Princess Health and Herald-Leader reporter wins Nieman fellowship to study at Harvard; her goal is to help other papers cover Obamacare.Princessiccia

Princess Health and Herald-Leader reporter wins Nieman fellowship to study at Harvard; her goal is to help other papers cover Obamacare.Princessiccia

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Gusty 08:52 Add Comment

Photo by Pablo Alcala,
Lexington Herald-Leader

Mary Meehan, a reporter for the Lexington Herald-Leader, has been selected for the 2016 class of Nieman fellows at Harvard University.
She is one of 24 journalists chosen for this prestigious honor and will begin her year of study at Harvard in September.

"I am going to Harvard to study for nine months. I hope to learn things I didn't know I yearn to learn, learn about healthcare and the massive social experiment underway." Meehan said in her shared blog, Menopausal Moms of Kentucky. "I also hope to learn something that can help in some small way to keep the newspaper industry upright."

Meehan has been with the Herald-Leader for 15 years, but began her career as a journalist 34 years ago as a columnist for The Voice of St. Mathews in Louisville at the age of 16. Before returning to Kentucky, she worked for the Tribune Newspapers in Phoenix, AZ, The Orlando Sentinel in Florida, and also as a freelance journalist in Florida.

She said that her "life changing" experience as a Blue Cross Blue Shield of Massachusetts Foundation Health Coverage Fellow last year is what prompted her to apply for the fellowship. She said she returned from the first fellowship energized to write about health, and has written "as many stories as I could" with information from that experience.

Still, she said, "I just came across stories that I couldn't get to, that were too complicated because I didn't have a good, deep foundation of health-care reform and the complex issues involving how people access health care, or what makes them seek it out even if they have insurance, and so that prompted me to file an application for the Nieman fellowship."

Meehan said that she made it clear on her application that she is not a full-time health journalist and that during any given week she has covered "a tractor parade, monster trucks and Salem the wonder cat." But she also said that while covering health, she has found that the Patient Protection and Affordable Care Act has accountability measures that apply everywhere, but are "very difficult to digest on the fly."

Each Nieman fellow proposes a study project. Meehan plans to examine the impact of the law and barriers to sustained health improvement among the previously uninsured.

"My goal is to help mid-size and small papers cover the Affordable Care Act in a meaningful way," she said. "The other part is highlighting positive things that are happening in communities, with a critical eye. Looking at not only what works, but also the challenges."

Meehan said being selected for the top fellowship in journalism hasn't really "soaked in yet," but she anticipates, based on previous fellows' comments, that she will discover "something that is amazing" that can't be predicted yet.

She said she is looking forward to working with the other fellows, half of whom will come from all over the world, and going back to college.

"I am a 50-year-old woman with white hair; I just love the visual of me sitting in a Harvard class," she said with pure joy in her voice. She earned her bachelor's degree at Western Kentucky University where she majored in political science and journalism.

In addition to taking classes, fellows attend Nieman seminars, workshops and master classes and work closely with Harvard scholars and other leading thinkers in the Cambridge, Mass., area.

The Nieman Foundation for Journalism has educated more than 1,400 accomplished journalists from 93 countries since 1938.

Princess Health and Louisville's PharMerica is still a defendant in federal cases in which big drug makers have paid billions in fines.Princessiccia

Princess Health and Louisville's PharMerica is still a defendant in federal cases in which big drug makers have paid billions in fines.Princessiccia

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Gusty 16:35 Add Comment

Abbott Laboratories has paid billions, and Amgen Inc. has paid millions, in fines for offering "rebates" or "kickbacks" to get pharmacy companies to increase their prescriptions of drugs in nursing homes, and PharMerica Corp. of Louisville is the remaining defendant in both civil cases, according to a detailed report by James McNair at the Kentucky Center for Investigative Reporting.

PharMerica manages drug benefits for nursing homes, hospitals and assisted living facilities. McNair paints a dismal picture of nursing homes and says they are ripe for this type of abuse, writing that they house "people with age-weakened bodies, multiple ailments and, often, severe mental impairment. Many are over-medicated. Many have no visitors. A third of them will die within a year of admission." (Click on chart for larger version)

McNair notes that a whistleblower lawsuit first called attention to Abbott Labs, which pled guilty in 2012 to a criminal charge, settled civil kickback and fraud claims, and paid $1.5 billion in fines for its role in paying millions of dollars in "rebates" to get pharmacy companies to increase prescriptions for an anti-seizure drug, Depakote, for uses beyond its Food and Drug Administration approval. Medicaid payments for this drug "went on to top $7 billion," McNair reports.

