Friday, July 29, 2011

Forest Labs' CEO Faces Exile

The Forest Laboratories CEO, Howard Solomon, who built his company's fortune on the antidepressants Celexa and Lexapro, faces exile from the health-care industry.

On Apr. 12, Solomon learned that the Office of Inspector General (OIG) which handles the U.S. Health and Human Services Department's efforts to fight waste and fraud in government health programs, is considering "excluding" him. Technically, this means exclusion from doing business with federal health programs such as Medicare, Medicaid, and the Veterans Affairs Department. Functionally, it means a ban from the entire health-care industry.

Forest's troubles began in 2001, when Joseph Piacentile, a non-practicing physician in N.J., filed an action alleging that Forest was providing kickbacks to doctors who prescribed Celexa. In 2003, Christopher Gobble, a salesman who had been fired in 2002 by Forest Pharmaceuticals, a subsidiary, filed a whistleblower suit in federal court in Boston alleging that the company was illegally pushing doctors to prescribe its antidepressants to children.

In September 2010, more than seven years after Gobble filed his suit, Forest Pharmaceuticals pleaded guilty to three criminal charges and settled civil claims filed by the Justice Department with a $313 million fine. Forest admitted it obstructed the FDA by concealing information, distributed an unapproved thyroid drug, and illegally promoted Celexa for use by children and adolescents.

In March, Lewis Morris, chief counsel to the inspector general, testified to Congress that "we are concerned that the providers that engage in health-care fraud may consider civil penalties and criminal fines a cost of doing business" and said that the government is forced to allow major pharmaceutical makers that have been convicted of crimes and have paid millions in fines to continue to participate in health-care programs because of the "potential patient harm that could result from an exclusion" of an entire company.

Hence, the move currently under consideration by the OIG to hold the CEO accountable by excluding him personally from participating in federal health programs, and thus forcing him out of the company.

Read the full article in the July 18 Bloomberg Businessweek.

Celexa and Lexapro manufactured by Forest are addictive and harmful psychotropic drugs prescribed for fraudulent mental disorders. There are no physical tests or scientific evidence to substantiate the theory that a chemical imbalance in the brain causes depression or any mental disorder. SSRI's such as Celexa and Lexapro are no more effective than placebo, and can cause violence and suicide.

Click here for more information about the side effects of these drugs.

Thursday, July 14, 2011

funding for health care

Costs of Health Care

An article in The Economist (25 June 2011, "Mass observation") discussing the 2006 health care reform legislation in Massachusetts, and on which the current federal health care legislation was based in part, makes the point that, although the percent of those lacking health insurance in Massachusetts dropped from 6.4% to 1.9%, the costs of health care and health care insurance have increased, and according to The Economist these costs are "unsustainable."

Costs for MassHealth rose 40% between 2006 and 2010, and costs for the subsidized health program for adults was 32% more than expected in 2008 and 11% more than expected in 2009. Also, uninsured hospital visits in 2010 were 14% above the level in 2009. Insurance premiums rose 12% between 2006 and 2008.

There are so many ifs, ands and buts about these figures that it is hard to make generalizations. However, one thing we can say for sure is that there is a general unwillingness to acknowledge and confront the contribution of fraud to the rising costs of health care and health care insurance, in particular the amount of patient abuse and fraud in the mental health industry.

Mental health practitioners perpetrate more fraud than any other sector of medicine. The U.S. loses about $100 billion to health care fraud each year, and up to $40 billion of this is due to fraudulent practices in the mental health industry.

The mental health monopoly has practically zero accountability and zero liability for its failures. This has allowed psychiatrists and psychologists to commit far more than just financial fraud. The roster of crimes committed by these "professionals" ranges from fraud, drug offenses, rape and sexual abuse to child molestation, assault, manslaughter and murder.

With mental health care insurance coverage being mandated in the U.S. through state and federal legislation, levels of fraud and abuse can be expected to continue to escalate, in spite of health care reform legislation.

What is the alternative? Provide funding and insurance coverage only for proven, workable treatments that verifiably and dramatically improve or cure mental health problems.

For more information download and read the CCHR booklet, "Massive Fraud — Psychiatry's Corrupt Industry — Report and recommendations on the criminal mental health monopoly."

