Granny Bird Award: Medicare Fraudsters

This edition of the Granny Bird Award, an award issued from time to time to those who harm the interests and benefits of the elders, goes to those who are fraudulently collecting money from Medicare.

From McClatchy DC:

Doctors, nurses and other licensed medical professionals were among 89 people recently arrested in nine cities, accused of scheming to defraud the Medicare program of nearly $223 million in false billings, the Obama administration announced Tuesday.

The defendants face charges of conspiracy to commit health care fraud, money laundering and violating federal anti-kickback statutes for submitting claims to Medicare for purchases, treatments and services that, according to federal officials, either were medically unnecessary or never provided.

In many cases, patient recruiters, Medicare recipients and others were paid cash to supply beneficiary information that later was used in billing scams, federal law enforcement officials said. Most of the alleged fraud involved home health care services, but the charges included mental health services, psychotherapy, physical and occupational therapy, durable medical equipment and ambulance services. ...

Over the past three fiscal years, every dollar spent fighting health care fraud has returned an average of nearly $8 to the U.S. Treasury and the Medicare Trust Fund, Holder said. But that success is threatened by the across-the-line federal budget cuts known as sequestration, which cut $1.6 billion from the Justice Department’s budget for the current fiscal year, he said.   [Emphasis added]

The illegal conduct was spotted by the Center for Medicare/Medicaid Services (CMS) primarily by a sophisticated computer program, but also by elders who checked the report from CMS each receives regularly and noted charges for goods and services they did not receive.  In other words, CMS is doing its job, but needs elders to do theirs as well.

While I am not Eric Holder's biggest fan, I do think the DOJ has been doing its job well in prosecuting Medicare fraud.  I hope the sequester is lifted soon so that we can continue to nail the sleazes who would rob the system so vital to elders.

Granny Bird Award: Hospitals Who Overcharge

This edition of the Granny Bird Award, given from time to time to those who adversely affect the rights and benefits of the elders, goes to those hospitals who overcharge for surgical procedures frequently required by the elders.

The Center for Medicare/Medicaid Services (CMS) has released a report showing the unbelievable variance in charges for procedures covered by Medicare.  The Los Angeles Times has checked California hospitals on that list and has found some pretty dramatic differences in charges for such procedures as hip replacements and gall bladder surgery.  Here's what the Times found on hip replacement:

Medicare released pricing information Wednesday for more than 3,300 U.S. hospitals on the top 100 procedures and treatments in 2011. The federal health program for seniors and private insurers only pays a fraction of these billed charges.

Nonetheless, this information shows the wide variation in prices among hospitals for common medical procedures at a time when policymakers are wrestling with how to hold down rising healthcare costs.

Officials said they released this data in hopes that increased transparency will help squeeze some excess cost out of the system and enable consumers to become savvier shoppers for healthcare.

One of the most common surgeries is for an artificial joint replacement. Medicare data show that Cedars-Sinai Medical Center in Los Angeles charged, on average, $110,123 for those cases. Keck Hospital of USC billed an average of $123,885 and Prime Healthcare's Centinela Hospital Medical Center in Inglewood averaged $220,881.

In contrast, Hoag Orthopedic Institute in Irvine billed Medicare $52,066, on average, for joint replacements and Kaiser's Los Angeles Medical Center charged $35,524.   [Emphasis added]

The spread on laprascopic gall bladder surgery is just as variable.  And, as the article points out, the "cash" price is often dramatically lower than any quoted price for the insured.

The problem is that elders don't have the ability to shop around for a good price.  Whether they have a Medicare Advantage plan or a straight Plan B and Plan D, they are pretty much stuck with the facility their doctor is on staff at.  And then what?  What about the balance?

And, just as importantly, who pays that balance?  Who ultimately gets stuck with the bill and what does that do to the cost of healthcare for everyone?

No, the system is messed up and needs to be cleaned up.  It's long past time to take medical treatment out of the hands of private enterprise.

Granny Bird Award: Barach Obama

This Granny Bird Award, given from time to time to those who go out of their way to harm the interest and benefits of the elders, goes to President Obama for his unconscionable proposal to cut Social Security benefits.

From the Los Angeles Times:

As part of his new budget, President Obama will propose cutting Social Security and other government benefits by lowering the cost-of-living adjustment, putting a key GOP negotiating demand into a formal White House proposal for the first time.

The proposed change to the government's inflation measure, the consumer price index, is opposed by many congressional Democrats, although House Minority Leader Nancy Pelosi (D-San Francisco) recently suggested she was willing to consider it, if it could be done in a way that did not hurt the poor. ...

A senior administration official said that the president’s budget, which he will send to Congress next week, was not his “ideal deficit reduction plan,” but also said, “This is a compromise proposal built on common ground, and the president felt it was important to make it clear that the offer still stands.” ...

Organized labor, as well as seniors and veterans groups, has raised objections, and the Senate unanimously rejected the proposal in a symbolic vote last month as Republicans, too, appeared uninterested in pursuing it.   [Emphasis added]

Of course the Republicans are uninterested in pursuing it:  conservative elders already on Social Security and those 55 and older don't want it.  They all know that the chained CPI actually lowers the benefit appreciably, especially over the life-time of the plan.  It is simply bad for elders, all elders.

And by opening negotiations with this "capitulation," President Obama has made it clear that he simply doesn't care about Social Security or the elders.  He just wants his "Grand Bargain" as detailed by Simpson and Bowles.

