Healthcare

DaVita Pays $450 Million for Drug Wastage Fraud, Largest Unjoined Whistleblower Settlement in History

| Importance: 9/10

DaVita Healthcare Partners agrees to pay $450 million (ultimately $495 million) to resolve False Claims Act allegations that it knowingly created unnecessary waste in administering dialysis drugs Zemplar and Venofer, then fraudulently billed Medicare and Medicaid for the avoidable waste. …

DaVita Kent Thiry Alon J. Vainer Daniel D. Barbir Department of Justice healthcare dialysis medicare-fraud whistleblower patient-harm +1 more
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Wall Street Journal Exposes Theranos Blood-Testing Fraud in Landmark Investigation

| Importance: 9/10

Wall Street Journal reporter John Carreyrou publishes the first investigative article exposing Theranos’ fraudulent blood-testing technology, revealing that the company was using traditional blood testing machines instead of its proprietary ‘Edison’ devices and that test results …

John Carreyrou Elizabeth Holmes Theranos Wall Street Journal Walgreens +1 more corruption fraud regulatory-capture tech healthcare +3 more
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Martin Shkreli Raises Daraprim Price by 5,000%, From $13.50 to $750 Per Pill

| Importance: 9/10

In September 2015, Turing Pharmaceuticals under CEO Martin Shkreli purchased the American marketing rights to Daraprim (pyrimethamine) and immediately raised the price from $13.50 to $750 per pill—a price increase of over 5,000%. The move became a symbol of pharmaceutical price gouging and exposed …

Martin Shkreli Turing Pharmaceuticals healthcare pharmaceutical-price-gouging corporate-crime regulatory-capture
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Supreme Court Rejects King v. Burwell Challenge to ACA Subsidies in Federal Exchanges

| Importance: 8/10

The U.S. Supreme Court ruled 6-3 in King v. Burwell that premium tax credits are available to qualifying individuals in all states, rejecting a challenge that would have eliminated subsidies for millions in the 34 states using the federal healthcare exchange (HealthCare.gov). The lawsuit, filed by …

U.S. Supreme Court Chief Justice John Roberts Justice Antonin Scalia King (Plaintiff) Sylvia Burwell (HHS Secretary) healthcare aca-sabotage supreme-court subsidies legal-challenges +1 more
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Marco Rubio's Risk Corridor Amendment Triggers ACA Insurance Market Destabilization

| Importance: 8/10

Senator Marco Rubio successfully inserted a provision into the Consolidated and Further Continuing Appropriations Act of 2015 that prohibited the Department of Health and Human Services from using general appropriations to fund the ACA’s risk corridor program, limiting payments to only user …

Senator Marco Rubio U.S. Congress Department of Health and Human Services Insurance Companies healthcare aca-sabotage insurance-markets legislative-sabotage republican-obstruction +1 more
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DaVita Pays $350 Million to Settle Doctor Kickback Allegations, Exposing Systematic Dialysis Profiteering Scheme

| Importance: 8/10

DaVita Healthcare Partners, the nation’s second-largest dialysis provider, agrees to pay $350 million to resolve False Claims Act allegations that it paid illegal kickbacks to physicians to induce patient referrals to its dialysis clinics from 2005-2014. The scheme involved DaVita offering …

DaVita Kent Thiry Department of Justice HHS Office of Inspector General healthcare dialysis medicare-fraud kickbacks regulatory-capture +2 more
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Max Baucus Confirmed as Ambassador After Healthcare Industry Staffers Become Lobbyists

| Importance: 8/10

The Senate confirmed former Finance Committee Chairman Max Baucus (D-MT) as U.S. Ambassador to China by a vote of 96-0, ending his 36-year congressional career. Baucus had served as chairman and ranking member of the powerful Senate Finance Committee, where he was the chief architect of the …

Max Baucus Senate Finance Committee Merck UnitedHealth Group Jeffrey Forbes revolving-door lobbying congressional-corruption healthcare regulatory-capture
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Healthcare.gov Launch Disaster Costs $1.7B from $93M Contract

| Importance: 7/10

The Healthcare.gov launch on October 1, 2013 became one of the most expensive government IT failures in history, with costs ballooning from an initial $93.7 million CGI Federal contract to over $1.7 billion total. The site crashed within minutes of launch, with only 6 people successfully enrolling …

CGI Federal Healthcare.gov HHS CMS Accenture +1 more healthcare it-failure government-contracting obamacare waste
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Supreme Court Allows Antitrust Challenge to Pay-for-Delay Drug Settlements Costing Consumers $3.5 Billion Annually

| Importance: 10/10

The Supreme Court ruled 5-3 in FTC v. Actavis that the Federal Trade Commission could bring antitrust challenges against “pay-for-delay” agreements where brand-name drug manufacturers pay generic competitors to delay bringing cheaper alternatives to market. The decision reversed lower …

