Monday, October 19, 2020

The Important Week Ahead

This Friday, 23 October 2020, oral arguments will be heard before the Third Circuit Court of Appeals regarding Kenney et al vs. the American Board of Internal Medicine (ABIM) class-action antitrust, racketeering, and unjust enrichment lawsuit (Case 20-1007). Some eyes of US physicians and all the eyes of the US certification industry will be on these arguments, even though the oral arguments are, for all intents and purposes, little more than theatre since written arguments have been fully briefed on both sides.

But the stakes for working US physicians and the physician certification industry could not be higher. Since the introduction of Maintenance of Certification® (MOC®) in 1990, ABMS board certification and lifelong re-certification have evolved into a $1 billion enterprise annually in the United States, nearly all of it funded by US physician-paid fees leveraged by coercive tactics and the monopoly on US certification enjoyed by the ABMS and its member boards. 

As this week unfolds, 

  • Let us not forget the accusatory physician sanction letter sent by the ABIM to thousands of vulnerable residents who attended an ACGME-accredited board review course with "concerns about their ethical and professional behavior" and promising to "place a copy of this letter in their file."

  • The unilateral revoking of ABIM board certification for three years that occurs without trial if the ABIM deems a physician does not "maintain moral, ethical, or professional behavior satisfactory to the board."

  • Let us not forget the strong-arming convicted felon who served as the ABIM's Director of Test Security and his work at the shady test security firm Caveon after orchestrating a raid with Federal Marshals on a physicians' home to seize computers and private email lists of physicians.

  • Let us not forget about the young physician who the ABIM pursued and accused of "cheating" - only to lose their case - and whose countersuit continues against the ABIM in Puerto Rico for the past seven years and counting.

  • Let us not forget the numerous tax form discrepancies (fraud?) published by the American Board of Internal Medicine and the Foundation over the years, that included misstated date of origin of the ABIM Foundation, the indulgent purchase of a $2.3 million personal condominium, undisclosed lobbying efforts, and off-shoring of millions in physician testing fees to the Cayman Islands.

  • Let us not forget that the ABIM has never allowed an independent audit of their finances as stipulated by the AMA House of Delegates.

  • Let us not forget the reporting of Kurt Eichenwald of Newsweek on the ABIM and their finances here, here, here, and here.

  • Let us not forget that physicians must agree to an adhesion contract that requires them to be research subjects without their informed consent.

  • Let us not forget that physicians' board data are sold by a subsidiary of ABMS for profit.

  • Let us not forget about the cool $1.426 million dollars paid to the CEO of ABIM and the ABIM Foundation in 2018.

  • And let us not forget that, in the end, this lawsuit is really about the integrity of US Medicine and the justice working US physicians deserve.


ABIM Foundation Trustee and Exact Sciences Labs said...

Like a fish in water, it's uncanny how the ABIM conflicts of interest follow the sure money

Let's not forget the egregious conflicts of interests that have persisted for nearly six decades at the ABIM. In spite of the bright red lipstick (legaleaze and doublespeak) they copy-paste on Schedule O.

ABIM Foundation "Trustees?" No one's buying their phony "Trust Campaign."

ABIMF's Jackie Judd and the trustee chair's personal Covid-19 "trust fund"

During such an unprecedented crisis, nobody could conceive that the ABIMF chair, Ms. Judd, could potentially be making so much money from the pandemic selling covid-19 test kits and testing results. But as jarring as it sounds, the ABIM chairperson is profiting dramatically from a testing company she owns a sizable piece of. How did she know to invest in Exact Sciences Laboratories in advance?

The story gets worse as another one of her "companies", a non-profit world relief organization, AJWS, is asking for donations and matching funds to pay Exact Sciences Labs (or a partner company) for their covid-19 test kits and lab testing abilities. The pandemic is growing the revenues and profits of her company at a staggering rate while other companies are stagnating or going under. It's hard to think of a more conflicted investment while the novel corona virus makes yet another ABIM affiliate and her company rich. I never thought the ABIM and "Foundation" could sink so low.

The ABIM Foundation really is a big piggy bank and investment club for rich elites and the corporations they represent - just a money laundering scheme.

