Thursday, February 9, 2012

California Dreamin'

As the late James Brown once sang,  Huuuuuuuuuuuuuuh!!!!!!!!

Super highways, Coast Coast to Coast
Doctors, Lawyers and Scam Artist are the Toast
Living in America, eye to eye station to station
Living in America hand to hand across the nation
Living in America got to have a celebration

Well TSB doesn't know why it took so long, but our friends at the WSJ, the bastion of capitalism, finally broke the story today entitled, " In Small California Hospitals, the Marketing of Back Surgery."  Yes Spine Nation, Mssrs. Carreyou, McGinty, and Millman had finally provided the public with an expose that was well, as Stephen Stills would say, "it's been a long time coming."  It seems that the Tri-City Regional Medical Center and Pacific Hospital have been singled out by the authorities as incubators rife with alleged corruption, involving doctors, lawyers, hospital administrators and former convicts.  Before we elaborate on this breaking story, has anyone ever wondered why people eventually get caught?  Well let's put it this way Tri-City billed workers' compensation insurers $65 million up from less than $3 million three years earlier.

The man behind the curtain helping incubate this business was one Paul Richard Randall a consultant to whom Tri-City had paid millions of dollars in marketing fees.  Here was his role;

  • Bring cases to the hospital by recruiting surgeons to operate there
  • Supply medical implants for the surgeries through distributorships he owned
By last August, the U.S. Attorney in Los Angeles had prepared a charge that if filed in court would accuse Mr. Randall of conspiring to inflate the cost of spinal hardware and use a portion of the proceeds to pay "kickbacks" to surgeons referring patients to Tri-City.  Mr. Randall's defense has been that he is just one of a dozen distributors who mark up the price of surgical hardware and "there's nothing illegal about what I'm doing, my lawyer tells me."  As for the alleged kickbacks, Randall was quoted as saying, "that's not true."  Just a word of advice to Mssr. Randall, "Quelle Horreur, you actually believe what your attorney tells you?"

The status of this investigation is unclear and no charges have been levied as of yet, by the U.S. Attorney in Los Angeles.

As for Tri-City, a hospital official stated that they ended their relationship with Mssr. Randall last year after it had outsted the executive who had hired him.  Based on public knowledge, an internal investigation is under way at Tri-City and that numerous "improprieties" have been found.  A lawyer conducting the internal inquiry said that the hospital did not know that Randall was inflating the cost of spinal-surgery hardware until late 2010, and it was never aware of any possible kickback to doctors.  Duh!!!!  As this expose unfolds one has to wonder whether those involved at Tri-City were living in the Twilight Zone.  TSB can hear Rod Serling, "The smoking gun leads to the shadowy tip of reality, you're on the through route to the land of the different, the bizarre, the unexplainable....go as far as you want on this word, this scam can go as far as you would like on this road, it's limits are only those of the mind itself."

Let's look at some facts.  California employers paid $7.1 billion in insurance premiums to cover workers' comp liability in '10.  Spinal surgery paid for 40% of these claims up from 30% in 2001. 

Mr. Randall, a 52 year old entrepreneur began his career as a hospital marketeer in the mid '90's after serving a brief stint in the Terminal Island Federal Correctional Facility in Long Beach Harbor, California.  Upon serving his time, he went into business with Michael D. Drobot, the owner of another small hospital near Tri-City called Pacific Hospital of Long Beach.  TSB is sure that a few of our readers have their own stories regarding Pacific.

For a decade, Mssrs. Randall and Drobot operated a business that arranged for MRI services. Randall introduced Drobot to doctors to increase spine surgery business at Pacific according to a person with knowledge of the arrangement.  As Mr. Drobot acknowledge through a spokesman, Randall introduced a "few" doctors.  Gotta love that "a few."

What is fascinating about this story is that finally someone has sunk their teeth into an industry that has been another of our industry's dirty little secrets and has become so lucrative that there are private equity investors, chiropractors, surgeons, lawyers, and middlemen scamming and conniving to take advantage of some poor and uneducated migrant worker all for the love of the Almighty Dollar.  The PEI's provide the necessary capital, the lawyers research the law to interpret potential legal violations, the surgeons do the dirty work, and the middleman, well let's just put it this way, they end up taking the fall when things start to unravel. But back to the story.

Mssr. Drobot created several businesses focused on workers' comp patients; 

  • A Van Service to shuttle patients back and forth
  • A provider of Spanish Interpretation
  • A distributorship of metal implants
Between 2001 and 2010 Pacific performed 5,138 spinal fusions, an average of 571 surgeries per year, and billed $533 million, which was three times as much as any other hospital in the state, including much larger facilities.  As usual a business dispute between the two men resulted in Mssr. Randall moving to Tri-City. As a business consultant at Tri-City, Mssr. Randall was paid $3.2 million between 2008 and 2011 as a business development consultant.  Randall obviously understood how to play the game, acting as a distributor, his distributorship would purchase hardware and resell it to Tri-City.  So here is the legal catch, California's WC Division permits hospitals to bill separately for spinal implants, rather than include their cost in the overall charge for surgery, as in the case of Medicare and Medicaid.  Since the California WC Division doesn't put a limit on how much a distributor may mark up the cost of implants when it sells them to a hospital, it does restrict how much a hospital may mark up its own implant cost when it bills an insurance company.

Mssr. Randall's distributorship imposed some steep markups, invoices revealed.  Invoices for 16 spine surgeries at Tri-City between July 2010 and March 2011 for which suppliers charged Mssr. Randall's distributors $326,000, while his distributors in turn charged the hospital $1.1 million, nearly a 400% markup.  Here's where people start to get greedy and rockets red glare while bomb's burst in thin air, in 2010 Randall submitted an invoice for $42, 467 for hardware used in surgery that was purchased at a price of $3,600.  Could it be that Mr. Randall was inflating the cost of his implants to pay chiropractors and physicians kickbacks of approximately $15-$20,000 per case?  By August of 2011 , the federal prosecutors had prepared a proposed pleas agreement for Mssr. Randall, as of this expose, he has not signed it.

Today, Tri-City has initiated policies that include requiring vendors to attest that they comply with all applicable laws and regulations.  In addition, a legal spokesperson for the hospital is examining some "highly questionable transactions" that a former chief executive "caused the hospital to enter into with third party vendors."  The former CEO Arthur Gerrick was removed from this position for misconduct, according to the hospital's general counsel, Beryl Weiner.  Weiner ended Tri-City's relationship with Mr. Randall last summer after receiving an anonymous letter that described his criminal past.

As this story continues to unfold many questions need to be answered. The first question is how does a hospital sign a business development consultant and not run a mandatory background check?  What type of surgeon operates at a facility that mandates use of products that the owner of the hospital distributes?  How does an assisting surgeon make a statement that the outcome had nothing to do with the surgery?  Dipshit, if the patient didn't have the surgery, the patient probably wouldn't have died. What, did the product kill the patient?  Or, did poor surgical judgement?  The reason you go to medical school is to use your education as a guide to make prudent operative decisions.  

TSB could hear the outcry, you socialist, you are anti-business, you don't understand free markets, but here's the reality, let alone the scrutiny that Carreyou, McGinty, and Millman will receive.  Each and everyone of you that works in this industry in sales and wakes up in the morning to provide a better life for you and your family, must be angry.  You should out these people given every opportunity that you get.  This is why delivering healthcare in this country has become nothing more than a free for all.  Lawyers, Chiropractors, Surgeons, Hospital Administrators, and Middlemen attempting to stay one-step ahead of the law, while they abuse the system for nothing more than financial gain, and take advantage of poor uneducated people.  As for the migrant workers' family, they should sue the ass off these surgeons, the hospital, the hospital CEO, the hospital attorney for incompetence because it is easier to look the other way than confront the problem head on.  TSB wants to know what my comrades in the Long Beach area think? Let us know your experience with Tri-City and Long Beach, because we are sure that if there are a dozen distributors like Mssr. Randall, there are quite a few hospitals along the Coast that are involved in these types of deals. As the O'Jays use to sing;

Money, money, money, some people got to have it
Hey, hey, hey, some people really need it
Hey listen to me, y'all do thangs, do thangs bad thangs with it.
For the love of money people will steal from their mother, their brother

244 comments:

  1. Any mention who the surgeon are? Or what implants/companies were used?

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    1. The surgeon did his job . He has never been involved in taking money for cases nor does he own a financial interest in anything. Bills only insurers for cases performed by his own compensation. no one else nor is mandated hardware use acceptable to him. This was the wrong patient to use as an example- hospital chart will bear that out. Perhaps these arrangements are legal? They should not be. But in this case the surgeon chooses only the hardware he feels will providie the best patient outcome. Further the "migrant workers" travel far because rural health care is substandard. This surgeon is concerned with well being of these. patients not financial gain and done very much for them. This is not to negate the problem which is all this nonsense . How about we dump competent people into jobs where these kinds of things are eliminated? Why not cut the trillion dollars needed in Medi-Care from the program by fraud elimination rather than cutting services. No different here-, insurers eliminatevall the bad guys and pay only legit- after they make this not legit?

