Thursday, September 15, 2011

Ride The Lightening

As Metallica rings in the background, one must ask the question, for whom does the bell toll?  Screw one of our readers who constantly bitches and complains about the use of lyrics and metaphors on our blog.  As James Hetfield of Metallica belts out;

For a hill men would kill, why?  They do not know, stiffened wounds test their pride
Men of five still alive through the raging glow gone insane from the pain that they surely know
For whom the bell tolls, marches on....................

Well fellow bloggers, could this be the beginning of the end for POD's?  As Hemingway wrote in his masterpiece "For Whom the Bell Tolls, the Scripps and Sharp's Hospital Systems have ordered the demolition of a bridge that links POD guerillas to the our own very existence?  Contrary to some madman's insinuations, TSB's sense of duty clashes with those whom call out their free market principles only to contradict themselves when it comes to their own survival.

Today, it was announced at the Sharp's Hospital Systems that no longer, yes fellow bloggers, no longer will Sharp's allow anyone involved in a POD to do business with their hospitals.  Just like Scripps the gauntlet has been laid down. In addition to laying out this mandate, the word on the Street is that Phygen is Persona Non Grata.

As for the Scripps and Sharps Hospital mandate, you know what Jim Morrision once said, "This is the End my Friend, Beautiful Friend."

57 comments:

  1. I heard from a Phygen member that all the surgeons were asked to put in more money. One of the docs hit reply all and simply wrote "F$ck! This will surely add to their pain. I guess the spine business is not as easy as they thought.

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  2. Can I get an amen from the congregation! Let's keep the mojo headed in that direction.

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  3. It's another night in hell, another child won't live to tell, can you imagine what its like to starve to death, as we sit free and well, another soldier has to yell, Tell my wife and children that I love them to death, C'mon now AMEN BROTHERS

    Kid Rock

    Rock On TSB

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  4. . . . And justice for all.

    Kill'em all, these Masters of Puppets

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  5. Good news from TSB, yet still tainted by an ineffective jab to his conservative readers. C'mon TSB, whats the purpose or relevance of free marketeers to this short entry?

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  6. what does persono non grata mean ?

    also, does anyone have a good website to spine instruments to purchase online ?
    please help!!

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  7. Does anyone have a copy of the Sharp document banning POD participation?

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  8. Has Grassley, et all came out with a statement yet? A surgeon friend of mine thought they released a statement/ruled on PODS and that they were legit, I told him I must have missed that.... Anyone? Anything formal been released brom Big Brother?

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  9. How was it announced? Link?

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  10. POD docs will simply take their business to shady little surgery centers. Kind of like cockroaches scurrying out of the light.

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  11. Big brother has not broken his silence yet. I'll give 10:1 odds that TSB's blog will post the findings within 2 hours of any announcement. Or, if the announcement has a negative position on PODSs you can just watch the stock ticker for AlphaPod and look for the 50% drop and assume the DOJ has spoken.

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  12. 5:20AM

    www.friedrich-daniels.com

    Quick, flexible, customer driven surgical instrumentation manufacturer.

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  13. Persona non grata (Latin, plural: personae non gratae), literally meaning "an unwelcome person", is a legal term used in diplomacy that indicates a proscription against a person entering the country. It is the most serious form of censure which one country can apply to foreign diplomats, who are otherwise protected by diplomatic immunity from arrest and other normal kinds of prosecution.

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  14. 7:44 - well done, kudos!!!

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  15. where can we find the confirmation?

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  16. 5:20 must be from another planet--one where there is no such thing as Google--and 7:44 just perpetuates this type of comment

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  17. 7:44 is cut and past from Wiki. Get over yourself 10:08

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  18. TSB finally something worth reading. POD new 3 letter word...RIP.

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  19. You misspelled "lightning".

    --The Spelling Nazi

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  20. Non-spine person here (other medical device). POD means what? I'm guessing physician owned xxxxx?

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  21. Physician Owned Dildo ... Or is that the rep covering the POD cases?

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  22. BBQ gone wrong? http://manchester.patch.com/articles/fire-heavily-damages-historic-cheney-mansion

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  23. physician owned distributorship

    http://online.wsj.com/article/SB10001424052702304778304576373592455703056.html

    http://physicianlaw.foxrothschild.com/2011/06/articles/fraud-and-abuse/physician-owned-device-distributorships-under-scrutiny/

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  24. And they'll tell you black is really white
    The moon is just the sun at night
    And when you walk in golden halls
    You get to keep the gold that falls
    It's Heaven and Hell

    RIP RJD

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  25. PODs will be fine. CMS just released their response back to 5 Senators and it sure sounds like it will be a while before they figure out if these arrangements are good for healthcare or not. All arrangements will be looked at individually so looks like you POD haters will have to continue to watch your arses get kicked! Come on TSB, post the letter from CMS before someone else beats you to the punch.

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  26. 8:48 obviously you are either a POD surgeon or an Alphatec rep. So... until you learn to either be a real surgeon or a real rep please refrain from posting on the TSB's Blog. Thank you, from the people who actually work for their money.