Exact Sciences Laboratories and Covid 19

ABIM Trustee Chair Jackie Judd owns a sizable stake in ESL, but it is not disclosed what that stake is worth today. There is loophole wording in the ABIM Foundation's disclosure form that only shows her initial stake, not what it is worth. The vague disclosure does not even indicate if any subsequent services have been provided; or if any consulting/referrals/brokering on behalf of the company have grown that stake.)

Jackie Judd is a paid board member of AJWS (we like them), but it's as conflicted as hell to sell/advertise Ms Judd's company tests through AJWS. It a not-for-profit. Look at the images and pleas for help to get testing supplies! Even if they sell another company's Covid testing products and services it only increased the demand by limiting the supply.

ABIM's Trustee who owns a chunk of Exact Sciences Laboratories is making a killing from corona virus testing and kits.

"How the process works
The order is placed by the clinician and the kit sent to the patient’s home by Exact Sciences or Everlywell, which makes the other home collection-approved kit. [ESL has a partnership with Everlywell.] The kits are then returned to Exact Sciences by the patient. The lab at Exact Sciences will then conduct the test on the specimen to determine whether genetic markers of COVID-19 are present.

The test results are then sent by Exact Sciences to the healthcare provider, who is responsible for reporting the result and next steps to the patient, according to the FDA.

Exact Sciences reported $34.6 million in revenue from COVID-19 tests, out of total revenue of $268.9 million, for its quarter ended June 30."

Data Sharing and Covid-19 Response said...

And one of Ms Judd's other companies which she derives income from, Camden Coalition, is cashing in on Covid-19 as well. Data sharing is rapidly on its way to becoming a "mutli-trillion dollar enterprise."
Right up the ABIM's secret dark alley along with the other ABMSers who are making bundles from this space.

"Christine McBride, Audrey Hendricks, and Natasha Dravid
August 13, 2020
The Camden Coalition Health Information Exchange (HIE) is a collaborative data-sharing effort to improve care delivery in Camden. It’s a web-based application that offers Camden and regional healthcare providers real-time access to important medical information for patients, reducing the need for patients to catch providers up on their medical history. Data from the Camden Coalition HIE helps us identify individuals eligible for enrollment in our programs, guide us in the design of new initiatives, and provide us the information we need to evaluate our existing programs.

In response to COVID-19, we have been working with our vendor CareEvolution to develop new ways to use the Camden Coalition HIE to support participating providers as they provide care during the pandemic. In particular, we have used the Camden Coalition HIE to support the region’s quarantine hotel, make COVID-19 data more available to providers, and create dashboards that integrate clinical and demographic data to give broader insight into how COVID-19 is affecting New Jersey."

"Covid-19 the road back brings and opportunity to go forward on equity"

JJ and the Third Wave Labs said...

"Business as usual" is the ABIM/ABIM Foundation's culture and motto.
Doubling down on MOC as "longitudinal assessment" is the "second wave" they hope will keep the whole Ponzi scheme rolling in money, power and data.

I'm not comfortable with the ABIMF Chairperson Ms Judd's consulting relationship with the University of Pennsylvania in Philadelphia. It smells like a lobbying position/relationship to me, and a platform from which to push the MOC agenda.

Philly is the land of influence, bribes and doing personal favors. And having their favorite judge in their own little pocket.
Don't we all know it.

Anonymous said...

Let's hope that Judge Beetlestone or any judge who reviews this case pounds the gavel long and loud on MOC so that every physician and patient in America knows that justice will be done.

Everyone should send a message to their representatives in DC that MOC as a mandate tied to certification, employment, and reimbursement needs to end immediately. We need swift, comprehensive and decisive legislation that will end the MOC mandate in order to protect physicians' and patients' rights.

Creole Gumbo said...

Will those of us who paid a MOC fee be entitled to a refund?

Anonymous said...

So wait, if I understand the prior comments, it'd sum up as something like...

power corrupts...
and absolute power corrupts...

well, like ABMS!

the only thing truly noteworthy in any of this is how long it's gone on, how deep it runs, and how little response there seems to be from the "taxpayers" in this situation.

ABIM Foundation Conflicts of Interest said...

