of diabetes. In the ACO model, there would be a significant investment in the preventive care needed to avoid the expensive amputation, obviating the hospital visit. In such a scenario, average diabetic care costs could be reduced to $20,000. The ACO could keep a chunk of the $10,000 savings as a new form of reimbursement. Moreover, doctors who achieve such quality enhancements would be able to earn bonus pay for better care and reduced costs. The reward is no longer based on consumption, which HMOs tried to restrict. Instead the incentive is for doctors to make decisions to improve a condition, which benefits patients, insurers, employers, and doctors alike.

A second break with the past is the onset of the notion that we must overcome fragmentation in health care. In our current system, people are passed among doctors, specialists, clinics, hospitals, and others, often without coordination of care or discussion by providers. This frequently means that vital information is unavailable when a clinical decision needs to be made, leading to duplicate or conflicting treatments, waste, and unnecessary expense. The Congressional Budget Office estimates that up to 30 percent of all health-care dollars are wasted in unnecessary or duplicate care, with no corresponding benefits in outcome.

In contrast, when working as part of an integrated ACO, doctors, specialists, nurses, long-term care providers, and others are all part of a united team that provides seamless access to care, any time, anywhere. That sort of teamwork will ensure that clinicians have the information they need to provide effective treatments to improve health.

The Top Five Branches Of Health Law GOP Wants To Prune

by LEXIE VERDON, BARA VAIDA AND JORDAN RAU

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January 24, 2011

The Republican effort to repeal the health care law is going nowhere in the Democratic-controlled Senate, but that doesn't mean that the GOP is backing down. House Republicans are already beginning work in committees to lop off and possibly replace some of the law's individual provisions.

Party leaders have released few specifics, but some of the changes that have been urged by Republicans and a few Democrats could affect Americans' health care spending and coverage under the law.

Ways and Means Committee Chairman Dave Camp of Michigan was blunt about the strategy when addressing reporters last week: "If the tree is rotten, you cut it down." If that doesn't work, "we'll prune it branch by branch."

Here is a quick look at five "branches" of the health law "tree" Republicans are eyeing.

1. Reporting Business Payments on 1099 Forms

What the law says: Businesses that make payments of $600 in a year for goods or services to a single provider must file a 1099 form to the Internal Revenue Service identifying the company or person receiving the payment.

Purpose: The reporting requirement is expected to raise $19 billion over 10 years to help pay for the cost of expanded insurance coverage under the health law. It is intended to help increase taxpayers' compliance with income reporting rules.

Where it stands: This provision quickly raised concerns from business groups, which argue that the $600 trigger is too low and will create an administrative nightmare, especially for small businesses. That prompted bipartisan support to change or repeal the provision; the White Houseagreed that it should be amended.

Both Republican and Democratic lawmakers have offered proposals, but none passed last year. The new GOP majority in the House is determined to take up the issue again and have made a bill repealing the reporting requirement a priority. Three Democratic senators have written Speaker John Boehner to urge quick passage of the bill.

2. Individual Mandate

What the law says: U.S. citizens and legal residents are required to have health insurance by 2014 or pay a penalty. A number of people are exempted from the mandate, including those for whom the coverage would cost more than 8 percent of their income, American Indians and those who have religious objections.

Purpose: The mandate is designed to discourage consumers from waiting to apply for coverage until they are sick and need costly treatments. Backers say that's important because insurers will be required to provide coverage to people with pre-existing medical conditions.

The Congressional Budget Office has estimated that if the provision were struck from the law, fewer healthy people would purchase insurance and the result would be a 15 to 20 percent increase in premiums in the individual insurance market. It also predicted that the number of uninsured Americans would rise to 39 million from 23 million by 2019 if the mandate is repealed or overturned by courts.

Where it stands: Republicans argue it is unconstitutional to force individuals to purchase a product and about two dozen states are challenging the provision in court.

The issue is expected to go all the way to the Supreme Court.

Even some Democrats who supported the law, such as Sens. Claire McCaskill of Missouri and Ben Nelson of Nebraska, have backed away. Various groups are promoting alternatives like limiting insurance plan enrollment to specific times or imposing penalties on those who do not enroll when they first become eligible; or replacing the mandate with an incentive to buy health insurance, such as a tax credit.

3. Independent Payment Advisory Board

What's in the law: This 15-member board is tasked with curbing the per capita rate of growth in Medicare spending. The board's recommendations will be automatically implemented in the 2015 fiscal year unless Congress comes up with its own solution.

Congress may also vote, by a supermajority, to reject the recommendations and send the bill to the president, who can sign or veto the measure. Both Congress and the board face statutory deadlines for action.

Purpose: Efforts by Congress to rein in Medicare spending have been met by repeated resistance from special interests, making it politically difficult for lawmakers to slow health care spending. The board is supposed to make the hard decisions on spending that Congress has been unable to implement.

