Attorney General Abbott Seeks
to Recover Taxpayer Dollars Taken in Medicaid Scheme
Sandoz, Mylan, Teva and subsidiaries accused
of falsely pricing Medicaid-covered drugs
AUSTIN - Texas Attorney General Greg Abbott in June charged three major pharmaceutical companies and their subsidiaries with defrauding the taxpayer-funded Medicaid system of tens of millions of dollars.
Defendants named in the Attorney General's petition are:
• Mylan Laboratories Inc. of Pennsylvania (with national subsidiaries Mylan Pharmaceuticals Inc. and UDL Laboratories Inc.)
• Sandoz Inc. of New Jersey (with subsidiaries Geneva Pharmaceuticals Inc., Novartis Pharmaceuticals Inc., Eon Labs and Apothecon Inc.)
• Teva Pharmaceuticals Inc. of Pennsylvania (with subsidiaries Lemmon Pharmaceuticals Inc., Copley Pharmaceuticals Inc. Ivax Pharmaceuticals Inc., Sicor Pharmaceuticals Inc., Teva Novopharm Inc. and Teva Pharmaceutical Industries, Ltd.)
"Texas taxpayers will not tolerate the abuse of our Medicaid system and those who depend on it for their health care," said Attorney General Abbott. "The Office of the Attorney General will crack down on anyone who schemes to evade the law and profit from defrauding the Medicaid program."
In order for pharmaceutical products to be eligible for Medicaid reimbursement, Texas law requires that manufacturers accurately report generally and currently available market prices to the Medicaid program.
According to the Attorney General's law enforcement action, the defendants sold hundreds of Medicaid-covered drugs at steeply discounted prices to large companies such as Wal-Mart, CVS Pharmacy and Walgreens, but defendants failed to provide the same pricing information to the Medicaid program. As a result, state officials were misled about current market prices for the drugs. When Wal-Mart and others sought Medicaid reimbursement for these drugs, the false price reports led the Medicaid program to unnecessarily spend millions of taxpayer dollars on the defendants' products. Thus, Medicaid reimbursed at significantly higher rates than the discounted rates already established between the defendants and these retailers. The scheme was brought to the Attorney General's attention by Ven-a-Care of the Florida Keys Inc., an industry whistleblower.
Today's legal action reflects Attorney General Abbott's continuing commitment to crack down on waste, fraud and abuse in the Medicaid system. In 2005 alone, the Texas Medicaid program cost more than $17 billion. To save taxpayer dollars, Attorney General Abbott has dramatically expanded both the Civil Medicaid Fraud Section and the Medicaid Fraud Control Unit. Since Attorney General Abbott took office, the civil and criminal Medicaid fraud sections have recovered almost $190 million.
Ramamurthy appointed
to ECFMG Board
Rajam Ramamurthy, MD, who served as BCMS president in 2004, was appointed to the Educational Council for Foreign Medical Graduates (ECFMG) Board to hold one of two positions held by the American Medi-cal Association (AMA).
"I hope to bring a global perspective to health education, which is in keeping with the programs of the ECFMG," Ramamurthy said.
Dr. Ramamurthy is the William and Rita Head Distinguished Chair in Developmental and Environmental Neonatology in the department of pediatrics and is the medical director of the Premature Infant Development (PREMIEre) Program.
She chaired the Texas Medical Association (TMA) International Medical Graduates (IMG) Section in 2000 and the AMA IMG Section in 2004. She compiled the first report on IMG's in the U.S. Physician Workforce, which is now updated annually by the AMA IMG Section. She also serves on the TMA Council on Medical Education.
The ECFMG Board is a national organization made of representatives from the Association of American Medical Colleges, American Board of Medical Specialties, AMA, Association of Hospital Medical Education, Federa-tion of State Medical Boards and the National Medical Association.
Through its program of certification, ECFMG assesses the readiness of international medical graduates to enter residency or fellowship programs in the United States that are accredited by the Accreditation Council for Graduate Medical Education (ACGME). Another aspect of the ECFMG is the Foundation for Advancement of International Medical Education and Research, which actively seeks opportunities to promote international medical education through programmatic and research activities.
As early as the 1940s, legislation facilitated entry into the United States by foreign trained physicians. In the 1950s the need for a formal program of evaluation of foreign medical graduates intensified due to the explosive demand for health care services in the United States and the greater dependence on physicians in training to provide medical care. In 1956, with the help of the National Board of Medical Examiners, a medical science and English proficiency exam was developed and in 1958 the exam was administered for the first time by ECFMG in 17 centers internationally. In 2006 the ACGME accredited 8,186 programs in 120 specialties that trained 103,367 residents. Twenty-four percent of resident physicians are international medical graduates. ECFMG has served the health care needs of United States and has helped health education globally.
Governor Signs Texas' First Needle Exchange Bill into Law
Pilot Program Set to Begin in Bexar County on Sept. 1, 2007
AUSTIN -
Governor Rick Perry signed a Medicaid reform bill (SB 10) into law, which includes a provision authorizing the first legal needle exchange program in Texas. The new law brings Texas up to date with most other states in the nation by starting a safe, legal needle exchange pilot program in Bexar County this fall.