Exact Sciences Laboratories and ABIM Foundation Pandemic Opportunism

Anybody in the media who would like to follow up on the shocking revelation that the ABIM Foundation Board of Trustees Chair here are a few links.

Such wrongdoing is common among the ABMS and their associates. Yes, physicians, patients and the taxpayer are too passive. But the media blacks out the truth of what is going on. Even shuns it because their sponsors would not approve. Everyone needs to unite and say no more.

ABIM's former CEO and Foundation signatory, Christine Cassel, pocketed millions while wearing corporate health and "non-profit" industry hats.
Cassel, the the queen of conflicts has a legacy of wrongdoing that typifies the ABIM and its lucrative foundation.

ABIM Board of Trustees ("About." Click on biographies, disclosures and verify the conflicts.)

EUA Emergency Use Authorization (a license to harvest Covid-19 dollars)

Here is the ABIM Foundation Trustee Company's EUA - "Emergency Use Authorization" for their Covid-19 testing products and services. It is one of the first authorizations issued to a testing company in the early spring of 2020.

The ABIM-F Chair, the ABIM and the Foundation are certainly well-connected and no strangers to Wall Street and K Street marketing/lobbying and industry insiders. Such insider influence would be improper for the ABMS medical specialty Boards.

Profiting during the pandemic, while sitting on conflicted boards and foundations is deplorable. Such conflicts are only part what needs to be followed up on by an investigative journalists and regulatory agencies. The ABMS/ABIM provides a rich milieu for self-enrichment and enhancing bottom lines of partners.

Nasal swab test also approved as mentioned in the EUA from September 2020

For use under Emergency Use Authorization (EUA) only
The SARS-CoV-2 RT-PCR assay will be performed at the Exact Sciences
Laboratories, located at 650 Forward Drive, Madison, WI 53711 and 145 E. Badger Road Ste. 100, Madison, WI 53713, which are certified under the Clinical Laboratory Improvement Amendments of 1988(CLIA), 42 U.S.C. §263a and meet the requirements to perform high complexity tests as per Laboratory Standard Operating Procedures that were reviewed by the FDA under this EUA.
The SARS-CoV-2 (N gene detection) Test is a high-throughput real-time RT-PCR assay intended for the qualitative detection of nucleic acid from SARS-CoV-2 in upper respiratory specimens (such as nasal, mid-turbinate, nasopharyngeal, and oropharyngeal swab specimens), from individuals suspected of COVID-19 by a healthcare provider. Testing is limited to Exact Sciences Laboratories, located at 650 Forward Drive, Madison, WI 53711 and 145 E. Badger Road Ste. 100, Madison, WI 53713, which are certified under the Clinical Laboratory Improvement Amendments of 1988 (CLIA), 42 U.S.C. § 263a, and meet the requirements to perform high complexity tests.

"b. Shipping Stability
FDA has reviewed analytical validation data from a swab stability study conducted by Quantigen Biosciences, with support from The Gates Foundation and UnitedHealth Group, that the sponsor references to support sample stability of synthetic tipped nasal swab shipped in saline (0.9%) for testing with the authorized Exact Sciences SARS-CoV2 test. Quantigen Biosciences has granted a right of reference to any sponsor wishing to
pursue an EUA to leverage their COVID-19 swab stability data as part of that sponsor's EUA request."

"Enough is Enough" say Appellate Judge to ABIM's Attorney. said...

The pursuit, prosecution and wrongful torture of physicians (and the profession of medicine)

ABIM is a business and their primary purpose is making money. They harm the profession of medicine. They are doing this through their greed and deceit.

How much money is enough? How much control over physicians' lives is enough?

MOC is a wrongful lever of coercion and profiteering. A cash cow for ABIM/ABMS executives. By controlling the professional labor force they enrich themselves and grow their expansive testing empire and lucrative business relationships.

I just heard oral arguments regarding ABIM versus Dr. Salas Rushford. It is a recent recording from the Appellate court in New Jersey. This doctors life has been truly harmed by ABIM's illegal seizure of property and utter disergard for privacy and constitutional guarantees. ABIM versu Salas Rushford is a story of ABIM's illegal pursuit, prosecution and torture of a decent and hard working Pureto Rican physician.

