Calif. center, ethnic outlets partner to examine elderly day care’s demise
Filed under: Aging, Health journalism, Health policy, Hot Health Headline
The California HealthCare Foundation’s Center for Health Reporting partnered with no fewer than nine different organizations to produce a sprawling story package examining the impact of the looming closure of many of California’s adult day health care centers. (Since the project launched, California reached a legal settlement that will allow adults most at risk of institutionalization to continue to receive services previously provided by adult day health centers. Existing centers will be able to provide services through the end of Feb. 2012. See this write-up in California Healthline.)
Jocelyn Wiener’s centerpiece stands alone, but the package really gains steam when you take the time to consider its full breadth and depth.
For those new to the issue, here’s Wiener’s primer and a hint as to why the package grew out of a collaboration with a kaleidoscope of ethnic media organizations.
Los Angeles County – especially its many ethnic minority communities –will be hit hardest by the closures. According to state data, the county is home to more than 60 percent of the program’s 38,000 enrollees statewide. One quarter have dementia. Forty percent are incontinent. Nearly half have a psychiatric diagnosis. More than 70 percent do not speak English.
The centers provide them with transportation, meals, exercise, medication management, physical and occupational therapy, as well as robust social programs that many participants say have renewed their will to live.
Health journalists will find Richard Kipling’s “how we did it” piece to be a natural entry point. Kipling unspools the narrative of how a brief suggestion became an anything-but-brief compendium of multilingual, multicultural, multigenerational reporting. Kipling’s blog also serves as a useful roadmap to the project.
Watch the AHCJ website for more about how this project was reported.
If the video doesn’t appear on your page, please click through to :Bibiana Viernes: Her Center, Her Life” from CAhealthReport on Vimeo.
How might retail clinics change health care delivery in your community?
I don’t routinely blog about the work of AHCJ board members (which doesn’t mean you shouldn’t read Charles Ornstein’s latest on Florida’s slow reaction to physicians who treated and prescribed drugs under Medicaid “amid clear signs of possible misconduct.”)
But I’m making an exception to my self-imposed rule for Julie Appleby’s recent Kaiser Health News piece “The Walmart Opportunity: Can Retailers Revamp Primary Care?“
What questions do you have about health reform and how to cover it?
Joanne Kenen (@JoanneKenen) is AHCJ’s health reform topic leader. She is writing blog posts, tip sheets, articles and gathering resources to help our members cover the complex implementation of health reform. If you have questions or suggestions for future resources on the topic, please send them to joanne@healthjournalism.org.
I’ve read other pieces about the future of retail clinics, including their potential for treating chronic disease. But I thought Appleby did a terrific job of asking – and often answering – many interlocking questions about the delivery of primary care, the management of chronic disease, the quality of care and what this all has to do with health reform.
While asking big-picture questions, she also wove in details that gave the story texture and made it a good read. If you saw my tweet, you’ll know I was particularly taken by the bit about how long-distance truckers can pull up in the parking lot of more than 600 centers to get their mandatory federal checkups.
As Appleby noted, the clinics – which sometimes lose money but bring customers into the stores – started with the low-hanging fruit, the “relatively healthy patients looking for convenient, low-cost care for simple problems.” The next stage is to try to start treating more expensive chronic diseases, such as diabetes and heart disease, which are big drivers of health care spending. Treating chronic disease, however, is definitely a problem in search of a primary care solution. As her story said:
“It’s sad that the existing health care establishment has not figured out a way to make primary care affordable and accessible,” says Jerry Avorn, a professor of medicine at Harvard. “We should not be surprised if someone outside of our world comes in and does it for us.”
Some of the retail clinics are already venturing into aspects of chronic care: diabetes management, weight-loss programs. (I think we can safely say that primary care physicians have not solved the U.S. obesity problem). Some employers are using the clinics for wellness and routine screening programs.
