TRICARE Breach Victims Report Fraud

8 Class Action Lawsuits Pending
Consolidation Sought


By Howard Anderson

healthcareinfosecurity.com

In the weeks following last year's TRICARE health information breach, some of the 4.9 million beneficiaries affected became victims of financial fraud tied to their credit cards or banking accounts. That new detail is included in an amended complaint tied to the original classaction lawsuit filed in the case, which claims the financial fraud is related to the breach incident.

Eight class action lawsuits have now been filed in the wake of the case. The breach involved the theft of unencrypted computer tapes containing personal information, including Social Security numbers, but not financial data, about TRICARE beneficiaries, officials with the military health program said last year. 

The entire story is here.

A Comparison of DSM-IV and DSM-5 Panel Members' Financial Associations with Industry: A Pernicious Problem Persists

By Krimsky Cosgronve

PLoS Medicine

All medical subspecialties have been subject to increased scrutiny about the ways by which their financial associations with industry, such as pharmaceutical companies, may influence, or give the appearance of influencing, recommendations in review articles, and clinical practice guidelines. Psychiatry has been at the epicenter of these concerns, in part because of high-profile cases involving ghostwriting, and failure to report industry-related income, and studies highlighting conflicts of interest in promoting psychotropic drugs. The revised Diagnostic and Statistical Manual of Mental Disorders (DSM), scheduled for publication in May 2013 by the American Psychiatric Association (APA), has created a firestorm of controversy because of questions about undue industry influence. Some have questioned whether the inclusion of new disorders (e.g., Attenuated Psychotic Risk Syndrome) and widening of the boundaries of current disorders (e.g., Adjustment Disorder Related to Bereavement) reflects corporate interests. These concerns have been raised because the nomenclature, criteria, and standardization of psychiatric disorders codified in the DSM have a large public impact in a diverse set of areas ranging from insurance claims to jurisprudence. Moreover, through its relationship to the International Classification of Diseases, the system used for classification by many countries around the world, the DSM has a global reach.

After receiving criticism that DSM-IV had no financial disclosure of panel members, to its credit the APA instituted a mandatory disclosure policy. The DSM-5 panel members are required to file financial disclosure statements, which are expected to be listed in the publication, and the APA has made a commitment to improve its management of financial conflicts of interest (FCOIs).

The entire story is here.

My Third Letter to the APA Trustees

A Poor Quality DSM-5 in Unacceptable

By Allen Frances, MD

DSM-5 press coverage has suddenly exploded—more than 100 stories from all around the world were published in just the last three weeks (see title and links below). The press is uniformly negative and extremely damaging to DSM-5, to APA, and to the credibility of psychiatry.

The APA responses have been few, unconvincing, and lacking in substance. Also troubling, 47 mental health organizations have expressed their opposition to DSM-5 by endorsing a petition requesting it to have a scientific review independent of APA. And many users are planning to boycott DSM-5 altogether by substituting ICD-10-CM (which will be freely available on the internet). It is fair to say that DSM-5 has become an object of general public and professional scorn.

What would Mel Sabshin be doing in this time of crisis? Of course, Mel never would have allowed APA to get into this mess—but once in any crisis he was an expert in damage control. Were he here today, Mel would certainly recommend that you immediately cut the DSM-5 losses to prevent its inflicting further damage on APA, on psychiatry, and most importantly on our patients.

The entire blog entry is here.

The Crazy Things That One Whistleblower Says Are Happening At JP Morgan Will Blow Your Mind

By Michael Snyder

Hawaii News Daily

Originally published March 16, 2012

Rampant silver manipulation? 

Rampant gold manipulation? 

Rampant LIBOR manipulation? 

Hiding MF Global client assets? 

These are all happening at JP Morgan according to an open letter reportedly written by an anonymous employee of the firm.  The whistleblower also warns of a "cascading credit event being triggered" by derivatives related to Greek government debt. 

Unlike Greg Smith at Goldman Sachs, this whistleblower has chosen to remain anonymous for now.  According to the letter, the whistleblower is still an employee of JP Morgan and has not resigned.  But that does make it much more difficult to confirm what he is saying.  With Greg Smith, we know exactly who he is and what he was doing at Goldman.  As far as this anonymous whistleblower is concerned, all we have is this letter.  So we must take it with a grain of salt.  However, the information in this letter does agree with what whistleblowers such as Andrew Maguire have said in the past about silver manipulation by JP Morgan.  And this letter does mention Greg Smith's resignation from Goldman, so we know that it must have been written in the past few days.  Hopefully this letter will cause authorities to take a much closer look at the crazy things that are going on over at JP Morgan and the other big Wall Street banks.

This anonymous letter was addressed to the CFTC, but unfortunately it looks like the CFTC has already chosen to ignore it.

