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The article is unclear. What happened could have been that the doc gave adults vaccine doses intended for children. It also could have been that children were given a single dose of a multi-dose vaccine and billed for a full vaccination. There are any number of things that could have happened. What it does NOT mean is that poor children get bad vaccinations. Sorry, conspiracy hunters, one greedy unethical doctor does not a conspiracy make.
The only vaccines that have different doses for adults and kids are Hepatitis A and Hepatitis B. Some flu vaccines have lower doses for kids under 3. Giving a single dose out of a multi-dose vial is SOP, e.g. for injectable polio vaccine. That would still be a full dose. Many vaccines for kids are not used in adults, e.g. DTaP, Hib, Prevnar (until age 65 and then they get it), Rotavirus, HPV after age 26.
So now we know that reporters can't write and readers can't read. So how many other stories are out there that are poorly worded and even more poorly understood leading to human sacrifice, dog and cats living together, mass hysteria....
It's a poorly written story. There are two offenses here:
Giving vaccines intended for Medicaid and uninsured children to privately insured patients
Giving those privately insured patients only a partial dose (while billing for a full dose)
So in other words, she was taking vaccines for 100 low-income kids and giving them to 200 privately insured kids. (Numbers for illustration purposes only)
Why would it be an offense to give non-medicaid and non-uninsured children vaccines meant for Medicaid and uninsured children instead of other vaccines if they were the same thing?
Why would it be an offense to give non-medicaid and non-uninsured children vaccines meant for Medicaid and uninsured children instead of other vaccines if they were the same thing?
Medicaid pays for the vaccines for Medicaid patients. Giving them to uninsured or commercially insured patients and then billing the patient or the insurance company is fraud. In addition, the person in the OP was not giving anyone full doses.
So now we know that reporters can't write and readers can't read. So how many other stories are out there that are poorly worded and even more poorly understood leading to human sacrifice, dog and cats living together, mass hysteria....
Lots of them about health care! That's why there's so much confusion about flu this year. The flu activity this season has been very poorly reported. I better stop now before I go into a total rant.
Why would it be an offense to give non-medicaid and non-uninsured children vaccines meant for Medicaid and uninsured children instead of other vaccines if they were the same thing?
Because it’s taking vaccines that have been paid for with government funds, and then billing private insurance. You don’t see the problem with that?
Why would it be an offense to give non-medicaid and non-uninsured children vaccines meant for Medicaid and uninsured children instead of other vaccines if they were the same thing?
Because the state provides free vaccine for use in patients who are uninsured, or on Medicaid. For the patients who have insurance, the pediatrician is expected to buy vaccine, and bill the insurer for it. The actual vaccines used are usually identical. Sometimes, there is a decision by the pediatrician to purchase for private pay patients a different brand of vaccine than what the state is providing for Medicaid patients, not because one vaccine is better, but to actually try to avoid making a mistake and inadvertently use state purchase vaccine for private pay patients.
It's illegal to take free vaccine and give it to privately insured patients, and bill and collect for the vaccine as if the pediatrician had purchased it.
That being said, it does seem odd that she was suspended for just two doses from Medicaid supply being directed to private pay patients. A busy pediatrician's office could be administering thousands of doses a year. If she only made a mistake with two doses, doesn't seem like much of an error. Sounds like they were suspicious that something was going on - and now they know there was.
About fifteen years ago, a couple of pediatricians got into trouble for routinely taking Medicaid vaccines, using them for private pay patients, and billing insurance for the vaccines. They had done this for something like a decade, without getting caught. The insurance companies reported it to the attorney general's office, I think. So something was not right - could be that the amount of vaccine she was actually buying didn't match up with the amount she was billing the insurers.
Because the state provides free vaccine for use in patients who are uninsured, or on Medicaid. For the patients who have insurance, the pediatrician is expected to buy vaccine, and bill the insurer for it. The actual vaccines used are usually identical. Sometimes, there is a decision by the pediatrician to purchase for private pay patients a different brand of vaccine than what the state is providing for Medicaid patients, not because one vaccine is better, but to actually try to avoid making a mistake and inadvertently use state purchase vaccine for private pay patients.
It's illegal to take free vaccine and give it to privately insured patients, and bill and collect for the vaccine as if the pediatrician had purchased it.
That being said, it does seem odd that she was suspended for just two doses from Medicaid supply being directed to private pay patients. A busy pediatrician's office could be administering thousands of doses a year. If she only made a mistake with two doses, doesn't seem like much of an error. Sounds like they were suspicious that something was going on - and now they know there was.
About fifteen years ago, a couple of pediatricians got into trouble for routinely taking Medicaid vaccines, using them for private pay patients, and billing insurance for the vaccines. They had done this for something like a decade, without getting caught. The insurance companies reported it to the attorney general's office, I think. So something was not right - could be that the amount of vaccine she was actually buying didn't match up with the amount she was billing the insurers.
I don't think it was just two doses. They just found two partial vials in a fridge.
What this one doc did is wrong, yes, because she inoculated kids with "less than the required dose." But the article also had this one disturbing line:
"...for allegedly giving patients with private insurance vaccines intended for Medicaid and uninsured children."
I don't know anything about Medicaid, but that line makes it sound like Medicaid kids are given weaker vaccines than kids with private insurance.
Unless Medicaid kids are vaccinated more often (which a little online research tells me they are not), this needs to be explained. That reporter should have asked a couple more questions.
Article is poorly written. My understanding is that she was screwing both Medicaid and private insurers.
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