A Miami-Dade doctor convicted of pocketing more than $1 million for writing phony prescriptions for unnecessary HIV treatments was sentenced Monday to almost 20 years in prison, for his key role in a massive Medicare fraud conspiracy. The scam bilked millions of dollars from the federal healthcare program. Rene de los Rios, a 72-year-old Cuban-born physician trained in Spain, said virtually nothing at his sentencing as U.S. District Judge Joan Lenard hammered him for violating his medical oath, stealing from the vulnerable government program and disgracing himself, his family and his community. She also accused him of "blatantly lying" as a witness during his trial that ended with a jury's guilty verdict in April. "Dr. de los Rios does not deserve the title of doctor anymore," the judge declared, rejecting his bid for about seven years in prison.
Before leaving the office to visit a homebound patient, Tony Ohotto, MD, gathered a few necessities: his stethoscope, medical notes, and a pair of well-worn bicycling shoes. Dark clouds threatened rain, so Ohotto packed a rain slicker before hopping on his 10-speed. Kevin Callahan, a certified occupational therapy assistant, joined him for a 15-minute ride to their patient's home, a residential care facility in Southeast Portland. "When you roll up on a bike, it gets you some street cred with patients and caregivers," says Ohotto, a geriatric specialist and staff physician at Providence ElderPlace, a program that provides healthcare, housing and other services for older adults. Through good weather and bad -- and despite the social and professional pressures favoring car transport -- Ohotto and Callahan have found on-the-job bicycling to be eminently practical.
Alarmed by a shortage of primary care doctors, Obama administration officials are recruiting a team of "mystery shoppers" to pose as patients, call doctors' offices and request appointments to see how difficult it is for people to get care when they need it. The administration says the survey will address a "critical public policy problem": the increasing shortage of primary care doctors, including specialists in internal medicine and family practice. It will also try to discover whether doctors are accepting patients with private insurance while turning away those in government health programs that pay lower reimbursement rates. Federal officials predict that more than 30 million Americans will gain coverage under the healthcare law passed last year. "These newly insured Americans will need to seek out new primary care physicians, further exacerbating the already growing problem of P.C.P. shortages in the United States," the Department of Health and Human Services said in a description of the project that it submitted to the White House. Plans for the survey have riled many doctors because the secret shoppers will not identify themselves as working for the government.
In his critics' eyes, with the national health overhaul pushed through by President Obama. Republican Presidential candidate and former Massachusetts Gov. Mitt Romney has given up trying to distance himself from his own creation, though he rejects the comparison to "ObamaCare." The greater question now isn't whether the Massachusetts overhaul is fairly named as his -- it is -- but whether the innovative changes he pushed through have worked as intended. A detailed Globe examination of voluminous healthcare and financial data, and interviews with key figures in every sector of the healthcare system, makes it clear that while there have been some stumbles -- and some elements of the effort merit a grade of "incomplete" -- the overhaul has, after five years, worked as well as or better than expected.
For a time this year, a psychiatric hospital run by the state of Maryland didn't have enough injectable drugs for schizophrenia patients who refused to take pills. Doses of the most effective drug to boost blood pressure in patients at risk of dying from infection-related shock were low at Johns Hopkins Hospital. And some local pharmacists were having trouble filling prescriptions for attention deficit hyperactivity disorder. The drugs are among hundreds that have been in short supply at the nation's hospitals, and more recently, community pharmacies. Pharmacists, doctors and advocacy groups say countless patients are getting less effective or more costly substitutes as a result. Occasionally, they may be receiving inappropriate drugs or doses ? or no treatment at all. "Every month we review what's not available to us," said Pamela Lipsett, MD, a professor of surgery at Hopkins. "We get one [drug] back and lose another. And some diseases have only one drug. It's very frightening."
Without explanation, the Arizona Supreme Court on Friday declined to stop proposed Medicaid cuts from taking effect this week or rule on whether the enrollment freeze is constitutional. Attorneys for three public-interest law firms, representing low-income Arizonans at risk of losing coverage under the Arizona Health Care Cost Containment System, already were preparing a separate case to be filed in Maricopa County Superior Court. That's likely the last chance for opponents of the AHCCCS cuts to stop them. Tim Hogan of the Arizona Center for Law in the Public Interest said a request for an injunction could be filed in Superior Court as early as today.