Personal Injury and Social Security Disability Blog

Friday Fun

Here is five minutes of stuff you can't do, and shouldn't try:

Drug Maker Mylan Agrees to Settle Medicaid Case for $65 Million

The  drug maker Mylan Inc. has agreed to settle a lawsuit brought against it by both the U.S. government and the State of Texas. The suit alleges that Mylan artificially inflated prescription drug prices, causing Medicaid to pay the company far more money than should have been reasonable. Mylan will pay $65 million under the terms of the settlement, while admitting no wrongdoing. Mylan is a generic-drug manufacturer located in Pittsburgh.

Mylan has been sued by several other states, and last year pharmaceutical companies Mylan, AstraZeneca, and Johnson & Johnson agreed to pay $124 million in settlement of claims that the companies violated the U.S. False Claims Act by underpaying Medicaid rebates.

No Cost-of-Living Adjustment for Veterans Compensation and Pension Benefits in 2011

This was a foregone conclusion, but there will be no increase in veterans pension or compensation benefits for 2011. I wrote previously about no increase in Social Security disability or retirement benefits, and because veterans benefits are based on the same government standard, we knew there would be no increase for those benefits.

However, the official announcement did not come from the VA until today. The press release follows:

Update on Cost-of-Living Adjustment for Veterans Compensation and Pension Benefits in 2011

COLA Tied to Social Security and Consumer Price Index

WASHINGTON – The Social Security Administration has announced that no cost-of-living adjustments will be made to Social Security benefits in 2011 because the consumer price index has not risen since 2008 when the last Social Security increase occurred.

Like recipients of Social Security and other federal benefits, Veterans, their families and survivors will also not see a cost-of-living adjustment in 2011 to their compensation and pension benefits from the Department of Veterans Affairs (VA).

Under federal law, the cost-of-living adjustments to VA’s compensation and pension rates are the same percentage as for Social Security benefits.

VA provides compensation and pension benefits to about four million Veterans and beneficiaries. For more information about VA benefits, go to www.va.gov or call 1-800-827-1000.

 

Big Business Finds Friends on U.S. Supreme Court

The New York Times tells us what most lawyers already know — that the Supreme Court of the United States is very "business-friendly." Not as much so as the Texas Supreme Court, but that would be a hard record to match.

Please read the article; you may be surprised at the influence big business has on the current court. The bottom line is that the U.S. Chamber of Commerce is filing briefs in many cases, and these briefs are apparently swaying the Court to make more decisions favoring business over consumers. Here are a few excerpts:

Almost 40 years ago, a Virginia lawyer named Lewis F. Powell Jr. warned that the nation’s free enterprise system was under attack. He urged the U.S. Chamber of Commerce to assemble “a highly competent staff of lawyers” and retain outside counsel “of national standing and reputation” to appear before the Supreme Court and advance the interests of American business.

The chamber now files briefs in most major business cases. The side it supported in the last term won 13 of 16 cases. Six of those were decided with a majority vote of five justices, and five of those decisions favored the chamber’s side. One of the them was Citizens United, in which the chamber successfully urged the court to guarantee what it called “free corporate speech” by lifting restrictions on campaign spending.

The chamber’s success rate is but one indication of the Roberts court’s leanings on business issues. A new study, prepared for The New York Times by scholars at Northwestern University and the University of Chicago, analyzed some 1,450 decisions since 1953.

It showed that the percentage of business cases on the Supreme Court docket has grown in the Roberts years, as has the percentage of cases won by business interests.

The Roberts court, which has completed five terms, ruled for business interests 61 percent of the time, compared with 46 percent in the last five years of the court led by Chief Justice William H. Rehnquist, who died in 2005, and 42 percent by all courts since 1953.

A study prepared by the Constitutional Accountability Center, a liberal group, examined the center’s success rate in the Supreme Court. It found that the positions supported by the chamber prevailed 68 percent of the time in the Roberts court, compared with 56 percent in the last 11 years of the Rehnquist court, a period without changes in the court’s membership.