Supreme Court of the United States Federal Trade Commission Solvay Pharmaceuticals Actavis Watson Pharmaceuticals +1 more pharmaceutical-industry patent-abuse regulatory-capture antitrust supreme-court +2 more
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ACA Architect Liz Fowler Leaves White House for Johnson & Johnson After Industry-Friendly Healthcare Legislation

| Importance: 9/10

On December 5, 2012, Elizabeth “Liz” Fowler announced her departure from the White House to join Johnson & Johnson as head of global health policy, completing her third spin through the healthcare industry revolving door. Fowler had served as the chief architect of the Affordable …

Elizabeth Fowler Johnson & Johnson WellPoint Max Baucus Barack Obama +1 more revolving-door regulatory-capture healthcare lobbying pharmaceutical-industry +3 more
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New England Compounding Center Fungal Meningitis Outbreak Kills 64, Sickens 798 - FDA and State Regulators Ignored Decade of Violations

| Importance: 9/10

The Centers for Disease Control and Prevention began investigating a multistate fungal meningitis outbreak in September 2012 that ultimately killed 64 people and sickened 798 individuals across multiple states who received contaminated methylprednisolone steroid injections from the New England …

New England Compounding Center Barry Cadden FDA Massachusetts Board of Pharmacy CDC +1 more pharmaceutical-industry regulatory-capture fda healthcare public-health +1 more
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Supreme Court Makes ACA Medicaid Expansion Optional, Enabling State Obstruction

| Importance: 9/10

The U.S. Supreme Court ruled 7-2 in National Federation of Independent Business v. Sebelius that the Affordable Care Act’s mandatory Medicaid expansion was unconstitutionally coercive, making it optional for states. While Chief Justice John Roberts upheld the individual mandate as a valid …

U.S. Supreme Court Chief Justice John Roberts National Federation of Independent Business Republican Governors Republican State Attorneys General healthcare aca-sabotage supreme-court medicaid partisan-obstruction +2 more
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House Republicans Launch Six Years of Symbolic ACA Repeal Votes

| Importance: 7/10

Three days after taking control of the House, Republicans passed H.R. 2, the ‘Repealing the Job-Killing Health Care Law Act,’ in a 245-189 vote with three Democratic defections. The bill was never considered by the Democratic Senate. This initiated a six-year campaign of symbolic repeal …

House Republicans Speaker John Boehner Rep. Joe Barton Rep. Pat Meehan Speaker Paul Ryan +1 more healthcare aca-sabotage republican-obstruction symbolic-politics legislative-theater +1 more
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ACA Passes with Individual Mandate Requiring Americans to Purchase Private Insurance, Delivering Industry Windfall

| Importance: 9/10

President Obama signs the Patient Protection and Affordable Care Act into law, the most significant healthcare legislation since Medicare. While expanding coverage to millions of uninsured Americans, the law’s architecture reflects extensive industry lobbying, featuring an individual mandate …

Barack Obama America's Health Insurance Plans Pharmaceutical Research and Manufacturers of America Max Baucus Liz Fowler +1 more healthcare insurance-industry regulatory-capture individual-mandate lobbying
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Obama Cuts $80B PhRMA Deal Abandoning Medicare Negotiation Promise

| Importance: 8/10

The Obama White House secretly negotiated an $80 billion deal with pharmaceutical industry lobbyists, abandoning the president’s campaign promise to allow Medicare to negotiate drug prices. White House officials Jim Messina and Rahm Emanuel met with PhRMA CEO Billy Tauzin, agreeing to maintain …

Barack Obama PhRMA Billy Tauzin Jim Messina Rahm Emanuel +1 more healthcare pharmaceutical-industry lobbying broken-promises regulatory-capture
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Mental Health Parity Act Signed into Law with No Enforcement Mechanism, Enabling Systematic Insurer Non-Compliance

| Importance: 8/10

On October 3, 2008, President George W. Bush signed the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act (MHPAEA) into law as part of the Emergency Economic Stabilization Act (TARP legislation), requiring health insurers to provide mental health and substance use …

George W. Bush Paul Wellstone Pete Domenici Department of Labor Employee Benefits Security Administration +1 more healthcare mental-health insurance-fraud regulatory-capture enforcement-failure +2 more
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Questcor Raises Acthar Gel Price from $1,600 to $23,000 Overnight - Eventually Reaching 97,000% Increase Through Bribery Scheme

| Importance: 9/10

Questcor Pharmaceuticals implemented an overnight price increase for H.P. Acthar Gel from $1,600 to $23,000 per vial on August 27, 2007, launching a decade-long price gouging scheme that would eventually raise the drug’s price by 97,000% from its 2001 level. Questcor had acquired Acthar—a …