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  27. Monty Hall thanks for volunteering that information, you must be an Alphatec distributor.

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  28. 3:18

    More likely he started the fire to collect the insurance money!

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  29. 8:48 obviously these "arrangements" are not saving hospitals money or the Scripps and Sharp systems would not have kicked them out.

    I love talking to surgeons that are part of Phygen and still want a development deal, consulting etc. Don't they realize that they are blacklisting themselves? Why would any company get them involved in anything?

    So...POD doctors, the industry knows who you are. As pricing goes down and the companies that supply you fail or get purchased don't be upset when you call your Medtronic, Depuy, Stryker reps back into your cases, and all they have to offer is good products and service for you and your patients.

    I have targeted POD members referral base in my area and have had very good success. I moved 2 busy chiropracor referrals to a surgeon I work with that used to go to a Phygen member. It was funny to hear the chiro complain that he never got his patients back and how greedy the surgeon was.

    I could care less about PODs; business is about adapting to the market. I would like to hear how others are adapting to the changing market.

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  30. Folks,

    Berwick and CMS responded back August 10th, and the OIG has produced their interim response earlier this week on the 13th. CMS wants to make their OWN decision and not be instructed by any one party, so they will respond regarding PODs and the Sunshine Act after further "review" of the responses. However, they will be adding PODs to the Sunshine Act when they formally respond. The public disclosure of the financials of the PODs will add further interest into this direct and unavoidable conflict of interest.

    Daniel Levinson and the OIG responded formally this week on Tuesday, stating that they will be investigating PODs and the hospitals that partner with these entities, the structure of those relationships, and the financial impacts, on a national scale, to determine further OIG interest in the issuance of any further guidance document.

    They close the response by re-stating their commitment to this effort by siting the United Shockwave Settlement Agreement, as a snapshot of things to come, when the OIG is engaged.

    Also of note, the DOJ has taken notice as well, and is involved in their own process of engagement. You will not have a chance to review those details until after either the settlements, or court dates, due to the nature of their investigations.

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  31. Good synopsis 10:24

    Here is the response from the 13th of this month for everyone's perusal...

    http://finance.senate.gov/newsroom/ranking/download/?id=eceb4bb0-c3da-4449-b8b3-d5715c63ef4e

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  32. TSB - since you can't stand Medtronic or Robin Young, what are your thoughts on his article outing the "swiss cheese ness" of The Spine Journal Infuse edition?

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  33. POD Haters...
    If the OIG thought that there was enough evidence of wrong doing then they would have made a much bolder stance. Just accept the fact that your "wishful thinking" to get back in the OR with the surgeon that dumped you may never happen....make up what you want from the CMS response...just sayin...getieup Cowboy!

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  34. Do you dumbasses really think that any Alphatec rep or distributor is part of a POD? When they sell product at wholesale to the POD, there is no distributor or rep involved. The transaction involves an order from the POD and ATEC simply ships the product and bills for it. If a POD starts up in a hospital, the distributor for that area gets cut out. That hospital gets removed from the distributors territory.

    The whole point of a POD is to cut out the distributor and the rep. And that includes ATEC distributors and reps.

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  35. meanwhile in Huntsville, AL ... the spine patients have no idea how many ways their neuro and ortho spine surgeons profit off these procedures. Long live PDP and SpinalUSA. f'n whores. Pretty funny when some of the SpinalUSA guys want to spread the business around it goes to .... wait for it ... PDP. I'm guessing some money changes hands at the country club!!

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  36. Who in the world is PDP?? That name sounds like a laxative...where else are they besides Huntsville?

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  37. Rumor has it that the WSJ I parked in Mobile, AL and Huntsville, AL. Get ready to get exposed Dr. West & friends and Dr. Morris Seymour & Co - free press isn't always good!

    The truth will come out!

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  38. Should say "WSJ is parked..."

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  39. 8:17pm, you are WRONG!

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  40. There r two 817s and they r both wrong

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  41. What is hilarious is that now that the PODs have brought everyone down to whore pricing, the hospitals are now suddenly "too ethical to work with PODs." Wonder if they passed on those screw-price savings to the patients? Why sure they did! Welcome to the real world POD boys, or should I say goodbye? Live by the sword, die by the sword, and good riddance.

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  42. "If you have further thoughts or questions, please call me or have your staff call Chris Hinkle, Director of Congressional and Regulatory Affairs, at (202) 401-2206 or christina.hinkle@oig.hhs.gov"

    I guess we should share the facts with the government. Here is a terrific avenue to do just that.

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  43. TSB

    You seem to be very passionate about this subject. Can you please start a new blog with the contact information of the OIG person as the title?

    thanks
    tb

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  44. PDP is just a surgeon owned distribution group based in Nashville with surgeon owners in Huntsville, AL, Mobile, AL to name a few cities. Alphatec and Spinal Elements are PDP's main suppliers. PDP has a few case coverage bitches fronting as "sales reps" shuttling sets around.

