And just were these now-newly-charged defendants thinking?

 The Secretary of the DHHS and the US Attorney General just announced that 107 physicians and others have been charged in a Medicare scam, “breathtaking in scope.”  The allegations are that these 107 doctors, nurses, and others have defrauded the government of up to $452 million in Medicare payments.  The illegal activities occurred in Chicago, Houston, Los Angeles, Detroit, Tampa, and Baton Rouge, Louisiana.  Reports are that in the latter city alone seven individuals from two community health centers have been charged with submitting false claims of $225 million.

 What is sad is that the services of community mental health services are needed, and criminal activities such as these place ALL of these centers, and others, under the spotlight in a manner that can affect the delivery of care.  But the fraud appears so vast, and the amounts of money so great, that one cannot help but understand why there needs to be a laser-like focus on fraud and abuse and compliance.  I hope that as time goes on and the government’s efforts at fighting fraud start bearing real fruit in the form of reduced fraud (and consequent reduced governmental expenditures) that the good guys rise to the top.

 Oh, and the answer to the question above?   To paraphrase Willie Sutton, Medicare is where the money is – a lot of it.

I’ve decided to spare readers yet another article and/or opinion about the argument before the U.S. Supreme Court on health care reform and the manner in which certain members of the Supreme Court addressed the issues.  I am digesting the arguments and the media’s handling of them.  For now, I have two points. 1. Whether the ACA survives constitutional scrutiny or not, payment reform is happening.  2.  Health care reform is not like forcing folks to eat broccoli.  Sheesh……

Speaking of broccoli, the Concord Monitor today featured an interview with Dr. Lorenzo Cohen, professor of integrative medicine at the University of Texas MD Anderson Cancer Center.  Dr. Lorenzo will give a free lecture this week on lowering “the risk of cancer and improving outcomes for those touched by cancer, through choices in diet, exercise and stress management.”

In the interview, Dr. Cohen, to his credit, spoke of the usual suspects  – diet and exercise.  I did not realize, however, that his research also focuses on stress and stress management.  His work as a research psychologist has led him from the psychological underpinnings of stress to its effects on the immune system.

As a layman, I find this interesting.  What is one way to get stress under control?  Breathing.  What is one way to become a better breather?  Being taught and taking the time to be taught.  What does that require?  Time away from other so-called productive pursuits.  Oh sure, I suppose you could rent a DVD on yoga or breathing techniques, but my sense is that participation in a full “classroom setting” with other motivated participants allows a more focused, and ultimately for those of you keeping count, efficient approach.

Dr. Lorenzo also spoke of the “western lifestyle” in the interview.  Decades ago, I doubt that a “western lifestyle” conjured images of – in Dr. Cohen’s words – “sedentary jobs, weight gain, and exposure to environmental toxins.”  But now in 2012 it does, at least in the international medical community.  In fact, the good doctor stated in the interview that an “anticancer lifestyle” has to with achieving a balance, and doing everything you can to decrease your exposure to the [Editor’s note: “now”] traditional western lifestyle.”

I hope that one take-away from his up-coming lecture will be how to allow us to re-engineer the western lifestyle so all in our society get to partake in the new benefits.

At the invitation of the NH Hospital Association, I was scheduled to testify against House Bill 1642 before the NH Legislature.  Time ran out, and I’ll go back on Thursday.  HB 1642 specifically would exempt “destination cancer hospitals” from any review by NH’s Health Services Planning and Review Board.  In other words, a certain kind of hospital would not be required to apply through the competitive process called for in new Hampshire’s Certificate of Need statute.  The proposed law would specifically exempt a “destination cancer hospital” from any review whatsoever.

There are many reasons why this law is unnecessary at best, and harmful at worst.  My testimony will be simple.  One, Certificate of Need review allows the public to weigh-in in a public forum as to whether there is a real need for the service.  Our HSPR Board must take into account the public’s comments.  Secondly, there is a myth circulating with regard to the manner in which the HSPR Board operates.  It does not “rubber stamp” Certificate of Need applications.  Indeed, I personally have been involved in several competitive applications.  The Board has had to make difficult decisions, but the Board has done so as it should under its statutory authority.  Why let one particular hospital project avoid this competitive process?  And for those who say that the statute does not adress “destination” health care facilities, I say that’s wrong – “specialty hospitals” are clearly allowed under current law

I was pleased that a number of physicians took time out of their busy schedules to testify before the Committee.  I hope those who did not get to speak can do so later this week.