The costs tend to be lower. Appleby cited a study in the American Journal of Managed Care that costs are 30 percent to 40 percent lower than in the doctor’s office and 80 percent cheaper than in the emergency department. Consumers like the predictability and transparency of the costs (although insurance can also pay) . They don’t get pricing clarity up front at the doctor’s office or hospital.
Several provisions of the federal health law may further spur interest in the clinics. For instance, small businesses will have incentives to offer worker wellness program. The clinics may help fill in some gaps in primary care which are expected to get worse before they get better because of the pent-up demand for care that may burst out when coverage expands under the health law starting in 2014. The Association of American Medical Colleges estimates a shortfall of 21,000 primary care doctors by 2015. Not everyone agrees that there is an across-the-board shortage, as opposed to a shortage in specific underserved areas.
How clinics make the jump from flu shots and throat cultures to the far more complex task of monitoring chronic disease is not completely clear. Remember that patients, particularly older patients, often have multiple chronic diseases (i.e. diabetes and hypertension and congestive heart failure and arthritis, etc.). Some questions remain: Will the clinics turn out to be good at managing relatively stable patients in the early stage of disease – where the convenient locations and evening and weekend hours may enhance compliance? What about with the more advanced illnesses? Will the retail clinics add to fragmentation and miscommunication? Or will the clinics somehow form relationships with “new, integrated collaborations between doctors, hospitals and insurers?”
I don’t want this post to get longer than Appleby’s article so, when you read it, pay attention to the other issues she raises, and think about how they are playing out in your community:
- Scope of practice. What is the role of nurses/nurse practitioners/physicians assistants versus physicians? Turf battles can produce good sources and good stories.
- Does your state have laws about clinics directly employing physicians?
- Will clinics “skim off” healthy patients from physician practice and leave them with all the sickest and most expensive ones, without greater reimbursement? Or, by taking on some routine medical tasks, will clinics allow physicians to spend more time doctoring?
- Who are the patients? (Other than truck drivers and high school students needing sports physicals.) Are clinics just a convenient way for insured middle-class people to get routine care? (I’ve taken my son in for a throat culture at 7 p.m. when he’s feeling scratchy and I know there’s strep in his class. It’s way better than waiting until the next morning to go to the pediatrician when he might be sicker, and he has to miss school and I have to miss work. And, if he does need antibiotics, I’d have to go the drug store anyway.) Or are the clinics avoiding poorer neighborhoods, meaning the underserved stay underserved?
- Appleby didn’t mention this explicitly but it’s worth adding to the mix: To the extent the clinics are in underserved communities, are they helping low-wage hourly workers who don’t have paid sick leave or the flexibility to take an hour or two off in the middle of the day to get their kid (or their mother-in-law) to the doctor?
- Are any of the clinics – anywhere – starting to share information with patients’ primary care physicians? Or, in the case of diabetes, heart disease, etc., are they sharing information with specialists? It can be as simply as faxing something, sharing electronic medical records or using secure email. If I take my kid for that throat culture, it’s really not a catastrophe if I forget to tell his pediatrician (and I don’t need to bother if it’s negative). But for things like immunizations, or A1C levels for diabetics, or blood pressure spikes or changes in medications - someone needs to keep track of the big picture. Of course, communication isn’t all that great right now between doctors without the clinics but, since health reform has some incentives for improving coordination, where do the retail clinics fit in?
That question about integration, which Appleby raised, doesn’t yet have a clear answer. Could the clinics end up having some kind of relationship with the “medical home” or the “Accountable Care Organization” or other models of integrated care? I am not sure of all the legal or contractual problems. If someone has written about this, please chime in. But I can envision ways that clinics can be brought into the coordinated or accountable care loop. It may turn out to be in everyone’s interest – patient, physician and clinic – to do the looping.