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    2. Randall and Drobots and cronies ( including hospitals, dc's lawyers, and some MD's) are the crooks. Hospitals and everyone else should stop this immediately! While might be technically legal, reeks of conflict and lack of integrity! These people will never change- until outlawed then just move spots around!. How sad have we become? This stuff is so persuasive it's disgusting ! This is why we can't afford health care!

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    3. Lets get the facts straight once and for all about the implants that Randall used. They were purchased first from Ted Spitzer who sold Spinal Elements and then they were purchased from Mike Davis. These are the cold hard facts and the invoices prove it. Randall was stealing cases from the guys in Temecula so they would never supply him with implants to steal cases they were planning on doing with their own inventory.

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    4. Randall didn't need to steal any cases they were his in the first place Williams was paying Randall 50k a month til Randall went into business for himself

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  2. The implants were Alphatec and SeaSpine. Drobot and Randall need to go to jail.

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    1. Why because they made money moron and u didnt

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    2. U need to go to dummies jail

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    3. Mic. McGrath the 25k month driver a month paid by tri to drive akmajian there every month is an interestin story too

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  3. PDP Spine in Nashville. You're next! Some surgeons in Mobile and Huntsville, AL are about to take a big fall. Even Bassett in Tuscaloosa. can't escape this one.

    Looking forward to the Bling Bling Horton exposé!

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  4. I'm shocked to hear Alphatec provided these implants! I believe that's a common thread with all of these WSJ & NYT exposes. (with the exception of SpineUSA)

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  5. Can you post the link to the article?

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  6. http://online.wsj.com/article/SB10001424052970204319004577088712149447348.html

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    1. Somehow my iPhone and iPad won't let me copy and paste... Time to write it down, lol.

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    2. this link only gives you the first few paragraphs, anyone have the full article? Would really like to read it.

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  7. As a surgeon trying to do things properly, this really pisses me off...I have enough trouble getting cases pre-certed. Likewise, California passes a law to outlaw a surgeon from implanting something that he either owns, or has invested in. They have thrown the baby out with the bath water!!!

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  8. If one remembers this company's legacy its former owner Roy there wasn't a situation I didn;t like micromanaging Yoshimi was a wheeler dealer, he liked Vegas way more than he loved his company, sad but the legacy continues.

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  9. Surgeons, Implants companies, assisting surgeons, surg tech, all involved in these surgeries should be listed in this story....it'a all about money and not the patients.

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  10. Alphatec is in the middle of all POD's and implant scams. They claim they are doing nothing wrong but know exactly what is going on. Rich "the POD supplier" Jackson was not the visionary he thought he was.

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  11. The story forgot to mention that Drobot was paying surgeons 50k-200k per month to bring their cases to Pacific Hospital.....but I am sure the forensic accountants will have no problem finding that info.

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    1. I don't know how accurate that ys

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    2. Oh I think it's very true but done very legally! Oh how they get away with this is amazing. Feel badly for MD' s who try their best to stay away from these dudes , practice good medicine! Hard to escape too much proliferates this business not just here!!! Time to get rid of all this!

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    3. R u kidding me feel sorry for the docs u r a real bozo

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  12. Tricity Oceanside had it's fair share of Seaspine and alphatec going in as well. I'm sure that is just a coincidence though.

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    1. I heard ATEC had stopped signing on new POD's. Is that true or has anyone seen a new one go up recently.

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    2. It is a coincidence as Tri-City Oceanside and Tri-City Hawaiian Gardens are not related in any way.

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    3. Marshal and wiener run tri cities they booted art out

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  13. peel back the onion...this type of business is pervasive in many other med centers. looking forward to seeing them all outed asap!

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    1. For you non accountants billed charges are far less than collected charges. There is sisporprtinate adjustments for lower income nedi-cal ptients. Spread over many yeas the costs are not uber sensational! But the whole Ethics stink!

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    2. Meaning WSJ OVERSTATES numbers that are not paid by insurers andbothers as inpliedn- makes better fodder BUT DOES IN NO WAY MINIMIZES PROBLEM!

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  14. Drobot Sr. used to be the majority owner of Pacific hospital AND the "distributor" for Alphatec and would do all sorts of outlandish activities to move things along (interesting surgeon incentives, new cars for executives, etc.) all in the name of surgery generation. Randall worked with Drobot Jr. in MRI referral, in-office pharmacy set-ups (nationwide), and other interesting things in and around WC just to make a buck. They're all really cocky too...hang 'em by their nuts, I say!

    A funny story used to float around that a surgeon was doing a case at Tri-City but Randall's sole-source entity didn't have the right implants so the rep told the doc, "Don't worry Sir, we're flying in what you need on our private jet out of Temecula"!

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    1. This is a story only an idiot would believe or make up. Any aviator would know that you would never fly a jet that short distance. It would take longer than driving. Besides the guys in Temecula would never supply Randall with implants so he could steal their business behind their backs. Only Mike Davis and Ted Spitzer were in on that scheme.

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    2. Ha ha that is funny

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    3. What about diamond Wayne Joey and reynoldo

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  15. Waiting for ASI and x spine to appear on wsj anytime now...

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  16. We need to treat the problem not the symptom. What is the problem? Medical Device companies, Hospitals, Reps, Surgeons....no. While everyone sits around pointing fingers at each other the insurance fat cats are smoking their cigars wearing their stovepipe hats laughing at all of us. Do not kid yourselves they have manipulated every facet of the medical industry to their benefit. They are nothing but casino's and the house always wins. They stack the deck in their favor by creating bureaucratic call centers for every level of their operation, kicking back "new technology" or not approving procedures, applying pressure on lowering DRGs, and influencing the FDA to stalwart new technology. What does that cause? It forces the industry not to be greedy but to be creative, find the loop-holes. Are loop-holes illegal? No. Are they ethical? Depends on what your definition of ethical is. Do some take advantage of a situation? Yes, most certainly, but taking advantage of a situation doesn't necessarily mean you are breaking the law. My point it this, we need to stop fighting each other and focus on the real problem at hand. Insurance companies are ruining the entire US economy including our industry, not just for us reps but everyone, hospitals, surgeons, and patients. A perfect example is if you look at the cap on law suits states. This was instituted to lower settlement payouts to people from surgeons for med mal cases. Thus reducing high insurance premiums. So then why did insurance premiums go up in everyone of the states that instituted those caps?
    And in speaking about banning together to fight a common enemy, why hasn't (or maybe they have and I just don't know it b/c I am a lowly peon rep) all of the smaller companies gotten together to fight MSD on their broadly written patents? Doesn't Depuy, Synthes, Globus and any other company with an MIS or lateral system think they are next after Nuvasive? Or are they dumb enough to think: ehh, Medtronic is going to be too tired to fight another battle in court and win millions.

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    1. One surgeon told me how an insurance company they use to cover the clinics employees notified them of a 20% premium increase and later that day, we're notified of a 20% reimbursement decrease.

      This insurance company's CEO also got a 40million dollar bonus.

      Another point, ever wonder why you can't go outside of your state to buy insurance for yourself?

      I agree 100% that insurance companies are ruthless, but what is the plan? Surgeons creating a union would be construed as collusion. It's a very frustrating situation but I'm not sure what can be done especially with the government all elected with insurance money backing them .

