Senior writer and co-founder of C-HIT, Lisa Chedekel is an award-winning investigative reporter who wrote for the Hartford Courant for 15 years, covering a wide range of beats, from politics to healthcare. In 1999, she was among a team of reporters awarded the Pulitzer Prize for breaking news reporting. In 2002, she was among a handful of U.S. journalists who visited Saudi Arabia in the year after 9/11 to report on the aftermath of the terrorist attacks. More recently, she co-authored a series on mental health in the military that won a George Polk Award, the Selden Ring Award for Investigative Reporting, and was a 2007 finalist for the Pulitzer in Investigative Reporting. Before writing for The Courant, she was a staff writer and columnist for the New Haven Register. You can contact Lisa at chedekel at c-hit.org
Connecticut had one of the highest rates in the nation of motor vehicle fatalities in which drivers were alcohol impaired in 2013, the most recent year for which data is available – 41 percent, compared to the national average of 31 percent, according to federal estimates. But the state also had one of the lowest rates nationally of reporting drunk-driving data in fatal accidents – a lapse that hampers efforts to gauge the impaired-driving problem and to develop and evaluate programs to address it, experts say. Connecticut reported blood-alcohol concentration (BAC) results for just 45 percent of fatally injured drivers -- far lower than the national average of 71 percent, according to data collected by the National Highway Traffic Safety Administration (NHTSA). Only Mississippi reported a lower rate of such testing. Thirty-four states reported testing rates of more than 70 percent.
Six dialysis facilities in Connecticut received low quality-of-care scores under newly updated federal Medicare ratings, while 11 facilities received the highest rating possible. Connecticut has 45 dialysis facilities in the Medicare program, all but four of them for-profit. Of the 41 for-profit centers, the majority are owned by two chains – DaVita, which has 24, and Fresenius Medical Care, with 13. The federal Medicare program rates dialysis facilities on a scale of one to five stars, based on nine measures of quality of care. The measures include mortality and hospitalization rates of patients, as well as rates of hypercalcemia, catheterization of more than 90 days, and the percentage of dialysis patients who had enough wastes removed from their blood during dialysis.
Connecticut hospitals reported fewer numbers of patients killed or seriously injured by falls or perforations during surgery or suffering from severe pressure ulcers in 2014 than in 2013, but the incidence of such “adverse events” still remains higher than in 2012, a new state report shows. The report by the Department of Public Health (DPH) shows that the total number of hospital adverse events, or errors, dropped by 12 percent -- from 534 in 2013, to 471 last year. Deaths or serious injuries from falls declined from 90 to 78; perforations during surgical procedures fell from 79 to 70; and life-threatening medication errors fell from six to one. The number of patients with serious pressure ulcers dropped from 277 to 245. Rates of all four of those incidents had climbed in 2013, in part because of an expansion of required reporting on pressure sores to include “unstageable” ulcers.
A Derby nurse who admitted taking kickbacks from a drug company that makes the powerful painkiller Subsys was pressured by sales representatives to increase her prescribing “so that the Subsys numbers would also increase,” according to court documents. In a hearing transcript recently made public, federal prosecutors charged that Heather Alfonso “continued to increase her prescribing of Subsys and to find more patients for whom she could prescribe the drugs” in exchange for a series of $1,000 kickbacks, totaling $83,000, from the company, Insys Therapeutics. Although the potent narcotic is approved only for cancer patients, some of the patients given Subsys by Alfonso “did not have a cancer diagnosis,” which would have meant that Medicare and private insurers would have refused to pay claims, federal prosecutors said. But “prior authorizations” submitted on behalf of patients falsely represented that they had cancer, misleading insurers into paying for the drug. It is not clear in the testimony who was involved in submitting the false authorizations to Medicare and insurers.
US Sen. Richard Blumenthal (D-Conn.) and U.S. Sen. Chuck Grassley (R-Iowa) have introduced legislation that would require drug companies and medical device manufacturers to start reporting their payments to nurse practitioners and physician assistants, as they do for physicians. “Requiring companies to disclose gifts and payments made to other health care providers – not just doctors – is absolutely essential,” Blumenthal said in a statement Tuesday. “The Provider Patient Sunshine Act will rein in dishonorable behavior by increasing transparency and accountability across the entire healthcare industry.”
Grassley added: “It makes sense to apply the sunshine (provisions) to anyone who prescribes medicine.”
