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Doc Convicted for Needless Surgeries; COVID Test Racket; Biden's FDA Chief

— The past week in healthcare investigations

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INVESTIGATIVE ROUNDUP over an image of two people looking at computer screens.

Welcome to the latest edition of Investigative Roundup, highlighting some of the best investigative reporting on healthcare each week.

Ob/Gyn Convicted in Unnecessary Hysterectomy Scheme

A federal jury convicted Virginia ob/gyn Javaid Perwaiz, MD, on 52 counts related to a scheme to perform unnecessary hysterectomies and other surgeries in order to defraud private and government payers out of millions of dollars, the .

In many cases, Perwaiz would lie to his patients that the surgeries were necessary to prevent cancer, according to DOJ. Evidence presented at the trial also showed that Perwaiz falsified records so he could induce labor and ensure that he would be reimbursed for the deliveries. Perwaiz also violated the 30-day waiting period required by Medicaid for elective sterilizations by submitting backdated forms, and billed for diagnostics that he didn't actually perform, DOJ said.

Witnesses at the trial included dozens of former patients, some of whom testified about ongoing complications they have due to their unnecessary surgeries, .

The 70-year-old Perwaiz, who has practiced in Hampton Roads, Virginia, since the 1980s, was arrested last fall after FBI agents discovered the unnecessary procedures. He has a troubled history that includes conviction for felony tax fraud in the 1990s, as well as earlier accusations of performing unnecessary hysterectomies that ended with his firing from a hospital for "bad note-taking," the Post said.

Perwaiz faces a maximum penalty of 465 years in prison. He is scheduled to be sentenced on March 31, 2021.

Doc's COVID Testing Racket

A Connecticut physician who set up COVID-19 testing sites in several towns reportedly "upcoded" for services performed at those sites.

Instead of just testing for COVID-19, Stephen Murphy, MD, an internist in Greenwich, Connecticut, ordered panels for more than a dozen respiratory pathogens, and charged for brief phone calls to deliver results, .

Fees for one woman totalled $1,944, including $480 for a quick phone call delivering results. She had been screened for more than a dozen respiratory pathogens even though she thought she was just being tested for COVID-19.

Another woman got tested at one of Murphy's sites even though she was asymptomatic because she wanted to contribute to the epidemiologic data in her area. Medicare paid $583 for her test because it, too, included the respiratory pathogen panel; Medicare usually pays $50 to $100 for a COVID-19 test.

Alexander McAdam, MD, an infectious diseases physician at Boston Children's Hospital, told the Times that the broad respiratory panel is inappropriate: "That panel should only be used for the critically ill or immuno-compromised, so we don't over-test and generate too large of a bill for our patients."

Murphy told the Times that he provides an important service. "I jumped on this," he said. "I decided, let's work up these patients. Let's care for them in the drive-through."

The story is part of an ongoing series in which the Times has collected more than 400 bills related to COVID-19 care. Patients of Murphy's testing sites generated more submissions to the newspaper's database than any other individual provider, according to the article.

Who Will Lead Biden's FDA?

Even if Biden quickly announces his choice to lead the FDA, the appointee could face a long battle during one of the most critical times in the agency's history, .

As a Republican-controlled Senate is looking more likely, it's not clear how soon after Jan. 20 the appointee will be able to start. In that time, the FDA will very likely be facing critical decisions about COVID-19 vaccines -- and it will probably have to rely on a temporary head to steer it during that challenging time.

In the recent past, it has taken about two months to get FDA commissioners confirmed. President Barack Obama's nominee Margaret Hamburg, MD, was nominated in March 2009 and confirmed in May 2009. President Donald Trump's first pick, Scott Gottlieb, MD, had a similar two-month timeline, starting the job in May 2017.

It's expected that Biden will have a number of "acting" agency heads rather than Senate-confirmed appointees during those critical months.

If an acting official is in charge when a specific vaccine is under review, it shouldn't make a difference because the agency's longtime scientists are the ones who do the heavy lifting in terms of scientific evaluations, KHN said.

An FDA staffing policy outlines who should be the acting head. Its most recent version from 2016 says the job goes to the deputy commissioner for foods and veterinary medicine, a title that was recently changed to deputy commissioner for food policy and response. That job is currently held by Frank Yiannas, a longtime food safety expert who joined FDA in 2018. However, the administration doesn't have to stick to that policy.

Unlike the FDA job, the director of the CDC doesn't need Senate confirmation, so Biden will have an easier time getting that position filled, KHN noted.

Child Abuse Pediatrician Podcast

An investigation into overly aggressive practices by child abuse pediatricians that wrongly took children from their parents has been turned into a podcast, which launched this week.

"" details the 2019 NBC News/Houston Chronicle series that investigated whether this newly minted specialty was wrongly accusing parents of abuse.

Critics have levied charges of abuse of power, and of potential bias when these doctors are paid by state child protection agencies. Some have even questioned whether the specialty has adequate training to make such life-altering calls.

"As a parent, some of the things I learned while reporting this project left me shaken," the series' lead journalist, . "This literally could happen to *anyone* -- though, as we'll reveal if you hang with the series, Black parents are at higher risk."

In other podcast news, the chart-topping Dr. Death has launched , this time focusing on a Michigan oncologist who allegedly lied about patients' cancer diagnoses and overtreated them for big profits.

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    Kristina Fiore leads MedPage’s enterprise & investigative reporting team. She’s been a medical journalist for more than a decade and her work has been recognized by Barlett & Steele, AHCJ, SABEW, and others. Send story tips to k.fiore@medpagetoday.com.