A prominent Supreme Court advocate who often represents businesses, Maureen E. Mahoney, chose her words carefully when asked at a chamber news briefing in September whether the Roberts court was especially receptive to the kinds of arguments pressed by corporations.

“The best court for getting a fair hearing on those issues,” she said, “is the Supreme Court.”

 

Texas Auto Liability Insurance Limits Increase January 1, 2011

Here's a sliver of good news for people who may get involved in a car wreck in 2011 or after. The automobile insurance liability limits that were raised from the decades-old minimum of $20,000 to $25,000 in 2008 will increase again, to $30,000 effective January 1, 2011. This will be for policies written or renewed after that date.

The minimum limits in Texas have lagged behind inflation for many years, but are now at least showing some movement. The bad news is that this is the last increase mentioned in the law, and it will take a new law to increase the limits further.

The new limits are $30,000 per person, $60,000 per incident, and $25,000 for property damage.

$30,000 doesn't go very far in paying for even a brief hospital stay, and $25,000 certainly isn't enough to pay for the damage to a luxury car, but at least we got a small increase from the Legislature.

Med Schools Flunk at Keeping Faculty Off Pharmaceutical Speaking Circuit

I've written several times about pharmaceutical companies paying doctors to shill for them. Speak-for-fee has gotten enough bad publicity recently that fewer doctors are accepting money from the drug companies to tout certain medications.

But, as a lengthy article at the ProPublica site details, medical schools are falling behind physicians in general in reining in this practice. Here are the opening paragraphs:

As medical schools wrestle with how to keep drug companies from corrupting their faculties, Stanford University is often lauded for its tough stance.

The school was one of the first to stop sales representatives from roaming its halls in 2006. It cut off the flow of free lunches and trinkets emblazoned with drug names. And last year, in a blow to its physicians’ wallets, Stanford banned them from giving paid promotional talks for pharmaceutical companies.

One thing it didn’t do was make sure its faculty followed that rule.

A ProPublica investigation found that more than a dozen of the school’s doctors were paid speakers in apparent violation of its policy—two of them earning six figures since last year.

Dr. Philip Pizzo, the dean of Stanford’s medical school, sent an e-mail to all medical school staff last week calling the conduct “unacceptable.” Some doctors’ excuses, he wrote, were “difficult if not impossible to reconcile with our policy.”

He was not the only school official caught off-guard.

Faculty at a half-dozen other institutions—including division chiefs—also lectured for drug firms in the last two years, ProPublica found, despite restrictions on such behavior. The University of Pennsylvania, the University of Pittsburgh and the University of Colorado Denver, among others, have launched reviews.

Conflict-of-interest policies have become increasingly important as academic medical centers worry that promotional talks undermine the credibility of not only the physicians giving them, but also of the institutions they represent.

Yet when it comes to enforcing the policies, universities have allowed permissive interpretations and relied on the honor system. ProPublica’s review shows that approach isn’t working: Many physicians are in apparent violation, and ignorance or confusion about the rules is widespread.

As a result, some faculty physicians stay on the industry lecture circuit, where they can net tens of thousands in additional income.

Critics of the practice say delivering talks for drug companies is incompatible with teaching future generations of physicians. That’s because drug firms typically pick the topic of the lecture, train the speakers and require them to use company-provided presentation slides.

 

Merry Christmas!

Here's wishing a very Merry Christmas (or whatever other holiday you may be celebrating) to all my friends. I love this Nativity Story for the millenial generation:

Friday Fun

This is one holiday song we can all relate to — the Christmas Can-Can:

The Medical Implants Loophole

"The brief and troubled life of DePuy’s A.S.R. hip points to a medical implant system that is piecemeal and broken on many fronts, critics say." This quote is at the heart of a lengthy article in the New York Times. The article explores in depth the approval process for medical devices such as the problematic hip implant manufactured by Dupuy Orthopaedics.

Other devices are also discussed, and the entire article provides great insight into the world of medical device manufacturers and the government agencies supposedly regulating them. Here are the opening paragraphs:

A recently recalled artificial hip made by a unit of Johnson & Johnson, designed to last 15 years or more, is failing worldwide at unusually high rates after just a few years.

