Consumer Health Digest #05-26

Your Weekly Update of News and Reviews
July 5, 2005

Consumer Health Digest is a free weekly e-mail newsletter edited by Stephen Barrett, M.D., and cosponsored by NCAHF and Quackwatch. 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.

OIG reports chiropractic overpayment. The Office of the Inspector General has concluded that in 2001, the U.S. Government paid chiropractors $285 million for services that should not have been billed to Medicare. The questionable payments amounted to 57% of what Medicare spent on chiropractic services that year. Chiropractors are entitled to payment for spinal manipulation for active therapy for certain conditions, but not for "maintenance care." (Under the Medicare program, active therapy is treatment that provides "reasonable expectation of recovery or improvement of function" and maintenance care is "a treatment plan that seeks to prevent disease, promote health, and prolong and enhance the quality of life; or therapy that is performed to maintain or prevent deterioration of a chronic condition." The improper payments included $186 million for maintenance and $24 million for manipulation of other areas or other treatments such as massage. The OIG report concluded that (a) about 40% of chiropractic services to Medicare patients are for maintenance care; (b) as chiropractic care extends beyond 12 treatments in a year, it becomes increasingly likely that individual services are medically unnecessary; and (c) lack of necessity increases even more significantly after 24 treatments. [Chiropractic Services in the Medicare Program: Patient Vulnerability Analysis. OIG Report #OEI-09-0200530, June 2005] Many chiropractors advise lifetime periodic spinal examinations and adjustments for what they call "preventative maintenance." Because "maintenance care" lacks a plausible rationale and has never been proven beneficial, insurance plans do not knowingly pay for it. The Medicare overpayment rate may improve because as of October 1, 2004, chiropractors must specify on their claims forms whether active or maintenance care was rendered.

FTC slams more phony diet pill marketers. The Federal Trade Commission has completed actions against the marketers of several products claimed to produce weight loss without diet or exercise:

Ravi Devgan arrested for fraud. Ravi Devgan, whose medical license was revoked in 2003 by the College of Physicians and Surgeons of Ontario, is facing criminal charges for illegally continuing to practice medicine. According to a release from the Toronto Police Service, he provided treatment to two 9-year-old boys who have cerebral palsy.[Doctor arrested in fraud investigation. Toronto Police service news release, July 2, 2005] In 1993, Devgan was reprimanded for professional misconduct and fined $5,000. In 1996, he faced the criminal courts over the same matter and was convicted of defrauding the patient. At the same trial, he was convicted of making a false statement by misrepresenting himself as part owner of a restaurant in order to get a $98,500 loan. The U.S. Food and Drug Administration issued an import alert listing Devgan as having prescribed Laetrile, Life Crystals, and other unapproved drugs whose importation has been banned by the FDA.

Consumer Reports goofs in article about "alternatives." Consumer Reports magazine, which usually publishes reliable advice about quackery-related topics, has fumbled badly in its recent article "Which alternatives treatments work?" The main part of the article (Aug 2005, pp 39-43) is based on the responses of about 34,000 readers to a survey about their use of chiropractors, acupuncture, herbs and several other nonstandard modalities for back pain, neck pain, and several other problems. The article contains several serious flaws:

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This page was posted on July 5, 2005.