Lexington doctor who exposed Kentucky hospital to be featured on CBS show.
https://www.kentucky.com/news/local/crime/article216037450.html
A Lexington doctor who helped uncover a widespread false billing scheme at a Kentucky hospital will be featured on CBS’ Whistleblower Friday night.
Whistleblower, airing at 9 p.m. Friday, features stories “of heroic people who put everything on the line in order to expose illegal and often dangerous wrongdoings,” according to its website.
Friday’s episode showcases Dr. Michael Jones, who along with fellow doctors Paula Hollingsworth and Michael Rukavina in 2010 and 2011, played a key role in blowing the whistle on an alleged overbilling scheme at St. Joseph-London Hospital.
The doctors noticed when they treated patients who had heart procedures done at St. Joseph-London that the treatments had been unnecessary, according to a lawsuit they jointly filed in 2011. One patient in London had 17 unneeded heart catheterizations and another patient had 10 catheterization procedures and seven stents placed to improve blood flow near arteries that were near normal.
St. Joseph-London and some doctors who worked there were accused of submitting bills to government-funded programs such as Medicare and Medicaid for hundreds of unnecessary heart procedures.
The alleged wrongdoings occurred before St. Joseph merged with Jewish Hospital and St. Mary’s HealthCare in 2012 to form KentuckyOne Health.
The owner of St. Joseph-London agreed to pay a $16.5 million settlement, which was the second-largest ever in a health care fraud case in the federal Eastern District of Kentucky.
The settlement resolved the claims against the hospital, but several doctors who practiced at the hospital and their clinics were also sued by patients.
Jones decided to take action because the procedures were invasive and costly enough to potentially bankrupt patients.
“I saw many patients who underwent unnecessary heart procedures,” Jones said, according to a release from CBS. “I was concerned they were being done for financial gain.”
Kevin Wells had a pacemaker installed that was unwarranted. His wife, Ruth Wells, is a part of the CBS episode. She said Kevin’s heart felt like it was beating out of his chest.
“Kevin could have died,” Ruth Wells said, according to CBS. “He could have died on that table. And to think it was for something he didn’t need.”
Jones practices at Baptist Health Lexington.
A statement provided by KentuckyOne Health Friday stated the London hospital is demonstrating clear action to prevent this issue from recurring.
“In February 2011, following a months-long internal investigation, Saint Joseph London self-reported to Federal authorities instances of interventional cardiology procedures that lacked adequate documentation to support the clinical indication for the procedures. The internal investigation was launched as a result of the hospital’s own proactive and ongoing compliance reviews, and the hospital then self-reported to Federal authorities, one month prior to the whistleblower lawsuit,” according to the statement.
“Saint Joseph London also fully cooperated in all subsequent government inquiries concerning the interventional cardiology procedures,” the statement continued. “Since then, the hospital has demonstrated clear action to address and prevent this issue from recurring, including monitoring, reporting and ongoing audits that exceed governmental requirements. In fact, in 2017 Saint Joseph-London was recognized by the Accreditation for Cardiovascular Excellence as adhering to the highest quality standards for cardiovascular care.”
Interventional pain procedures
Filed under: General Problems
I’ve mentioned this before on another post, but since this subject has come up again with its importance it bears repeating, again. In my research of bipolar disorder I have discovered there is a risk of having a full blown manic/psychotic episode with the use of steroids. There is a risk as well with ESI’s. We trust our Dr’s to know of every possible interaction and my PM has a complete list of my medications so i thought I was safe. Not only did I learn this isn’t an FDA approved procedure as mentioned in the post, but I learned of the chance of having a manic episode. That is not a risk I’m willing to take for anyone or anything. So keep this in mind and if you know anyone that is a CPP that is also Bipolar, pass this long…
This is so appalling…extortionist medicine. Even the maker of the methylpred has been saying it shouldn’t be used for ESIs! How the hell can doctors require patients to undergo unnecessary procedures knowing that they’re so dangerous? What the hell happened to things like “ethics” or “doing no harm”? They should all be slammed in jail.
THIS IS A LONG ONE, BUT PLEASE READ!!
