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Amputated Methodist patient awarded $10 million

A Harris County jury has ruled in favor of a Houston man in a medical malpractice case, awarding him $10 million in damages stemming from a lawsuit against Methodist Hospital and the doctors who treated him there.

John German developed gangrene that required the amputation of his left leg above the knee, all the toes on his right foot and all of his fingers in the aftermath of heart surgery in 2002 .

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FBI raids prosthetics office

Agents seized computer files along with boxes of patient records, billing receipts and other business documents Tuesday from a Brunswick company being scrutinized in a federal investigation of suspected health care fraud in two states.

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Cuomo Probes

NEW YORK (Reuters)—New York Attorney General Andrew Cuomo said Wednesday he is conducting an industrywide probe of health insurers into an alleged scheme to defraud consumers by manipulating reimbursement rates.

At the center of the scheme is Ingenix, the nation’s largest provider of health care billing information, which serves as a conduit for rate data to the largest insurers in the country, Mr. Cuomo said in a statement.

Mr. Cuomo said he intends to sue Ingenix, Ingenix parent UnitedHealth Group Inc., and three additional subsidiaries.

Mr. Cuomo said he has issued 16 subpoenas to the nation's largest health insurance companies, including Aetna Inc., CIGNA Corp. and Empire Blue Cross Blue Shield, a unit of WellPoint Inc.

The subpoenas to insurers request documents on how they compute reasonable and customary rates and communications between Ingenix and the insurers on the issue, among other information, Mr. Cuomo said.

A six-month probe found that Ingenix operates a “defective and manipulative” database that most major health insurance companies use to set reimbursement rates for out-of-network medical expenses, Mr. Cuomo said.

"Getting insurance companies to keep their promises and cover medical costs can be hard enough as it is," Mr. Cuomo said. "But when insurers like United create convoluted and dishonest systems for determining the rate of reimbursement, real people get stuck with excessive bills and are less likely to seek the care they need."

UnitedHealth said it was in ongoing discussions with Mr. Cuomo’s office on the issue and would continue to cooperate fully.

"UnitedHealth Group recognizes the excellent health care delivered to patients by the physicians of New York and is committed to fair and appropriate payment for physicians, the state's other health care providers and consumers," UnitedHealth said in a statement.

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Amputee Sues, Claiming Discrimination

POSTED: 11:51 am CDT September 28, 2007

UPDATED: 12:40 pm CDT September 28, 2007

RAYTOWN, Mo. -- An electrician is suing a Raytown, Mo., company, claiming they didn't hire him because of his amputated leg.

Robert Stufflebeam is an amputee who wears a prosthetic. (Actually, he wears a prosthesis.)

He said that when he walked into The Electrical Corporation of America to apply for a job, a safety director noticed his limp and concluded he would be a safety risk. "I've always had to prove myself when I go to work for somebody new; I've had to prove that I can do my job, that I am qualified. I've always been given a chance to do that. This time that didn't happen," said Stufflebeam.

The Equal Employment Opportunity Commission is filing a lawsuit on behalf of Stufflebeam. The company in Raytown would not comment on the case.

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