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    2. The WSJ article misses the real problem with the injured worker. The insurance company has 30 days from the date of the injury to take care of the patients injury and diagnose the problem and get the patient the proper treatment for their injured spine. If they did their job and took care of the patient as they are supposed to, then there would never be any spine surgeries at these hospitals. They have full control of the patient under California Law for the first 30 days. It is because they want to deny care and deny the injured worker the treatment he needs for his back, that they end up with this mess. The astounding truth of this preposition is that over 70% of all work comp spinal fusions cases in California are applicant. That means that the patient had to go and get an attorney to fight the insurance company to get the proper treatment. This is where the money starts to add up. From the time of the injury it takes roughly a year for the patient to get into surgery and all the tests and costs involved to get the patient to surgery pile up. All these tests are required to show that the patient needs to have surgery. At the end of the road is the spinal fusion and since the insurance company has given up control of the patient including which doctor who will do the surgery and which hospital it will be done at, then they only have themselves to blame for the end result. It is because they do not take care of the patient to begin with that they end up in this mess.

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    3. There is another disturbing fact that is not mentioned in the WSJ article. It is what happens to the injured worker because he has been denied care by the insurance company. Obviously if the patient is truly in need of spinal fusion surgery, he will be under a great deal of pain. As mentioned in a previous post, the patient will be waiting roughly a year to get his spinal surgery approved because of all the proof the insurance company and the law requires to show that these cases are necessary. During this time, the patient will require pain medication. This is supplied to him by his physician and it paid for by the work comp payor. The doctor often bills these meds to make a profit so their is no shortage of medications for the injured worker. Often times these patients become addicted to these pain medications as they are heavy narcotics. This turns the patient into a drug addict. Some of these patients are in such bad shape that we have found them living in shelters and in the back alley of a housing project. They cannot think or reason and many of them are psychotic. An associated problem is that their work comp benefits are barely enough to live off of so they are constantly being asked to settle their case for cash and not have the surgery they need. This saves the insurance company money. I have heard of settlements as low as 60k. This is a lot of money at one time to an injured hispanic farm worker who makes minimum wage. Not being in their right minds because of all the medications, many of these patients take the money and live with their debilitating pain. They are sold out by both the insurance company and their attorney.

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    4. A final point about the WSJ article. This article deals with the high cost of implants. However, it is a incontrovertible fact that implant prices in other states outside of California are much much higher by the time they get to the work comp payor. Most states allow the hospital to mark up the implants by 2-4 times cost. So a spinal fusion case that may cost the hospital 15k with end up as 45-60k by the time it gets to the insurance company. I have heard of spinal fusion hardware cases in Illinois that have billed for 110k for one level spinal fusion case. The cost of those implants from the vendor was about 10k. So here is the question for all you spine wizards: Why is it ok for these hospitals to get away with charging these kinds of mark ups, but when the implant companies do it, it becomes greed?

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  17. Alphatec, Globus, Integra/Seaspine, K2M, Medtronic, Pioneer, Synthes, Trans1. I have seen their trays at Pacific Hospital in Long Beach.

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    1. Yes, but Drobot's company distributes Alphatec and SeaSpine. The other companies there were probably legit and billed the hospital directly.

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    2. Yes, I'm sure that with the docs making money on the kickbacks from Drobot and the WC referrals that they still use all of those other companies because their screw and plate is so much better. They are obviously in it for the patient, right. It sounds like the entire patient population of the hospital is workers comp. What idiots are running the WC programs there that they don't look at implant costs and try to negotiate a reasonable price. They are as culpable as the rest because they know they can get those products cheaper, they are just willing to take part in the scam on some level and let the company foot the bill.

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  18. Tsb, why the negative comments on capitalism? What the hell is wrong with you. Capitalism is what made America great! Guess you prefer the USSR??? Wait, they failed over night! .....wait we are heading that direction fast. I guess you and liberals like you will only be happy when America fails...the good news for you, bad news for me is that we 75% there...all we need is Obama to Win in 2012 and then it will be a slam dunk! Cuba here we come!

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  19. Pacific is the most egregious example of surgeon greed. But let’s face it, are there any surgeons left in LA that aren’t involved in PODs or kickback schemes? Yes, there are a few, but the list is getting very, very short.

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    1. I work in the San Fernando Valley where there is a POD on every corner. There is a hospital similar to the one's listed in the article in the WSJ by the name of Mission Community Hospital in Van Nuys. Mission is a hive of POD activity and was just about ready to go out of business two years ago. Since marketing to POD's, Mission recently purchased a O-ARM and DaVinci in the same year. All of the small companies are represented there and the Alphatec rep can be seen weekly assisting surgeons and handing instrumentation. I hope the WSJ patrols this blog. There is a another chapter to be written if the authors are up to the investigative challenge.

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    2. Follow the stench. A doctor who is part of the management company at Tri-Cities has an ownership interest at Mission.

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    3. This comment has been removed by a blog administrator.

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    4. 8:16 You are so out of line. Are you a rep that Mission refused to do business with because you wanted them to take it up the a--hole? Im sure you are. This hospital is on the up and up, you sound like someone scorned and angry.

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    5. Sounds like there is a touch of truth concerning Mission.Uneducated comments from the POD coverage reps 3:46 and 7:09 proves the point of 9:32 Mission truly is a cesspool who's time is coming. Memo to the POD rep's your the plague of the industry and with your job history none of the major's will ever hire you in the future, nothing last forever.Try to show some professionalism POD boys I know it goes against everything you believe in.

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    6. Mission has a transparent policy! That means ANYONE who is curious, can stop by and see if they utilize any POD's or for that matter do anything that can be remotely preceived as inappropriate. 7:09 is right, this facility is on the up and up. Any educated and intelligent data-driven review will prove it.
      Don't be a coward and use this opportunity to sling some mud because they wouldn't approve your $3,000 pedicle screws. Don't go away mad, just go away

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    7. Tri-City, Pacific, Mission, Temple, Silver Lake, Monrovia and the list goes on ...

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    8. You forgot Coast Plaza. California is 1 month away from issuing IOUs again and these scumbags are ripping us off overcharging WC.

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    9. Don't forget. Rancho

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  20. It was a matter of time before this story got out. Workers comp is, plain and simple, a soiled playground for disgruntled employees feigning injuries supported by a network of complicit attorneys, doctors, other health care providers and hospitals all out to bilk insurance companies. My guess is that real costs of "true" workers comp injuries is 25% of current expenses. The rest is FRAUD.

    This particular story is not done and if Randall is striking a plea deal, get ready for a monsoon of indictments of some well known SoCal orthos, neuros, chiros, WC and PI attorneys.

    The WSJ article touched upon Drobot's van company, translation services and implant business but did not mention his management company, PSPM, a prepackaged medication business or his past business owning surgery centers.

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  21. Hey 1:01 you're a fool! You are the 1% that make ridiculous and sophomoric comments on this site. You don't know TSB, you think you know TSB. Chill out you might have a stroke. Liberal? Liberal doesn't even come close in describing TSB, the entire team here is more radical than the Tea Party and Occupy Wall Street combined. So where's the negative comments about capitalism?

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  22. I'm assuming we'll see 1:01 in a future issue of the WSJ!!!

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  23. What is the latest on Mississippi's Spinal USA? Heard they recently added some more doctors (investors) to their operation.

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  24. Other folks to look at are Phygen and Kyle Webb as well as Melissa Kremer. They were all inter connected with these guys.

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  25. Isn't Paul Sendro involved with Phygen

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  26. 2:59, what about Zimmer? I doubt very seriously that they are involved in a POD.

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    1. They are a downward spiraling bunch of bozos with tired technology and no innovation. 22% decrease is year over year sales run by Stryker retreads. Ask your local rep or distributor how much of a cut they are being asked to take this year for the team.

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  27. If he is involved with Phygen the apple never falls far from the tree, hopefully the feds will pursue criminal charges and the entire ex-Blackstone senior management team will sing like canaries, LMAO

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  28. Several California PODs are breaking up but Phygen still keeps telling it's "investors" that what they are doing is legal. Kyle Webb is such a dbag looser. Anyone that would seek his leadership has questionable judgement.

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  29. Fret for your figure and
    Fret for your latte and
    Fret for your hairpiece and
    Fret for your lawsuit and
    Fret for your prozac and
    Fret for your pilot and
    Fret for your contract and
    Fret for you car, it's a...

