(NEWSER) – For nearly his entire life, a 29-year-old man living in the United Kingdom has had the polio virus living in his gut—where the strain has mutated from the weakened form he received in a vaccine as an infant to a much more virulent strain, according to a study published in PLOS Pathogens. It’s a case that NPR sees as “a worrisome new development in the polio end-game.” Live Science and the Guardian report the man was given an oral form of the polio vaccine at 5, 7, and 12 months. Unlike the injectable version, the oral vaccine uses a live virus that’s typically excised from the child’s gut within two months. But the man had an immune disorder that killed his gut’s ability to kill the virus. And so it has lingered there, and in his stool: More than 100 samples taken over the past 20 years have returned significant levels of what had become a mutated virus.
Note to Healthcare providers. It can create liability if you provide your services in another country while claiming to provide those services in the United States.
This may seem obvious, but apparently it was not so obvious to Dr. Santiago B. Montoya and his son Rodney. Dr. Montoya is going to serve a four year prison sentence.
The Montoyas ran a health clinic in Managua, the capital of Nicaragua. They worked with Florida Health Care Plus, which had 1,000 Miami area expatriate patients enrolled and claimed to provide healthcare services to the patients under Medicare Advantage plans.
The scheme without borders broke Medicare laws because the federal insurance program for the elderly and disabled does not allow coverage of beneficiaries’ claims if they are receiving the services in a foreign country.
DC Whistleblower Lawyer Tony Munter mused, “The Miami Herald Article makes me want to know so much more. I have so many questions, like how did the government learn about this? Is a whistleblower responsible, and if so, did that whistleblower get any kind of reward for shutting down this scam?”
It says something about the state of health care fraud in the U.S. that the Judge felt it necessary to be slightly lenient to the Montoya’s on the theory that at least they actually provided some healthcare, even if that care was in Nicaragua and not in Miami. The scam even extended to include a clinic in the Dominican Republic.
It’s a little unusual for cases involving Medicare fraud to involve prison sentences for the people committing the fraud, but nonetheless, the Department of Justice has the authority to prosecute individuals as criminals.
The Herald Reported that the company funding these operations received about $10.5 million in government payments for illegally treating the beneficiaries in Nicaragua and the Dominican Republic.
An amazing doctor, writer and human being is gone:
Oliver Sacks, the world-renowned neurologist and author who chronicled maladies and ennobled the afflicted in books that were regarded as masterpieces of medical literature, died Aug. 30 at his home in Manhattan. He was 82.
Dr. Sacks — whom millions knew as the physician played by actor Robin Williams in the 1990 film “Awakenings” — revealed in February that he had terminal cancer. A rare and long-ago-treated ocular tumor had metastasized to his liver, he wrote in the New York Times, which was one of several publications, along with the New Yorker magazine and the New York Review of Books, that printed his writings over the years.
His death was confirmed by his longtime assistant, Kate Edgar.
An Englishman who made his life in America, Dr. Sacks devoted his career to patients with rare, seemingly hopeless conditions of the nervous system. He distinguished himself both in the clinic and on the printed page and was often called a “poet laureate” of modern medicine.
His books, many of which were bestsellers, generally took the form of clinical anecdotes. A man who mistakes his wife for a hat, an artist who can no longer see in color, a hospital full of patients gloriously, but fleetingly, “awakened” from years-long catatonia: In each case, Dr. Sacks sought to uncover some wisdom, medical or moral.