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January 27, 2015

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Doctors’ consulting fees at UMC prompt state investigation

A New York Times expose of the University Medical Center’s preference for a particular manufacturer of pacemakers and defibrillators has sparked a state probe into whether the cardiologists who implanted the devices had improperly accepted consulting fees from the manufacturer.

Gov. Brian Sandoval on Monday asked the Health and Human Services Department to investigate whether patient safety is at risk or if improper billings have been made.

The Board of Medical Examiners is also looking into the relationship between the pacemaker’s manufacturer, Biotronik, and cardiologists with Nevada Heart and Vascular.

According to The New York Times, 95 percent of the pacemakers implanted in patients at UMC last year came from Biotronik. The devices became popular at UMC in mid-2008 after Biotronik hired several cardiologists as consultants, paying them fees as high as $5,000 a month, according to the report.

“I really can’t talk about the investigation, but it has been brought to our attention and the board is going to take an initial look into the situation,” said Doug Cooper, executive director of the Board of Medical Examiners.

Cooper would not comment on whether the probe was initiated as a result of the story or was under way before the report.

State law prohibits doctors from accepting fees or compensation that would influence the care or evaluation of a patient. “That would violate our medical practices act,” Cooper said.

An initial review by Health and Human Services turned up no billing irregularities or patient safety issues, according to Director Mike Willden.

“Our role is the patient safety role, and we don’t have anything to indicate there is a patient safety issue,” Willden said. “We’ve also asked our utilization review team to look at all billings out of the heart group and if we see a pattern we can refer it for further investigation.

“But I’m scrolling through it right now and don’t see anything unusual.”

In 2007, Nevada Heart and Vascular was the subject of a federal inquiry into its Medicare billing practices. Willden said his department is looking at whether any Medicaid billing irregularities exist.

Click to enlarge photo

Kathy Silver

In a statement released Monday, UMC CEO Kathy Silver said no Biotronik pacemaker has been the subject of a recall and the devices have shown “significantly improved outcomes for our cardiac patients who receive them.”

“UMC also takes its financial responsibilities seriously,” Silver said. “The hospital’s contract with Nevada Heart and Vascular provides for a distinct level of quality care for our patients, at a very reasonable cost to us. Additionally, with the inclusion of new pricing agreements with all four vendors, including Biotronik, we have been able to reduce costs for cardiac implants by approximately $1.1 M every year.”

Silver said hospital policy adopted in 2010 requires physicians to disclose any financial ties they have to vendors. The doctors named in the Times article, however, haven’t come up for reappointment since that policy was adopted, so they haven’t yet been asked to disclose any relationships with Biotronik.

The newspaper investigation also caught the attention of Nevada lawmakers.

Assemblywoman April Mastroluca, D-Henderson, chairwoman of the Assembly Health and Human Services Committee, said she’s concerned about the allegations in the report.

“We need to figure out how it happened, and we are looking into whether it should be common practice or it shouldn’t,” she said.

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  1. Why don't they sell medical devices, like pacemakers, in vending machines out at UMC, so people can make their choice? That's the free market that people out at NPRI want.

  2. Right, and this State is thinking about "Medical Tourism?" They have a long way to go to improve the medical profession and its regulation here.

  3. Having these companies employ doctors as "consultants" sounds like a real joke, just another ruse to encourage them to prescribe their products.