    Bull...sh**...three...ring...circus...sideshow of

    Freaks here in this, hopeless f**king, home we call LA
    The only way to fix it is to flush it all away
    Any f**king time, Any f**king day
    Learn to swim, I'll see you down in Arizona Bay

    Some say the end is near
    Some say we'll see Armageddon soon
    Certainly hope we will
    I sure could use a vacation from this

    Bull...sh**...three...ring...circus...sideshow of

    Freaks here in this, hopeless f**king, home we call LA
    The only way to fix it is to flush it all away
    Any f**king time, Any f**king day
    Learn to swim, I'll see you down in Arizona Bay

    Some say a comet will fall from the sky
    Followed by meteor showers and tidal waves
    Followed by faultlines that cannot sit still
    Followed by millions of dumbfounded dipsh**s

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  30. Wasn't that from the original hip hop artist Bobby Darrin? What next White lines?

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  31. Replies
    1. Maynard James Keenan can definitely write some great lyrics

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    2. He was my classmate at the U.S. Military Academy Preparatory School (USMAPS), Fort Monmouth, NJ back in 1983-1984. Really interesting dude, and yes I agree, he creates great lyrics.

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  32. They could run the same expose in Birmingham, Mobile, Nashville, or Chattanooga.

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  33. 7:37AM Is correct - http://www.southeasternspinespecialists.com/index.php

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    1. Bassett did his fellowship at U of Wisc.--learned from the master--Dr. Z.

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  34. This comment has been removed by a blog administrator.

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    1. Not true, that company runs a clean program and is well respected.

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  35. I think that this Site is starting to become inflammatory where the barrage of negativity and ridiculous conclusions are not productive. Sure, the WSJ article cited some bad apples but some of the comments are unnecessary and comes with consequences for EVERYONE.

    PLEASE use caution when throwing out names to protect Families, Colleagues, and Friends as these comments do affect communities and reputations. It might seem cute but it is really damaging to more than the actual person being improperly accused.

    TSB seems like a fun and professional Site but some of these comments are beyond sensible.

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    1. This blog site really has gone out of control. There's no way in hell that any one of us would speak to each other like this in a room face-to-face. TSB continues to perpetuate this pattern of useless anonymous banter and abuse. It is truly a sad state of affairs.

      Delete
    2. You are right about the tone of dialog on the site, however, don't blame the messenger for the actions of these docs. If their families would be ashamed to read about it, then thats the docs fault for doing it (to the patients).

      Way too much testosterone and not much fact bouncin around in here. But the docs named in these POD scams for the most part are involved in something that may well land them in jail or with huge civil monetary penalties. The thing about consulting agreements is that its hard to know who actually has one unless they disclose it publicly (which most private guys do not do). So the jacklegs on this site use that as an excuse for losing business because they assume that is the only way someone could beat them. POD's on the other hand, are not private matters that are undetectable. If a doc switches all of his business overnight to one of the companies we all know and love to hate, they have already admitted to their rep/drinking buddy what they are doing.

      I have talked to my local OIG Inspector, have you? All of the docs whose names I gave have now been published in the WSJ. We can only hope that they, and their wives, are losing some sleep. The sad thing is, if they are losing sleep its because they fear the loss of income or criminal prosecution. They have never lost sleep ove the crappy care they gave their patients.

      Delete
    3. Hey Deep Throat - Shame on You! These Surgeons above haven't been implicated for anything? The WSJ article did not cite any of the names. Also, your statements about Wives and Family is beyond idiotic. You may feel that you are justified in this behavior but the karma you create might offer a boomerang effect! Seriously, your conduct is crude! Again, would love to know who you really are and who is buying what your selling...

      Delete
    4. 11:57 this isn't deep throat but to answer your question it probably is the LA attorney and most of us are sure that time is not on the side of anyone that has been affiliated with Tri-City and Pacific.

      Delete
    5. Drobot donated a lot of money to Brown's campaign. If our system follows the status quo he will get a slap on the wrist when he should be put in prison.

      Delete
    6. 11:57
      I was not referring to this WSJ article but a previous one where doctors WERE named. The wives got themselves into the conversation by posting comments on that article. They claimed to be medical professionals with knowledge of the doctors excellent care and judgement. It wasn't hard to figure out who they were since they used their real names. I hope Karma is real because if it is, the docs I was referring to will have some debts to pay.

      Delete
  36. Hey 5:27pm: that attitude is the reason why our healthcare system is so f****d up. These dirty rats need called out for who they REALLY are. Surgeons, reps, hospital administrators can all be dirty. Its been entirely too long for all of this behind closed door deals to go unnoticed. There are plenty of reputable docs and reps out there. Too bad we dont praise them enough for doing good and playing on a level field. Hang the SOBs for all i care. We need to send a clear message that this behavior wont be allowed anymore. Time to make some examples of the rats in our industry. Spine needs a good cleansing!

    ReplyDelete
    Replies
    1. It is obvious that the person behind the 6:05 PM posting is jealous or has been slighted somehow. Perhaps, this is a tactic slanted at some sort of revenge. It would be fun to know more about them and how they came to this conclusion.

      I guess we will never know but for curiosity since you have the audacity to cite names of Surgeons that you term as "Rats," tell us who you feel is reputable?

      Delete
    2. @ 6:05. If you want to "send a clear message that this behavior wont be allowed anymore" then posting as anonymous doesnt quite acheive that. I agree with other posters that its cowardly to name names and then post as anonymous. do as to others as you would have done to you.

      Delete
    3. 5:37pm.....don't hide behind your guilt......whistleblower hotlines are setup the same way to shield this sort of rancor by you and others. Let the information flow and those responsible who monitor this site will do their own investigations. Let the anonymous bring forth the news...WE"RE TIRED OF THIS AND WE"RE NOT GOING TO TAKE IT ANYMORE!

      Delete
  37. 4:37 pm- You have no idea what you are talking about. Do some research next time before you start spouting off names of doctors. Half of these gentlemen do not even operate at the aforementioned facilities. You're lucky you post under anonymous because your comment would be considered libel.

    ReplyDelete
  38. This is 4:37. I agree with the last post. This cover-up has gone on long enough. Like I said if no one has anything to hide and did nothing wrong, then why keep covering the fraud up? If these guys are reputable, then let them speak out.

    The cream rises to the top...and eventually all rats are caught. These guys don't care about "families, colleagues, or friends" as alluded to in 5:27. To them, and I quote as they have said, "it's just business". Everyone is tired of the BS.

    ReplyDelete
    Replies
    1. Again, not sure who you are but evidently you are speaking for everyone? "Everyone is tired of the BS." Every Spine surgeon should be indicted and 4:37 is going to start his own MPN of good and bad surgeons. The good ones use 4:37 product where advisable and avoid surgery as operating on pain is not an option...The bad Spine Surgeons will be marched off to jail while 4:37 and his MPN REPUTABLE docs have a line out of the door cause 98% of the Spine surgeons are locked up!

      Moral of the story is 4:37 is on to something...I think he is full of good ideas...NOT!

      Delete
    2. 8:29pm........to come to 8:04pm defense.......you are a prick and we'll all see how it plays out. Many are playing on both sides and the public disclosure will bring the good and the bad to the stage. May your games still feed the fire of discontent. Doing so only gives you heartless the loose lips and loose morals to continue to be exposed. Bring it on with both barrels!!

      Delete
    3. 9:33 PM, it is no wonder you can't push any product. You are classless and repugnant. Calling me a "prick" is useless bravado. Games? What games do you speak of? There is no Game - your wanton disrespect will one-day manifest itself into your own self pity and pathetic lifestyle of blaming others for your obvious jealousy and failure.

      Delete
    4. @8:04 you want to expose surgeons but you wont expose yourself? that is the height of hypocracy. I would be delighted to read your list of surgeon names - but let us know who you are too??? or are you too afraid?

      Delete
    5. Anonymous 5:41 calling out Anonymous 8:04 for being anonymous now that's entertainment

      Delete
  39. An open comment to 4:37pm: you have a sharp tongue but a not so sharp mind.........

    While we are all granted "freedom of speech" under our constitutional rights, there are laws that punish foolish people for speaking their minds about others even if it is known truth and fact.

    8:03 is mostly right on spot. Your blatant lack of knowledge about slander and libel are headed you down a track you don't want to be on. Even though you think you post "anonymous", a subpoena/summons to the blog/web developer can turn you into a public figure in a New York minute.

    Whether or not you know the 5 surgeons you speak of personally, or are gaining this information second hand, you may want to consider a statement of retraction, unless you think you look good in stripes and you have plenty of money for candy and cigarettes.

    You can save a lot of grief for yourself in the future if you remember that you are a master of what you think and a slave to what you speak.