The original letter from this anonymous whistleblower has already been taken down from the CFTC website.  When you go there now, all you get is this message....

"The Comment Cannot Be Found. Please Return to the Previous Page and Try Again."

Fortunately, there are many in the alternative media that copied this entire letter from the CFTC website.

The entire story is here.

Who Cheats, and How

By Allie Grasgreen

Inside HigherEd

Eighty-four percent of students at a public research university believe students who cheat should be punished, yet two of every three admit to having cheated themselves. Most of the cheating students admit to involves homework, not tests, and they see academic misconduct applying differently to those two kinds of work.

These findings were part of a study presented here this week at the annual convention of NASPA: Student Affairs Professionals in Higher Education. Depending on how much you buy into the “Dirty Rotten Scoundrels” theory – the idea, for which this session was named, that faculty believe students are “just a bunch of cheaters” – the findings may or may not come as a surprise. But either way, those results, coupled with the fact that many instructors devote little if any time to discussing academic integrity, led the researchers to an obvious conclusion: setting clear expectations, and repeating them early and often, is crucial.

“It’s about communicating clearly in the classroom and spending time on the topic,” said Angela Baldasare, divisional manager of assessment and data analysis at the University of Arizona, about clarifying expectations and increasing the intrinsic values of assignments, “so that there’s something more to it than just a grade.”

The study into the frequency and type of offenses, and the faculty policies and responses, surveyed more than 2,000 students and 600 instructors on the Arizona campus.

It found the highest rates of cheating among fraternity and sorority members and international students, the latter of whom were most likely to use technology to cheat. Fewer than 10 percent of Arizona students said they’ve used technology to get answers during an exam, but more international than American students admitted to obtaining test answers online (21 versus 11 percent), having copied material from the Internet for a writing assignment without citing the source (23 versus 13 percent), and sending or receiving text messages during an exam (12 versus 3 percent). Cheating was reported least among students receiving need-based aid, and non-degree seeking and first-generation students. (The more education a student’s parents had, the more likely he or she was to have cheated.)

Freshmen were least likely to have cheated, and the likelihood that students had cheated rose from year to year at an almost linear, small but significant rate. (Interestingly, under most circumstances, the opposite was true when students were asked how likely they think they would be to cheat in the future.)

The entire story is here.

Getting Doctors to Think About Costs

By Pauline Chen, MD
The New York Times - Health
Originally Published on March 15, 2012

My first formal lesson on health care costs occurred one afternoon on the wards when I was a medical student. The senior doctor in charge, a silver-haired specialist known for his thoughtful approach to patient care, had assembled several students and doctors-in-training to discuss a theoretical patient with belly pain. After describing the patient’s history and physical exam, he asked what tests we might order.

One doctor-in-training proposed blood work. A fellow student suggested a urine test. Another classmate asked for abdominal X-rays.

My hand shot up. “A CAT scan,” I crowed with confidence. “I’d get a CAT scan!”
There was complete silence. Everyone turned to stare at me.

The senior doctor coughed. “That’s an awfully expensive test,” he said, a grimace appearing on his face. Another student asked him just how much a CT scan cost, and he shifted uncomfortably in his seat and shrugged. “I don’t really know,” he said, “but I do know that we can’t just think about the patient anymore.”

He took a deep breath before continuing, “We are now being forced to consider costs.”

That was 20 years ago, when the managed care movement was first in the headlines. Today his lesson still rings true, as doctors continue to struggle to reconcile cost consciousness with quality care. And doctors-to-be are not getting much help in learning how to do so.

Here is the whole story.

Prisons Rethink Isolation, Saving Money, Lives and Sanity

By Erica Goode
The New Yor Times - US
Originally published March 10, 2012

The heat was suffocating, and the inmates locked alone in cells in Unit 32, the state’s super-maximum-security prison, wiped away sweat as they lay on concrete slab beds.

Kept in solitary confinement for up to 23 hours each day, allowed out only in shackles and escorted by guards, they were restless and angry — made more so by the excrement-smeared walls, the insects, the filthy food trays and the mentally ill inmates who screamed in the night, conditions that a judge had already ruled unacceptable.

So it was not really surprising when violence erupted in 2007: an inmate stabbed to death with a homemade spear that May; in June, a suicide; in July, another stabbing; in August, a prisoner killed by a member of a rival gang.

What was surprising was what happened next. Instead of tightening restrictions further, prison officials loosened them.

They allowed most inmates out of their cells for hours each day. They built a basketball court and a group dining area. They put rehabilitation programs in place and let prisoners work their way to greater privileges.

In response, the inmates became better behaved. Violence went down. The number of prisoners in isolation dropped to about 300 from more than 1,000. So many inmates were moved into the general population of other prisons that Unit 32 was closed in 2010, saving the state more than $5 million.

