While there are countless examples of good-natured, passionate individuals in the healthcare industry, there are numerous bad actors at play.
“Pharma bro” Martin Shkreli is perhaps the most egregious example of someone taking advantage of patients and the industry at large for personal gain. But even in Shkreli’s absence, there are plenty of others unfortunately following in his footsteps.
Award ‘winners’ include several notable healthcare companies as well as a dentist who broke patients’ teeth purposefully to bill insurers for expensive procedures and a private equity-backed company that ran two rural hospitals into the ground for profit.
“If we’re ever going to get to the great health system that Americans deserve, we have to call out bad behavior,” Dr. Vikas Saini, president of the Lown Institute, said in a statement. “The Shkreli Awards are a mirror that’s hard to look into, but we’ve got to do it.”
Below are the top 10 2022 Shkreli Award winners.
1. Insurers overbilled Medicare Advantage, costing taxpayers up to $25 billion in 2020.
Many large Medicare Advantage insurers overbilled the U.S. government by “mining” patients for more and often unnecessary diagnoses, a recent investigation by The New York Times found.
2. Private equity-backed startup Noble Health bought two rural hospitals, then proceeded to run them into the ground for profit.
As more private equity companies seek to buy healthcare clinics throughout the U.S. — aiming to generate quick financial returns, according to Kaiser Health News — some are doing so in dubious ways.
Noble bought two struggling rural hospitals in Missouri, but proceeded to stop paying for employees’ health insurance and created an unsafe condition for patients through drug and supply shortages.
The rural hospitals were closed two years later, after Noble pocketed $20 million in federal COVID-19 aid funding.
3. Richmond Community Hospital in Virginia profited off the 340B drug program by diverting the money to other hospitals.
The federal 340B drug program requires hospitals and pharma companies to provide discounts on medications for low-income patients.
The program is also much-maligned amid criticisms that bad actors take advantage of it for financial gain at the expense of patients.
Richmond Community Hospital sought to profit off the program by diverting the money to hospitals in wealthier neighborhoods, without providing an ICU or maternity ward for its own patients, according to another investigation by The New York Times.
4. Novus Hospice CEO and employees committed healthcare fraud by trying to hasten patient deaths to avoid caps on government reimbursement.
Texas-based Novus directed its staff to dispense beyond the maximum levels of morphine and hydrocodone to patients without physician oversight.
5. Johnson & Johnson tried to seek a subsidiary bankruptcy loophole to avoid lawsuits and payments over the asbestos in baby powder scandal.
Recently, the company created a subsidiary for all its baby power-related liabilities then declared it bankrupt.
6. Philip Morris has recently acquired companies that develop inhaled therapeutics, aiming to treat conditions caused by its tobacco products.
In an ironic twist, Big Tobacco has recently tried to cash in on the respiratory health business. This comes despite being a major driver of illnesses like lung cancer or chronic obstructive pulmonary disease by producing tobacco products.
In particular, Phillip Morris has invested billions into the healthcare industry, acquiring companies that develop products like inhalers. Critics say Phillip Morris continues to push tobacco and its attempts to profit off respiratory disease treatments are insincere.
7. Providence health system sent debt collectors after patients who qualified for financial assistance, as part of a larger plan to increase revenue.
Executives at one of the nation’s largest nonprofit hospital chains, Providence, designed a plan called “Rev-Up” to wrangle money out of patients in order to boost revenue.
That scheme even sent debt collectors after low-income patients who qualified for financial assistance from the hospital, according to The New York Times.
8. Three North Texas laboratories bribed physicians to order unnecessary drug tests and blood work to make up to $300 million in extra Medicare reimbursements.
The laboratories collaborated with two marketing firms to bribe physicians to order unnecessary tests – a common ploy to rack up extra money.
Some of the physicians involved received up to $400,000 in kickbacks, according to The Dallas Morning News.
9. Catholic Medical Center protected cardiac surgeon Dr. Yvon Baribeau despite his lengthy malpractice record.
Baribeau allegedly performed countless surgical errors that led to 21 medical malpractice settlements. The hospital, however, continued to feature him in hospital ads until he retired in 2019.
10. Wisconsin dentist Scott Charmoli broke patients’ teeth unnecessarily in order to bill insurance companies for expensive procedures
Charmoli broke patients’ teeth to boost the number of “fixed crowns” from 434 a year to more than 1,000. This was all in the attempt to justify expensive procedures to insurance companies. This cruel act led to an increase in his salary by $1.1 million. However, Charmoli has since been convicted of healthcare fraud, is serving prison time and owes $1 million in fines.