What he also doesn't care about is the 2014 elections, during which the GOP will run campaign ads pointing out that it was the Democrats who want to destroy this key benefit, thereby making it difficult for Democrats running for the House and Senate.

Congratulations, Mr. President.  You've gotten this Award the old-fashioned way:  you earned it.

Granny Bird Award: Pharmacies and Pharmaceutical Companies

Today's Granny Bird Award, given from time to time to those who go out of their way to rip off elders or harm their rights, goes to pharmacies and pharmaceutical companies who play games with the cost of generic drugs.

From a David Lazarus column in the Los Angeles Times:

Diane Shattuck filled a prescription in December for a generic antibiotic called doxycycline. With insurance, she paid $4.30 for 60 pills at a CVS store in Orange.

She returned at the end of February to refill her prescription. This time, she was told her cost for the drug would be about $165.

"It was bizarre," Shattuck, 73, told me. "And no one at CVS could explain why the price was so high."
Unfortunately, I won't be able to offer a clear-cut answer, either. But my effort to untangle Shattuck's situation cast a harsh light on the shadowy world of drug pricing.

It revealed that different manufacturers can charge wildly different prices for what is essentially the same generic medicine, and that drugstores can rake in unconscionable profits by passing along marked-up meds to customers without the slightest explanation. ...

A CVS pharmacist in Los Angeles, who asked that his name by withheld because of fear of retaliation by the company, shared with me the average wholesale price of different makers' doxycycline, as made available to pharmacists by the McKesson Connect online ordering system.

The system shows that the average wholesale price of 100 doxycycline pills made by Watson with a strength of 100 milligrams is $328.20. The same number of doxycycline pills at the same strength made by Mylan cost $1,314.83.

But the average wholesale price, or AWP, as it's known in the industry, may have little, if any, correlation with what a drugstore charges customers.

"The AWP prices are as made up as the prices that come out of hospitals," said USC's McCombs. "It's not the price that CVS or other drugstores pay."

In other words, drugstores negotiate their own prices with manufacturers of generic drugs, as do the pharmacy benefit managers who often serve as intermediaries in wholesale drug transactions. They may be able to cut sweetheart deals based on the volume of medicine they can move to retail customers.   [Emphasis added]

In other words, elders continue to be targeted by the pharmaceutical companies and the pharmacies with these slimy practices.  Instead of cutting Medicare benefits to the recipients, maybe CMS needs to start busting chops of providers, yes?

Granny Bird Award: CVS

This edition of the Granny Bird Award, given from time to time to those who go out of their way to harm the interests and benefits of elders, goes to CVS, the pharmacy chain which has gone into the Medicare business by offering a Part D benefit.  They roped in a lot of elders with their promises of lower prescription prices and then did a bait-and-switch on them.

The federal Centers for Medicare and Medicaid Services said in a letter to CVS' SilverScript subsidiary that its inability to process prescriptions correctly "poses a serious threat to the health and safety of Medicare beneficiaries."

The federal agency blamed the problems on "widespread data system failures" that have "created disruptions in tens of thousands of Medicare beneficiaries' access to prescription medications."

SilverScript handles the drug requirements of about 4 million Medicare beneficiaries.

In Shapiro's case, she told me that she'd ordered a 90-day supply of an estrogen pill that was supposed to cost $85. Instead, SilverScript sent her a 30-day supply running $70.61.

Shapiro said she got the runaround from three separate CVS supervisors until a company representative finally insisted that she had to take what she was given and pay the amount CVS was demanding. ...

Medicare says it received 2,340 complaints about SilverScript in just the first two weeks of January — a rate four times greater than for all other Medicare-approved drug programs combined.   [Emphasis added]

Go read all of David Lazarus's column (link above) to see the lame excuses being offered.  Then write the White House and urge that they push to remove CVS from the approved list of Part D providers. 

Granny Bird Award: Charles Agbu

This edition of the Granny Bird Award, given from time to time to those who harm the rights and lives of elders, goes to Charles Agbu, who has copped a plea in a Medicare fraud case.

A Carson pastor pleaded guilty Monday to submitting more than $11 million in Medicare reimbursement through fraudulent clinics and by promising patients expensive equipment, according to the Department of Justice.

Charles Agbu, 58, of Carson, pleaded guilty to one count of conspiracy to commit healthcare fraud and one count of money laundering in U.S. District Court.

Agbu, a pastor at Pilgrim Congregational Church, faces up to 20 years in prison and a $500,000 fine when he is sentenced in May.

Agbu admitted to owning Bonfee Inc., a fraudulent medical equipment supply company, and acknowledged that he paid patient recruiters to approach Medicare beneficiaries and convinced them to give him their Medicare information in exchange for specialized power wheelchairs, officials say.

Agbu would then bill Medicare officials for the wheelchairs without delivering them to his clients. He also admitted to paying for fake prescriptions and other fraudulent documents in order to be able to continue  billing Medicare for medical equipment, authorities say.  ...

The case was brought by the Medicare Fraud Strike Force, a special unit of investigators launched in May 2009 by the Justice and Health and Human Services departments.   [Emphasis added]

Apparently "Pastor" Agbu wasn't too familiar with the Ten Commandments, especially that one about lying.  Some attribute for a man of God.

While the article isn't clear as to how much money the good "pastor" reaped by his scam, the fine does seem a little low, even by plea-deal standards.  That 20 years in prison, however, does seem appropriate and I hope the judge gives him all 20 years.  That will at least send a message.