I had 10 injections done in my lower back, for degenerative disc disease. Apparently they typically help reduce pain in people with my condition. However, I was also hit, dragged and then run over with my lower back being the point of impact. Some people tell me that I’m lucky to have survived it. I don’t know how lucky I am, considering that I now have a lifetime’s worth of pain to deal with now, with no help .The injections did not provide the purported relief that I was told I SHOULD have gotten from them. I told them this after the first injection, but they continued to do them. I was given a fentanyl/versed combo for the procedure the first few times. The last time I had the injections done in a hospital setting, the drug combo started to ‘wear off’ before he was done with the procedure. I distinctly heard the pain specialist tell his assistant that he was almost done, so not to worry about pushing any more. I could feel the remainder of the procedure. Then, he decides to move the injections to his office, as he apparently got it set up so that he could. Instead of the usual drug combination of fentanyl/versed, I was told I was going to be given Valium only. I was nervous about this, because I already had an idea of how painful the injections might be, without the fentanyl, given that they were seriously uncomfortable when I had already been given the injections when the combo wore off. Anyway, I was told that it would be recommended that my doctor stop with the opioid therapy I was on, if I did not agree to the injections, so I reluctantly agreed. This was the last of the 10 injections that I had, by the way. And for a good reason. I had told them every time before, that I was not getting any noticable relief from the injections, but was told that opioid therapy would be recommended to cease if I did not continue to have them. It was the only thing that was actually helping me, so I had to agree to it or face losing them. Back to the office injections, though. I took the Valium, exactly as I was told to. I went in to the office, still nervous about the injections. I disrobed and out on a gown, got up on the table and they strapped me down on it, which I might add contributed to my anxiety, and then when he started the injections, they hurt so badly it made me scream in pain. I was expecting maybe a little more pain than I felt in the hospital when the drug combo wore off, but nothing like I actually felt. He stopped and looked at me like he was confused. They kept asking me if I took the Valium. I told them that I took it just like I was told to. And then he continued. I screamed again. I need to add here that I do not generally curse at people but the words that involuntarily left my mouth were not very nice or appropriate in a professionals office.He then decided to stop the procedure again and they all asked me again, if I had taken the Valium, to which I told them once again that I had taken it EXACTLY how they told me to. Here is the thing. I have been telling my doctors for years that I have pain that is out of proportion to injury. Last year, I went to a specialist that told me that I have CRPS, but refused to officially diagnose me with it because he doesn’t treat it. I begged him to please diagnose me so that I could get proper treatment for it and my primary doc had told me to tell him that she would treat me if he gave me the diagnosis. So he agreed to see me one more time, for a diagnosis. I had to fight tooth and nail to get his report, though. And when I finally did get it, he had diagnosed me with 2 conditions that it was long since we’ll established that I already have. Osteoarthritis and fibromyalgia. And that they were “overlapping” and making each other worse. So now, I still don’t have a proper diagnosis and if I do indeed have CRPS, I won’t be able to tell any future doctor’s, especially if I have to have another procedure that might cause me more pain than a typical patient. Because CRPS is painful and no one wants to touch a patient that has pain with a 10ft pole anymore, since they aren’t “allowed” to treat pain now, or risk losing everything they worked so hard for. Another interesting point is that I had an EMG/nerve conduction study that showed an “abnormality” in my lower back on the EMG. I was told this by the doctor that did the EMG. I was also told by the referring specialist that he was the absolute best in the area at doing EMG/nerve conduction studies. When I went back to the referring doc and asked about the lower back abnormality, he told me that he didn’t know what I was talking about. So I was forced to drop it, for the time being. This was about 4 years ago. Last year, I mentioned to my primary doc that I had that EMG, with the lower back abnormality, and she told me that she had a copy of that report and could see it. I asked her about it and she said there were no noted concerning that in particular, but that I should ask the referring doc. I already did and he acted like I was making stuff up. So now I’m stuck there, too, because I may have adhesive Arachnoiditis. I know something very bad and very painful is wrong with my lower back. I have been told it is only osteoarthritis and degenerative disc, but when I talk about the levels of pain I have in that specific area, I’m told “it shouldn’t be that bad”. I’ve been told that by several different physicians. I was even told by one neurologist that my ddd would get better over time, when the process was almost complete. I told another neuro that and be about fell out of his chair, telling me that if anything, ddd gets WORSE pain wise, over time. And the worst thing is that there is nothing i can do about any of this. It’s my word against theirs. Who do you think will win that one? I don’t know why I keep getting these doctors that either straight up lie to me, to then find out later that I was indeed lied to, or that flat refuse to help me. I have read that if you are a minority, female, young, etc, you are less likely to be taken seriously. Unfortunately, I am all of those aformentioned things. I can’t help that I got the lot in life that I did. I