    ReplyDelete
    Replies
    1. 9:46 it is evident that not only are you either a salesperson, relative or surgeon associated with the aforementioned surgeons but you are also an expert on libel. If you think that the US Attorney in LA is not investigating everyone that has or is affiliated with Tri City and Pacific you are in for a surprise. The more people that come forward the faster this stench will be cleaned up. There is something fundamentally wrong when you pay $ 3,600 for product as a stocking distributor and charge $47,000 of course you see nothing wrong with this behavior, you are no different than the robo signers and IB's that nearly brought the economy down. We'll see you in court for violating anti-kickback statutes, fraud, and criminal negligence until then wrap yourself in free markets. Oh and by the for someone calling out others on their anonymity it's interesting that you posted as anonymous. When least expected you may be asked to join the party.

      Delete
    2. I think it is funny that 9:43 AM (who is also probably 4:37 PM on 2/10) acts like a pedantic Schoolchild when addressed with the possibility that their actions are outrageous. I think that 9:46 PM (on 2/10) makes a salient point about being careful of thoughts and actions. I will take it a step further and remark: “Better to remain silent and be thought a fool than to speak out and remove all doubt.”

      Lastly, 9:43 AM you seem to be the purveyor of all the toxic rumors on this blog – why don’t you tell us what you do? At the very least, tell us the names of the products that you endorse and possibly the Surgeons that agree to work with you. Really…YOU seem to be the “Game Player” on this blog…indulge us…

      Delete
    3. There's nothing illegal, or immoral about a big mark up if you can find a fool willing to pay it. The illegal business is the kick backs and the implant business in exchange for the referrals. There may be some other shenanigans going on, but the cost versus sales price is not an issue. In fact, the manufacturer that sold it for $3600 may only have $300-400 costs tied up in those implants.

      Delete
    4. Fraud is fraud, you sound like the Wall Street guys or John Paulsen. Rig the game, bilk the system who cares if everything else or everyone else crashes and burns as TSB would say its a teenage wasteland, everything goes

      Delete
    5. For the "Master of Thought/Slave of Speech" concept: Actions are the only measure, for example: There is a CEO of a Temecula firm who, as a young man, worked as a shepherd and as a result, became fond of sheep. Later, as he grew in wisdom and stature, he began to think of himself as "the apple of God's eye," and as master of those thoughts began to speak in glowing promises which could not be sustaioned. This caused many folks to be left (like Uriah the Hittite) in the forefront of battle. Now this CEO, came to really believe it was his God-given right to do do these things. His Cali-silicone Bathsheba became estranged and there were many harsh words between the two. One day, after roaming in the round-about-thereof, the King appeared at Bathsheba's bedside, holding a sheep under his arm and thus spake, "Honey, I would like you to meet the pig I have been sleeping with."
      Whereupon, the fair lady responded, "You stupid idiot, can't you tell a sheep from a pig?"
      The King responded, " Madam, what makes you think I was talking to you?"
      THAT is a kick to the curb.

      Delete
  40. All 4:37 said is those surgeons operated at those hospitals on workers comp patients. Nothing else. No libel.

    Deal with it.

    ReplyDelete
    Replies
    1. I believe the word "dirty" was used, and they "played the WC game" that has some context in this forum. Not quite as benign as you portray it.

      Delete
  41. The likely hood of your average Joe coming across this website and taking the time to read this article, in addition to commenting, is very unlikely. It goes without saying that most people that take the time to leave these witty anonymous comments are either in or out. If you were left out in the cold hoping you were part of those “behind close door meetings” you are now wishing for those scoundrels to be hung by the nuts. If you’re one of those scoundrels your hoping this goes away so you could continue milking the WC system for what it’s worth and flying your private jets. With that said let’s not forget that the majority of us are neither in nor out. We are simply trying to make an honest living in this industry that’s not perfect. Please try to keep it professional and avoid creating a witch hunt out of this.

    ReplyDelete
    Replies
    1. At least during America’s witch-hunt of the 17th & 18th centuries the accused had the benefit of facing their accusers. A lot of blogs have cowards hiding behind their anonymous name who are quick to drop names and expect the person(s) accuse(d) to defend themselves if they have nothing to hide. 8:04, it’s idiotic to accuse someone without validity and expect them to prove they are innocent. Would you like for one of your buddies or coworkers to anonymously leave a note on your car accusing your mother to be a *hore? Would you then expect your mother to speak out since she has nothing to hide? Or better yet, what if the same was said and her name was posted on a blog that hundreds of people read? If she has nothing to hide what’s the harm?

      Delete
    2. Welcome to the 21st century, a place where anyone can claim you are a pedophile and you have to prove you are not. Quit whining about not being able to intimidate your accusers and walk with your head held high knowing you are doing nothing wrong and have nothing to hide if indeed that is the case.

      Delete
  42. If she was a whore, and had screwed all my coworkers I guess I wouldn't be threatening slander and libel! All the physicians, companies and reps better be looking for a new gig. When these law breaking physicians, companies and reps are exposed, the industy bubble bursts and we lose the confidence of the patient we can all say good bye to the money. Even those few of us doing things the right, legal and morale way. In that regard I hope the offenders of the system are exposed anonymously or not as in my mind it is the only way to save this sinking ship although it is probably too late!

    ReplyDelete
  43. Spinal USA is bringing their foul stench to Florida as well. They have given the hospitals a bat to whack everybody's prices by giving away once-precious product made in Korean sweat shops. They're paying the surgeon "investors" and hiring dunces as reps. Welcome to the future of Obamacare. Sad. I hope the patients are being told that the docs are using products on them that pay a kickback to the surgeon. Hey, at least the hospitals get to keep a few extra pieces of silver in the transaction. Hippocrates cries.

    ReplyDelete
    Replies
    1. Spinal USA may be neglect in their practices in some aspects, but they do make the product in the USA. Check your facts. Ergo (nod to Hippocrates), your words are baseless. Make product here for pennies and sell to those hospitals at FRACTIONS of the going prices. Capitalism at work while you create stories.

      Delete
    2. For a list Spinal USA doctors/owners simply search the SEC's website. $77,713 buy in.


      http://sec.gov/Archives/edgar/data/1462841/000146284112000001/xslFormDX01/primary_doc.xml

      Delete
    3. 9:40
      "Fractions of the going prices"? Think again. Spinal USA pricing in Huntsville and Dothan are higher than the pricing in Birmingham and Montgomery, where no POD's exist, but have the same reimbursement climate with BCBS Alabama. Seems everybody has facts they choose to ignore!

      Delete
  44. If you cannot avoid being caught posting on blogs then you probably shouldn't post on this blog.
    That being said I think all these crooks are going to get cleaned up, it just going to take time.

    All POD owners will be outed soon, referring physicians are going to raise eyebrows when they learn that their patients are almost a lock for being cut on when they get sent to the POD owners.

    ReplyDelete
  45. MM you're the moron! You put occupy losers and great American's (tea party folks) in the same sentence? (FYI, tea party demonstrators are peaceful, pay taxes and don't smell).....Go ahead and put an 80 year old war vet who has served his country and paid a life time of taxes in the same breath of some smelly hippies that should be deported who have never done a damn thing for this country....come to Charlotte pal, the occupy trash here have been dumping there $hit in the sewer at the court house which goes to the local stream and contaminates it. Just like a liberal, they complain while providing no value to society, just parasitic waste. If only the 1 percent could jettison the 99(dead weight).

    ReplyDelete
  46. Does anyone know the accurate number of Neuro & Ortho Spine Surgeons in the USA?

    ReplyDelete
    Replies
    1. Approximately 6,000 split about 50/50 with maybe a little more on the ortho side. About 4500 surgeons due approximately 90% of the procedures.

      Delete
    2. What is your source?

      Delete
  47. 9:40 reply to 8:04:
    I stand corrected, not a Korean sweatshop but a Mississippi sweatshop. Their business plan is to take advantage of surgeon/hospital greed and destroy a great industry. Would you have a Spinal USA implant put into your mom's body knowing that chain of dirtbaggery? Do they even have an R&D budget to advance the science of spine? They are parasites.

    ReplyDelete
    Replies
    1. Again I say...check the facts....yes they have an R&D budget and have hired ex- NASA engineers, etc. If you want to beat these guys, you need better stuff than this. Otherwise, stop talking as your not helping.