Questcor Pharmaceuticals Mallinckrodt Federal Trade Commission Humana Congress +1 more pharmaceutical-industry drug-pricing healthcare corporate-fraud bribery +2 more
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Ares Management Acquires Aspen Dental: Private Equity Dental Roll-Up Strategy Launches Industry Consolidation

| Importance: 9/10

Private equity firm Ares Management acquired Aspen Dental in 2006, launching an aggressive roll-up strategy that would help consolidate the fragmented dental industry and establish the template for private equity’s systematic monopolization of healthcare sectors including dental, veterinary, …

Aspen Dental Ares Management Leonard Green & Partners American Securities antitrust consolidation private-equity dental healthcare +4 more
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Tom Daschle Joins Private Equity Firm and Lobbying After Senate Majority Leadership

| Importance: 8/10

Former Senate Majority Leader Tom Daschle (D-SD) joined InterMedia Advisors, a New York-based private equity firm, as a consultant and chairman of its executive advisory board just months after losing his 2004 reelection bid. Simultaneously, Daschle joined the law and lobbying firm Alston & Bird …

Tom Daschle InterMedia Advisors Alston & Bird Leo Hindery revolving-door lobbying congressional-corruption healthcare private-equity
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Billy Tauzin Joins PhRMA as CEO After Shepherding $200B Medicare Drug Bill

| Importance: 9/10

Pharmaceutical Research and Manufacturers of America (PhRMA) announced that former House Energy and Commerce Committee Chairman Billy Tauzin (R-LA) would become its president and CEO, effective January 2005. The announcement came shortly after Tauzin’s retirement from Congress, where from 2001 …

Billy Tauzin PhRMA Medicare revolving-door regulatory-capture healthcare lobbying congressional-corruption
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Merck Withdraws Vioxx After Concealing Heart Attack Risk, FDA Failure Causes Estimated 28,000-55,000 Deaths

| Importance: 9/10

Merck voluntarily withdraws Vioxx (rofecoxib) from the market after concealing evidence that the blockbuster arthritis drug increases heart attack and stroke risk. Internal company documents reveal that Merck knew of cardiovascular dangers years before withdrawal, while the FDA failed to act on …

Merck Food and Drug Administration (FDA) David Graham Raymond Gilmartin healthcare pharmaceutical-industry regulatory-capture fda drug-safety +1 more
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Medicare Part D Passes After Pharmaceutical Industry Writes Price Negotiation Ban

| Importance: 9/10

The House of Representatives passed the Medicare Prescription Drug, Improvement, and Modernization Act at 5:53 AM after an unprecedented 3-hour vote that House leaders held open for nearly three hours past the normal 15-minute voting period to secure enough votes. The legislation created Medicare …

Billy Tauzin House Energy and Commerce Committee PhRMA Medicare regulatory-capture healthcare pharmaceutical-industry congressional-corruption lobbying
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HCA Healthcare Pays $1.7 Billion in Largest Medicare Fraud Settlement in U.S. History

| Importance: 10/10

The Department of Justice announced that HCA Inc. (formerly Columbia/HCA), once led by Rick Scott, agreed to pay the United States $631 million in civil penalties and damages, bringing the total recovery to $1.7 billion when combined with earlier settlements—the largest healthcare fraud case in U.S. …

HCA Healthcare Rick Scott Department of Justice healthcare medicare-fraud hospital rick scott regulatory-capture +1 more
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Insulin Prices Begin Tripling 2002-2013 as Three Manufacturers Control 99% of Market - From $231 to $762 Annually

| Importance: 9/10

The average price of insulin in the United States began a decade-long tripling from $231 per patient annually in 2002 to $762 in 2013, according to congressional hearing data—with some patients paying up to $900 per month for insulin products that cost $4.34 per milliliter in 2002 but reached $12.92 …

Eli Lilly Novo Nordisk Sanofi Congressional Diabetes Caucus Big Pharma pharmaceutical-industry drug-pricing healthcare monopoly insulin-crisis +1 more
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Patients Bill of Rights Dies After HMO Industry Spends $60 Million Lobbying Against Managed Care Accountability

| Importance: 8/10

The Patients’ Bill of Rights, legislation that would have allowed patients to sue HMOs for denying medically necessary care, dies in Congress after the managed care industry spends over $60 million lobbying against it. Despite bipartisan support and public outrage over HMO denials that …

George W. Bush Health Insurance Association of America American Association of Health Plans John McCain Edward Kennedy +1 more healthcare managed-care lobbying regulatory-capture insurance-industry +1 more
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FDA Modernization Act Accelerates Drug Approvals and Expands Direct-to-Consumer Advertising Under Pharma Pressure

| Importance: 7/10

President Clinton signs the FDA Modernization Act (FDAMA), codifying accelerated drug approval pathways developed during the AIDS crisis while expanding provisions favorable to pharmaceutical manufacturers including streamlined advertising approval. The law accelerates the transformation of FDA from …

