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

Inside a Russian Hospital Hacker Mob

that detail the operations of a key Russian hacker group involved in U.S. hospital ransomware attacks.

Trickbot is run by a core team of about six people, with headquarters in St. Petersburg, and employs an estimated 100 to 400 people, Wired reported. The group develops its own malware but also deploys well-known products like Ryuk, which has caused disruption at many U.S. hospitals.

Ridgeview Medical Center in Waconia, Minnesota, was one of hundreds of hospitals attacked by the group in late October 2020, when the country was dealing with another COVID surge. Hackers knew they could take advantage of the situation: "You see, how fast, hospitals and centers reply," one key member of Trickbot wrote in a message to a colleague, which Wired reviewed. "Answers from the rest, [take] days. And from the ridge immediately the answer flew in."

The magazine reviewed hundreds of messages sent between Trickbot members in the summer and autumn of 2020, months before and shortly after U.S. Cyber Command disrupted much of the group's infrastructure and temporarily stopped their work. Since then, the group has scaled up operations and furthered its malware efforts, the article stated.

$500 for Clinical Trial Consult

A patient has been hit with a nearly $500 bill just for learning about a clinical trial at the Mayo Clinic, .

John Mathna of Chattanooga, Tennessee, has significant pain from a brachial plexus avulsion injury, and last June he got in touch with a Mayo physician who was conducting a trial of electrical stimulation to ease that pain.

Mathna said he had a 20- to 30-minute video call with the doctor, and was surprised when he subsequently received a $476 bill for the visit. His insurer, Cigna, said the consult was out-of-network and was not covered.

Cigna didn't respond to a request for an interview from Axios, and Mayo declined to comment on the case -- but it did waive the fee and notified its collections agency to "cease all contact" with Mathna after the Axios inquiry.

Mathna told Axios he was glad the charges were waived, but that the experience "made me feel very uneasy about the supposedly respected medical treatment facilities out there."

"What you don't want to do is create barriers for people who are interested in participating in a study," Erin Fuse Brown, JD, MPH, a healthcare law and policy professor at Georgia State University, told Axios.

PeaceHealth Silencing Healthcare Workers?

Nurses who worked for PeaceHealth hospitals said they faced severe consequences, including being fired, when they tried to advocate for nurse or patient safety, .

Marian Weber, RN, a travel nurse who worked at Ketchikan Hospital in Alaska, said she was fired after raising concerns about two COVID-19 patients who were placed in a med-surg unit despite needing the central monitoring system and transparent doors of an intensive care unit room. She said her contract was terminated a few days after filing an internal complaint about the issue.

Sarah Collins, RN, who worked at PeaceHealth Southwest Medical Center in Washington state, said she was put on 3-month administrative leave after doing an interview about safety concerns with a local news outlet that was set up by her union. She said she was subsequently terminated.

There's also an ongoing lawsuit filed in April 2020 in Washington state Superior Court by 9,000 hourly paid healthcare workers at three PeaceHealth hospitals who pointed out problems with the work environment, including being prevented from taking lawfully required meal and rest breaks, NBC News reported.

Perhaps the most high-profile case involving PeaceHealth was that of Ming Lin, MD, an emergency physician who was fired after publicly posting the letter he wrote to St. Joseph Medical Center's chief medical officer outlining his pandemic-related safety concerns. Lin's case was delayed due to COVID-19 and is currently awaiting a trial date.

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