      Delete
    2. Come on! You have to admit that R and D is not what is getting the business at Spinal USA. The were shipping implants in zip lock sandwich bags with no label, no IFU and no sandwich. The FDA nearly shut them down and their current products CANNOT be sold to surgeons who are not invested. And the current products are a far cry better than the ones the Huntsville docs started with. I would venture to guess that the NASA engineers may have a relationship with the Huntsville surgeons? I wouldn't think many rocket scientist live in Jackson MS.
      You can defend the "facts" about minutia, but don't ignore the facts that the company is owned by its customers and it's customers have the unique privilege of having someone else pay for the implants they "buy". And the POD surgeons who don't own a share of the Spinal USA manufacturing arm are getting the same deal with hospitals/insurance buying the products they sell, they just don't get a share of the manufacturing profits.

      Delete
    3. Ex NASA engineers. Holy shit to funny, no wonder they scrapped the space program.

      Delete
  48. 12:45 Your always spewing your hate for "liberals" and "hippies." What about the vet that is a "hippie" I have met a few of them and I am ex military so I would appreciate you not bringing the military into it. I am guessing you haven't served and your married to some fat redneck teabagger pushing 275lbs. So be careful about throwing stones loser.

    ReplyDelete
  49. PS We're all sorry you couldn't get laid in high school, college and had to marry the fat girl. We all have our cross to bear!

    ReplyDelete
    Replies
    1. Nice post....are you 5yrs old?

      Delete
  50. By the way... Blackstone investigation ended 2 days ago... Two whistle blowers get a couple dollars, government made millions and life goes on without any further legal issues...

    ReplyDelete
    Replies
    1. Whaaaat??? But all the geniuses on this board said all the Blackstone guys would be getting a$$-raped in prison by now!!! Just another case of chest-thumping idiots acting like they know something.

      Delete
    2. That is accurate..

      Delete
    3. Genius civil litigation entirely different from criminal investigation which has no statute of litigation let's wait and see

      Delete
    4. You mean statute of limitation

      Delete
    5. No, he meant statute of litigation. He just doesn't know what he's talking about.

      Delete
  51. Another great thread where each of you continue to show your true colors,,

    Regardless: Anyone know when Globus is goning public?

    ReplyDelete
    Replies
    1. Couple of thoughts... Who cares if and when Globus goes public... How many of you reps have lost bizz to Globus? Serious hate on here...2nd who cares what happens to Ofix...really, having to sell those products is a life sentence in itself. If any of you have lost bizz to Ofix, either quit or hang yourself or combination. Lastly, why pick on lowly Ofix? Worry about important stuff not kicking a 3 legged dog when it's down....

      Delete
  52. Penile USA's R&D budget:
    $500/hr to get some dirtbag attorney to RESEARCH other companies' IP
    $20 to DEVELOP each copycat screw
    Minimum wage to get jackoffs to cover cases

    ReplyDelete
    Replies
    1. ...and there goes your baby's blue suede shoes, mamas new ring and your lap dances.

      Delete
    2. I heard Penile USA is a "sucky" spine company..

      Delete
  53. Penile USA is an industry leader in new technology, everybody knows it. NASA engineers rock!

    ReplyDelete
    Replies
    1. NASA engineers have to find something to do...The Obama white house cut the space budget 200million this year... but the good news is that all food stamp respients received a free cell phone and 250mins a month thanks to the US tax payers. (that means top 5% of tax payers, nobody else pays). Only cost 1.8billion a year. After all, cell phones are a necessity and a God given right....

      Delete
  54. Regarding Spinal USA: Look at one of the appointments to the 2005 Hospital Equipment and Facilities Authority made by former Mississippi Governor Haley Barbour (link below). GO back to the SEC filing forms (all of them) for Spinal USA. Notice a familiar name of a certain orthopedic surgeon? Pardon the irony, but this is disgusting and needs to be investigated.

    http://www.governorbarbour.com/appointments/archive/appointments/2005/mar/apptHospitalEquipment.htm

    ReplyDelete
  55. This post is really disappointing. As a direct rep selling for the past 6 years, I have busted my hump and weathered numerous pricing cuts, competitive companies, etc to do things the right way and hit quota year after year. Then, I read about these used care salesmen all over the country buying business with shady practices, doing a third of the work I do and making 5x as much as I do. Its a disgrace. Level the playing field. These PODs need to go away if this line of work is going to continue. Otherwise, we are just making it easier for hospitals, insurances, and even the government to obselete us. Start putting people in jail. If you have PODs in your area, start voicing your concerns and get the word out. Enough is enough. Good selling

    ReplyDelete
  56. Hey TSB - I'm not suggesting censorship, but I must agree with some of the other readers out there on the "naming of names". If you are going to call someone out here, you should be prepared to give your name, otherwise your post is deleted. This is a great blog but it is moving in the direction of cafe pharma. Having a few basic rules might keep this forum from becoming a "has been".

    PS: even though I haven't made any accusations, I see the equivocation in posting anonymously.

    ReplyDelete
    Replies
    1. Hey 6:53. The "other readers" you are speaking of are the fellow crooks that fuel what the WSJ article is talking about.

      Delete
    2. Hey 9:49, not necessarily. I'm another reader (and not 6:53), have nothing to do with anything, but do see the argument that if you're going to call out someone's name that hasn't already been mentioned in a negative way, that you should at least provide support for your assertion or credibility for your identity. (e.g. "I'm a rep in the area...") While it doesn't guarantee accuracy, it makes either the reader more aware, or forces the poster to tell an even bigger and more specific lie for which they can be held accountable, and thus makes them less likely to do so.

      Delete
  57. TSB, it's time to close the chapter on this blog. Of late the reactions here make cafe pharma look like a meeting of intellectuals

    ReplyDelete
  58. Wow, this is the first time I have followed this blog and I have to say it is unprofessional at best and libelous at worst. I have been in the medical business in LA and nationwide for over 30 years. There are "bad apples" in every industry. However, to start throwing around names of people who haven't been indicted or arrested is beyond disappointing.

    On the topic, there is a reason that Drobot and Randall flourish in this business. Why - because if it isn't proven that they are providing kickbacks to surgeons or others to pay for referrals, they probably haven't broken any laws. There is a reason that these "pending indictments" haven't been filed. Its the same reason they haven't been arrested or charged before. It certainly isn't because they are "flying under the radar". Everyone in the medical field in CA and every WC payer knows these guys. These guys have made a career of studying the WC regulations and starting questionable businesses that profit from inconsistencies or big holes in the regulations. They have made fortunes in physician dispensing, surgical implants, MRI "networks", and surgical procedures where there was no established fee schedules. (If you really want to see some big dollars, look at what they charged for epidural injections in ASCs prior to the WC fee schedule for these procedures being instituted.) So, these "bad guys" are marking up an implant by 400% while a hospital charges $70 for a pillow or $30 for tylenol? Most hospitals mark up implants between 3 to 5X cost so they can try to break even after the insurers slash their bills. The point is, this is a common occurance and just because it is distasteful doesn't mean its illegal.

    Lets either shore up the laws to prevent this type of behavior. Also, lets wait until these guys are convicted before there is too much locker room talk. My bet - unless they are paying kickbacks, they won't be charged.

    ReplyDelete
    Replies
    1. Personally don't know anything about this but wow u sound desperate and scared. Where there is smoke there is fire too here. Are u gonna call the media when they say the same thing crying like a bitch?

      Delete
    2. Libel only matters if there are measurable and privable damages. This would actually be libel per se, which could award general damages if it is proven that the comments were intended to hurt the accused. The burden of proof in libel cases falls on the plaintiff. Keep in mind that truth is a legitimate defense. Also keep in mind that the statements must be specific, much more specific than those made above. Calling someone "dirty" is not specific, "playing the WC game" is not specific. Those statements are just value statements, or references to participation in treating workers comp patients. Context, and other comments on a blog cannot be included in the accusation, not attributed to the defendant.

      Quit grandstanding and trying to intimidate. Let the names flow.

      Trust me, prosecuting attorneys and defendants attorneys are watching this blog, as well as accumulating leads to investigate from many, many sources.

      These stories from the WSJ, are just a build-up to a major expose.

      Delete
  59. NASA engineers are the best and they are an indication of how serious Penile USA is about innovation.
    Sincerely,
    The crews of Challenger and Columbia (posthumously)

    ReplyDelete
  60. 2-questions for Stryker:

    Did MacMillan get credit for his frequent flyer miles and did he take the same plane (and crew) home????

