Fraud and Abuse: United States ex rel Merena v. SmithKline Beecham Corp.; United States ex rel Spear v. SmithKline Beecham Clinical Lab.; United States ex rel Grossenbacher v. SmithKline Beecham Clinical Lab.

2000 ◽  
Vol 28 (2) ◽  
pp. 191-193 ◽  
Author(s):  
Allyson Behm

The United States Court of Appeals for the Third Circuit held that when quitam relators file a multi-claim complaint under the Fraudulent Claims Act (FCA), their share of the proceeds must be based on an individual analysis of each claim. More importantly, the court held that relators are not entitled to any portion of the settlement of a specific claim if that claim was subject to dismissal under section 3730(e)(4) Relator Merena filed a quitam suit against his employer, SmithKline Beecham (SKB), claiming, among other things, that SKB defrauded the government by billing for laboratory tests that were not performed, paying illegal kickbacks to health care providers, and participating in an “automated chemistry” scheme. Soon thereafter, additional relators filed suit.

2008 ◽  
Vol 3 ◽  
Author(s):  
Christine Massing

By 1850 the United States government already had a half century's experience providing health services to its Indian population. During the first halfof the nineteenth century, however, these services were focused primarily on containing epidemic diseases, especially smallpox. By mid-century, the rise of intemperance and venereal diseases among Indians convinced the government that more control over Indians' health was necessary. Professionally trained physicians, bolstered by advances in medical knowledge, led this interventionist effort at improving Indian health care. Government health care providers increasingly came to believe that success depended on undermining traditional lifestyles and leadership.


2020 ◽  
Vol 32 (5) ◽  
pp. 276-284
Author(s):  
William J. Jefferson

The United States Supreme Court declared in 1976 that deliberate indifference to the serious medical needs of prisoners constitutes the unnecessary and wanton infliction of pain…proscribed by the Eighth Amendment. It matters not whether the indifference is manifested by prison doctors in their response to the prisoner’s needs or by prison guards intentionally denying or delaying access to medical care or intentionally interfering with treatment once prescribed—adequate prisoner medical care is required by the United States Constitution. My incarceration for four years at the Oakdale Satellite Prison Camp, a chronic health care level camp, gives me the perspective to challenge the generally promoted claim of the Bureau of Federal Prisons that it provides decent medical care by competent and caring medical practitioners to chronically unhealthy elderly prisoners. The same observation, to a slightly lesser extent, could be made with respect to deficiencies in the delivery of health care to prisoners of all ages, as it is all significantly deficient in access, competencies, courtesies and treatments extended by prison health care providers at every level of care, without regard to age. However, the frailer the prisoner, the more dangerous these health care deficiencies are to his health and, therefore, I believe, warrant separate attention. This paper uses first-hand experiences of elderly prisoners to dismantle the tale that prisoner healthcare meets constitutional standards.


2020 ◽  
Vol 59 (04/05) ◽  
pp. 162-178
Author(s):  
Pouyan Esmaeilzadeh

Abstract Background Patients may seek health care services from various providers during treatment. These providers could serve in a network (affiliated) or practice separately (unaffiliated). Thus, using secure and reliable health information exchange (HIE) mechanisms would be critical to transfer sensitive personal health information (PHI) across distances. Studying patients' perceptions and opinions about exchange mechanisms could help health care providers build more complete HIEs' databases and develop robust privacy policies, consent processes, and patient education programs. Objectives Due to the exploratory nature of this study, we aim to shed more light on public perspectives (benefits, concerns, and risks) associated with the four data exchange practices in the health care sector. Methods In this study, we compared public perceptions and expectations regarding four common types of exchange mechanisms used in the United States (i.e., traditional, direct, query-based, patient-mediated exchange mechanisms). Traditional is an exchange through fax, paper mailing, or phone calls, direct is a provider-to-provider exchange, query-based is sharing patient data with a central repository, and patient-mediated is an exchange mechanism in which patients can access data and monitor sharing. Data were collected from 1,624 subjects using an online survey to examine the benefits, risks, and concerns associated with the four exchange mechanisms from patients' perspectives. Results Findings indicate that several concerns and risks such as privacy concerns, security risks, trust issues, and psychological risks are raised. Besides, multiple benefits such as access to complete information, communication improvement, timely and convenient information sharing, cost-saving, and medical error reduction are highlighted by respondents. Through consideration of all risks and benefits associated with the four exchange mechanisms, the direct HIE mechanism was selected by respondents as the most preferred mechanism of information exchange among providers. More than half of the respondents (56.18%) stated that overall they favored direct exchange over the other mechanisms. 42.70% of respondents expected to be more likely to share their PHI with health care providers who implemented and utilized a direct exchange mechanism. 43.26% of respondents believed that they would support health care providers to leverage a direct HIE mechanism for sharing their PHI with other providers. The results exhibit that individuals expect greater benefits and fewer adverse effects from direct HIE among health care providers. Overall, the general public sentiment is more in favor of direct data transfer. Our results highlight that greater public trust in exchange mechanisms is required, and information privacy and security risks must be addressed before the widespread implementation of such mechanisms. Conclusion This exploratory study's findings could be interesting for health care providers and HIE policymakers to analyze how consumers perceive the current exchange mechanisms, what concerns should be addressed, and how the exchange mechanisms could be modified to meet consumers' needs.