DoD spent nearly $363 million on weight-loss surgeries in past decade
Filed under: Health data, Health journalism, Hot Health Headline, Public records
Reporting for KIRO-Seattle, Chris Halsne used FOIA requests to find out how much the military’s TriCare plan is paying for weight-loss surgeries for soldiers and their dependents. Including post-surgery tummy tucks, Halsne calculates (PDF) that the government was on the hook for at least $362,971,831 for such procedures over the past decade.
The military defends the expenditures by pointing to the long-term savings of having healthier TriCare enrollees, though Halsne found those savings difficult to prove, as 86 percent of soldiers and their families leave the plan before they qualify for lifetime benefits.
Halsne found that even some active-duty personnel are getting bariatric procedures, which are officially off limits to them as they are required to stay fit through diet and exercise to remain in the military.
While analyzing Defense Department records on health-related costs, KIRO Team 7 Investigators also discovered the military continues to pay for some weight loss surgery for active duty personnel. Records show $2,400,000 worth since 2001. The military banned bariatric procedures for active duty soldiers and sailors in 2007, yet it appears they approved around 57 of them after that.
Tricare, the military’s health insurance program funded by federal taxpayers, declined KIRO’s repeated questions for an interview.
Medicaid programs slow to act against system exploiters
Filed under: Conflicts of interest, Health data, Hot Health Headline, Public records
At ProPublica, senior reporters Charles Ornstein and Tracy Weber have published the latest turn in their ongoing analysis of conflicts of interest, problem physicians and the disciplinary systems meant to reign them in. This time, they look at Medicaid in Florida and find at least three instances when the state “allowed physicians to keep treating and prescribing drugs to the poor amid clear signs of possible misconduct.”
Their piece revolves around those key examples – two of which were, in all seriousness, brought to their attention by a Scientologist-run watchdog website – and I strongly recommend you read the whole thing for the details. Below, I’ve just highlighted the bigger picture.
In general, Ornstein and Weber found, state Medicaid programs, as well as the federal Centers for Medicare and Medicaid Services, which doesn’t track relevant state data, have failed to act on information which seems to strongly indicate that certain physicians are abusing or exploiting state programs.
Medicaid programs across the country have long had evidence that physicians have been prescribing risky drugs in excess and perhaps to the wrong patients. These prescriptions also racked up huge bills for the programs.
But like Florida, many states did not act on that evidence. Last year, (Sen. Charles) Grassley demanded data from each state about its highest prescribers of pain pills and antipsychotics, and he asked state and federal officials to determine whether the prescriptions written by these doctors were legitimate.
AHCJ asks Supreme Court to permit broadcast of health reform arguments
Filed under: Government, Health care reform, Public records
AHCJ has asked Chief Justice John G. Roberts of the U.S. Supreme Court to permit live audio and video coverage of the oral arguments next March in the case challenging congressional authority to mandate health insurance coverage and other provisions of the Affordable Care Act.
The Court has long permitted print journalists to cover its proceedings and, more recently, began offering time-delayed audio recordings of oral arguments. But AHCJ is pushing for real time audio and video coverage in this case, due to the historic significance of this case and potential impact on millions of Americans.
In the letter to Chief Justice Roberts, AHCJ contends that these provisions are inadequate for such a historic case with potentially sweeping impact on the health care system and millions of Americans.
The Radio Television Digital News Association has filed a similar request with the high court, as has C-SPAN and U.S. Sen. Charles Grassley, R-Iowa. The New York Times weighed in with an editorial last week.
Numbers reveal how often, or how rarely, states check doctors’ disciplinary records
How often does your state medical board search doctors in the National Practitioner Data Bank?
Surprisingly not often, according to data provided to the Association of Health Care Journalists by the U.S. Health Resources and Services Administration, which runs the data bank.
Get a spreadsheet showing how often each state medical board searches for doctors in the National Practitioner Data Bank. One worksheet shows information about physicians, the other shows information about residents and interns.