    ReplyDelete
    Replies
    1. Hahaha! Corporate mile high club is rare air. Enjoy retirement.

      Delete
  61. I say all companies join together and take on all the stupid ass rep tracking programs. We all need to start charging a $250 service fee per case to bring trays into surgery, call it administrative fee, and all hospitals that belong to the programs lose all discounts...

    ReplyDelete
  62. Sleazy lawyer infuse commercials have started.

    ReplyDelete
  63. How about a sort-of fund raiser basketball game where fat attorneys and ortho-docs get to play real basketball with real tv teams to raise money for tri-cities legal defense, lose weight and shower with them after

    ReplyDelete
    Replies
    1. What are you talking about?

      Delete
    2. ...strange, that was said about the last5 one, also.

      Delete
    3. *****************WARNING EXTREME CONTENT*******************

      As Charles Barkley once put it... "A slam dunk is a slam duck"

      Chicken, poultry and the rest of the "POD" entities have been liable.. Yes there is corruption, compulsion and computation in regards to these allegations. I know for one that most of these "turkeys" who claim the cranberries are ripe will be rightfully stuffed and the potatoes will be mashed. You can thank father government and his disciples for these "religious" POD backers.

      Hey Sadam knew when it was time to crawl into a hole under a piece of plywood when they gazzeled his goose. (No, that's not a Top Gun reference) That's true life sixteen and pregnant reality. Sure we'd all enjoy dancing with the stars under a full moon but sometimes you just have to have the voice to stand up to the X-Factor. You see, Americans have to be idolized and so these "Survivors" of this corrupt and enronic ponziac River of dirty DEEDS.

      Fo ma homies mmmmmmmm

      Delete
  64. I love the comments coming from this area (check the IP) that are so concerned about people naming names. They are all surgeons, surgeons's wives, surgeons staff's I guarantee you. Hey guys, when you bill a million dollars for 16 procedures this is what you get. POD's are desparate and hence these insane prices. Sick and tired of hearing how POD's save money. Where are you now Dr. Steinman? Haven't heard you lately? Still willing to sit in front of Congress and state your money saving case for POD's?

    TSB don't you dare cave to these cowards. Shame on the hospital staff that let this happen for so long. Hospital purchasing directors are going to be culpable.

    Why does the legal community not start advertising for POD surgeries like the do Infuse, Hip recalls, ect? This is a slam dunk. You could easily name the most common POD's (Alphatech, X-Spine, Titan, Eminent, Pioneer,Spinal)

    Very interested to hear feedback: what are the POD's in your area? Reply back I'm anxious to hear. Also- if you lost business to a smaller company- please dont assume the doc is getting paid. We want some facts for this project.

    Send it.

    ReplyDelete
  65. Jackson Mississippi - Spinal USA, Nutech
    Tennessee - PDP, Spinal USA
    Huntsville - Spinal USA (Ortho Group) & PDP (Neuro Group)
    Jasper, Tuscaloosa & Birmingham - Nutech
    Mobile - Spinal USA (Neuro Group), PDP (Ortho Group), NMS (Ortho & Neuro Group)
    Dothan - Spinal USA, I think

    How come the boys at Choice Spine aka NMS don't get much coverage, not very successful POD? Why if it is so legal to all the companies shelter and separate the POD from the Manufacturing company with an LLC acronym? I think they should all have to change their Acroynm's to more closely resemble their business model such as PSP - Piece of Shit Products, PPR - Piss Poor Representation, or GJS - Going to Jail Soon.

    Hey Doc, could I get you to commit to using PSP? I know, I know the products suck and I wouldn't donate them to the local vet but we will let you buy in for a small fee and pay you for using them. Don't worry our attorneys say they don't violate the Stark Laws or the Anti-Kickback laws, there is some loop hole where if we form a bs llc and you all become surgeon owners or investors we can pay you. Sounds crazy but it works great in Mississippi, Tennessee, Alabama, Florida and California.

    ReplyDelete
    Replies
    1. Just curious, who are the doctors? This sure sounds like a MAJOR conflict of interest.

      Is Spina USA's James Pastena still on the board of Custom Spine in NJ?

      Delete
    2. Heard he"s providing such good direction from investors that the revenue is going south, nice another of the industrys visionaries

      Delete
    3. Who knows what POD ventures are in Nashville, Chattanooga, and Memphis. PDP I'm told is not in Nashville but just has an office there.

      Great acronyms.

      Delete
    4. Have not heard of a POD that Pioneer is associated with...can you elaborate on that one?

      Delete
  66. Stay tuned for more to come....

    ReplyDelete
  67. Health Industry Council of Texas is promoting POD's on their website......

    http://www.healthindustrycouncil.org/areas-of-involvement/events/webinars/physician-owned-distributorship-webinar/

    ReplyDelete
    Replies
    1. Oh my god! Admitting it right out in public! Send over the gendarmes, you've got all the proof you need! What's their crime? Depriving me of the commission income I deserve! Call the OIG! Call the Wall Street Journal! The outrage! The humanity!

      Delete
    2. Maybe the surgeons should get a cut of all the products that go through the OR. The whole concept is retarded and is a short term gain.

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    3. in webinar, does Hochshuler participation imply he's got his own POD? Is that all of TBI or just his spine industry pals? How many pieces of the whole pie does he get cut of? Texas is ripe for this stuff. Is this bcuz Texas policy works like the California system (aka WSJ article on Randal)?

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    4. Hochshuler? Isn't he the genius behind a former company that raised 60-70 mil only to burn thru it? Another visionary? You betcha! Are there people still giving this person money?

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  68. PODs are not illegal, no matter how many idiots on this blog would like for them to be. In the US, being a doctor is and always has been a for-profit BUSINESS. Yes a business with responsibilities to patients, but also with responsibilities to the bottom line like any company. Recognise docs for the businesses they are and you will win, deny it and you will lose everytime.

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  69. Actually it is illegal to pay physicians to use your products that accept Medicare and Medicaid, you might want to read the Stark Laws and Anti-Kickback Laws again. Just because you invest or take investments in a POD and become part owner doesn't make it legal. If that were true all the joint companies could just have the surgeons invest/buy stock in their respective companies and could have avoided the DPA and hundreds of millions of dollars of fines. PODs haven't been tried in a court of law (I believe they will) and vary in form, so for you to come on here and infer they are legal makes you out to be the idiot. What POD do you belong to and where do you practice and or sell if they are so legal?

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  70. If PODs are legal why is the FBI all over California asking questions? Seems odd that they would waste their time if they clearly are legal. Sleep well greedy dirtbags.

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  71. PODs, when properly designed, are legal. There are physican-owned hospitals, physican-owned surgery centers, physican-owned MRIs, physician-owned physical therapy centers, physican-owned pharmacies, physican-owned wellness centers, physican-owned dialysis centers, and physican-owned everything else. ALL LEGAL, as long as they stay within the rules. The only difference between PODs and these other entities (which move plenty of devices) is that they deprive large-company spinal representatives of income.

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    1. -How many POD's generate no more than 40% of sales from investing surgeons?
      -How many POD's market to non-investors in the same manner as investors?
      -How many POD's have less than 40% ownership by investing surgeons
      -How many POD surgeon owners have never pressured a CEO to do business with the POD
      -How many POD's are clear of the "single purpose rule" that states if a single purpose (not necessarily the main purpose) of the arrangement is to capture a financial benefit, then the entire arrangement is illegal
      -How many POD's can claim that inducement is not present in the arrangement, even if it is not acted upon?

      10:30, you are right that a POD can be written up as a legal entity, but it is virtually impossible for the surgeon owners to abide by the by-laws of the arrangement and therefore they run afoul of the AKS with their actions, not via the setup of the POD.

      Disclaimer, I am not a lawyer, but I have read the AKS and the safe harbors. It seems clear the POD's I know about do not fall within all of the safe harbors.

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  72. It looks like Tri City is making a Fight over this! Anyone see the Work Comp Central Article???

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    1. No..did not get to read it as have to pay $6.99. What did it say?

