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End-of-Life Choices

Trends in end-of-life care show that not only does the care given vary widely from region to region and hospital to hospital, but also patients often don't get the care they prefer. What can be done?

Care Management Puzzle

Chronic diseases and the cost of care are rising. Are disease management programs improving outcomes for patients with complex, chronic conditions?

No Middleman

Under the "direct primary care" model, patients pay a monthly fee for basic medical services. Learn about the history and current landscape of physician practices offering this arrangement.

Health Plans

Friday, January 27, 2012

Insurer Says State Has Launched Fraud Probe of Lap-Band Surgery Clinics

According to the health insurance company Aetna, the California Department of Insurance has started an investigation into the business practices of weight-loss surgery centers associated with the 1-800-GET-THIN marketing initiative, the Los Angeles Times reports.

The 1-800-GET-THIN campaign markets the Lap-Band procedure, which is used to treat obesity by surgically implanting a ring around the stomach to discourage overeating (Pfeifer, Los Angeles Times, 1/26).

Background

In December 2011, FDA sent warning letters to 1-800-GET-THIN and its affiliated surgery centers about ads that were misleading about the procedure.

The company later added a disclosure to its website, saying the surgeries can result in death.

Since 2009, five Southern California patients have died after having the Lap-Band procedure, according to autopsy reports, lawsuits and public records.

Los Angeles County supervisors are examining whether the county can regulate weight-loss ads (California Healthline, 1/24).

In addition, the Los Angeles County Board of Supervisors and members of Congress are examining the ads and risks associated with Lap-Band surgeries.

Details of Possible State Investigation

Aetna said it was cooperating with the state insurance department's law enforcement branch to "investigate alleged fraud against our members by the 1-800-GET-THIN ... surgery centers."

CDI spokesperson David Althausen neither confirmed nor denied that the department was investigating the centers.

Officials with 1-800-GET-THIN and its affiliated surgery centers said that they did not know of the CDI investigation and that they have not broken any laws.

Robert Silverman, president of 1-800-GET-THIN, said the company "has never engaged in any type of insurance fraud and has not been contacted by the Department of Insurance" (Los Angeles Times, 1/26).



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