Finally, at a time when the vile idiots in Washington are considering cuts to Medicare/Medicaid, perhaps that could be accomplished by tightening up the language of the original legislation which left loopholes for this kind of fraud to be accomplished.  The Center for Medicare/Medicaid Services, the agency charged to oversee such billings needs to be ramped up so that it can spot these scams before they hit the $11 million mark.  And more money to the agencies investigating such fraud (DOJ and HHS) would also be helpful in rooting out the wrongdoers, recovering their ill-gotten gains, and slamming their backsides in prison for long terms.

Let your congress critters know that these are the only kind of "cuts" to Medicare/Medicaid which are acceptable and do it today.   

Granny Bird Award: Michael McGough

The latest recipient of this award, given from time to time to those who go out of their way to harm the interests or benefits of the elders, is Michael McGough of the Los Angeles Times whose opinion piece (issued just one week before the election) implies that Dianne Feinstein just might be too old for another six years as Senator from California.  Mind you, he doesn't exactly state that.  Oh, no, not him.  Instead he engages in media bafflegab under the headline "Does Senator Dianne Feinstein's Age Matter?"

In her uphill campaign against Sen. Dianne Feinstein, Republican Elizabeth Emken, albeit obliquely, has made an issue of Feinstein’s age. The senator turned 79 on June 22 and if reelected she would be 85 at the conclusion of one more term.

Would that be unusual? Yes, but not unprecedented.

He then proceeds to list the other octogenarians who have served past their 80th birthday.  At least he did some research there.  What he didn't research, however, is telling.  He didn't check to see if Sen. Feinstein has behaved in any manner which suggests she probably should call an end to her career.  He doesn't give any indications that she has missed any roll-call votes on bills, nor any indications that she is not showing up for committee meetings or party caucus or state caucus meetings.  He doesn't list any bizarre behavior, like forgetting where she was or peeing on the Senate floor.  He just, well, implies that she's pretty old.

Age isn’t “just a number.” At the same time, it’s evident that people are living and thriving longer. (That’s why the solvency of Social Security is, or should be, an issue.)  It wouldn’t be a medical miracle if Feinstein remained healthy and active through another term.  But as an octogenarian she would definitely be in a small and select group.

Look, DINO Dianne is not my favorite politician, but it's not because of her age.  In fact, she has become wilier with time.  I wouldn't be surprised if she won the election, served a month into the next administration and then retired to work with a think tank or some such (i.e., pulled a "Jane Harmon").  But, she's doing just fine at 79, thank you very much.

So, Mr. Magoo Mr. McGough, I suggest you polish up your spectacles so you can do your job a little better.  Unless, of course, you're just polishing up your act in case Rupert Murdoch does buy the L.A. Times.

Granny Bird Award: Mitt Romney

It's been a while since I've issued a Granny Bird Award, given to those who go out of their way to harm the interests of elders, but Mitt Romney certainly deserves this one for his now infamous characterization of the 47% of those who pay "no taxes" as defective mooches on the other half of the country.

I've seen a lot of great analyses of just how wrong and how nasty this superior being is in his assertion, but one of my favorites came from Michael Hiltzig.  His most recent column nails Romney for his blatant abuse of the facts.  I especially appreciated what he had to say about the elders place in all of this.

Voters can decide for themselves whether Romney's words, taken at face value, bespeak a hopelessly crabbed approach to government's role in our lives or a principled stand for private enterprise and economic freedom.

But they should be concerned about the fundamental inaccuracy of Romney's claims and the erroneous conclusions he draws from them. For those point to the important questions of how he can make policy in a fact-free context, and how he can even know his own mind if he doesn't know what he's talking about.

So let's examine Romney's numbers and their significance.

The key number he cited is that 47% of Americans "pay no income tax." The statistic is true as far as it goes, but it doesn't come close to reaching the finish line. In fact, its shock value derives from the legerdemain of focusing solely on the federal income tax. This misleads Romney and his audience into thinking that the group in question is mostly people on a lifelong dole.

The truth is that the vast majority are people who are working or who have worked in the past. Their ranks include millions of Americans who are now retired, living on Social Security and Medicare benefits they paid for throughout their working lives.

Preach it!

Those of us who receive Social Security and Medicare are not mooches getting a free hand-out from the federal government.  We worked for years and had money deducted from our paychecks to cover these benefits.  We paid in advance.  We're just getting our money back now.

While the elders may not be paying federal income taxes now, they sure as hell did in the past.  Furthermore, they are still paying sales taxes to their state and local government.

Somebody needs to grab Mitt by the shoulders and shake him like an etch-a-sketch.  In the mean time, this award will have to suffice.

Granny Bird Award: Simpson-Bowles Enthusiasts

This edition of the Granny Bird Award (given from time to time to those who go out of their way to damage elders' rights and benefits) goes to those who continue to support the disastrous Simpson-Bowles "Grand Compromise", including those Democrats who have sold their souls on the issue.

After nearly a year of exposing the Simpson-Bowles report (which did not get the support of the Super Committee of which it was a part) for what it was, a gift to Wall Street, you'd think it would be dead. You would be wrong: vampires and the undead are in this year.

Fortunately, there are still people who are paying attention, people like Michael Hiltzig of the Los Angeles Times who notes that the report always brings to mind that classic cartoon sequence of Wiley Coyote, treading air, as he jumps off the cliff to catch the Roadrunner.