AHCJ and other media groups have been pushing the government to restore unfettered access to the Public Use File of the data bank, citing important stories that journalists have written about lax oversight of doctors by state medical boards.
State medical boards have access to complete information within the data bank about a doctor’s disciplinary history, hospital sanctions and malpractice payouts. The Public Use File, which had been available to reporters and researchers for years, provided the same information without identifying information about the doctors involved.
HRSA removed the Public Use File from its website on Sept. 1 following complaints from a doctor that a reporter from The Kansas City Star inappropriately used it to identify him. The agency restored the file last week, but with new restrictions that seek to bar reporters from using it with other data sets to identify physicians. AHCJ and other media groups call the new restrictions unworkable and an unconstitutional prior restraint.
AHCJ requested data from HRSA so reporters could see how often their states check the backgrounds of MDs and DOs, as well as interns and residents. The numbers are available in two different charts. Beyond that, HRSA said, three state boards have a relationship with HRSA in which they automatically get updates when new information is entered on a physician. They are: Nevada (DO), Oregon (MD) and Pennsylvania (MD).
“I encourage journalists to look up their state medical boards in our chart and see how often they consult the data bank,” AHCJ President Charles Ornstein said. “If they are not looking physicians up, they should be asked how they are sure they are protecting the public from dangerous or incompetent doctors.”
HRSA spokesman Martin Kramer said in an email that,
HRSA is also working proactively to protect the public by reducing potential barriers for State licensing boards to receive NPDB information.
One step that HRSA took in the past year was to conduct a small pilot study with the Federation of State Medical Boards to determine if hospitals and medical malpractice payers send a copy of the NPDB report, as required, to the licensing board.
To assure that Medical Boards receive the hospital and medical malpractice payment reports, in January 2012 the reporters (hospitals and medical malpractice payers) will be able to send an electronic copy to the State medical board through the NPDB.
We believe this change will be cost saving and time effective for the reporters and State medical boards.”
For more background, this timeline tracks the story:
AHCJ members tackle job changes, book publishing and earn awards
Health journalists have been busy, with a number of job changes, awards and new books out. Here’s the latest news about AHCJ members:
Lominda Afedraru won an award in science reporting in the print category from the Uganda National Council for Science and Technology.
Bianca Alexander was nominated for a Chicago/Midwest Emmy for “Outstanding On-Camera Performance” for the show “Soul of Green,” about entrepreneurs of color in the green and holistic health movement in Chicago.
Mark Andersen has been named an assistant city editor at the Lincoln (Neb.) Journal Star. Anderson is a member of the inaugural class of AHCJ Regional Health Journalism Program Fellows and expects to continue to be involved in the paper’s coverage of health care.
Jeff Baillon, an investigative reporter for KMSP-Minneapolis/St. Paul received an Upper Midwest Regional Emmy Award in September for Investigative Reporting. The series of reports, “Dead Wrong?” (Part 1 | Part 2) revealed serious mistakes made by a Twin Cities medical examiner whose findings lacked sound science but nevertheless were the primary evidence used in several murder convictions.
Amrit Banstola has been chosen as a “Youth Leader Speak Column Writer” from Nepal for Climate Himalaya, an India-based organization that works for climate change.
Bob Barrett, producer of “The Health Show” for WAMC/Northeast Public Radio, will host a second nationally syndicated public radio program. “The Best of Our Knowledge,” about education, is heard on almost 150 radio stations in the United States, Canada and the Caribbean, as well as Armed Forces Radio around the world.
Blythe Bernhard and Jeremy Kohler of the St. Louis Post-Dispatch were named “top reporters” in the Riverfront Times’ Best of St. Louis awards and their work was tapped for a Lee Enterprises’ President’s Award, recognizing outstanding journalism from the company’s 48 newspapers. The two were honored for their investigative series, “Who Protects the Patients?” which exposed Missouri’s lax and secretive system of doctor discipline. The reporting team previously won the APME Missouri sweepstakes award and Bernhard was recently honored with a Missouri Public Health Association media award for significant contributions to health education in the state.