One of the most troubled orthopedic implants of the past decade, this artificial hip — known as the A.S.R., or Articular Surface Replacement — was originally promoted as a breakthrough in design that would last longer and provide patients more natural movement.

But many patients soon developed inexplicable pain, and surgeons, when replacing the implant, discovered mysterious masses of dead tissue near the thighs of some patients.

Until late summer, officials at the Johnson & Johnson unit, DePuy Orthopaedics, the largest maker of replacement hips worldwide, maintained that the A.S.R. was performing on a par with competing devices. But interviews with doctors indicate that DePuy received repeated warnings that the implant was failing and that surgeons were abandoning it.

The brief and troubled life of DePuy’s A.S.R. hip points to a medical implant system that is piecemeal and broken on many fronts, critics say. Unlike new drugs, many of which go through a series of clinical trials before receiving approval from the Food and Drug Administration, critical implants can be sold without such testing if a device, like an artificial hip, resembles an implant already approved and used on patients.

That way, manufacturers can rapidly make small changes to a device to improve it. But those simpler procedures have also effectively created a loophole, experts say, that lets producers bundle a component from an unapproved implant into an existing design and sell a device with minimal testing. With the A.S.R., that process unfolded with devastating results.

“You are basically testing these devices in an uncontrolled way on a large number of people,” said Dr. Sidney M. Wolfe, the director of the Public Citizen’s Health Research Group and a longtime F.D.A. critic.

 

Editorial: Preventable Medical Mistakes Take Intolerable Toll

Preventable hospital negligence and medical malpractice cause far too many patient deaths each year. A recent editorial in USA Today put this in perspective. Here are excerpts:

If a 747 jetliner crashed every day, killing all 500 people aboard, there would be a national uproar over aviation safety and an all-out mobilization to fix the problem. In the nation's hospitals, though, about the same number of people die on average every day from medical "adverse events," many of them preventable errors such as infections or incorrect medications. Where's the outrage?

Obviously, patients who die one-by-one don't attract attention the way a fiery air crash does, and the problem isn't new. A 1999 report by the Institute of Medicine estimated that as many as 98,000 people a year died in hospitals from medical errors. Now, 11 years later, a new survey from the inspector general of the Department of Health and Human Services finds that about 1 in every 7 Medicare patients in hospitals suffers a serious medical mishap.

The report says these adverse events contribute to the deaths of an estimated 180,000 patients a year. Of those, roughly 80,000 are caused by errors that could be caught and prevented, such as letting infections develop, giving the patient the wrong medication or administering an excess dose of the right drug. Aside from the human toll, the extra medical care required to correct for these mistakes costs taxpayers more than $4 billion a year.

It's a problem crying out for a fix, and here are three remedies already being used but worth expanding:

•Checklists. No airline pilot would dream of taking off without using a checklist, and increasingly, medical personnel are being encouraged to use them, too. Studies show that forcing surgeons and nurses to follow simple steps they sometimes skip —donning sterile gowns before inserting a "central line," for example — can dramatically lower infection rates and save lives.

•Transparency. Until recently there was little beyond word of mouth to help people decide which hospital they wanted to go to. Now, the government runs an increasingly robust Hospital Compare website to allow patients to evaluate their local hospitals. (USA TODAY.com and HealthGrades.com also carry comparisons.) There's nothing like pressure from consumers and competitors to force a business to do better.

•Financial incentives. Medicare won't pay for the extra care required to treat patients whose conditions worsen as a result of hospital-acquired conditions that are "reasonably preventable," such as giving a patient a transfusion of the wrong blood type. And the new health law penalizes hospitals with the worst error rates. In both cases, the principle is the same: Hospitals shouldn't profit from failure.

These and other remedies — increased use of electronic prescriptions and medical records, for example — should help chip away at health care's stubbornly high error rate.

It has taken decades of aggressive effort to reduce aviation accidents. While medicine is far more complex, the same sort of single-mindedness is needed to decrease the unacceptable level of medical "crashes."