Amgen also enlisted these same pharmacy companies to promote its anemia drug, Aranesp, for uses beyond its FDA approval, and after pleading guilty settled civil kickback and fraud charges and paid a total of $762 million in fines.

These two cases brought more government attention to such schemes, which are "standard practice in the pharmaceutical industry," and also on the pharmacy companies that are on the receiving end of the payoffs, McNair writes.

McNair describes PharMerica as the "second-biggest operator of nursing home pharmacies in the country" and writes that it had " $1.9 billion in revenue last year," making it the "10th-biggest publicly traded company in Kentucky, according to rankings by The Lane Report." Since 2007, the chief executive has been Gregory Weishar (pronounced WISH-er) .

Companies like PharMerica, and its larger competitor Cincinnati-based Omnicare Inc., act on behalf of the nursing homes, buying drugs from the pharmaceutical companies in bulk and then dispensing them under the supervision of "consultant pharmacisits," McNair reports.

The Abbott Labs and Amgen lawsuits assert that PharMerica gave "certain drugs to nursing home patients in return for drug company kickbacks, not because they were the "right medication."" McNair reports that the suits were filed by drug company insiders who have knowledge of these payoffs disguised as "rebates" or "discounts."

"PharMerica denies the claims," writes McNair. But the company has been in this type of case many times since 2005, McNair reports: It has agreed to pay $40 million in fines to settle federal complaints, five additional closed cases connected to this company.

McNair also reports that just last week, the Justice Department said PharMerica will pay $31.5 million for dispensing addictive painkillers to nursing home patients without prescriptions, then falsely billing Medicare. As part of this settlement, PharMerica also agreed to a five year "corporate integrity agreement," which McNair notes later in the article are rarely enforced.

McNair goes on to list the details of several other cases PharMerica has been involved in, one of them "deemed so flagrant that the inspector general sought to ban PharMerica from federal health-care programs for 10 years."

PharMerica declined to make its executives available for an interview with the Kentucky Center for Investigative Reporting but said in a statement: �PharMerica is committed to outstanding compliance and the highest standards of ethical conduct, and we are diligent in ensuring that we comply with all applicable law and regulation,�

Jan Scherrer, vice president of Kentuckians for Nursing Home Reform, a non-profit advocacy group based in Lexington, told McNair that the CEOs of companies involved in kickback schemes should be held personally accountable, "These are not victimless crimes," he said.

�It�s the same players -- PharMerica and Omnicare,� Scherrer continued. �They keep doing this over and over and over, and all they get is a fine. And for them that fine is nothing more than the cost of doing business.� (Read more of this detailed report by clicking here.)

Princess Health and Princess Health andTodd County weekly's editor-publisher wonders why so many uninsured locals haven't signed up for health insurance.Princessiccia

Princess Health and Princess Health andTodd County weekly's editor-publisher wonders why so many uninsured locals haven't signed up for health insurance.Princessiccia

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Gusty 16:27 Add Comment

With open enrollment in the new health-insurance exchanges ending March 31, at least one country editor is wondering why most people in his community who lack coverage haven't take advantage of the historic opportunity. And since he's in Kentucky, he used the state's next-to-last ranking in the latest Gallup-Healthways Well-Being Index as the point of departure for an article that took up most of his editorial page.

"Kentucky is its own worst enemy . . . and if you think this is just an Eastern Kentucky problem, you aren't paying attention," Editor-Publisher Ryan Craig, right, wrote in last week's Todd County Standard, in Western Kentucky. "Our numbers suggest we are as miserable as anywhere in the state, i.e., the nation." Craig then listed statistics for poverty, income, education and health insurance and said bluntly, "We are near the bottom in all of these categories, which are the same categories that cause Kentucky to have such a dismal ranking in the Miserable Test year after year."

Craig says Todd County, "it, seems, is among the bottom of counties who signed up for the Affordable Care Act," and wonders why only 533 of the estimated 2,455 people in his county without health insurance have signed up for it: "Is it because of fear of the unknown? Politics? The prevailing answer people tell me is that they would rather pay the tax penalty and not have the insurance. What would happen if that person or someone in their family was in a car wreck? They readily admit that they are taking a big chance, but don't see how they can afford the insurance even when it is cheaper now, especially those who are very sick and couldn't get insurance before." One man told him he would have to declare bankruptcy.

"The deadline to apply for health insurance through the exchange is March 31," Craig writes. "If you don't have insurance, at least consider the process." The Standard has been judged Kentucky's best small weekly newspaper seven years in a row, but doesn't put news or editorials online. For a scan of the editorial as a PDF, click here.