Friday, July 01, 2011

Florida psychiatrist pleads guilty to massive Medicare fraud

 

http://www.justice.gov/opa/pr/2011/June/11-crm-871.html

 

Department of Justice

Office of Public Affairs

FOR IMMEDIATE RELEASE

Thursday, June 30, 2011

Miami-Area Psychiatrist Pleads Guilty for Role in $200 Million Medicare Fraud Scheme

 

WASHINGTON - A Miami-area psychiatrist pleaded guilty today in U.S. District Court in Miami for his part in a fraud scheme that resulted in the submission of more than $200 million in fraudulent claims to Medicare, the Department of Justice, FBI and Department of Health and Human Services (HHS) announced.

 

Dr. Alan Gumer, 64, of Tamarac, Fla., pleaded guilty to one count of conspiracy to commit health care fraud.   Gumer was charged on Feb. 15, 2011, with one count of conspiracy to commit health care fraud and four counts of health care fraud.

 

According to court documents, Gumer was a psychiatrist at American Therapeutic Corporation (ATC), a Florida corporation headquartered in Miami.   ATC purported to operate partial hospitalization programs (PHPs) in seven different locations throughout South Florida and Orlando.  A PHP is a form of intensive treatment for severe mental illness.

 

Gumer admitted that he signed evaluations, notes and other documents in medical files for patients who did not need the treatment for which ATC billed Medicare.   Specifically, as a psychiatrist, Gumer knew that the patients attending ATC did not need intensive mental health treatment, and that the treatments offered by ATC were not the type of intensive treatments a PHP should provide.   Gumer admitted that he signed these files without examining the patients, or writing and reading the statements he was signing.   Gumer also admitted to writing prescriptions for psychiatric medications for patients who did not need them in order to make it appear to Medicare that the patients qualified for PHP treatment.   According to court documents, Gumer also referred hundreds of ATC patients to a related company, the American Sleep Institute (ASI), for unnecessary diagnostic sleep disorder testing.

 

According to court filings, Gumer’s co-defendants and ATC’s owners and operators paid kickbacks to owners and operators of assisted living facilities (ALFs) and halfway houses and to patient brokers in exchange for delivering ineligible patients to ATC and ASI.  In some cases, the patients received a portion of those kickbacks.  Throughout the course of the ATC and ASI conspiracy, millions of dollars in kickbacks were paid in exchange for Medicare beneficiaries, who did not qualify for PHP services, to attend treatment programs that were not legitimate PHP programs so that ATC and ASI could bill Medicare for more than $200 million in medically unnecessary services.

 

According to the plea agreement, Gumer’s participation in the fraud resulted in $19.3 million in fraudulent billing to the Medicare program.   Sentencing for Gumer is scheduled for Jan 19, 2012.  Gumer faces a maximum of 10 years in prison and a $250,000 fine. 

 

ATC, its management company Medlink Professional Management Group Inc., and the owners and lead manager of ATC, Medlink and ASI, were charged with various health care fraud, money laundering and other offenses in a separate superseding indictment unsealed on Feb. 15, 2011.   Two of the three owners and the lead manager, as well as both ATC and Medlink, have pleaded guilty and have admitted to the fraudulent scheme and that more than $200 million in billings were submitted to the Medicare program as a part of the scheme.   They are scheduled for sentencing on Sept. 14, 2011, by U.S. District Court Judge James Lawrence King.   The trial of the third owner charged in the separate superseding indictment is scheduled to begin on Aug. 15, 2011.  

 

The remaining 17 co-defendants named in the indictment in which Gumer was charged are scheduled to stand trial on Nov. 7, 2011, before U.S. District Judge Patricia A. Seitz.

 

An indictment is merely an accusation and defendants are presumed innocent unless and until proven guilty in a court of law.

         

Today’s guilty plea was announced by Assistant Attorney General Lanny A. Breuer of the Justice Department’s Criminal Division; U.S. Attorney Wifredo A. Ferrer of the Southern District of Florida; John V. Gillies, Special Agent-in-Charge of the FBI’s Miami field office; and Special Agent-in-Charge Christopher Dennis of the HHS Office of Inspector General (HHS-OIG), Office of Investigations Miami office. 

         

The criminal case is being prosecuted by Trial Attorney Jennifer L. Saulino of the Criminal Division’s Fraud Section.  The case was investigated by the FBI and HHS-OIG and was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Southern District of Florida.

         

Since its inception in March 2007, the Medicare Fraud Strike Force operations in nine locations have charged more than 1,000 defendants that collectively have billed the Medicare program for more than $2.3 billion.  In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG are taking steps to increase accountability and decrease the presence of fraudulent providers.

         

To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to:  www.stopmedicarefraud.gov