2020 ◽  
Author(s):  

Electronic cigarettes are the tobacco products most commonly used by youths in the United States. The use of e-cigarettes, also known as vaping or JUULing, is a public health epidemic. This collection offers reviews and research to assist pediatric health care providers in identifying and treating adolescent use and exposure to e-cigarettes. https://shop.aap.org/pediatric-collections-vaping-effects-and-solutions-paperback/


PEDIATRICS ◽  
1994 ◽  
Vol 94 (5) ◽  
pp. 774-775 ◽  
Author(s):  

This statement describes a modification of the recommended routine schedule for administering trivalent oral poliomyelitis vaccine (OPV). The American Academy of Pediatrics previously has recommended that healthy children receive a three-dose primary series of OPV at 2, 4, and 15 to 18 months of age and a fourth dose at the time of school entry (4 to 6 years of age).1 Available data indicate that the response rates to the third dose of OPV administered at 6 months of age are as good as the rates following administration of this dose at 15 to 18 months of age. Completion of the three-dose primary series at an earlier age will help health care providers induce immunity against poliomyelitis at an early age. Although wild type poliomyelitis has not caused disease in the United States for many years, the virus remains prevalent in many countries. Continued introduction of the virus into the United States by travelers could result in transmission and disease if high levels of immunity are not maintained in preschool age children. For example, wild type poliovirus type 3 was recently introduced into Canada by a religious sect that did not believe in immunization.2 The virus was probably imported from the Netherlands, where a small epidemic of poliomyelitis occurred in members of the same sect in 1992 and 1993.3 SERUM ANTIBODY RESPONSE FOLLOWING OPV ADMINISTRATION After two doses of OPV are administered at 2 and 4 months of age, 89 to 100% of children vaccinated in the United States have evidence of humoral immunity to poliomyelitis types 1 and 3, and 99 to 100% have immunity to type 2 (Table).


Author(s):  
Paula Aristizabal ◽  
Lena E. Winestone ◽  
Puja Umaretiya ◽  
Kira Bona

Adult cancer disparities have been documented for decades and continue to persist despite clinical advancements in cancer prevention, detection, and treatment. Pediatric cancer survival has improved significantly in the United States for the past 5 decades to over 80%; however, disparate outcomes among children and adolescents with cancer still affect many populations in the United States and globally, including racial and ethnic minorities, populations with low socioeconomic status, and residents of underserved areas. To achieve equitable outcomes for all children and adolescents with cancer, it is imperative that concerted multilevel approaches be carried out to understand and address health disparities and to ensure access to high-quality cancer care. Addressing social determinants of health, such as removing barriers to health care access and ensuring access to social supports, can reduce pediatric cancer disparities. Nevertheless, public health policy, health system interventions, and innovative delivery of evidence-based services are critically needed. Partnerships among patients, caregivers, and health care providers, and among health care, academic, and governmental institutions, have a pivotal role in reducing cancer disparities and improving outcomes in the 21st century.


OTO Open ◽  
2020 ◽  
Vol 4 (2) ◽  
pp. 2473974X2093357 ◽  
Author(s):  
Kyohei Itamura ◽  
Franklin L. Rimell ◽  
Elisa A. Illing ◽  
Thomas S. Higgins ◽  
Jonathan Y. Ting ◽  
...  

This study evaluates the patient experience during virtual otolaryngology clinic visits implemented during the coronavirus disease 2019 (COVID-19) pandemic. Patient satisfaction surveys were queried from January 1, 2020, to May 1, 2020, for both telehealth and in-person visits. A descriptive analysis of the question responses was performed. There were 195 virtual and 4013 in-person visits with surveys completed in this time period. Ratings related to provider-patient communication were poor for virtual visits. Telehealth has become the new norm for most health care providers in the United States. This study demonstrates some of the initial shortcomings of telehealth in an otolaryngology practice and identifies challenges with interpersonal communication that may need to be addressed as telehealth becomes increasingly prevalent.


2017 ◽  
Vol 10 (2) ◽  
pp. 139-163
Author(s):  
Thomas Allan Heller

Medical Malpractice claims are frequently asserted in the United States. At various time and places, an extraordinarily high number of claims and payouts led to what some have called medical malpractice crises. Consequently, in some geographical locations physicians either could not purchase malpractice insurance as carriers withdrew from the market, or, insurance became increasingly expensive and the overall costs associated with the delivery of health care continued to rise. Other undesirable consequences of these crises included a shortage of qualified physicians in certain parts of the country. Many of the states responded to these problems legislatively through a long series of tort reform measures. The health care industry itself has evolved in numerous ways. In particular, many health care providers have turned away from traditional private insurance models to self-insured models such as captives. Further, the industry has continued to consolidate, with fewer, but larger hospitals and clinics, and with an increasing number of physicians employed directly by hospitals and large clinics. The results of all of these changes have had mixed results.


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