From Dr. Janet Parker and National Whistleblower Groups -
please put your name and forward to your Senator:

Dear Senator:

I join with the undersigned whistleblower, public interest, scientist, taxpayer, patient and consumer groups urge you to approve protections for private-sector whistleblowers involved in all aspects of health care. The Senate health care reform bill as written now would not protect employees who alert the government to waste, fraud, abuse and threats to public health and safety as they pertain to a wide range of health care activities, including preventive services, prescriptions, innovative treatments, and access to health care. That is because protections to whistleblowers apply only to title I in the bill for basic hospital care, or only around 25% of the bill’s provisions.

If this bill truly will try to contain health care costs, whistleblowers are crucial to its implementation. Through the help of whistleblowers, the federal government last year was able to identify health care fraud totaling $5 billion.

Drug companies, hospitals, laboratories, medical transportation providers, medical device suppliers, nursing homes and hospices all have been guilty of wasting taxpayer dollars.

Whistleblowers also have exposed similarly broad patient care breakdowns, ranging from improper administration of unsafe drugs to the use of untrained hospital staff to administer anesthesia.

An accountability loophole would be inexcusable. Protection for employees defending part of a statute would be unprecedented. Every corporate whistleblower law ever passed has covered the entire law. The loophole also would cut back on accountability boundaries in the stimulus law, which has whistleblower protection for all medical care stimulus spending.

For all these reasons, we urge you to approve whistleblower protections covering all titles in the health care reform bill.

Sincerely,

(Your Name)

Executive Director, Medical Whistleblower
Dr. Janet Parker DVM
P.O. Box C
Lawrence, KS 66044
785-766-5784

MedicalWhistleblower@gmail.com

Alliance For Patient Safety
Bill of Attainder Project
Californians Aware
Center for Medical Consumers
Disclosure Watch
Government Accountability Project
Focus-On-Indiana
Information Trust
International Association of Whistleblowers
iSolon.org
Liberty Coalition
The E-Accountability Foundation

Memorandum January 15, 2010

To: Congressional staff on health reform legislation

From: Tom Devine and Bryn Mayes, Government Accountability Project (GAP)

Re: Necessity for whistleblower protection beyond Title 1 of health reform bill

The posted Senate text for HR 3590, the Patient Protection and Affordable Health Care Act (health reform bill) has an excellent whistleblower protection, but only for Title 1 of the legislation. That means employees could be fired at will for challenging misconduct in three quarters of the bill, ironically including the titles for transparency and program integrity, revenue, payment accuracy, changes to the health care workforce, Medicaid and Medicare prescription drug treatments, expansion of Medicaid for the poor, beneficiary access, rural services, preventive services and innovative treatments.

This accountability loophole would be inexcusable. Protection for employees defending part of a statute would be unprecedented. Every corporate whistleblower law ever passed within a statute has covered the entire legislation. The loophole also would cut back on accountability boundaries in the stimulus law, which has whistleblower protection for all medical care stimulus spending.

COST CONTROL AND FRAUD

Fraud only is the tip of the iceberg for unnecessary health care expenditures, but False Claims Act lawsuits by whistleblowers conclusively prove that -- 1) the medical care industry is the nation’s worst for misspending taxpayer funds; and 2) whistleblowers have been the nation’s most effective weapon against that misspending.

Drawing from Taxpayers Against Fraud statistics at www.taf.org last year over $5.6 billion was recovered against civil and criminal fraud through FCA lawsuits, with over $5 billion of that total from the medical care industry. Fraud by defense contractors was a distant second, accounting for some $420 million. The defendants and misconduct extended to every facet of health care spending, including drug company off-label advertising; overcharges for medicine; improper billing for occupational therapy, psychiatric counseling, patient transportation and outpatient care; kickbacks for contracts to supply medical equipment, doctor referrals, and prescriptions of potentially dangerous or lethal drugs; overcharges for medicine; and false diagnostic tests; among other abuses.

The misspending has not been limited to hospitals or direct provision of medical care. Defendants have run the gamut of all institutions relevant to provision of medical care, including drug companies, hospitals, laboratories, medical transportation providers, medical device suppliers, nursing homes and hospices.

BREAKDOWNS IN PATIENT CARE

Whistleblowers contacting GAP have alleged retaliation for challenging –

* removal of fallopian tubes without informed consent; a practice shielded by hospitals due to increased reimbursements for the unnecessary care.

* Insurance company “purging” of customers by sharply increasing rates to unaffordable levels when families receive diagnoses of expensive conditions. While policyholders can appeal, delays even for successful challenges can be fatal, as when a 17 year old died because a liver transplant did not timely take place. Although her family prevailed in the appeal, it was too late.

* Unnecessary, prolonged treatment of juveniles with emotional disorders, plus prescriptions and coerced administration of drugs with dangerous side effects, leading to suicides in some instances; and billing for drugs that were not used in treatment.

* Provision of home health services by untrained staff who aggravated preexisting conditions for elderly patients.

* inadequate security and corresponding violence against social workers providing pre and post natal counseling, and against home health care workers who have been attacked by Doberman guard dogs and unstable individuals with knives.

* disproportionate rates of caesarian deliveries, including 100% rates in some counties, because it leads to higher Medicare reimbursements. The rate for the U.S. generally is 10.6%, compared to 6.2% in Europe. The caesarian deliveries are more likely to be premature, with increased risks of brain damage, undeveloped organs and blindness.

* using drugs such as Lortab to induce labor and premature pregnancies, leading to longer hospital stays and higher Medicaid reimbursements, but risking brain damage and immune system deficiencies for infants. Because it is addictive, misusing Lortab forced methadone treatment for infants to minimize the risk of death from withdrawal.

* failure to check for allergic conditions before providing vitamins and drugs that have caused pregnancy-induced hypertension and kidney damage for the mother. Care providers make a profit through reimbursements for the prescriptions.

* untrained personnel administering highly-controlled substances like anesthesia and cardiac medicine, with consequences from brain damage to lifelong staph infections.

* communications breakdowns between doctors and revolving support personnel, leading to consequences such as not timely sewing a patient back up after surgical procedures and forcing emergency blood transfusions.

*substitution of nurses and interns for primary care physicians in critical patient care functions, although the former have not been trained sufficiently to understand all the codes for next steps in care.

* mistreating rape victims by strapping them naked to beds for hours without care.