Rachel Boehm is now a reporter for the Bureau of National Affairs’ Daily Tax Report covering the Internal Revenue Service.
At a National Education Alliance for Borderline Personality Disorder conference in November, Kevin Dawkins presented preliminary date from a recently completed randomized controlled trial of a documentary series on borderline personality disorder. The series targeted families who have a member diagnosed with BPD and presented the experiences of four individuals and their families with commentary provided by researchers and clinicians.
The latest book from Nicholas DiNubile, M.D., “FrameWork for the Shoulder“ has been released. It is the third installment in the FrameWork “Active for Life” series geared toward keeping individuals active for life, especially those with musculoskeletal ailments.
M.J. Ellington will do freelance health journalism in addition to her new position as health policy analyst for Alabama Arise, a statewide advocacy organization for the poor. Previously, Ellington covered state government and politics as capital bureau chief for The Decatur Daily and the Florence Times Daily newspapers.
Bob Finn is the assistant managing editor at Medscape Medical News where, among other things, he works with freelancers, assigning and editing stories based on medical journal articles. Finn was with the International Medical News Group for 10 years, first as San Francisco bureau chief and then as social media and web content editor. He’ll continue working from home, which he’s done for the past 19 years.
Joe Goldeen, health care reporter at The (Stockton, Calif.) Record, received the President’s Award from Healings in Motion. Mary Nicholson, of Healings in Motion, said, “Goldeen has been a beacon for those enduring challenges from an illness. Through his stories and blog, Joe shares credible resources and a calendar of events related to health and health care in San Joaquin County.”
Independent journalist Samantha Gluck is a contributing author for HealthyPlace.com, a mental health resource for patients and mental health professionals.
“Top Screwups Doctors Make And how to Avoid Them,” by Joe Graedon and Teresa Graedon, was published by Crown Archtype.
Shuka Kalantari is a member of the 2011 New America Media Fellowship Program on Health, Health Care and Environmental Health. She will produce a radio story about PTSD among Middle Eastern refugees in California.
Jonathan Michels recently wrapped up a short documentary about healthy food access in Candor, N.C. The film was made with a grant from Healthy Kids, Healthy Communities and FirstHealth of the Carolinas.
Gary Schwitzer, publisher of HealthNewsReview.org, presented his project’s findings to an International Biomedical Journalism Symposium at the University Pompeu Fabra in Barcelona in September. He also helped plan a National Cancer Institute workshop for Latin American journalists in Guadalajara and spoke in four sessions at the November event. Stateside, he was a speaker at a National Breast Cancer Coalition media workshop in New York City in September.
Andrew Seaman is a medical journalist with Reuters Health, where his main focus is on the division’s Web page, and he will be reporting. Seaman finished the Kaiser Family Foundation’s media internship in August at Reuters’s Washington Bureau, where he covered the Affordable Care Act and general health policy.
Elizabeth Stawicki, J.D., health care reform correspondent for Minnesota Public Radio, is working on an initiative between NPR/Minnesota Public Radio/Kaiser Health News.
Stephanie Stephens has launched www.MindYourBody.tv for female baby boomers. Stephens is host, writer and executive producer, using expert resources from Los Angeles, Orange County and San Diego. Topics are presented with a video/audio podcast and blog, and focus on mind, body, nutrition, healthy travel, beauty, caregiving and other boomer-centric topics.
Judy Stone, M.D., is a guest blogger for Scientific American. The column started with “Molecules to Medicine: Clinical Trials for Beginners” in October.
Liz Szabo, of USA Today, won the Excellence in Media Award from the Campaign for Public Health Foundation.
Jessica Wapner will be a fellow at the Medical Evidence Boot Camp offered by Knight Science Journalism in December.