Is it that the debate over when and how to cure the federal deficit has reached new heights of cartoonish inanity? That we are now being treated to finger-wagging about the need to get our fiscal house in order by corporate CEOs like JPMorgan Chase's Jamie Dimon (trading loss $5.8 billion and counting, potential cost to ratepayers from alleged manipulation of the California electricity market $200 million and counting).

Or is it that the remedies for the deficit always seem to involve cutting taxes for the top 1% of U.S. income earners while cutting Social Security retirement benefits (average monthly check: $1,230) for everyone else? ...

...there's still reason for most Americans to fear the deal-making aimed at avoiding the fiscal cliff. For one thing, the debate seems increasingly to be driven by the wealthy, who can be trusted to protect their own prerogatives while declaring everyone else's to be wasteful. Just two weeks ago, a squadron of CEOs and bankers, including Dimon and hedge fund billionaire Pete Peterson, lined up behind a campaign to impose adult supervision on our squabbling Congress. ...

The Simpson-Bowles plan has inexplicably become the starting point for deficit cutters in both parties. House Minority Leader Nancy Pelosi (D-San Francisco), who in 2010 pronounced a draft version "simply unacceptable," more recently has signaled that she'd support it. [Emphasis added]

Say what?

A plan to cut Medicare costs by forcing the elders to pay for vouchers for care they've already paid for by withholding taxes the past 30 or so years? Pelosi is in favor of such a plan? She'd garner votes in the House for that?

But, again, there's more:

In any environment of serious debate, Simpson-Bowles would be dismissed out of hand. Praised for its sober bipartisan spirit, it's a compendium of flatulent platitudes ("We all have a patriotic duty to make America better off tomorrow than it is today"), vague prescriptions ("cut all excess spending" and "avoid excessive taxation" — as if reaching broad agreement on the meaning of "excessive" is a snap), and the occasional nostrum that earns a "not" on the gonna-happen scale (strip down the mortgage-interest deduction). According to some estimates by the nonpartisan Tax Policy Center, the plan's sample cuts in the tax deductions wouldn't replace the revenue lost to its proposed reductions in marginal tax rates. ...

The single program getting the bulk the Simpson-Bowles plan's attention is Social Security, which in fact contributes not a dime to the federal deficit, and can't by law. Something else is at work here other than deficit reduction: It's a plan to cut benefits to seniors by ratcheting back on inflation protection and sharply cutting the benefit formula for everyone, starting with those whose average lifetime earnings are $9,000 a year.

What's riskiest about Washington's peculiar approach to deficit cutting, which erodes the programs most important to working Americans while preserving those enjoyed by the wealthy, is that it could sap the resolve of President Obama and his Democratic colleagues to end tax cuts on high levels of income while extending them for average and low-income earners. [Emphasis added]

Hello?

Once again, this "Grand Compromise" gives everything to the Wall Street Banksters and their 1% owners and nothing to the rest of us. We didn't cause the financial melt-down. Social Security didn't screw up the economy. Why is this set of lies still getting any currency?

Hiltzig has a response to that:

...as much as corporate CEOs and other privileged incumbents claim they're concerned about the future, it's their future they mean.

Exactly.

Maybe it's time we start insisting that our future, and that of our children and grandchildren, the ones who will actually be paying for this nonsense, receive some attention.

Granny Bird Award: Alan Simpson

This edition of the Granny Bird Award (given from time to time to those who go out of their way to damage elders' rights and benefits) goes to former Senator Alan Simpson for his work on the bipartisan "cat food commission" and his comments thereafter explaining why Social Security is a socialist plot which was never intended to serve the interests of elders. I could have given him the award months ago, and probably should have, but I was holding off to see how far he could shove his foot in his mouth before someone in the press finally called him on his mendacity.

Michael Hiltzig did just that in a recent column in the Business Section of the Los Angeles Times.

Former Sen. Alan Simpson (R-Wyo.), who has long been the go-to guy for obnoxiously know-nothing takes on Social Security, this week uncorked yet another spectacularly misinformed "factoid" about the program's history.

In a letter to Max Richtman, a former Senate staffer who now heads the National Committee to Preserve Social Security & Medicare, Simpson asserted that Social Security's creators did not design it to be a retirement program. The letter dated Friday was obtained and made public by ABC News.

Simpson wrote in his unbelieveably rude and ignorant letter to Richtman: "You know damn well that the system was never created as a 'retirement' -- it was an 'income supplement' to take care of folks working in CCC camps and who lost everything in the Great Depression."

It's hard to know what to think of Simpson's version of history, but the term "sheer fantasy" comes to mind. ... [Emphasis added]

Hiltzig then proceeds to demolish Simpson's assertion by nailing down the actual history of the legislation and the express intentions behind it. It's clear that Simpson's allegations don't even merit the designation of "truthy", much less truth, but that certainly hasn't stopped Simpson from flapping his gums on the issue.

The man is a liar, and his lies go to the very heart of a program that is keeping a lot of us alive and eating. He is, to be polite, an arrant knave whose head is so far up his netherparts that major surgery would be required to restore any vision to him. Ironically, this is from a man who after three terms in the Senate retired with a cushy government pension and the best health care plan the American taxpayers can provide.