The proposed Provider Payment Sunshine Act, would require drug companies and device makers to publicly disclose payments to nurse practitioners and physician assistants for promotional talks, consulting and other services. The companies already report such payments to physicians in a national Open Payments database, under prior legislation co-authored by Grassley. The payments to nurse practitioners and physician assistants would be added to that database. Nurse practitioners and physician assistants write a significant number of prescriptions in the federal Medicare program, data show.
Kathy Navaroli, 50, of Windsor, hadn’t seen a primary care doctor in years when she decided to go for a physical this summer. She didn’t ask about preventive care screenings, such as a mammogram or Pap test, in part because she worried they might involve an insurance co-pay or deductible. Her household income is below $30,000 a year. “I got a physical, they did some blood work, and that was it,” she said. Kerrishian McCants, 31, of Hartford, a mother of four, has a family history of diabetes and high blood pressure, but has not discussed those possible risks with her doctor.
A state initiative that would have required drug companies and device manufacturers to start reporting their payments to advance practice registered nurses (APRNs) this year has been delayed to 2017. The original APRN legislation, passed in 2014, called for quarterly reporting beginning in July 2015. That law was amended this spring to push back the start date and require only annual reporting, after urging from the pharmaceutical industry, state officials said. The delay comes as an APRN at a pain clinic in Derby, Heather Alfonso, awaits sentencing on charges that she received kickbacks from the drug company Insys Therapeutics in exchange for prescribing a potent painkiller intended for cancer patients. The payments to Alfonso for promoting the drug were not reported publicly under federal rules because APRNs are not included in the Physician Payment Sunshine Act, which requires public reporting of drug company payments only to physicians and teaching hospitals.
Five dialysis facilities in Connecticut received low quality-of-care scores under a new Medicare rating system, including one center cited for a high death rate, while 11 facilities received the highest rating possible, federal data show. Connecticut has 45 dialysis facilities in the Medicare program, all but four of them for-profit. Of the 41 for-profit centers, the majority are owned by two chains – DaVita, which has 24, and Fresenius Medical Care, with 13. Medicare began rating dialysis facilities earlier this year on a scale of one to five stars, based on nine measures of quality of care. The measures include mortality and hospitalization rates of patients, as well as rates of hypercalcemia, catherization of more than 90 days, and the percentage of dialysis patients who had enough wastes removed from their blood during dialysis.
The company alleged to have paid kickbacks to a Derby nurse in exchange for her prescribing of a potent pain medication has agreed to pay $1.1 million to settle a case brought by the state of Oregon, which accused the firm of deceptive marketing and kickback payments involving the same drug. In a notice of unlawful trade practices filed against the Arizona-based drug maker Insys, the Oregon attorney general’s office charged that the company used an “unconscionable tactic by making payments to doctors that you intended to be a kickback to incentivize the doctor to prescribe Subsys.” The attorney general also charged Insys with using “unconscionable, false and deceptive sales tactics” designed to increase the “off-label” use of Subsys, which is approved only to treat breakthrough cancer pain. The case in Oregon comes as Connecticut nurse practitioner Heather Alfonso, formerly with the Comprehensive Pain and Headache Treatment Center in Derby, awaits sentencing on charges she received $83,000 in kickbacks from Insys from 2013 to 2015. In pleading guilty, Alfonso, 42, admitted that the money she was paid for attending “dinner programs” as a speaker -- many of them sham dinners, with just an Insys sales representative or her friends or co-workers --- influenced her prescribing of the drug, according to the U.S. Attorney’s Office for Connecticut. The charge of receipt of kickbacks in relation to a federal healthcare program carries a maximum term of imprisonment of five years and a fine of up to $250,000.
All but one of Connecticut’s acute-care hospitals will lose Medicare reimbursement in 2015-16 as a penalty for high readmissions of discharged patients, new federal data show. The penalties against 28 hospitals mean Connecticut has one of the highest percentages nationally – more than 90 percent -- of hospitals facing Medicare reductions. Only the Hebrew Home and Hospital of West Hartford escaped penalties; the Connecticut Children’s Medical Center is exempted from the federal program. None of the state’s hospitals faces the maximum 3 percent reduction to Medicare reimbursement, but seven face reductions of more than 1 percent. They are: Milford Hospital (1.70 percent); Middlesex, in Middletown (1.38); Johnson Memorial, in Stafford Springs (1.27); Charlotte Hungerford, in Torrington (1.19); St.