Last week, we hosted the 6th annual Shkreli Awards, calling out the worst profiteers and dysfunction in the healthcare system in 2022. In a perfect world, these awards wouldn’t be necessary. In our world, we have a plethora of candidates to consider.
We named the Top 10 worst offenders at the Shkreli Awards, but they are not alone in their egregious acts of exploitation. Allow us to introduce you to our runner-ups, in no particular order.
Hospital charges facility fee for patients who never set foot in the facility
When Arielle Harrison agreed to a telehealth visit with her son’s pediatrician specialist, the last thing she expected to get charged for a “facility fee.” But after scheduling the video appointment, Harrison was told by Yale New Haven Health that they would owe a facility fee because the doctor was taking the video call on hospital property, according to Kaiser Health News. Pat McCabe, senior vice president of finance at Yale New Haven Health System defended the practice, saying “[The facility fee] offsets the cost of the software we use to facilitate the telehealth visits, and we do still have to keep the lights on.”
Source: The Charges Seem Crazy’: Hospitals Impose a ‘Facility Fee’ — For a Video Visit – Kaiser Health News
Doctor who makes living from surprise billing sues feds for protecting patients from surprise bills
The “No Surprises Act,” which took effect in 2022, prevents privately insured patients from getting an out-of-network bill for emergency care. The law is almost universally popular… but one doctor isn’t happy. Dr. Daniel Haller, who works as an acute-care surgeon on Long Island, sued the federal government to have the law struck down, saying it violates his constitutional rights to bill patients for any “balance of the fair value” of his services. Haller argues that charging out-of-network rates is about doctors making a “fair living wage,” even though these out-of-network charges for emergency care are on average 637% of what Medicare pays for the same services. Haller’s lawsuit was dismissed by a New York judge in August 2022.
Source: The doctor who is trying to bring back surprise billing – STAT; Update at Reuters
Liberal prescription of Adderall helps telehealth app grow and retain patient base
The CEO of Cerebral, a telehealth startup, allegedly pushed employees to prescribe more stimulants to increase patient retention, according to a lawsuit brought by a former Cerebral executive. The lawsuit alleges Cerebral’s executives pushed for more prescriptions to retain subscribers. In May, it was reported that the DEA was investigating Cerebral and thus, the company halted all prescriptions of stimulants. During the Covid-19 pandemic, the government loosened regulations around prescribing schedule 2 controlled substances, allowing clinicians to prescribe them after an online visit. One project was designed to “nudge” clinicians toward preferred treatments, including stimulants for ADHD patients. A separate one sent emails to clinicians to push them to prescribe stimulants to 100% of ADHD patients without comorbidities.
Source: Mental health company execs encourage Adderall overprescription to keep patients using the app – Wall Street Journal; Bloomberg
Blood thinners are billion-dollar boondoggle for price-hiking pharma buddies
Anticoagulant drugs Eliquis and Xarelto were revolutionary when they hit the market in 2011 because they were safer than the previous standard of care. But as their popularity has grown over the past decade, so has their price, reported advocacy group Patients for Affordable Drugs. PAD’s 2022 report alleges that drug companies Pfizer and Johnson & Johnson have increased the prices of their drugs in lockstep, a practice known as “shadow pricing.” The prices for both of these drugs have more than doubled since 2011, and Eliquis and Xarelto are now the #1 and #3 most costly Medicare drugs, respectively.
Source: Eliquis and Xarelto: Lockstep Price Hike and Patent Gaming Exploits Patients and Taxpayers– Patients for Affordable Drugs
Government program designed to forgive student loans saddles healthcare workers with more debt
The National Health Service Corps offers a simple trade; work for 2 to 3 years in underserved areas and reduce your student debt in return. It’s a win-win for young clinicians who need financial assistance and communities in medical deserts with a dearth of providers. But when COVID hit and clinics closed down and cut staff, healthcare workers were suddenly in violation of their contracts. Even though this was out of the workers’ control, the NHSC charged the workers’ interest and demanded pay for time unserved. Nurse practitioner Brandi Barrick, for example, entered the program to have $25,000 in student debt relieved – instead she ended up owing the federal government $85,557.
Source: Program to Cut Student Debt Sticks Some With Even More – The Wall Street Journal; Medical Program Offering Student-Debt Relief Takes Hard Line in Covid-19 Pandemic – WSJ