But here's the scary part, and Hiltzig nails it:

Alan Simpson obviously has a problem with the facts, and with the basic concept of civility in public discourse. Yet he's been held up by President Obama as a paragon of bipartisan policy-making. So here's a question for the president: Does Alan Simpson speak for him on Social Security? [Emphasis added]

It is the question that should also be posed to Nancy Pelosi, the Minority Leader of the House who has suggested that the catfood commission's suggestions (no report ever issued) must be considered, and to every senator and representative in Congress. Apparently the Democrats have taken this as a fall-back position given the GOP's drive to completely demolish the system in favor of a Wall Street privatized version of retirement funding.

ENOUGH!!

Call, fax, write, email your congress critters and scream long and hard about this travesty. If the funding of the trust fund is such a concern remind them that the easiest, quickest, and smartest solution is raising the payroll deduction cap so that those who make more than $110,000 per year can pay a few bucks more to ensure that their parents and they themselves have a guaranteed income upon retirement.

Do it.

Now.

Granny Bird Award: NIMBY-ists

This edition of the Granny Bird Award, given from time to time to those who go out of their way to harm the rights of elders, goes to a neighborhood near Hollywood, California, who decided they did not want a board-and-care facility for elders with dementia in their midst because it might depress property values..

On a stretch of leafy Sierra Bonita Avenue near Hollywood, an operator of board-and-care facilities wants to tear down a duplex and construct an 11-bed facility for elderly residents suffering from dementia. In theory, that's fine: According to state law, a city cannot prohibit licensed care facilities that meet the zoning requirements. But in this area, zoning regulations permit single-family homes and duplexes, and the state defines a family as consisting of any number of related members or up to six unrelated people. Because Raya's Paradise, the operator of the facility, wants to go over the six-bed limit, it applied for a zoning variance.

Neighbors weren't pleased. Some complained that 24 facilities for the elderly are already located within a mile of this project. Care facilities mean multiple cars of staff and visitors, parking problems, more trash and — some say — lower property values.

...a city zoning administrator denied the variance, saying it would set a precedent that could start an erosion of "the low-density character and appearance of the area." Gamburd tried again under a different city ordinance and was again denied. His appeal of that ruling is scheduled to be heard Tuesday. [Emphasis added.]

If Gamburd loses that appeal, he still has one more option: he can build a duplex (two units) which will satisfy the ordinance. It will be more expensive for him, and thus for his residents, but it will have to be tolerated.

It pleases me that the editorial board of the Los Angeles Times has taken up this issue, and I especially liked its conclusion:

This page is generally not sympathetic to NIMBY arguments, and it is particularly troubling that people would disdain living near elderly people in group homes. We all get old — if we're lucky. We should not flinch from sharing with aging neighbors the communities that they helped build. [Emphasis added.]

Exactly so.

Granny Bird Award: Abbott Laboratories

Last December, I issued a Granny Bird Award (given from time to time to those who have an adverse effect on the health, welfare, and rights of elders) to those doctors, nursing home operators, and pharmaceutical companies who allow the off-label use of powerful antipsychotic drugs to pacify nursing home patients with dementia.

It now turns out that not only antipsychotic drugs are being used off label for this purpose. And it also turns out that Abbott Laboratories, the current recipient of this award, went out of its way to sell Depakote for such a dangerous off-label use.

Global pharmaceutical giant Abbott Laboratories has agreed to pay federal and state governments $1.6 billion in criminal and civil fines for illegally promoting unapproved uses of its drug Depakote, including to sedate elderly patients in nursing homes, officials announced Monday.

The settlement, which includes an agreement to plead guilty to a criminal misdemeanor, is the second-largest in a string of multimillion-dollar payouts in recent years resulting from stepped-up enforcement by the Justice Department and state investigators against drugmakers that “misbrand” their products. ...

“Not only did Abbott engage in off-label promotion, but it targeted elderly dementia patients and down-played the risks apparent from its own clinical studies,” Tony West, acting associate attorney general, said in a statement. ...

The attorney for Meredith McCoyd, one of four former Abbott sales representatives whose whistleblower lawsuits prompted the investigation, said the company offered nursing homes a second rationale.

“Abbott directed its sales force to get Depakote widely used in nursing homes, principally to neutralize older patients as a substitute for proper staffing,” attorney Reuben Guttman said in a statement. “Abbott essentially preyed on the most helpless patient populations.” [Emphasis added]

Depakote is a drug which is designed for neurological disorders such as epilepsy, not to pacify dementia patients. Further, the company's own clinical studies showed that such use was dangerous and had disastrous side effects such as dehydration. That didn't stop it from touting the benefits of keeping such difficult patients loaded to save nursing home staffing costs, nor did it stop it from offering some bakshish to pharmacies which service such nursing homes rebates for increasing sales to them.

The fine is a stiff one relatively speaking (you know the old saying, "a billion here, a billion there, pretty soon you're talking real money), but don't worry about Abbott Labs. They are doing just fine according to last year's numbers:

Revenue $39 billion
Net Income $5 billion

While it is gratifying to see such a large "fine" levied, I would have been happier with really serious criminal sanctions. I would like to have seen the marketing guru who came up with this scam and all of his superiors right up the line arrested and facing years in prison for fraud and everything else the states and feds could come up with. That's the only way PHARMA will get the message.

But I guess that's asking too much right now.

Granny Bird Award: ALEC

This edition of the Granny Bird Award, given from time to time to people who go out of their way to adversely affect the rights and lives of the elders, goes to the American Legislative Exchange Council, "ALEC," for its unconscionable activities in promoting voter suppression laws in states all over the country. This organization of major corporate and conservative groups is determined to deny the vote to the poor, minorities, and elders and it is working in concert with conservative state legislators to accomplish its mission.

