Monthly Archives: October 2016

Health fraud scheme

To prosecutors, Bernard Greenspan saw dollar signs when a blood-testing lab company came to his office seeking referrals several years ago, and he reaped a $200,000 windfall in illegal bribes.

Greenspan’s attorney tells a different story, of an “old-school, solo family practitioner” still practicing while pushing 80 whose transactions were legitimate but who wound up in the wrong place at the wrong time — in the middle of an investigation into a $200 million health care fraud scheme.

More than 40 people, including more than two dozen doctors in New York and New Jersey, have pleaded guilty over the last four years in the scheme. This week, the government’s evidence will be tested for the first time when the 79-year-old Greenspan, who faces maximum penalties that would mean spending the rest of his life in prison, goes on trial.

Opening statements are scheduled for Tuesday in federal court.

“He stands on different footing than the other doctors who have pleaded guilty,” Greenspan’s attorney, Damian Conforti, said Monday. “It differs significantly in that it wasn’t criminal.”

The charges stem from an investigation into Parsippany-based Biodiagnostic Laboratory Services, a previously nondescript New Jersey company that had experienced a large spike in revenues between 2006 and 2013.

There was a reason for the uptick in the company’s fortunes, the U.S. attorney’s office contended when it announced charges in April 2013: the company was bribing a network of doctors in exchange for referrals, often involving unnecessary tests.

The company made $200 million between 2006 and 2013, with more than $100 million as a result of the bribery scheme, according to authorities. U.S. Attorney Paul Fishman estimated Medicare was defrauded out of tens of millions of dollars during that time.

BLS president David Nicoll, who is expected to testify against Greenspan, pleaded guilty in June 2013 to conspiracy and money laundering and faces up to 25 years in prison. Authorities said he used BLS’s profits on a $300,000 Ferrari, $392,000 on tickets to sporting events and $154,000 at a gentlemen’s club and restaurant.

The U.S. attorney’s office alleges one way BLS bribed Greenspan and other doctors was by paying them inflated rents for office space. In one example, BLS allegedly paid a doctor $2,200 per month for about 100 square feet of space.

BLS also paid for Greenspan’s holiday office parties and gave a job to an employee with whom Greenspan was having a sexual relationship, the criminal complaint alleges.

The investigation reflected federal officials’ increased focus on health care fraud over the last 10 years. According to an annual report by the Department of Health and Human Services and the Department of Justice, in Fiscal Year 2016 the federal government won or negotiated more than $2.5 billion in health care fraud judgments and settlements.

What happen if overdose antidote kits

West Virginia health officials are responding to opioid overdoses by distributing more than 8,000 kits with an antidote — Naloxone — that can get people breathing again if administered in time.

Money for the kits comes from a $1 million federal grant to West Virginia, which has had the nation’s highest rate of overdose deaths.

“Naloxone is a lifesaving antidote that, if administered in a timely manner, can effectively reverse respiratory depression caused by opioid and opiate overdose and revive victims,” said Dr. Rahul Gupta, commissioner of the Bureau for Public Health. “This collaboration represents an essential step toward turning around West Virginia’s staggering overdose statistics.”

Federal data show West Virginia had 725 overdose deaths in 2015, the highest rate of any state at 41.5 per 100,000 people. Last year’s numbers are expected to show little improvement.

“We have seen a significant and steady increase in all drug overdose deaths in West Virginia over the last several years. Unfortunately, based upon the trend we are seeing, the number of overdose deaths has not yet peaked,” Gupta said. “We expect our preliminary data for 2016 to further increase as more toxicology results are recorded.”

Meanwhile local emergency medical services agencies administered 4,186 doses of Naloxone last year, up from 3,351 the year before and 2,165 two years ago. Gupta said that data doesn’t include uses by hospital emergency departments, urgent care centers, first responders and family members.

The project is funded with a $1 million federal grant managed by the state Bureau for Behavioral Health and Health Facilities and administered by Gupta’s bureau. West Virginia University’s Injury Control Research Center will implement and evaluate the project.

More than 4,000 of the two-dose kits will go out in the next few weeks to high priority areas, including needle-exchange programs and police and fire departments in the cities of Huntington, Charleston, Wheeling and Morgantown and other urban and rural areas.

Pose poison risk for kids

Parents who store medicines and household cleaners out of reach to protect their kids from accidental poisoning shouldn’t forget to consider any drugs they have for the family pet, a new study suggests.

Children five and under account for 88 percent of calls to poison control centers for exposure to veterinary medicines, researchers report in Pediatrics. In almost all of these cases, kids consumed drugs intended for the family pet.

About one in four of these poisonings happened while someone was trying to give medicine to a pet, the study also found.