Bill Clinton Pharmaceutical Research and Manufacturers of America Food and Drug Administration (FDA) James Jeffords healthcare pharmaceutical-industry regulatory-capture fda drug-safety
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HIPAA Passes with Limited Portability Protections While Granting Healthcare Industry Control Over Patient Data

| Importance: 7/10

President Clinton signs the Health Insurance Portability and Accountability Act (HIPAA), bipartisan legislation that ostensibly addresses insurance portability between jobs but creates a regulatory framework that permits extensive healthcare industry data sharing while blocking more comprehensive …

Bill Clinton Nancy Kassebaum Edward Kennedy Health Insurance Association of America American Hospital Association healthcare insurance-industry regulatory-capture data-privacy portability
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Clinton Healthcare Reform Dies After Insurance Industry Lobbying Campaign

| Importance: 9/10

Senate Majority Leader George J. Mitchell declares the Clinton administration’s Health Security Act dead, with the bill never coming to a vote in either chamber of Congress. The failure represents a devastating defeat for comprehensive healthcare reform after an intense lobbying campaign by …

Bill Clinton Hillary Clinton Health insurance industry Health Insurance Association of America Pharmaceutical Industry healthcare regulatory-capture lobbying insurance-industry corporate-power +1 more
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EMTALA Passes as Unfunded Mandate, Enabling Insurance Industry to Shift Emergency Care Costs to Hospitals

| Importance: 7/10

President Reagan signs the Consolidated Omnibus Budget Reconciliation Act of 1986 (COBRA), which includes the Emergency Medical Treatment and Active Labor Act (EMTALA) requiring hospitals with emergency departments to screen and stabilize any patient regardless of ability to pay. While framed as …

Ronald Reagan American Hospital Association Health Insurance Association of America Pete Stark healthcare unfunded-mandate emergency-care cost-shifting regulatory-capture
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Hatch-Waxman Act Grants Pharma Patent Extensions While Creating Loopholes to Block Generics

| Importance: 8/10

President Reagan signs the Drug Price Competition and Patent Term Restoration Act, known as Hatch-Waxman, which ostensibly balances pharmaceutical innovation incentives with generic competition but creates loopholes that brand-name manufacturers exploit to extend monopoly pricing for decades. The …

Orrin Hatch Henry Waxman Ronald Reagan Pharmaceutical Research and Manufacturers of America healthcare pharmaceutical-industry regulatory-capture patent-abuse lobbying
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Medicare Adopts DRG Prospective Payment System Creating Hospital Profit Incentives for Reduced Care

| Importance: 7/10

The Social Security Amendments of 1983 establish Medicare’s Prospective Payment System (PPS), fundamentally transforming hospital economics by replacing cost-based reimbursement with fixed payments based on Diagnosis Related Groups (DRGs). Under the new system, hospitals receive a …

Ronald Reagan Richard Schweiker American Hospital Association Federation of American Hospitals healthcare medicare regulatory-capture hospital-industry cost-shifting
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Medicare and Medicaid Signed Into Law After Defeating Decades of AMA Opposition and Reagan Propaganda Campaign

| Importance: 8/10

President Lyndon B. Johnson signs the Social Security Amendments of 1965 into law at the Truman Presidential Library in Independence, Missouri, creating Medicare and Medicaid with former President Harry Truman at his side. The legislation provides federal health insurance for Americans over 65 …

President Lyndon B. Johnson President Harry S. Truman American Medical Association Ronald Reagan Wilbur Mills healthcare institutional-capture corporate-resistance lobbying propaganda
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King-Anderson Medicare Bill Defeated in Committee After Intense Corporate Lobbying

| Importance: 7/10

The King-Anderson bill, President Kennedy’s Medicare proposal introduced by Representative Cecil King and Senator Clinton Anderson, is defeated in committee despite strong public support after intense lobbying by the American Medical Association, corporate healthcare interests, and …

Cecil R. King Clinton Anderson John F. Kennedy Wilbur Mills Harry Byrd +4 more medicare healthcare lobbying ama corporate-opposition +2 more
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Truman Proposes National Health Insurance, AMA Mobilizes Unprecedented Opposition Campaign

| Importance: 8/10

President Harry S. Truman becomes the first sitting president to propose a comprehensive national health insurance program, sending a special message to Congress calling for federal health insurance that would cover all Americans regardless of employment status. Truman declares healthcare …

Harry S. Truman American Medical Association Morris Fishbein Robert Taft Whitaker and Baxter healthcare institutional-capture lobbying propaganda ama +1 more
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