Where it stands: Republicans see the board as another expansion of government over health care, and many House Democrats oppose an independent board exercising control over Medicare. Many powerful interests, including doctors, drug companies, hospitals and patients-rights groups have begun lobbying Congress to get rid of the provision. They say they're worried the cuts will be draconian, disrupting the health care system.

4. Health Care Flexible Spending Accounts

What's in the law: Starting this year, people who put money into pre-tax flexible spending accounts (FSAs) can no longer use those funds to buy over-the-counter medications or health care products without a prescription. Starting in 2013, the maximum contributions to those accounts will be capped at $2,500 a year.

Purpose: The change is intended to help the government pay for the broader health overhaul. Many economists also argue that FSAs encourage consumers to make needless purchases because they fear forfeiting their account balances at the end of the year.

Where it stands: Companies that administer these accounts are pressing Congress to rescind the restriction on over-the-counter medications and products. They also hope that if Congress won't raise the $2,500 annual limit, lawmakers will at least allow people to roll unspent money into the next year's account or have it returned to them as taxable income.

5. The CLASS Act

What's in the law: This insurance program would allow people to volunteer for a payroll deduction to help them finance long-term care in their own homes if they become disabled.

Purpose: The payments of at least $50 a day can be used for a variety of expenses, including paying for a home health aide or family member who provides care, household modifications, respite care, special transportation or technology needs or to help pay for assisted living expenses. There is no lifetime limit on benefits.

Where it stands: Conservatives argue that the program will quickly outpace its funding and become an entitlement that the country cannot afford. Some of these experts, including theHeritage Foundation, have urged Congress to repeal the provision before CLASS begins operation.

Last year, Rep. Charles Boustany, R-La., introduced a bill requiring Congress to reconsider whether the program was self-sustaining but lawmakers did not act on it.

This story was produced through collaboration between NPR and Kaiser Health News (KHN), an editorially independent news service and a program of the Kaiser Family Foundation, a nonpartisan health care policy organization that isn't affiliated with Kaiser Permanente.

Medicare, Medicaid, CHIP Final Rules 2011

Medicare, Medicaid, CHIP Final Rules 2011

Final rules with opportunity for public comment only on fingerprinting requirement.

These regulations are effective on March 25, 2011

Medicare, Medicaid, CHIP Additional Screening Requirements, Application Fees, Temporary Enrollment Moratori...

AstraZeneca, The Policy Pimps Of Medicaid Fraud

AstraZeneca, The Policy Pimps Of Medicaid Fraud

A precious gem I have discovered!

This is an excellent specimen of pathological propaganda. In 2004, AstraZeneca, LP, a pharmaceutical corporation, sponsors a symposium with a university to reshape Medicaid. The main focus was on mental health and children, not on quality of life but to increase funding to expand eligibility for drugs.

That's right, boys and girls, a drug company pays off a university to get Congress to pay more money for their drugs. This is tangent to the practice of  ghostwriting in medical literature.

These cats were so good at manipulating public policy to make more money that they even got former Michigan Governor John Engler, the king of privatization, to come and support their agenda. For those of you who may not know, Governor Engler was the individual who established the nation's first  privatized child welfare system. As a result, Medicaid fraud has been astronomical. Here is a sample of his work.

Without further adieu, I present to you, a hallmark in the history of Medicaid fraud child welfare!  The Future of Medicaid: What Will Medicaid Look Like in 2010?

What makes this so-called "Medicaid vision" so entertaining is that it is now 2010 and look at what the Department of Health and Human Services Office of Inspector General caught AstraZeneca, LP doing... "wrongfully and illegally marketing" their drugs

I am not sure as I have yet to investigate, but I believe the U.S. Food and Drug Administration was allowing Medicaid to pay for the experimental drug trials on foster kids for AstraZeneca, LP. Even so, Medicaid pays for using  foster kids as lab rats.

In the end, the only lesson I am trying to teach is that it is time for transparency and accountability. No more secrets. CORPORATE INTEGRITY AGREEMENT BETWEEN THE OFFICE OF INSPECTOR GENERAL OF THE DEPARTMENT OF HEALTH AND HUMAN...

AstraZeneca's policy pimping only gets funnier. Utah's Attorney General Shurtleff wants his money back. I wish the other States would follow suit. Utah Seroquel Risperdal Complaint

Stop Child Medicaid Fraud

Stop Child Medicaid Fraud

HHS and DOJ Health Care Fraud and Abuse Annual Report 2010

HHS and DOJ Health Care Fraud and Abuse Annual Report 2010

The Department of Health and Human Services and The Department of Justice Health Care Fraud and Abuse Contr...

Mythbusting on Health Care Reform

Myth Buster Health Reform Destroys Jobs FINAL