Unfortunately, the rapid spread of these proposals in states as different as Florida and Wisconsin is not occurring by accident. Instead, many of these laws are being drafted and spread through corporate-backed entities such as the American Legislative Exchange Council, or ALEC, as uncovered in a previous Center for American Progress investigative report. Detailed in that report, ALEC charges corporations such as Koch Industries Inc., Wal-Mart Stores Inc., and The Coca-Cola Co. a fee and gives them access to members of state legislatures. Under ALEC’s auspices, legislators, corporate representatives, and ALEC officials work together to draft model legislation. As ALEC spokesperson Michael Bowman told NPR, this system is especially effective because “you have legislators who will ask questions much more freely at our meetings because they are not under the eyes of the press, the eyes of the voters.”

The investigative report included for the first time a leaked copy of ALEC’s model Voter ID legislation, which was approved by the ALEC board of directors in late 2009. This model legislation prohibited certain forms of identification, such as student IDs, and has been cited as the legislative model from groups ranging from Tea Party organizations to legislators proposing the actual legislation such as Wisconsin’s Voter ID proposal from Republican state Rep. Stone and Republican state Sen. Joe Leibham. [Emphasis added]

I urge you to read not only the linked article but also the report to which it refers to see just how this legislation affects us all, including elders in their 80s and 90s who for various reasons (including cost) cannot comply with the new laws. People who have rarely missed voting in an election are suddenly shut out because they cannot provide a birth certificate or because they cannot even get to the government office which issues the "picture ID".

This has nothing to do with voter fraud (which is so rare as to not qualify even as "negligible") and everything to do with keeping people who might vote against the interests of our corporate owners. And who are these corporate owners? Think Progress has a list of those who contributed to the recent ALEC annual meeting.

The list is revealing. It not only includes the "usual suspects" (Koch Brothers) but also some surprises: Amazon.com, Johnson & Johnson, Walgreens. And the linked-to article also lists some other posts which indicate some corporations who have pulled out of the sponsorship list because of consumer outrage, among them Coca Cola, PepsiCo, and Kraft.

And that's the key. We have to get involved and let the corporations know we aren't having any of this anti-American crap. Look at the list and pick out companies you've been spending money at and let them know that you won't be doing so anymore because of their stance on something as basic as voting.

And then let President Obama and Attorney General Holder know that you expect the federal government to enforce the voting rights of all Americans, not just the wealthy.

It's important.

Granny Bird Award: Johnson & Johnson

The winner of this edition of the Granny Bird Award, an award given from time to time to those who go out of their way to harm the health and welfare of elders, goes to a large health care provider for its distribution of a hip replacement device that the company had to have known was was unsafe.

From the New York Times:

The health care products giant Johnson & Johnson continued to market an artificial hip in Europe and elsewhere overseas after the Food and Drug Administration rejected its sale in the United States based on a review of company safety studies.

During that period, the company also continued to sell in this country a related model, which earlier went on the market using a regulatory loophole that did not require a similar safety review. ...

...During some eight years on the market, the two implants were used in about 93,000 patients worldwide, about one-third of them in the United States. Both models were based on the same component, an all-metal hip socket cup that experts say was faulty in design. [Emphasis added]

Johnson & Johnson behaved despicably in two separate ways. The first is the company went ahead and sold the device in other countries even after the FDA rejected it for safety reasons. What, people (mostly elders) in other countries aren't entitled to a safe hip replacement?

The second is that the company used a regulatory loophole to get a related device on the US market and continued to sell it even after the FDA disapproved the other device for safety reasons. The designs of a crucial part were the same.

What is particularly galling is that the company did nothing illegal, nothing which would bring the wrath of the federal government down on it. The recipients of the device, however, do have standing for some pretty hefty product liability suits. I hope those affected lawyer-up with the best lawyers in the nation to smack the hell out a company which showed such total disregard for the health and safety of its consumers.

Ah, the joys of unfettered capitalism, where all that matters is making money anyway one can.

Granny Bird Award: Komen Foundation

This edition of the Granny Bird Award, given from time to time to those who in some impair the rights or welfare of the elders, goes to the Susan G. Komen for the Cure organization for their weak-kneed yanking of grants to Planned Parenthood.

From an AP report:

The nation's leading breast-cancer charity, Susan G. Komen for the Cure, is halting its partnerships with Planned Parenthood affiliates — creating a bitter rift, linked to the abortion debate, between two iconic organizations that have assisted millions of women.

The change will mean a cutoff of hundreds of thousands of dollars in grants, mainly for breast exams.

Planned Parenthood says the move results from Komen bowing to pressure from anti-abortion activists. Komen says the key reason is that Planned Parenthood is under investigation in Congress — a probe launched by a conservative Republican who was urged to act by anti-abortion groups. [Emphasis added]

As even the anti-choice people must know, abortions comprise a very small portion of the services which Planned Parenthood provides. One of the services provided which is key to women's health is breast exams and access to mammograms to women who could not otherwise afford them. This, of course, includes elders who do not have health insurance and who do qualify for Medicare for any number of reasons, including the fact they have not yet reached age 65.