The transformation of the Mississippi prison has become a focal point for a growing number of states that are rethinking the use of long-term isolation and re-evaluating how many inmates really require it, how long they should be kept there and how best to move them out. Colorado, Illinois, Maine, Ohio and Washington State have been taking steps to reduce the number of prisoners in long-term isolation; others have plans to do so. On Friday, officials in California announced a plan for policy changes that could result in fewer prisoners being sent to the state’s three super-maximum-security units.

The whole story is here.

Mike Daisey is a Liar, and So am I

By John Warner

HigherEd

Originally published on March 17, 2012

Mike Daisey is a liar.

John D’Agata is a liar.

Greg Mortenson is a liar.

James Frey is a liar.

I am a liar.

You are a liar.

---

When I discuss ethics with my students, we try to suss out whether or not there are any universal truths, things which we all agree are wrong. They name the usual suspects, murder, stealing, assault, cheating, lying, etc… I then go down the line and ask how many of them have violated one of these rules at some point in their lives. They laugh as I ask about murder, and even assault. Some will admit to a petty theft of a sister’s sweater or a candy bar from a convenience store. Lots will admit to having cheated in school at one point or another. (But never in my class, of course.)

I leave lying out of the discussion, and then turn to other matters briefly before coming back to our list, and ask, “have any of you committed one of these terribly foul acts today?” Again, they laugh. Here, maybe I’ll go to the board and tap the dry erase pen on the word “lying.”

“Who’s told a lie today?” I ask.

It’s fun to watch a room full of people think. It’s one of the chief pleasures of teaching. After a few more beats as their faces softly collapse in that way that signals a small epiphany, I’ll say, “I’ve told a lie today, probably several if I think about it, and you have too.”

I ask them what they’ve lied about that day, and it’s always trivial. A lie to mom and dad about what they did the night before, or to a friend about their availability for lunch. My own lies are the same, why I didn’t make it to the previous night’s hockey game, or if I noticed that we were almost out of milk before I poured the last of it on my cereal.

In our minds, we use the “white lie” defense, a “diplomatic or well-intentioned untruth.”

“Well-intentioned.”

(cut)

Let us also acknowledge the rationale that we tell these lies in service of some greater truth is also complete and utter bullshit. Mike Daisey and Greg Mortenson and John D’Agata and James Frey, and me will tell you that we tell the lie not to enrich ourselves, or for reasons of self-preservation, but because, in the words of Daisey, we “want to make people care.”

This is convenient, and maybe we even believe it, but that doesn’t make it true. It would even be handy to blame these lies on simple greed. Mortenson and Frey have profited to the tune of millions. It’s possible Daisey is approaching that.

But I think there’s a deeper truth here, a motivation that extends beyond the transparent B.S. that these lies are in the service of a higher calling.

What these lies invariably do to the stories is take the focus off the story itself, and place it on the storyteller.

Even before Daisey’s lies were exposed, his use of them served to make himself more central to the tale. The story is no longer about exploited workers, but about an intrepid and dogged Mike Daisey who cares so darn much he has to go and witness firsthand how his gadgets get made, and once there, connects so personally and profoundly with these workers, that only he can come back home and tell the story in a way that will change hearts and minds. Daisey isn’t in it for the money, but for the ego.

The entire text is here.

Tennessee insurer to pay $1.5 million for breach-related violations

BlueCross BlueShield agrees to pay HHS for HIPAA violations tied to 2009 breach that exposed data on 1 million members

Computerworld

Originally published March 13, 2012

A 2009 data breach that has already cost BlueCross BlueShield of Tennessee nearly $17 million got a little more expensive Tuesday.

The insurer today agreed to pay $1.5 million to the U.S. Department of Health and Human Services (HHS) to settle Health Insurance Portability and Accountability Act (HIPAA) violations related to the breach.

Under the settlement, BlueCross BlueShield has also agreed to review and revise its privacy and security policies and to regularly train employees on their responsibilities under the HIPAA of 1996.

The settlement is the first resulting from enforcement action taken by the HHS under Health Information Technology for Economic and Clinical Health (HITECH) breach notification requirements.

The notification rules require all HIPAA-covered entities to notify affected individuals of any breach involving their health information. It also requires them to notify the HHS and the media in cases where the breach affects more than 500 people.

Leon Rodriguez, director of the HHS Office for Civil Rights (OCR) said the settlement underscores the department's intent to vigorously enforce HIPAA's security and privacy rules.

"This settlement sends an important message that OCR expects health plans and health care providers to have in place a carefully designed, delivered, and monitored HIPAA compliance program," Rodriguez said in a statement.

The entire story is here.