I was shocked to learn of this ABIM appeal in the case of Dr. Salas Rushford. It was not in the media. ABIM clearly lost their case against Jaime Salas Rushford, MD long ago for many reasons, not just the statute of limitations. It is a lawsuit that should have never been filed in the first place after several monkey trials at the ABIM in Philadelphia.

Listen to the ABIM's appeal to the courts just so they can apply more harm to the profession of medicine and induce more fear in those who take an oath to serve others. Listen only if you can stomach it.

The ABMS is a monopoly involved in racketeering. They defraud the public. They violate anti-trust laws. It is wrong. It is illegal.

How many years will the ABIM be allowed to destroy lives and the profession of medicine?

Appellees and Friends: How the ABIM Maintains Its Monopoly Power said...

Monopoly, Moneyed Interests and Judicial Lobbying

Some problems with this case:

-A Senior judge (85yrs) dismissed key elements in the case using talking points from ABIM and Pillsbury - a conflicted PRO MOC/trade association insider. Pillsbury wrote an Amicus brief to Judges Kelly and Beetlestone for the ABIM.

-Pillsbury wrote the authoritative "handbook on trade association law", which covers the complaints. The Appellate panel may use their handbook as a lodestone and err again, by leaning on ABIM/Pillsbury's talking points. Getting it wrong again confusing conflicted/colored expertise and science for fact/law.

-Pillsbury is co-founding member of the Professional Certification Coalition PCC, established to fight anti-MOC legislation in the state courts. Co-founders ICE and the ASAE are certification and accreditation trade associations, comprising the PCC "coalition".

-ABMS and medical specialty boards are members/collaborators with ICE/ASEA/PCC. They play roles of profound influence.

-ASAE/ICE/PCC-Pillsbury have been influencing the court in behalf of ABIM/ABMS pushing a regulatory financial agenda. They lobbied the Supreme Court in behalf of trade association wrongdoing "setting standards" for the banks (charging exorbitant ATM fees). Pillsbury argued for trade associations . . .
"pointing out the risk that the court of appeals decision could facilitate antitrust allegations against associations that merely adopt rules and ask their members to follow them."

-The conflicted parties above make a market for themselves in certifications, accreditations, and trade association relationships. Huge fees charged. Legal costs to trade associations and their partners/clients enormous. A blow to the ABIM, ABMS or MOC® would be detrimental to their [monopolistic] markets.

-The Amicus Brief from the judicial lobbyist Pillsbury appears on the full appellate docket for consideration by a three judge panel. PCC's Amicus does not show up on the summary docket, which misleads about their influence over the court.

-Judge Beetlestone appears as "trial judge" on the full docket, but Kelly wrote the opinion; or was signed by him. Kelly transferred the case to Beetlestone raising questions; who actually is/was involved in this case.

-We don't know who is briefing the case "in camera" with the Appellate Court a panel of three justices. Is Pillsbury a silent party on the panel? What about Beetlestone/Kelly, are they sharing views with the appellate justices?

-The official minutes to the oral arguments are locked on Pacer not available for public view.

Pillsbury/ABIM Continuum. said...

Further concerns/potential bombshells

-Pillsbury represented Exact Sciences in a 2019 2.8 billion dollar merger/combination with Genomic Health. Therefore, they playing a leading role in ABIM Foundation's "investment" in Exact Sciences. Trustee Chair Jackie Judd has a substantial positions in Exact Sciences, according to ABIM disclosure statements from 2018.

-There's a complex conflicted web involving ABIM, Pillsbury, & others which the Courts, IRS, DoJ and SEC should look into.

-Pillsbury's egregiously conflicted relationship with ABIM is a huge red flag. It raises questions, not only of egregious conflicts of interests with their judicial lobbying, but we see financial conflicts with executives and board at the ABIM linked into the Pillsbury continuum. ABIM employees investing in healthcare could be yet another example of insider trading/unjust enrichment at this 501(3)(c).

-The revelations above is further evidence that the ABIM is not a non-profit corporation. Such under-the-radar business relationships are telling; it answers why ABIM employs a PwC Wall Street insider as "Chief Medical Officer" at the ABIM and not a clinical or academic physician. The ABIM maintains complete autonomy over the executive/board and who they hire and select.

All crimson warnings.

ABIM Insider Investments: Cecity said...