Share your news
If you have news to share about a new job, fellowship, award or other accomplishment, please send us a note about it to info@healthjournalism.org to be featured in a future Covering Health post and in HealthBeat, AHCJ’s printed newsletter.
Welcome to AHCJ’s newest members
Please welcome AHCJ’s newest members! All new AHCJ members are welcome to stop by this post’s comment section to introduce themselves.
- Diane Atwood, independent journalist, Gorham, Maine (@Diane_Atwood)
- Christina Boufis Peterson, independent journalist, Oakland, Calif.
- Matthew Brady, senior staff writer, Angie’s List, Indianapolis
- Jody Charnow, editor, Renal & Urology News, New York
- Bobbi Conner, producer/writer/host, Parents Journal, Mount Pleasant, S.C.
- Myiesha Demery, student, Suffolk University, Dorchester, Mass. (@sicklecellsista)
- Margaret Dick Tocknell, online reporter/editor, Healthleaders Media, Jacksonville, Fla.
- Tom Dickey, digital content editor, Remedy Health Media, New York
- Marissa Donovan, student, Syracuse, Rensselaer, N.Y.
- Matt Drange, reporting fellow, Toni Stabile Center for Investigative Journalism, Rosemead, Calif. (@mattdrange)
- Susie Fagan, writer, editor, Kansas Health Institute, Topeka, Kan. (@KHIsusie)
- Glenda Fauntleroy, independent journalist, Carmel, Ind.
- Bianca Fortis, reporter, The Chronicle, Centralia, Wash.
- David Freeman, managing editor, CBSNews.com Health Channel, New York
- Anita Fritz Phillips, independent journalist, Orange, Mass.
- Karen Herzog, reporter, Milwaukee Journal Sentinel, Milwaukee (@HerzogJS)
- Alison Knopf, independent journalist, Carmel, N.Y.
- Kim Krisberg, independent journalist, Austin, Texas
- Danny Kucharsky, independent journalist, Montreal
- Bev Lucas, executive editor, Remedy Health Media, New York
- Stephanie Myers, independent journalist, San Diego
- Louise Radnofsky, reporter, The Wall Street Journal, Washington, D.C. (@louiseradnofsky)
- Gerald Secor Couzens, managing editor, Remedy Health Media, New York
- Jane Stevens, independent journalist, Winters, Calif.
- Diane Umansky, Remedy Health Media, New York
- Barbara Van Tine, editor, Remedy Health Media, New York
- Mark Wert, data & investigations editor, The Cincinnati Enquirer, Cincinnati (@mwert)
- Winnie Yu, independent journalist, Voorheesville, N.Y. (@Writerwinnie)
If you haven’t joined yet, see what member benefits you’re missing out on: Access to more than 50 journals and databases, tip sheets and articles from your colleagues on how they’ve reported stories, conferences, workshops, online training, reporting guides and more. Join AHCJ today to get a wealth of support and tools to help you.
‘Dual eligibles’ pingpong between programs, getting stuck along the way
Filed under: Government, Health care reform, Health policy
The phrase “dual eligibles” has always been a mouthful for describing people old enough (or disabled enough) to be on Medicare and poor enough to be on Medicaid.
M.C. Kim, a cardiac patient quoted in Anna Gorman’s nice Sunday Los Angeles Times piece on the “duals,” comes up with a clear and easy-to-grasp alternative image: pingpong patients.
M.C. Kim had four heart attacks in as many years. Each time, he left the hospital not knowing why his heart had failed.
When he tried to enter a cardiac rehabilitation program to learn how to reduce the odds of having more heart trouble, the Medicare office told him to call Medicaid. The Medicaid office told him to call Medicare. In the end, he said, both denied coverage.
“I was like a pingpong ball,” said Kim, 51, who lives in Los Angeles. “Nobody wanted to take responsibility.”
So Kim kept returning to the emergency room, racking up expensive medical bills for taxpayers.
What questions do you have about health reform and how to cover it?
