We retired our private practice of medical oncology in Pittsburgh last year after 50 years of service. In the last few years, we were aware that UPMC was abusing the system by declaring the oncology offices to be part of outpatient departments of selective hospitals of theirs, regardless of the position of the office geographically.
In the excellent investigative report by Bill Toland (“UPMC Abusing Drug Discount Plan?,” June 10), he showed that this abuse was under the guise of Section 340B of the Public Health Service Act of 1992. This act allowed certain hospitals to buy chemotherapy drugs inexpensively and to be rewarded handsomely for their use.
The reason for this was to help poor people in covering their chemotherapy bills. This is not what UPMC was doing. The fees were obviously to enrich the oncology department of this medical giant.
The article suggested that this act was being reviewed congressionally and would be changed. I would hope there will be a requirement that the money be reimbursed or that there be major fines.
Recently my wife and I experienced another variation on this theme. My wife had injections of a joint by her pain doctor. She had this several times in the past and it had taken the usual 20 to 30 minutes. This time, the cost was $3,565 and the bill was pretty much split between two different injections of a local analgesic and probably some steroid. This fee did not include the doctor’s charge and required a co-payment.
Our insurance covered the bill except for a rather large co-payment for this as well.
I would warn patients to beware of minor surgical procedures done in an office declared part of the outpatient department of a hospital.
In this case the excuse seems to be that the physician is an employee of the hospital and the fluoroscope in the office is owned by the hospital.
ALAN D. BRESS, M.D.