Not just distractions but center of focus: ABIM's moneyed interests

Note about Cecity and ABIM's CEO Christine Cassel

The ABIM bolstered the earnings of Cecity, a healthcare data management service company, through backdoor avenues and directly with cash infusions as their "contractor". For years they conducted deliberate conflicted clandestine work, involving the collection of "measurement activity". Data on physicians extraneous to offering a certification. It is the view of many that the ABIM executives illegally profited by this and many other activities not fit for a non-profit 501(3)(c) corporation.

CECITY, contractor or investment vehicle

Cecity was listed as "contractor" on ABIM taxes for years until Cecity was bought out by Premier, Inc. The ABIM/ABIM-Foundation CEO, Christine Cassel was on the board of Premier, Inc. during the period in question.

Cassel received cash and lucrative stock for her "services" and provided additional special influence as an industry insider. Cassel's work paid off for her and other insiders. The acquisition of Cecity boosted Premier's share price. Cassel's work at the ABIM and White House as a PCAST advisor opened the door for corruption. There was a great deal of profiteering with other insider activities @ Kaiser Foundation Health Plans and Hospitals.

ABIM's perfect storm of conflicts leading to self-enrichment

Cassel was advisor to the White House, on the board of Premier, Inc., manipulating healthcare to favor Kaiser Permanente, all during the time she acted as CEO of the ABIM/ABIM-Foundations.

This activity with CECITY appears to be money laundering and insider trading using the ABIM as an investment bank; it violates SEC rules operating ABIM as an unregistered investment advisory/brokerage house/market maker for publicly and privately held companies.

Mystery of ABIM's missing "letter of determination" and IRS form 1023

Investigation of ABIM's tax filings reveals an obvious ruse. ABIM appears to be operating under a grandfather clause with a "dusty determination" of non-profit status based on 1936 state and federal laws. They had little to no activity at the time over 80 years ago. Today they are a jaw-dropping financial and political juggernaut/financial market maker. Many of us can't understand how they get away with it. Is the ABIM waving their noses at the IRS, DoJ and SEC, by never filing a 1023 from with the IRS.

ABIM funneled millions of dollars into their co-venture startup Cecity

The ABIM, not only nurtured the startup for Premier funneling millions in physician fees, bolstering Cecity's revenues, but they managed to create a tool which enhanced their own business as "quality gatekeepers". Cecity requires physician data/regulatory capture and as we know the ABIM/ABMS is a market maker/government shaker with its own mandated data collection, which is primarily dependent on the continuous flow of data via MOC. We don't know the depth of their data markets or how many business relationships they have. We don't know how many privacy laws they have trammeled

Cectiy merged with Premier which now owns the brand.


Blowing the whistle on Cecity and Premier; who was listening?

Will the Last Physician @ABIM/ABMS Please Turn Out the Lights When You Leave said...

Private Equity Walks Right In

Case in point: the American Board of Preventive Medicine fired their board certified physician a couple years ago and placed a former Blackstone Private Equity man with zero background in healthcare to be "in charge". Or is Blackstone in the drivers seat controlling the health markets, not public safety.

This is another blatant example of market manipulation. The director of the ABPM is also trying to get more revenue from the ABMS MOC franchise. By whatever new names the ABMS/ABIM comes up for MOC, they run it like it was a Burger King franchise.

Pennies on the dollar for a failing franchise

"Appearances" suggest that GSO, a subsidiary of Blackstone now runs the American Boards . . . all 24 of them and the umbrella. They purchased the failing MOC program for pennies on the dollar to build it up again and cash in.

Team Health was bought out by Blackstone in 2017. They acquired a DOJ whistleblower lawsuit as well.

Team Health: Medicines Big Short

ABIM Behind Closed Doors

This for-profit activity and transformation of the ABIM/ABMS into a huge business is made possible by MOC dollars. It points to a decades-long pattern of tax evasion at the ABIM/ABMS if they were investigated thoroughly with colluding partners brought into focus as well.

The CEO, Cassel and many others clearly profited by this business activity within the ABIM/ABIM-F offices. Behind the closed doors of an alleged 501(3)(c).

It time for the IRS to look at the ABIM and the rest of the ABMS.