Consumer Health Digest #17-13

Your Weekly Update of News and Reviews
March 26, 2017


Consumer Health Digest is a free weekly e-mail newsletter edited by Stephen Barrett, M.D., with help from William M. London, Ed.D., M.P.H. It summarizes scientific reports; legislative developments; enforcement actions; news reports; Web site evaluations; recommended and nonrecommended books; and other information relevant to consumer protection and consumer decision-making.


Three patients blinded by unapproved stem cell therapy. The New England Journal of Medicine has reported that three women have become permanently blind after having their eyes injected with a stem cell preparation. The patients, who ranged in age from 72 to 88 years, had age-related macular degeneration. Newspaper reports have identified the clinic as Bioheart Inc., also known as U.S. Stem Cell Inc. and say that stem-cell procedure involved liposuction to remove fat from the abdominal area, isolating the stem cells from the fat, and injecting those cells directly into eyes. The complications included detached retinas, hemorrhages, and vision loss. Knowledgeable observers believe that the FDA should regulate stem-cell treatment more closely and that unapproved studies should not be listable on ClinicalTrials.gov because that gives them undeserved respectability. [McGinley L. 3 women blinded by unapproved stem-cell 'treatment' at Florida clinic. Chicago Tribune, March 16, 2017] Another article in the New England Journal noted that, "Outside a few well-established indications, the assertion that stem cells are intrinsically able to sense the environment into which they are introduced and address whatever functions require replacement or repair is not based on scientific evidence."


Chirobase posts OIG reports on chiropractic under Medicare. Since 1973, Medicare has covered manual manipulation of the spine for the treatment of certain neuromusculoskeletal conditions. To get paid, chiropractors are supposed to (a) specify the region(s) of the spine where the supposed problem exists, (b) diagnose a medically recognized condition that is related to that spinal region, (c) document symptoms, physical findings, and/or x-ray findings that are related to that region, and (d) record a treatment plan that specifies goals and objective measures to evaluate treatment effectiveness. The chiropractor must also attest that the patient is receiving "active" treatment, which is defined as a "reasonable expectation of recovery or improvement of function." Services intended to prevent disease, promote health, prolong or enhance the quality of life, or maintain or prevent deterioration of a chronic condition are considered "maintenance care" and are not covered. To increase Medicare payments, many chiropractors manipulate more spinal regions than necessary, treat more frequently than needed, and/or report treating more regions than actually treated. Some also try to conceal the fact that they are providing maintenance therapy by changing their diagnosis every 12 visits. The Office of the Inspector has been expressing concern about Medicare payments to chiropractors for more than 30 years. Chirobase has posted these reports plus how to detect miscoding and unnecessary treatment.


High-volume chiropractor indicted for Medicare fraud. Enrique (Henry) Posada, D.C., who practices in Chicago, has been charged with submitting bogus claims for purported physical therapy and chiropractic services that were never provided. According to the indictment:

The indictment, which includes 18 counts of health care fraud, seeks forfeiture of the $5.1 million, as well as $850,000 in cashier checks, a 2013 Lexus LX 570 automobile, and a property in Watseka, Illinois. From 2014 to 2014, Posada was among Medicare's highest paid chiropractic recipients. In 2014, Medicare paid him $276,683, which was the third-highest total received that year by a chiropractor. He ranked #16 in 2012 and #2 in 2013.


Predatory journals hit by "fake editor" sting. A Polish research team has found that many journals that they classified as "predatory" accepted the application of a nonexistent person to become an editor. In 2015, the researchers created a profile of a fictitious scientist named Anna O. Szust (Oszust is the Polish word for fraud) and applied on her behalf to 360 journals, 120 from each of three well-known directories: the JCR (journals with an official impact factor as indexed on Journal Citation Reports), the DOAJ (journals included on the Directory of Open Access Journals) and "Beall's list" (potential, possible or probable predatory open-access publishers and journals, compiled by University of Colorado librarian Jeffrey Beall). "Dr. Szust" was accepted by 40 on Beall's list and 8 on the DOAJ list. At least 12 conditioned acceptance on, or strongly encouraged, some form of payment or participation in a profit-making scheme. [Pisanski K and others. Predatory journals recruit fake editor. Nature 543:481-483, 2017] Predatory journals, which appear to exist primarily to extract money from authors, exhibit questionable marketing schemes, follow lax or nonexistent peer review, and lack scientific rigor and transparency. More than 10,000 publications appear to fit this description. Beall's list was removed from the University of Colorado Web site in January 2017. [Straumsheim C. No more 'Beall's List': Librarian removes controversial list of "predatory" journals and publishers, reportedly in response to "threats and politics." Inside Higher Ed, Jan 17, 2017] At the time of its removal, it had about 1,200 entries.


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This page was posted on March 26, 2017.