April 12th, 2007 by Dr. Val Jones in News
Tags: Fraud, Health Policy, International, Medicare, News
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I was reading a news story about how medical fraud is becoming more frequent in Australia. They attribute this to the recent transition to electronic record keeping, which makes it easier to file fraudulent claims. Although these tactics are old news in the US, I think it’s worth a little summary (from the article) here – stay on the lookout for overcharges and fraud! The best way to protect yourself is to review your bills with vigilance. It’s sad that it has come to this…
Fraudulent tactics
Supply companies:
* Upcoding of items and services where, for example, a medical supplier may deliver to the patient a manually propelled wheelchair but bill the patient’s health fund for a more expensive, motorized wheelchair, or where a routine follow-up doctor’s office visit might be billed as an initial or comprehensive visit.
* Billing for medical services or items that are in excess of the patient’s actual needs. These might include a medical supply company delivering and billing for 30 wound care kits per week for a nursing home patient who only requires one change of dressings per day, or conducting daily medical office visits when monthly office visits are adequate.
Providers:
* Duplicate claims, where a certain item or service is claimed twice. In this scheme, an exact copy of the claim need not be filed a second time. Rather, the provider usually changes part of the claim so the health insurer does not realize it is a duplicate.
* Unbundling, where bills are submitted in a fragmented fashion so as to maximize reimbursement for tests or procedures that are required to be billed together at a reduced cost.
* Kickbacks, when a healthcare provider or other person engages in an illegal kickback for the referral of a patient for healthcare services that may be paid for by Medicare.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
April 9th, 2007 by Dr. Val Jones in News
Tags: Gastroenterology, Research, Weight Loss
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In a recent study published in the British Medical Journal, researchers found that blood tests and a history of patient symptoms might be all that’s needed to diagnose the majority of individuals with celiac disease. Until now, a diagnosis required a biopsy of the intestinal wall.
It is estimated that celiac disease (caused by an autoimmune reaction to wheat gluten) remains undiagnosed in a whopping 85% of cases. This may be due to the fact that symptoms are often non-specific (diarrhea and constipation, fatigue, anemia, tooth enamel defects, weight loss, and dry skin are some of the symptoms).
The researchers report:
We devised and evaluated a clinical decision tool that used a combination of pre-endoscopy serological testing (for tissue transglutaminase antibodies) and assessment of symptoms to identify patients with coeliac disease. This decision tool might help increase the detection of coeliac disease in patients attending for gastroscopy without the need to perform routine duodenal biopsy.
As efforts are underway to increase awareness in the primary care community about the disease, it is good to know that diagnosis may no longer require an invasive test!
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
April 8th, 2007 by Dr. Val Jones in News, Quackery Exposed
Tags: Complementary And Alternative Medicine, Infectious Disease, News, Research, Urology
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The number one Google news item today is a report of a mouse study (published in Nature Medicine, but apparently still embargoed to the public as it is not listed on their website) that suggested that an herbal supplement could (in combination with antibiotics) “eradicate” urinary tract infections.
In usual fashion, the buzz preceded the science, and now we have thousands of people on the lookout for forskolin (a root extract of coleus) tablets from the local health food store. Do these have any possible merit?
A recent review of the literature about this herb was conducted by the good docs at Harvard, and turned up “no conclusive evidence for its [forskolin’s] use for any health condition.”
My friend Dr. Charles also read the reports of this “miraculous” new cure – which posits that recurrent urinary tract infections are caused by pockets of bacteria that hide inside bladder walls. Dr. Charles rightly points out that there are many different points of entry for bacteria, and that an herb which (and we don’t know that it even does this) relaxes bladder walls would surely not affect the alternate routes of entry, hence it cannot be curative in all cases.
So my friends, I’m sorry to say that there is little justification for enthusiasm yet. But we will follow the research with interest, in case human subjects do indeed show benefit in the future.
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
March 28th, 2007 by Dr. Val Jones in News
Tags: Food and Nutrition, News, Pediatrics, Pharmaceuticals
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This is one of the coolest David & Goliath stories I’ve heard of in a while. As part of a science experiment, two 14 year old girls from New Zealand set out to test the amount of vitamin C in a popular black currant drink. Ribena’s marketing campaign suggested that the black currants in Ribena syrup had four times the Vitamin C of oranges, but the teen girls discovered that the syrup actually had about ¼ the vitamin C of oranges, and that the ready to drink form of Ribena had no detectable Vitamin C content at all!
The Commerce Commission had pushed for a fine between $275,000 and $350,000 and corrective television advertising. Glaxosmithkline wanted a fine of about $60,000 and no corrective television advertising.
GSK has a worldwide turnover of more than $61 billion, second only to drug giant Pfizer.
Although it’s unclear what the ultimate fine will be, this high school science experiment led to ensuring honesty in advertising. A far cry from the usual volcano/dry ice project that most of us worked on!
And by the way, Ribena is quite delicious.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
March 24th, 2007 by Dr. Val Jones in News
Tags: Animals, Cancer, Dermatology, News
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In my last blog post I was describing how adversity can be used for good, and as I was reading the medical news this morning I found another great example. While gardening, a British man was bitten on the neck by a spider. Now, the report doesn’t say exactly what type of spider this was, but judging from the outcome it was probably not a black widow or brown recluse. I’m assuming that the insect was some sort of common garden spider, though it must have had “fangs.” (Imagine my sister recoiling in horror here.)
As it turned out, the spider bit the man right next to a growth on his neck that he hadn’t noticed before. When he went to the doctor’s office to have the bite inspected, they found the growth and decided to biopsy it. The growth was cancerous, and the medical team was able to remove it before it had spread anywhere.
The little spider inadvertently saved a man from cancer. As he weaves his web, nestled between the coarse, hairy leaves of turnip plants, this tiny creature may never understand his contribution to humanity. Small actions can have a positive ripple effect, and a seemingly bad experience can save a life.
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