    Ken Horton (NuTech - Birmingham, AL) formed a "PDP like" POD that purchases their implants from SpinalUSA. Rumor has it he has 25-30 surgeons, throughout the Southeast but mainly based in Alabama.

    Funny that BCBS of Alabama has turned a blind eye to all of the revision surgeries their patients need because of failed implants.

    Truly tragic. Looking forward to the WSJ article and then the local news media asking these surgeons and BCBS of AL some tough questions.

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  45. POD's in Northern Cali are just as bad, if not worse. We have a few of these "surgeons" here in the Sac/Alameda Counties.

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  46. Sounds like the OIG will perhaps (I doubt they will) investigate certain areas of high volume hospitals that do CMS surgeries and utilize POD's as vendors.

    I personally would not want to be the hospital purchasing director or Compliance Officer when interviewed by Big Brother. Well sir, Dr. X told us they would take all of their business to a different hospital. That's an easy 50 million payout for the government.

    They could plan a nice little trip south for the fall. Spend a week in Huntsville, Mobile, Chattanooga. Spinal USA, PDP, Phygen- it's all the same gear with different people getting paid. Good thing for the government these surgeons are the busiest in each area. Interesting how greed goes hand in hand.

    Hey Mr. OIG- looking where to investigate- look for the busiest spine surgeon in each area. Odds are quite high the highest billers are the POD guys. So these guys are not only hitting you with unneeded 100K surgeries but also lining their own pockets with the PO the hospital cuts to the surgeon. Put them behind bars and you will have your savings. If I was the hospital I would pay the surgeon directly rather than cutting a PO to some fake LLC. Heck- wouldn't need a POD admin person- eliminating costs right??

    Nice website PDP, for some reason many of the tabs are under construction, the about us tab, the physicians tab, the manufacturers tab- please let us know when you get it up and running. Nice description of the "PDP Model." Now that everything is the same price- they mention reps upsell in the OR. What they mean is the PDP reps that used to work for other companies used to upsell because they had no business and the rare case they were in they were forced to upsell. We're not all blessed to have married into the family of the biggest cutters in the southeast.

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  47. FOUNDED IN MISSISSIPPI!

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  48. My favorite part of the PDP website is the term "Muculoskeletal Care" in the tagline. They clearly hire only the most brilliant people.

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  49. Horton and the lizard skin boots at it again!!

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  50. According to Fox Sports' Jay Glazer, Peyton Manning went to Europe sometime before his most recent neck injury to receive "stem cell therapy". The article does not state exactly what type of "stem cell therapy" he received, but it does, however, imply that the season ending neck surgery that he just underwent last week was actually a revision of the same level previously "treated" with said "stem cell therapy".

    This can't be good news for all of the folks out there touting stem cells as a miracle cure-all substance capable of curing just about any pathology a human spine can dish-out. The old saying, "any press is good press" certainly does not ring true in this situation. Sorry about your luck Mr. Young.

    Here's a link to the article on Yahoo!:
    http://sports.yahoo.com/nfl/news;_ylt=AiSOqY4.n9Z66J7fER2po2iLCpJ4?slug=nfp-20110918_manning_had_stem_cell_therapy_in_europe

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  51. 8:05

    You sound like a disillusioned POD surgeon with his fingers crossed.

    CMS is only discussing PODs as they relate to the Sunshine Act.

    OIG is taking a big step after positioning earlier about how all of the controls they need are in place etc... The OIG is now investigating PODs, whether you like it or not, whether you are convinced or not, or whether you deny it or not, they are now investigating PODs and the hospital's arrangement with them.

    The DOJ is already doing their thing without telling you about it step by step, because they don't have to.

    They have no need to inform you of what they are doing, before they do it. Call the guys behind United Shockwave, and ask your peers how much was known about them and how extensive the investigation was, before anyone bothered to call them.

    We will read all about you later.

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  52. The key element in the IG letter is investigating whether or not the actual conduct of the surgeon investors during implementation and operational phases. Also key will be the amount of revenue generated by the investors. Not many POD models, regardless of how they are set up, will pass these tests.

    1:02, I have called Chris Hinkle twice, with no response yet. I also met with the local OIG Fraud Investigator and he had never heard of a POD and never quite grasped the concept. Not exactly reassuring. I'm hoping the people up the chain are a bit more sentient.

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  53. Grammatically challengedSeptember 19, 2011 at 5:10 PM

    Drop "whether or not" above

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  54. Does anyone have a link to the CMS response letter? Please post.

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  55. OK, here you go...

    Both the response from OIG as well as from Don Berwick at CMS are listed as a PDF on the upper right hand side if you care to download them.

    http://finance.senate.gov/newsroom/ranking/release/?id=126c415e-f1a3-41e9-ab49-665a71188f1c

    Thanks Grammatically challenged. However, in this case the "whether or not" is inserted and repeatedly for emphasis for 8:05 to glean that he has no choice in the matter, as opposed to simply stating the facts at hand, which was not the intention of the response.

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