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Groups Pipe Up on Stent Case

The American College of Cardiology and the Society for Cardiovascular Angiography and Interventions say they're trying to address the issue of questionable stent implants and high costs to Medicare. In a joint e-mail, the they responded to a Senate Finance Committee report alleging that Maryland cardiologist Dr. Mark Midei had inappropriately implanted 600 stents from 2007 to 2009 at a cost to Medicare of $3.8 million. The report said that Abbott Laboratories feted Dr. Midei as one of its “Project Victory” cardiologists for top stent volume and paid him to promote the company's stents. Acknowledging that inappropriate implantations would be a violation of the Hippocratic Oath and a black mark on cardiology, the two groups said that they and their Maryland chapters have “been proactively addressing the issues raised by these allegations” by, for instance, helping states draft laws requiring accreditation of hospitals performing percutaneous coronary interventions.

State Smokes Heart Disease

The Massachusetts Medicaid program has curbed smoking prevalence and hospital admissions for some smoking-related diseases, according to a study reported in Public Library of Science Medicine. In 2006, the program began comprehensive coverage of tobacco cessation therapies and counseling. About 75,000 Medicaid recipients used that benefit from 2006 to early 2009 and smoking dropped from 38% to 29% among the Medicaid population, reported researchers from the state's Tobacco Cessation and Prevention Program and Harvard Medical School, Boston. Moreover, the percentage of smokers who said they quit during the previous year increased from 7% in the prebenefit period to 19% 2.5 years later. The rate of Medicaid hospital admissions for coronary atherosclerosis declined 49% and that for acute myocardial infarction dropped 46%. However, there was no change in admissions for lung diseases or some other tobacco-related conditions. In a statement American Heart Association Chief Executive Officer Nancy Brown said the study “provides ample evidence that comprehensive smoking cessation benefits must be a core component of antitobacco initiatives.”

Another Industry-Pay List

Massachusetts has published an online database listing 6 months of payments from pharmaceutical companies and medical device makers to health care providers. The data show that the top-spending company in the state was Boston Scientific, which paid $2.5 million to 129 recipients including physicians and hospitals. From July to December 2009, 283 companies paid $35.7 million to all recipients, including $16.4 million to 5,048 physicians, according to the Boston Globe.

Guilty of Inflated Prices

Three drug makers – Abbott Laboratories, B. Braun Medical, and Roxane Laboratories – have agreed to pay $421 million to settle the government's claim that they inflated wholesale prices of their drugs to get higher reimbursement from Medicare and Medicaid. The Department of Justice said the government had paid “millions of claims of far greater amounts than it would have if Abbott, B. Braun, and Roxane had reported truthful prices.” Roxane was charged with reporting false prices for azathioprine, diclofenac sodium, furosemide, hydromorphone, ipratropium bromide, Oramorph SR, Roxanol, and Roxicodone. The Abbott drugs were dextrose solutions, sodium chloride solutions, sterile water, vancomycin, and erythromycin. B. Braun was alleged to have inflated prices for 49 products. The case was brought to light by a whistle-blower in Florida, who is to receive nearly $90 million, according to the government statement.

Hospital Adverse Events Common

More than 13% of Medicare beneficiaries hospitalized in late 2008 experienced at least one adverse event causing lasting harm during their stays. Among them, 1.5% had an event that contributed to their deaths, according to a report from the Health and Human Services Office of the Inspector General. Another 13% of hospitalized beneficiaries had temporary harm, such as hypoglycemia, the report found. The combination of events cost Medicare an estimated $324 million in October 2008, the month the report covered, which means that such events could cost $4.4 billion a year. Physicians reviewing the data said that 44% of the adverse events, such as hospital-acquired infections, and temporary-harm events were clearly or probably preventable.

AMA Issues Social Media Policy

Physicians using social media sites such as Facebook and Twitter should carefully guard patient privacy while monitoring their own Internet presence in order to make sure it is accurate and appropriate, the American Medical Association said in a new policy statement. During its semiannual policy meeting in San Diego, the association called for physicians to “recognize that actions online and content posted can negatively affect their reputations among patients and colleagues, and may even have consequences for their medical careers.” The AMA urges physicians to set privacy settings on Web sites at their highest levels, maintain appropriate boundaries when interacting with patients online, and consider separating personal and professional content online.

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Policy & Practice : Want more health reform news? Subscribe to our podcast – search 'Policy & Practice' in the iTunes store
MDedge Cardiology