The Komen Foundation claims that under a newly adopted rule that forbids grants to organizations under investigation by authorities. Planned Parenthood, a favorite target of the Religious Reich, is currently being investigated by a House Committee to see if it illegally has provided abortions with federal money. Launched by Rep. Cliff Stearns, R-Fla., the investigation is just a little grandstanding by the right in its attempt to roll back women's rights. That a foundation which claims to be deeply concerned with an important health issue for women -- breast cancer -- would cave in to such a despicable ploy is both astounding and shameful.

It is also worthy of the Granny Bird Award.

Granny Bird Award: Rick Santorum

Rick Santorum is the latest winner of the Granny Bird Award, that award given from time to time to those who go out of their way to harm the interests of the elders in this country. The GOP candidate for the 2012 GOP nomination earned this prize in particularly dramatic fashion: by trying to win the duel to see who could gut social security benefits the fastest.

Republican presidential candidate Rick Santorum called Friday for immediate cuts to Social Security benefits, risking the wrath of older voters and countless others who balk at changes to the entitlement program.

"We can't wait 10 years," even though "everybody wants to," Santorum told a crowd while campaigning in New Hampshire and looking to set himself apart from his Republican rivals four days before the New Hampshire primary. ...

This week, he told New Hampshire audiences that Americans over 65 were society's poorest age group in 1937, when Social Security was created. Now that group is the wealthiest, he said.

He also noted that Americans now live much longer, putting far bigger demands on the government retirement program. [Emphasis added]

Like his confreres, Santorum conveniently overlooks the fact that this program is not paid for by the government, but by money which each worker has deducted from his paycheck. Some of us paid into our accounts for nearly fifty years. It's our money they're talking about.

Further, while the Social Security Trust Fund will need some shoring up, that can be accomplished by simply raising the limit of earned income subject to the payroll tax by 5-10%. That will hardly bust those earning more than $106,000 per year.

Finally, as to the assertion that those over 65 years of age compromise the wealthiest group in the country, well, that's one he pulled out of the south end of his alimentary canal. Most baby boomers I know don't have the benefit of an employer-provided pension to supplement social security, and their 401k accounts have been decimated by the economic upheavals of the past ten years.

Little Ricky is playing us, and is doing so just to get votes. He's earned his award.

Granny Bird Award: RehabCare Group Inc.

Unfortunately, it's time for another Granny Bird Award, given from time to time to those who make it a point to harm elders in some egregious way. This time it goes to a fraudster, someone bilking our system.

Intervening in a lawsuit by a Minnesota whistleblower, the U.S. Justice Department has sued a large health care company based in Kentucky, alleging that it paid more than $10 million in kickbacks for access to Medicare and Medicaid patients living in a chain of nursing homes.

In a civil complaint filed in Minneapolis, the U.S. attorney said RehabCare Group Inc. began making illicit payments in 2006 as part of a deal with Missouri businessmen who owned 62 nursing homes in their state and an in-house company that provided health services to the residents. The deal was premised on RehabCare's plan to take control of the services and expand billings under Medicare and Medicaid, the complaint said.

"The suggestion was straightforward: Facilities that contracted with RehabCare could expect [it to] provide more therapy to the facilities' beneficiaries, and as a result, the facilities would make more money,'' said the complaint filed by Assistant U.S. Attorney Chad Blumenfield.

The recipient of the alleged kickbacks, Rehab Systems of Missouri LLC (RSM), received an initial $600,000 payment and a cut of more than 10 percent of RehabCare's ongoing billings, which have exceeded $70 million since 2006, the suit said.

The litigation is based on a federal anti-kickback law that makes it illegal to pay others for referrals of Medicare patients. Patients are supposed to receive services based on their medical needs, not as a result of financial inducements paid to their health care providers. The lawsuit seeks fines and financial recoveries. [Emphasis added]

$70 million, much of it for unnecessary treatment. That's a lot of money flowing out of our system. Fortunately, a whistleblower stepped up and reported the scam. We can't, however, always count on some honest soul to do the reporting in each case. Those of us who receive Medicare have a role to play as well.

First of all, we need to remember to guard our Medicare card and our policy number. People offering us a free lunch so that they can offer us some "free tests" don't need either.

Second of all, Medicare sends out regular reports with itemizations of billings they have received for our accounts. We need to read those reports as soon as they arrive and not just toss them as junk mail. If an item appears that doesn't seem right to you, such as a motorized wheelchair when you don't need any such assistance or a diagnostic test you never received, notify Medicare immediately by phone (or on their web site). Medicare adjusters will look into it, and if they see a pattern of such abuse from a provider, they will report it to the Department of Justice.

Third, Congress and the White House keep looking for ways to cut the cost of Medicare. You might let both know that one way to contain costs is to go after Medicare Fraud and to go after it hard. If it means giving more funding to the DOJ, then so be it. The system could save millions every year just by prosecuting and fining these con artists, far beyond what it might cost to fund a special unit to do the work.

We really do need to start making some noise, especially these days.

Granny Bird Award: Nursing Home Operators, Doctors, and PHARMA

It's time for another Granny Bird Award, this time to those doctors, nursing home operators, and pharmaceutical companies who allow the off-label use of powerful antipsychotic drugs to pacify nursing home patients with dementia.

From an AP article:

So-called antipsychotic drugs are designed to help control hallucinations, delusions and other abnormal behavior in people suffering from schizophrenia and bipolar disorder, but they're also given to hundreds of thousands of elderly nursing home patients in the U.S. to pacify aggressive behavior related to dementia. Drugs like AstraZeneca's Seroquel and Eli Lilly's Zyprexa are known for their sedative effect, often putting patients to sleep.