was 15 when I got hit by the SUV. I was 28 when I saw the pain specialist the first time. I am a bit overweight because my back and knees prevent me from doing too much or they put me down with pain. So I go in to see him and he looks at me, then asked why I as dragging my leg. I told him that it hurts and I was told I have sciatica. I also showed him where my left leg was reconstructed after a brush guard in the SUV caught it and twisted it all the way around, tearing everything in there apart. I was lucky to find a doc that told me he thought he could save it because they wanted to amputate. Anyway, the pain specialist looks at me again and says “Well I think you’re back problem is mainly your weight. You need to do core strengthening excercises and put down the potatoes chips and bon bons. You also need to TRY to walk at least 300 ft a day”. I was in shock at what I had just heard. He was just getting ready to dismiss me when I asked if he would at least take a look at my MRIs. He sighed loudly and turned to his computer. He looked for a couple of seconds and then literally exclaims “You’ve got the back of a 60 yr old woman”!!! He then immediately told me he wanted to do the injections. Told me he would have his nurse set them up for me. He then goes to dismiss me again and then tells me that I should try a vegan diet and some vitamins as well, because it wouldn’t hurt me, he does both and gives vitamins to his kids so he wouldn’t give them something that would hurt them. I was furious. If my back was not so terrible or there was another pain specialist in my area that was not just as bad or worse (I found this out later), I would have never went back to him. But I got stuck. I tried going another place later, they wanted to do injections with NO meds, which they did not tell me until the day of the injections. And after I told them the injections were not relieving pain as well. Then they accused me of looking for pain meds, when I told them the last specialist used them. I told them that I assumed that there was a reason that they were used by a different doctor and that I did not want to do the injections without them. They told me I wouldn’t be allowed to come back and threatened to call the doc that prescribed the opioid therapy to me to tell her to discontinue it because I was a drug seeker. This is only a snippet of my experiences with the healthcare system in my area. I wish I was making this stuff up, but sadly, I’m not. It goes on, including the hospital that my dad was in after having a major heart attack. The staff called me over a dozen times a day telling me that I needed to remove him from life support. He had brain activity. This started the day after he arrived. They had a chaplain follow us around the hospital when we went to visit him, after we were verbally assaulted by the charge nurse in his room. She talked very deliberately and slowly, like you see someone on the movies talk to someone they assume doesn’t speak English, waving her hands over her head as she said “braaaaiiinnn iinnnjuuuuryyy” and then when she said “heeaaarrrrtttt attttttaaaaccckkk”. Like we were too stupid to understand the situation. They then tried to tell me my name was not on the medical power of attorney, even though it clearly was, right behind my brother’s name. We asked to bring him home, so that if he was going to pass, he could do it here. They agreed but then called hospice to tell them that they didn’t think we could handle it, even though my mom took care of 2 other family members in their last days, in conjunction with hospice. After she talked to hospice and they remembered her, they called the hospital back and the hospital called me, telling me that we would need to do it tomorrow then. Hospice had not even had time to have someone come out and bring a bed yet. We told them this. So because we told them we were going to bring him home the following Monday, as this was on a Weds I believe with hospice coming Friday and we were just getting over being sick at my house, the hospital went ahead and took my dad off of life support and saying I gave them permission to because of the transfer and my dad died at the hospital. I couldn’t even get down there to see him, because I was sick. They literally robbed me of the last moments with my dad and why? No one ever told me. There was a lot more involved in this. I even went into my dad’s room one time to see that they had MY MED LIST pulled up on the mobile computer screen in his room. I’m assuming that they were trying to look for a way to circumvent dealing with me, like an antipsychotic or something, which I don’t take, because they had no reason or permission to do this. Also, they were harrassing my brother after I told them to deal with me, even though he was on the power of attorney for dad, his house burned to the ground and he lost everything just after dad had the heart attack. They knew why I told them to deal with me, they just didn’t care. So yeah. Trust me, I realize there are some absolutely wonderful medical staff out there and that they aren’t all like this. But none of them appear to live in my area. I could literally write a book based on my experiences alone. Not to mention the doc that tried to OD my son with a med that a specialist luckily caught before we gave it to him. Or that my husband’s liver enzymes are through the roof and his doc knows it but refuses to do any testing to find out why it do anything to treat it. Or the fact that my husband has a vetebrae that you can visually see is twisted, near the top of his back. This apparently happened after an accident at work but the Workman’s Comp doc “saw nothing wrong” and he has only seen one doc at an urgent care for another issue that told him he needed to see a neurologist and that he might need back surgery or he could have a major issue if it broke or slipped any further. What is going on here? I know there are generally 2 sides to every story but when you walk in with a problem, are honest about it and are lied to or ignored, where is the patients fault in that?? Please, tell me so I can fix it and get real help!