“This could have happened if the pet spit the medicine out onto the floor then the child ate it or if the medicine was mixed in with food such as a hot dog or piece of cheese and the child ate the food containing the medicine,” said study co-author Kristin Roberts of the Center for Injury Research and Policy at Nationwide Children’s Hospital in Columbus, Ohio.

“The good news is that you can help keep everyone in the family a little safer by storing medicine for pets up and away and out of sight, only giving medicine to pets when the children aren’t in the room and by making sure the pet has taken the medicine,” Roberts added by email.

To assess the risk veterinary medicines pose to children, Roberts and colleagues analyzed data on 1,431 calls to a regional poison control center in Ohio from 1999 through 2013.

Most of the calls – 88 percent – related to medicines for dogs, the study found.

In 93 percent of cases, children ate or drank pet medicines. Another 2.3 percent of the calls involved children getting veterinary drugs in their eyes, and 1.1 percent of cases were for skin exposure.

While most instances happened at home and could be managed without a visit to the doctor, children went to a health facility for treatment in about 6 percent of cases.

When children did go to a hospital or health facility, they were evaluated and treated or released in about 60 percent of cases.

When parents were told children needed to see a doctor, the most common exposures were for pet pain medicines, or drugs for parasites, convulsions or other ailments.

In most cases, the children had few or no bothersome symptoms or didn’t require follow-up care because their exposure to the pet medicines was determined to be nontoxic or not that harmful.

The study was limited by the fact that it was done at a single poison center, and recording of different types of veterinary medicines by poison control specialists was inconsistent.

Not all families have pets, and the odds of poisoning from veterinary medicines may be lower than for other things around the house, said Dr. Carl Baum, a researcher at Yale School of Medicine in New Haven, Connecticut, who wasn’t involved in the study.

Still, curious toddlers are going to be at risk, Baum added by email.

“Try as you might to teach toddlers not to explore/touch/taste/swallow objects, they will do so,” Baum said.

Scientific facts about twins

Beyoncé is pregnant with twins! The singer and actress, 35, announced the news on Instagram today, posting a photo of her baby bump and writing that she and husband Jay Z “have been blessed two times over.”

Pregnancies with multiple babies aren’t as rare as they once were, but they’re still an uncommon event. So in celebration of the couple’s happy news, here are 10 fascinating things you may not know about twins—identical, fraternal, and otherwise.

Twin births are on the rise

There were 135,336 twin births in the United States in 2014, the latest year for which data is available. That means about 3.4% of all babies born that year were twins—a record high, according to the United States Centers for Disease Control and Prevention.

The twin birth rate has been climbing steadily since 1980, and experts say that the prevalence of in vitro fertilization (IVF) and other assisted reproductive technologies has likely played a role.

Older moms are naturally more likely to have twins

Even without IVF or other fertility treatments, mothers are naturally more likely to have twins as they get older, says Christine Greves, MD, an obstetrician and gynecologist at Winnie Palmer Hospital for Women and Babies in Orlando.

“It may have to do with evolution,” says Dr. Greves. “Women at an older age won’t be able to have babies for much longer, so it makes sense that they’d have more at one time.”

Twins live longer than singletons—and so do their moms

In a 2016 study from the University of Washington, researchers found that identical twins tend to live longer than fraternal twins, and all twins tend to live longer than the general population. “There is benefit to having someone who is socially close to you who is looking out for you,” said study author and postdoctoral researcher David Sharrow, PhD, in a press release. “They may provide material or emotional support that leads to better longevity outcomes.”

There’s good news for moms of twins, as well: In 2011, University of Utah researchers discovered that women who give birth to twins tend to live longer than other mothers. (It’s not because having twins makes you healthier, say the researchers, but that healthier women are more likely to have twins.)

Disease Control and Prevention

According to the Centers for Disease Control and Prevention (CDC), more women are waiting until later in life to start a family. As of 2014, the average age of first-time pregnancies reached a record high of 26.3. The report suggests a decline in women having babies in their teenage years and an increase in women giving birth in their 30s.

But what do these statistics mean for American women’s fertility? We got the following email from a viewer:

Dr. Manny,

I am 30 years old, and I am focused on my career. I hear a lot of conflicting information about when to start a family. Is this something I should be thinking about now, or do I have time?


Many women have similar concerns when it comes to starting a family. CDC data suggests 12 percent of women between ages 15 and 44 are infertile— and the condition can be expensive for those who want to have children. In vitro fertilization (IVF) is a popular alternative fertility option, but one cycle can cost up to $12,000.