But the drugs can also increase the risk of death in seniors, prompting the Food and Drug Administration to issue multiple warnings against prescribing the drugs for dementia. Antipsychotics raise blood sugar and cholesterol, often resulting in weight gain. ...

A report by Levinson's office issued in May found that 83 percent of Medicare claims for antipsychotics were for residents with dementia, the condition specifically warned against in the drugs' labeling. Fourteen percent of all nursing home residents, nearly 305,000 patients, were prescribed antipsychotics. The HHS Inspector General's office Medicare claims during a 2007 six month period.(sic) [Emphasis added]

That patients with dementia often display aggressive behavior is not in issue. That's one of the reasons the patients are in nursing homes: families cannot cope with the tirades and physical behavior. What is in issue is how the episodes are treated. Drugging the patient into a zombie state with often lethal results as the preferred regimen is the very lowest of the low. The only reason I can see for the drug usage is that it's paid for by Medicare and therefore cheaper than hiring adequate staffing.

But the fault lies with more than unscrupulous nursing home operators. Doctors and the pharmaceutical industry are also involved:

In January 2009, Eli Lilly & Co. Inc. agreed to plead guilty and pay $1.4 billion for illegal promotion of Zyprexa, including marketing to nursing home doctors. The company told its sales representatives to use the slogan "5 at 5," to persuade doctors that giving 5 milligrams of the drug at 5 p.m. would make dementia patients sleep through the night.

AstraZeneca PLC has paid nearly $600 million in two separate settlements with federal and state prosecutors over alleged off-label promotion of its drug Seroquel.

Although the study involves data from several years ago, Medicare presumably commissioned the study because it is still receiving an untoward number of bills for the drugs. So more elders, unable to fend for themselves because of the very nature of their illness, are continuing to receive the drugs which rather than ease those symptoms will kill the patients.

It's a case of clear elder abuse, shameful and shabby.

Granny Bird Award: Those Who Knew And Did Nothing

This edition of the award, given from time to time to individuals or groups who adversely affect the rights and interests of the elders, goes to all the people who knew that Jerry Sandusky was molesting children and did nothing to stop him. It goes to everyone at Penn State who knew, to the public school employees who certainly suspected, to the donors to his "child care" organization who may have availed themselves of Sandusky's services: all of them. Their excuse that "No one said no to Jerry Sandusky" is appalling.

No one said no to Jerry Sandusky.

That's the underlying message from those closest to the alleged victims in the child-molestation scandal that has engulfed Pennsylvania State University.

After all, Jerry Sandusky, once the heir apparent to legendary football coach Joe Paterno, had been an assistant football coach at Penn State, a longtime community volunteer, and the founder of a well-known charity to help troubled youth.

Last Saturday, after a multiyear grand jury investigation, Sandusky was arrested on charges of sex abuse of eight minors from 1994 to 2009.

I have avoided comment on this horrific story for many reasons, chief of which was my profound disgust and heartbreak over the details as they slowly began to emerge. People freakin' knew, they knew. But Sandusky was a big shot at the big shot football program at the big shot university. They let him slide. They protected him. They let the children suffer.

Like all elders I know, I am deeply concerned for the generations which will follow me. I may not have children or grandchildren, but my friends and relatives do. I care about those children and all children. They represent the future, the continuation of our species even after I'm gone. I don't like the thought of all that the next generations will have to face because of our misfeasance. And I hate the thought that these children will have an even heavier burden because of the malfeasance of the perpetrator(s) and their enablers.

May God forgive them all. Quite frankly, right now, I cannot.

Granny Bird Award: The Washington Post

It didn't take long for a new Granny Bird Award, an award which is given from time to time to individuals or groups who adversely affect the rights and interests of the elders, especially if they go out of their way to do so. I guess it's a sign of the times.

This one goes to the Washington Post for its article on Social Security.

Now, Social Security is sucking money out of the Treasury. This year, it will add a projected $46 billion to the nation’s budget problems, according to projections by system trustees. Replacing cash lost to a one-year payroll tax holiday will require an additional $105 billion. If the payroll tax break is expanded next year, as President Obama has proposed, Social Security will need an extra $267 billion to pay promised benefits.

But while talk about fixing the nation’s finances has grown more urgent, fixing Social Security has largely vanished from the conversation. [Emphasis added]

The article is wrong on so many bases it's hard for a mere mortal to know where to start. Fortunately, Paul Krugman, no mere mortal, rather gracefully pointed out the most basic flaws in his blog post:

In legal terms, the program is funded not just by today’s payroll taxes, but by accumulated past surpluses — the trust fund. If there’s a year when payroll receipts fall short of benefits, but there are still trillions of dollars in the trust fund, what happens is, precisely, nothing — the program has the funds it needs to operate, without need for any Congressional action.

Social Security is not sucking money out of the treasury. It is still solvent and will be for a good while. Why the Washington Post didn't mention that fact is pretty clear evidence of what's really afoot: the GOP wants to dismantle the program and push us all into the stock market by privatizing a safety net and the paper is only too willing to help catapult the propaganda.

Atrios got it right

And, no, sensible liberals, there is no way to make this "debate" go away with some "grand compromise." Fake news articles like this should make that clear. The rich want that Social Security money, it's how they guarantee themselves a lovely tax cut.

Morons. Evil, evil morons.