"The public health and safety of Texas requires that we offer public health programs that prevent the spread of infectious diseases. Fiscal responsibility also requires that preventive programs be made available, and this is just one way that we can begin to curb the spread of hepatitis and HIV in geometric proportions. I am pleased that we can begin this process with a pilot program in Bexar County," said Rep. Ruth Jones McClendon, who sponsored the provision and represents part of San Antonio and Bexar County.
This year, Sen. Robert Deuell and Rep. McClendon teamed up to sponsor SB308/HB 856, which was originally proposed to authorize needle exchange programs statewide. The bill passed through the Senate, but appeared to die in the House Public Health Committee when the Chair did not call for the committee's vote. Rep. McClendon resurrected the concept by attaching an amendment to the Medicaid bill. Her amendment allows the health authorities in Bexar County to design and operate the program, which is expected to reduce disease and improve outreach to injection drug users.
Disease prevention is the goal of most needle exchange programs, but they also provide an opportunity to connect addicts to treatment.
After filing the bill, Sen. Deuell said, "The local health authorities who administer these programs may also provide drug counseling and treatment. This might be the only time we can get to these people and give them the opportunity to rehabilitate themselves. One study showed more than 1,000 drug users found their way into treatment through a needle exchange program."
San Antonio has a history of strong and outspoken support for needle exchange.
Rep. McClendon said, "In particular, we especially appreciate the encouragement received from Judge Nelson Wolff, Sheriff Ralph Lopez, Dr. Fernando Guerra of San Antonio Metro Health and other local foundations and healthcare organizations. This pilot program is bound to be successful."
Rep. Garnet F. Coleman, who sponsored needle exchange legislation in years past added, "After working on this issue for two sessions, now we have a state-sanctioned opportunity to save lives through needle exchange. Hopefully this pilot program will lead to legislation next session that sets up needle exchange programs statewide."
"Needle exchange has become a standard disease prevention practice around the country, and we commend Rep. McClendon, Sen. Deuell and the rest of the legislators who worked hard to bring this important public policy measure to Texas," said Tracey Hayes, Director of the Access Project at the ACLU of Texas.
BCMS Joins Border
Health Caucus
By Karen Littleton
The Bexar County Medical Society has formally announced its participation with the Texas Border Health Caucus.
The Border Health Caucus (BHC) is a united partnership representing more than 9,000 members, composed of county medical societies from throughout the border region and further north to Bexar and Nueces county medical societies.
The primary goal of BHC is to
communicate a unified message about state and federal legislative and regulatory issues affecting physicians, especially along the border.
San Antonio Metropolitan Health Director, Fernando Guerra, MD said, "The Society's participation with
the Border Health Caucus underscores Bexar County's central location, and how the BCMS can help physicians communicate throughout the state."
BCMS CEO Stephen Fitzer said, "By participating with the BHC, issues of common concern to physicians in the combined regions can be brought to Texas legislators with a stronger voice."
As new members of the caucus, BCMS member physicians are invited to participate in upcoming BHC activities including in September, 2007 the Second Annual Border Health Conference in Washington, D.C. - where the first 30 physicians to sign up will receive a $1,000 stipend.
Slated for spring 2008
The BCH will begin its Preceptor Program for state elected officials in El Paso, Laredo and McAllen. In this program, legislators will shadow doctors along the border to see for themselves what areas of concern the physicians encounter on a daily basis.
Because the BHC is sponsored by the Texas Medical Association, BCMS member physicians who choose to participate in BHC initiatives and activities can do so without paying dues or membership fees.
Physicians interested in learning more about the BHC can visit the TMA website at www.texmed.org and click the "Related Organizations" bar at the top of the page.
Governor Signs
HB 3618 into Law
Texas-Mexico
Border Diabetes & Obesity Prevention Bill
The highest diabetes rates in the U.S. occur along the Texas-Mexico border.
HB 3618 places an evidence-based diabetes prevention program in school districts that are situated in contiguous counties along the Texas-Mexico border with populations less than 600,000. In addition, all program materials must be bilingual and culturally appropriate.
HB 3618 also states that measure-ments of height, weight, and blood glucose be taken at the beginning of the school year and at another appropriate time during implementation of the
program to determine effectiveness.
The Bienestar coordinated school health program will be used as the intervention as it is both culturally and medically appropriate for the region. Bien-estar is the only school-based diabetes and obesity prevention program in the U.S. proven to decrease blood glucose, increase dietary fiber intake, and in-crease physical fitness levels in children.
For more information, contact David Saldana at 1-866-676-7472 or
by e-mail atdsaldana@sahrc.org.
New Law Requires Electronic Death Certificate Filing
Starting Sept. 1, physicians who have renewed their license electronically before that date must use the Texas Electronic Registrar-Death Registration system to certify and/or file death certificates for patients who have died while in their care.
Physicians who do not renew their licenses electronically before Sept. 1, 2007, do not have to comply with the law until Sept. 1, 2008.
The requirement is part of House Bill 1739 passed by the last session of the legislature and signed by the governor in June. The bill also applies to funeral homes.
The bill's sponsors say it will make the death reporting system more efficient and accurate, and also may eliminate delays in postmortem legal proceedings such as settling estates, accessing the deceased's accounts, and collecting insurance claims.
