The state’s top insurers were more likely to approve claims for mental health services in 2015 than the year before, but rates of rejection for residential care remained high, a new state report shows. About 6.4 percent of claims for mental health services were rejected by eight top managed care insurers – down from about 8 percent in 2014 – according to an analysis of the 2016 Consumer Report Card on Health Insurance Carriers in Connecticut. At the same time, insurers continued to deny more than one in six requests for residential behavioral health care. And the percentage of managed care plan enrollees who received any inpatient services for mental health was low, with most companies providing such services for fewer than 0.3 percent of all enrollees. The analysis is based on eight companies that reported the same categories of data in 2015 and 2016 to the state Insurance Department, which changed the reporting format across the two years.
State officials and parent advocates gave different versions Tuesday of how often, and why, the Department of Children and Families (DCF) takes custody of children with severe behavioral health problems – and whether the practice should continue. Advocates, including a group of adoptive parents, told the legislature’s Committee on Children that a proposed bill that would prohibit DCF from “requesting, recommending or requiring” that parents relinquish their custodial rights when seeking mental health treatment for their children is needed to stop a practice known as ‘trading custody for care.’ The bill, drafted by state Rep. Rosa Rebimbas, R-Naugatuck, was prompted by an October C-HIT story that described DCF’s use of “uncared for” custody petitions against parents who could not manage their children at home and insisted on specialized residential care. In testimony Tuesday, DCF Commissioner Joette Katz said the agency resorts to taking over custody only in rare cases in which parents refuse to take their children home from inpatient settings or “will not cooperate” with clinician-recommended in-home or community-based treatment services. “We disagree with the notion that DCF requires parents to completely relinquish custody of their children” to receive suitable behavioral health care, Katz said. She acknowledged that the agency has sharply reduced the number of children it places in residential treatment.
A federal judge has agreed to a six-month delay in sentencing a Derby nurse who pleaded guilty to accepting kickbacks in exchange for prescribing a powerful opioid painkiller because she is cooperating in “numerous ongoing criminal investigations,” according to court records. U.S. District Judge Michael Shea approved a Jan. 17 agreement between federal prosecutors and attorneys for Heather Alfonso that delays her sentencing another six months, until July 2017. Alfonso was charged in June 2015 with accepting $83,000 in kickbacks from Insys Therapeutics in exchange for her high prescribing of the drug Subsys. In arguing for the new sentencing delay, the U.S. attorney’s office in Connecticut said Alfonso “continues to cooperate in (investigations in) several federal and state jurisdictions, including the District of Connecticut.” A previous story by C-HIT reported on prior sentencing delays because she was cooperating in an ongoing federal probe.
The state Board of Examiners for Nursing on Wednesday disciplined three nurses, including one who dealt in anabolic steroids. In the steroid case, the board fined RN Michael Mase of New Milford $3,000 and placed his license on probation for a year. He has said he started using steroids in connection with power lifting and that he bought them for his own use and to share with friends, records show. In 2015, he pleaded guilty to one count of conspiracy to distribute and intent to sell steroids, records show, and is now on criminal probation through 2018. Under the consent order he signed with the nursing board, Mase must undergo random drug tests but he can stay employed as an independent contractor with Vivacity Life Center in Stamford.
The state Medical Examining Board disciplined four doctors on Tuesday, including fining a Stonington doctor $8,000 for failing to provide adequate follow-up care for a patient who later died of cancer. Dr. David Burchenal of Stonington was also reprimanded and placed on three years of probation under a consent order approved by the board. During the probation, Burchenal must hire a physician to randomly review his patient records and must take a course in assessing urinary tract disorders. In November, the board had rejected a $3,000 fine against Burchenal, with some members saying they wanted a stiffer penalty. Burchenal failed to follow up on test results that showed his patient, George A. Ruffo, had abnormally high red blood cell counts in 2011 and 2012, state records show.
