Although U.S. attorneys, Justice Department lawyers and investigators, the FBI and HHS' inspector general's staff regularly hog headlines for nabbing fraudulent healthcare providers, the Internal Revenue Service wants crooked doctors, hospital executives and other healthcare officials to know it's watching, too.
In an unusual press release, the IRS noted that from fiscal 2000 to fiscal 2002 the service initiated 182 investigations into healthcare professionals and recommended 108 for prosecution, resulting in 113 convictions. The average incarceration rate for those prosecutions was 79%, with convicted offenders averaging 15-month sentences.
To date in fiscal 2003 (Oct. 1, 2002, through March 31), the IRS has initiated 43 cases and won 18 convictions. The IRS said in a release that it's seen an increase in tax fraud in the healthcare professional community, citing a range of offenses from failure to file personal income taxes to money laundering. The release listed some of the recent scalps. In February, Wilbert Streeter, a Highland, Ind., physician who allegedly gave one patient a poultice remedy to treat her breast cancer, admitted to laundering $1.5 million from a fraudulent billing scheme. He was sentenced to 21 months in prison. In October, San Diego physician Rick Shacket was sentenced to 33 months for diverting more than $540,000 from his corporation's medical practice for his personal use, for which he paid $370,000 in back taxes.
Television programming always has had its critics, but one channel in particular has some public advocates saying it's crossed the line into exploiting a captive audience-hospital patients.
Since last fall's launch of the Patient Channel, a 24-7 mix of medical programming and drug advertising piped into patient rooms across the U.S., GE Medical Systems has been under fire by Commercial Alert, a public advocacy group in Portland, Ore., whose advisory board is chaired by Ralph Nader. The group is concerned that sponsored advertising will be misinterpreted by patients as product endorsement by the hospitals. In April, Dennis O'Leary, president of the Joint Commission on Accreditation of Healthcare Organizations, sent a letter to GE, asking it to stop using any reference to compliance with JCAHO education standards in Patient Channel marketing materials.
"We're trying to stop GE from gulling the sick in their hospital beds," says Gary Ruskin, executive director at Commercial Alert. In February, the group, along with 37 doctors and healthcare professionals, sent letters to CEOs at 60 hospital systems with more than 2,000 beds, asking them to ban the Patient Channel: "Hospitals are in the healing business, not the business of tapping the emotions of vulnerable patients for the benefit of hucksters of pills."
GE has contracts with 710 hospitals and has a goal of tapping into 1,100 hospitals by year-end, according to officials at Patient Channel. Drug advertising constitutes about 50% of the ads, which includes healthcare sponsors such as medical supply companies.
Bruce Dan, managing editor of the Patient Channel and an adjunct faculty member at the Vanderbilt University School of Medicine, says it's insulting to suggest patients are vulnerable to drug ads.
"These are grown-ups. These are the same ads they would see in their homes. They're some of the most regulated advertising in the world," Dan says.
As for whether the ads have more credibility when combined with high-quality medical programming, Dan says if patients go their doctors and "ask for a particular drug to lower their cholesterol, and the patient has benefited from that conversation, then we think it's a great thing."
Robert Wise, a JCAHO vice president, says the "transition from programming to advertising was not clearly demarcated, and that can be confusing to some people." Wise hasn't seen any of the channel's medical programming, but says it is "clothed in a world of advertising, and that brought up an ethical issue (as well as the problem of compliance). We asked them to remove our name. And they did."
Bringing home the Baldrige
SSM Health Care last week accepted the prestigious Malcolm Baldrige National Quality Award, the first healthcare organization to win in the award's 16-year history.
Representing the 21-hospital St. Louis-based system at a ceremony near Washington, President and CEO Sister Mary Jean Ryan said, "SSM Health Care is living proof that healthcare in the United States is capable of improving, despite many predictions to the contrary. ... Being the first healthcare organization to win the Baldrige is an extraordinary achievement made possible by extraordinary people."
Vice President Dick Cheney and Commerce Secretary Don Evans presented the awards, which recognize companies for outstanding achievement in performance and quality. Awards also went to Branch-Smith Printing Division in Fort Worth, Texas, and the commercial, government and industrial solutions sector of Motorola.
"The Baldrige awards are not given out lightly," Cheney said at the ceremony. "Being good isn't enough. You must be great." The healthcare award, Cheney said, represents an industry category that is "absolutely critical to the nation's economy and well-being."
SSM's honor was first announced last November (Nov. 25, 2002, p. 4).