We’re ClearHealthCosts — telling people what stuff costs in healthcare and helping them navigate this messy and complicated world. Welcome to our newsletter!
When the FBI and the Justice Department settled in to our site
We like knowing our readers! So it was nice to see that we are getting a ton of visitors from the U.S. Department of Justice, the F.B.I. and the Food and Drug Administration, checking out our coverage of the wound care industry.
Care for wounds that won’t heal has brought a wide range of complaints recently, and we’ve been digging into the issue. The treatment of these wounds can involve substances called “skin substitutes,” made of tissue from placentas, infant foreskins, cadaver skins and, oddly, fish skins. Usage and prices have skyrocketed, and industry sources say there may be serious wrongdoing and patient harm.
When used on the appropriate patient and with full-patient wound care conventions — investigation of the cause of the lack of healing, such as poor nutrition, or circulatory problems — the substances can be invaluable. But increasingly they are slapped willy-nilly on any patient that can be found by an unscrupulous wound care company that is out to make a buck — strip-mining the bodies of older Americans for money, threatening the Medicare trust fund and backing truckloads of dollars up to the loading dock.
Federal investigators are sniffing around, and the owners of one company have been charged. A series of regulations have been proposed to rein in these practices. They were to go into effect on Feb. 12, but they were halted by the Trump administration, with a new target date for implementation of April 13.
But then President Trump made a Truth Social post disparaging the regulations. So … will they or won’t they go into effect?
We were also interested to see that Cologuard, the colon cancer detection company, came to read about wound care. And a handful of big banks, plus numerous hospitals, law firms, accountable care organizations and manufacturers of these substances.
(Our analytics program was a lot richer before the lockdown, when people were working from offices, and the analytics could “see” that; now there are a lot of mobile carriers and other signs of work-from-home readers — “Icloud Private Relay” and “Verizon Fios,” for example.)
Links to our coverage:
Wound care and skin substitutes: Rising costs, new policies and a whiff of scandal
Skin substitutes and possible danger: Is patient harm happening in wound care?
Federal investigators probe wound care industry
Trump makes social media post disparaging proposed wound-care rules, setting off speculation
Care groups raise concerns about ‘heartbreaking’ wound care practices
Insurers’ wide payment reviews drive therapy practices to despair
A Los Angeles company that offers comprehensive mental health treatment is “teetering on the edge of shutting down,” with $400,000 worth of unpaid claims from insurers during multiple payment reviews. A New York City therapy practice has been waiting for months for $90,000 in payments delayed by a pre-payment review from Blue Cross Blue Shield.
A practice treating children in Atlanta has seen its payments delayed by pre-payment reviews from two insurance companies, threatening it with shutdown. A solo practitioner in California found himself in pre-payment reviews that were so onerous he decided to close his practice and instead go to work at a non-profit hospital.
Insurers love to slow-pay or no-pay clinicians. We did a series that brought a flood of readers. The most recent, about four therapy practices that are being driven out of business or near to the brink, got a lot of traffic — including from law firms and the National Library of Medicine. Continue reading.
ADHD medications: Getting Adderall and similar meds on time
The shortage of stimulant medications like Adderall has, perhaps predictably, exploded into shortages of similar medications like Ritalin, Vyvanse, Concerta and others — causing havoc for patients, including one woman who called nearly 100 drugstores in one day in an attempt to fill her prescription. Our piece about that topic, written by a pharmacist who himself has ADHD and continuously updated, is getting an increasing amount of traffic. Read more here.
Talk to us!
Do you have anything we need to be writing about? Email us: jeanne@clearhealthcosts.com, or encrypted Signal 914-450-9499.
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