In an unusual move, the FBI is reaching out publicly to patients who were prescribed the powerful narcotic medication Subsys, which federal agents allege was improperly dispensed by practitioners across the country, including a nurse in Derby. In a posting on its Victim Assistance Program website, the FBI asks people who were prescribed Subsys between March 2012 and December 2016 to complete a brief questionnaire that will assist in a federal probe of Insys Therapeutics, the company that makes Subsys. The appeal follows the indictments in December of six top executives and managers of Insys on charges they led a nationwide conspiracy to bribe doctors and nurses to prescribe Subsys, which is approved for treating cancer patients suffering episodes of breakthrough pain. In exchange for bribes and kickbacks, the practitioners wrote large numbers of prescriptions for patients, most of whom were not diagnosed with cancer, the indictments allege. One of the practitioners named in the indictments is Heather Alfonso, formerly an advanced practice registered nurse (APRN) at the Comprehensive Pain and Headache Treatment Center in Derby. She has pleaded guilty to accepting kickbacks from Insys through a sham “speakers’ program,” in exchange for prescribing Subsys.
Nearly half of Connecticut hospitals – 14 out of 31 – will lose a portion of their Medicare payments in 2017 as a penalty for having too many patients who acquired preventable infections and injuries while hospitalized. The hospitals are among 769 nationwide that will lose one percent of their Medicare reimbursements this year as part of the Centers for Medicare and Medicaid Services’ (CMS) Hospital-Acquired Condition Reduction Program. The CMS program, now in its third year, penalizes the lowest-performing hospitals where a relatively high number of patients got infections from hysterectomies, colon surgeries, urinary tract catheters and central line tubes. It also takes into account patients who suffered from blood clots, bed sores or falls while hospitalized. New this year, CMS also factored in the incidents where antibiotic-resistant bacteria – namely, methicillin-resistant staphylococcus aureus (MRSA) and Clostridium difficile (C.
The state Department of Public Health has fined five nursing homes for various violations, including two in which residents went missing. Blair Manor in Enfield was fined $3,000 after a resident with dementia and neurocognitive disorder left the facility. Staff noticed the resident was missing around 7:20 p.m. on Oct. 4, 2016. According to the Department of Public Health (DPH) citation, earlier that day five staff members separately witnessed the resident saying he was going to leave the facility and packing his belongings, but none reported it to their supervisors.
When Clinton resident Austin Haughwout uploaded YouTube videos of his pistol and flamethrower-equipped drones last year, he triggered a national debate over the use of weaponized drones that is expected to result in new state legislation. Eight states, including Vermont and Maine, now have laws prohibiting or limiting the weaponization of drones, and Connecticut is expected to take up a similar ban in the next legislative session. A proposal in Connecticut to make it a felony to carry a weapon or an explosive in a drone was approved by the House during the 2016 legislative session, but the Senate failed to take action. “Hopefully, next year, we will get the legislation across the finish line,” said Rep. Stephen Dargan, D-West Haven, co-chair of the legislature’s Public Safety and Security Committee. Nationally, there were 632,068 drones registered as of December, according to Alison Duquette, a spokeswoman for the Federal Aviation Administration (FAA).
The state Board of Examiners for Nursing disciplined six nurses this week, including several cases of nurses who abused drugs or alcohol. On Wednesday, the board revoked the license of Michelle Murphy, a registered nurse from Longmeadow, Massachusetts, for violating an earlier probation by not submitting drug test results to the state Department of Public Health, records show. In April, the board had placed her on probation for two years based on findings that she took the painkillers fentanyl and Dilaudid for her own use and abused controlled substances to excess, records show. The board also revoked the license of licensed practical nurse Adam Burr of New Britain, who was intoxicated while working for PSA Healthcare of Plainville doing care in a patient’s home, state records show. The board found that Burr’s abuse of alcohol and an emotional disorder or mental illness he has suffered from since 2013 were affecting his ability to practice nursing.