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  73. 1030am There are other differences such as using cheap reps with little training and cheap implants that often violate patents and have little to no quality, compliance or a legit company associated with them. Also, in case you weren't aware the state/government isn't letting surgeons set up their own hospitals, surgery centers or MRIs in most states anymore. The few States that still allow those arrangements/entities require a ton of restrictions and they will eventually put a minimum tesla rating on MRIs while reducing reimbursement meaning all those surgeons that bought those MRIs will have a million dollar hunk of shit on their hands, much like your implants. There are other differences as well but that should suffice to illuminate the wisdom of your position (or lack thereof).

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    1. Perhaps you could try reading:

      "Physician-owned ancillary care facilities can provide financial boost"

      http://www.orthosupersite.com/view.aspx?rid=82544

      Wake up to the real world and stop believing what your assistant manager tells you. If PODs weren't taking dollars out of your pocket you wouldn't care a bit about em. Now every 8% commission corporate geek thinks he's a compliance attorney.

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  74. And every surgeon and distributor involved in a POD think that they are an attorney. Let's face it, if you all thought you were in the clear you would sign your names to all those ridiculous posts that criticize those that find these business models unethical and illegal, but then again no different than those that nearly brought the economy down. SHAMELESS, GREEDY BASTARDS, FROM ONE SCAM TO THE NEXT....to be continued

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    1. This comment has been removed by a blog administrator.

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  75. 3:21 this was copied from your article, which also said much of what I said in 1:18 about these ancillary services being more difficult and restrictive in many states.


    "Finally, think about how your ancillary service would look on the front page of the local newspaper. If you can envision the public being proud, then you are on the right track. If it sounds like you may supply the critics with ammunition to deride the “greedy doctors,” then come up with a different plan.

    Ancillaries are an investment of time, money and reputation. Think it through carefully so that you maximize your control over the patient outcome. If you give the patient a fabulous care experience then you will have a successful ancillary. I am not saying you should ignore the financial side. You have to win the financial game to win the clinical game. They go together, but if you do it only for the money you’ll never have enough."

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  76. Once the POD plug is pulled in California, the venerable Alphatec will deflate like a leaky balloon and lay at the bottom of the sewer.
    What say all you spinebloggers? Besides Alphawreck, what other POD driven company will bite the dust?

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    1. Many small and medium sized companies have done some POD sales. Even the majors have dabbled a bit. The ones who seem to be predominantly POD oriented are Phygen, Choice, Titan, and Spinal USA.

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    2. Shortz works with Sam v and Steven Martinez too and Brendon bakir

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  77. Fraudbot has a get out of jail free card. His best friend, is his Governor. This goes way high if they dig deep enough.
    PODs are not illegal.
    OBTW, does anyone think Romney is going to take back our country?
    Not gonna happen. Strap up men, it only gets worse.
    Thank you WSJ and TSB for trying to help tho. I am going to start selling used cars... a more noble profession that might garner more respect.

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  78. Heard that Choice just launched an innovation pedicle screw LMAO! Isn't that company run by Laurel and Hardy?

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  79. Havnt seen a screw out of Choice in Fl yet. Have seen lots of cages being implanted though. Are they POD supporters?

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  80. PODs will never satisfy Safe Harbors protection (40% physician ownership, etc), and thus have to rely on making their model as legal as possible. Hooper, Lundy, Bookman healthcare attorneys have enabled some of the PODs to exist "legally" as possible. The only protection against the POD physicians is if the hospitals prohibit the PODs from doing business at their facilities. The OIG is gutless and has not taken a stand on this issue. I turned a egregious spine surgeon into the Medicare Fraud and Abuse. It took a year for the FBI to contact me. It took another 2.5 years for their investigation. They concluded that he could not find anything illegal with the surgeon despite using a POD, performing 10 level fusion in 85 year old patients for low back pain, deaths due to aggressive spine surgery, mutlilevel anterior neck procedures that were not indicated and one with severe soft tissue edema after the surgeon used Infuse. The patient spent 2 months in the hospital recovering after his PEG and trach were done. I wrote a letter to Levinson of the OIG about the BS investigation and lack of findings. This guy did 500 spine fusions (most of them more than 2 levels) in a year. I do about 170 cases a year, usually 2 lumbar fusions per month. He does not examine patients and only looks at a MRI scan and tells the patient they need to have surgery or become paralyzed, etc. There is so much BS out there that it becomes difficult to know what is good patient care anymore? Local docs look at this guy as the go-to-guy for spine surgery. I look at it as "evil prevails when good people do nothing." What can we do?

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  81. Companies like the one that made their own ped screws at a Murrieta-Temecula machine shop then marked theyourm up for use at Tri-Cities should be preventeted from doing business

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  82. What is frustrating to me is individuals such as Randall that are still walking around. Mr. Randalls personal life is much more deviant then his business life. There is so much more illegal activities that he is involved in and were not discussed in the WSJ article. There is ample evidence out there that should convict him. Look at Orange County California Civil Case Search website. Type in Paul Richard Randall and see how many fraud, RICO (organized crime) and breach of contracts there are against him that he lost or settled. 4 breach of contracts, 1 RICO, 3 Fraud, and 10 other civil disputes. And that is ONLY in Orange County California! He is a convicted felon. And still this man is walking freely? He claimed bankruptcy last year and stated that he made $5000 a month? But he drives a brand new Mercedes and has a multi million dollar home in Orange? Really? I see posts from legitimate people in the industry. I know good people that work hard to make a living in the medical field. And they work and struggle to earn a living. And again they see a POS like him roaming the streets and making millions with his fraud and cons. It's disheartening. All I see is a snake that seems to slip through the cracks. And law enforcement that seems to have there own agenda while he continues to lie his way out of things...FRUSTRADED.

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  83. Off topic. But does anyone know how much Kyphon division of Medtronic impacted 9% decline? What are US sales now? They never mention in the earning reports -- is it really that bad?

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  84. There's too much crying going on

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  85. I have known Randall since he graduated Magna cum Claude from Clare Mont college 30 years ago one of the hardest working guys u will ever meet as far as his deviant personal life he's been married 30 years with 3 great sons the problem he has is that he has trusted too many people that have burned him like the couple living in his rental who tried 2 extort 275k from him I would advise all 2 be careful he has lots of contacts and could bring the curtains down on the industry if he chose

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  86. Promises, Promises, Promises, who is he going to bring the curtain down on himself? You have to be kidding. By the way really impressed that graduated Magnum Cum Claude , who's Claude?

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  87. Hey idiot u think this is about Randall or about 500 or more dirty docs attorneys adjustor's and hospital owners who have cashed in shamelessly. Don't b a moron u ain't seen nothing yet

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  88. I agree this is the tip of the iceberg many many people will go down before this is over wait til tricities is exposed and the mark ups they sanctioned r discovered collection contracts paid to doctors and doctors wives wow

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  89. I'm sitting on the banks of the river and watching the bodies flow by this is far from over u can run but u can't hide docs r going down as in down the river

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  90. I met Randall actually a very smart guy made pacific and tri millions of dollars with his contacts lets hope he doesn't start talking loose lips sink ships

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  91. Yeah he made drobot Jr was selling baseball cards b4 Randall showed him the biz drobot cocktail made docs filthy rich some as much as 500k a month

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  92. You can run but you cannot hide, their coming to take you away. NASS: A joke AANS: A joke CNS: ISASS: A joke. When you read what nefarious dealings some of its so-called members are involved in, it's a wonder why there are massive ongoing investigations to uncover the fraud and corruption that takes place in the spine industry, and please spare us your free-market bs and everything is being done within the boundaries of the law. The 20% that behave in this manner are a malignancy that needs to be eradicated because their greed destroys everything that the 80% strive for. Does anyone truly care that if someone sings like a canary the lid will be blown off of the scharade that has been perpetrated by these individuals? How just will it be to watch some of the attorneys, surgeons, and distributors/middlemen carted away in orange? Surgeons can vilify the big bad government, has anyone performed a diagnosis on your own peers? And then we wonder why healthcare is under assault in this country? Contrary to the greedy, it's not okay to mark up a product 150% because we all pay for it, regardless if one thinks that they are beating the system. People that behave in this manner will respond to a comment by justifying their behavior by call those that play by the rules, weak, stupid, incompetent by the law eventually catches up to you, you are on borrowed time, enjoy it while you can because when they get done crawling up your ass you' ll have experienced the ultimate proctological examine ever. It just won't be fraud, they will investigate your taxes and any other thing that they can find to ensure that this never happens again, until then party on.

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  93. Well said sir...Well said.

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  94. Randall will b exonerated but many docs r prob peeing their pants right now

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