Joanne Kenen (@JoanneKenen) is AHCJ’s health reform topic leader. She is writing blog posts, tip sheets, articles and gathering resources to help our members cover the complex implementation of health reform. If you have questions or suggestions for future resources on the topic, please send them to joanne@healthjournalism.org.
The “duals” get their doctors and hospitals paid for by Medicare, and their long-term care by Medicaid. (That’s overly simplistic, but you get the main idea.) As they go back and forth between settings, they get caught between two systems that should mesh but often are more like mismatched gears that grind and jam and make noise and get stuck.
Care transitions, a weak point in the health care system in the first place, are particularly disastrous for this population. In fact, the mismatched incentives and insane amount of built-in levers to shift costs may increase the number of care transitions -which boosts costs and create all sorts of opportunities for mishaps and miscommunication that can harm patients.
Gorman’s story is a nice illustration, giving examples from both the elderly and the disabled. She puts a face behind the red tape.
The health reform law takes some steps toward solutions - although this is a tough problem and it’s certainly too soon to say that the reform law will fix it.
A few pieces of a potential solution:
CMS now has a special office on the duals. I interviewed Director Melanie Bella for Kaiser Health News earlier this year. She has testified at least twice before committees in Congress: On June 21 (PDF) she went before the U. S. House Committee on Energy & Commerce, Subcommittee on Health and on Sept. 21 (PDF) she was before the U. S. Senate Committee on Finance. Her testimony can give you an idea of what steps her office is taking and which part is relevant to your state or community.
Medicaid managed care, advanced medical homes, ACOs, penalties for high readmission rates, payment bundling and other reforms may eventually provide better coordinated care for the “duals.” Some of the new programs for the elderly encouraged by the law, such as Independence at Home, may also help. There are more details about delivery system and the duals in this Kaiser Family Foundation brief.
The Alliance for Health Reform also did a whole briefing on this topic a few months ago. This link will take you to resources, an archived webcast, and a transcript (for those of you who would rather skim than watch the webcast)
The SCAN Foundation also has a lot of material on the duals on its website, including this report on state-based solutions.
Feds indict doc whose abuses were detailed in 2010 WSJ series
Filed under: Government, Health data, Health journalism, Public records
In The Wall Street Journal, John Carreyrou reports that a physician the paper spotlighted in a data-driven series on Medicare abuses has now been “indicted by a federal grand jury … for allegedly submitting more than $13 million of false claims.”
The article marks the first time the Journal has been able to print the physician’s name (Emma Poroger), even though they’ve been aware of it for more than a year.
The Journal identified Dr. Poroger, a doctor of osteopathy, as having suspicious billing patterns by mining the Medicare claims database, a computerized record of every bill submitted to the program. But her name was withheld in the October 2010 front-page article because Medicare keeps information pertaining to individual doctors confidential under a three-decade-old court injunction.
That injunction stems from a 1979 lawsuit filed by the American Medical Association, the doctors’ trade group, to keep secret how much money physicians receive from Medicare. At the time, the court said doctors’ privacy trumped the public’s interest in knowing how tax dollars are spent.
The Journal’s publisher, Dow Jones & Co., filed court papers this year seeking to overturn the injunction. In September, a federal judge in Florida ruled that Dow Jones’s case could proceed.
Carreyrou also called out a few other physicians featured anonymously in the series whose names had also been made public in various official proceedings.
Related
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Awards for Excellence in Health Care JournalismDeadline: Feb. 3
- How I did it: Falsified charts in nursing homes linked to patient care
- Access Denied: Looking at a lack of health care availability
- Transparency & medical errors: Public reporting of patient harm is a potent force
- Focus on freelancing: Tips for buying liability insurance
- Why do some patients get stuck in hospitals for weeks, months?
- Investigate health professionals and the boards that regulate them
- Presidents of AHCJ, SPJ call for more openness from Obama administration