Causes of infertility include:
Drinking alcohol in excess
High stress levels
Poor dieting

Dr. Kaylen Silverberg is board-certified in obstetrics, gynecology and reproductive endocrinology, and she is the co-founder of Los Angeles-based fertility lab Ovation Fertility. He recommended that women in their late 20s and early 30s get an annual evaluation of their ovarian reserve at their OB-GYN or a trusted fertility clinic by having their blood drawn on the third day of their menstrual cycle.

The test measures a woman’s Anti-Mullerian hormone (AMH,) as well as her estradiol and follicle-stimulating hormone (FDH). With this information, specialists can determine if a woman’s ovarian reserve is stable or starting to diminish.

“The major benefits of ovarian reserve testing are that you’ll know where you are in your reproductive lifespan,” Silverberg told “If in fact your numbers are starting to deteriorate already— suggesting that your ovarian reserve is starting to fall— we’ll know the rate at which it’s falling, and therefore fertility specialists or even gynecologists can recommend how fast you need to get moving.”

Recipes for your cosmetic needs

Finding the right skin care products for your routine can be difficult, especially if you want to avoid conventional cosmetics, harmful chemicals, or animal testing. But did you know that you can make your own cosmetics and skin care products from all natural and even organic ingredients? Making your own organic beauty products is much easier than you think! With just a few simple ingredients, you can create a daily routine that is free of chemicals and good for you and the planet.


DIY Moisturizer to Beat the Winter Blues

This is a great moisturizer that will keep your skin looking smooth and fresh during the cold, dry winter months. It’s so simple to make that you won’t miss your expensive little tubs of commercial goop one bit!

What you need:
• 1/3 cup aloe vera gel (don’t use juice or aloe from a plant, as the cream won’t whip properly)
• 2 tablespoons sweet almond oil
• 2 tablespoons jojoba oil
• 1/2 tablespoon beeswax
• 10 drops lavender essential oil

In a double boiler, gently heat the almond and jojoba oils with the beeswax. If you don’t have a double boiler, you can simply use a glass or metal bowl over a pot of simmering water on the stove. Once melted, transfer your mixture to a deep mixing bowl so it won’t splash out. Leave to cool for an hour until it reaches room temperature. Now start to blend your mixture with a hand blender. Pour in the essential oil and slowly start adding the aloe vera. Add aloe (mixing continuously) until you reach the desired consistency. Store in an airtight container.

Symptoms that could signal a serious problem

If you’re like us, you tend to overreact when you notice anything new or strange going on with your body. A little ache in your arm? OMG cancer! A few extra hairs in your comb? Impending baldness!

While it’s good to be on guard, not every new symptom should send you racing to your doctor’s office, says Rob Danoff, DO, an osteopathic physician and director of family medicine at Philadelphia’s Aria Health System.

At the same time, Danoff says some seemingly benign symptoms—stuff most of us would brush off—are worthy of close examination, especially if they stick around for more than a week or two. “I call it body talk,” he says. “Your body does a good job of sending you signals or clues when something’s wrong.”

But sometimes those signals are super subtle. Here are a few of those signals you don’t want to ignore.

Your handwriting is shrinking.

Any changes to your handwriting could signal a developing tremor, which is an early indicator of Parkinson’s disease, Danoff says. Especially if your handwriting is getting smaller and tighter, this may be a furtive sign you’re struggling to hold your hand steady, he says. (Find out what else your hands say about your health.)

Your skin feels different.

Dry and itchy skin are common issues. But if seasonal shifts—or a new soap or moisturizer—can’t explain your sudden skin changes, you’ll want to tell your doctor if your skin suddenly seems dryer, itchier, thicker, or scaly, says Lauralee Yalden, MD, a New Jersey-based family medicine physician. “The thickening of the skin can signify high blood pressure or kidney problems,” Yalden explains. “Dry, itchy skin could be caused by an underactive thyroid, a nutritional deficiency, or even an autoimmune disorder.”

Your breath smells fruity.

“With diabetes or prediabetes, people sometimes give off this weird, almost fruity odor,” Danoff says. He and other experts attribute the smell to your body’s efforts to burn off the excess sugar in your blood stream. “You’d notice the smell, and so would people around you,” Danoff adds.

MORE: 10 Foods That Lower Blood Sugar Naturally

You suddenly have trouble calculating tips.

If math is an old foe of yours, a little confusion while figuring out the tip isn’t a big deal. But if you’ve always been good with numbers, problems calculating a tip or managing your finances could be an early warning sign of Alzheimer’s or dementia, Danoff says. “If it happens once or twice, don’t worry too much about it,” he says. “But if you keep staring at your bill and you can’t figure out what 20 pecent is, that may be something to pay attention to.”