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What It's Like to Win an Ig Nobel; Oxygen Company Too Big to Ban? AI Cuts Care

<ѻý class="mpt-content-deck">— This 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.

What It's Like to Win an Ig Nobel

While Ig Nobel honorees aren't always sure they want the recognition, the prizes do bring attention to their research, according to reporting .

The Ig Nobel prizes -- founded in 1991 by Marc Abrahams, who had long kept track of interesting and whimsical research -- honor achievements that "make people laugh, then think." Abrahams reaches out to researchers months in advance of the annual awards because people are often hesitant to accept them.

Take for instance Eleanor Maguire, PhD, the University College London neuroscientist who discovered that London taxi drivers' brains have larger-than-average hippocampi. The first time she was offered an Ig Nobel Prize, she turned it down out of fear for what the silly award would do to her career. But years later, after becoming more familiar with the awards, she accepted -- and her work got even more attention.

"It was useful for my career because people wanted to talk about it," Maguire said.

Other awardees have included research on levitating a frog with magnets, and the first reported instance of homosexual necrophiliac ducks.

Oxygen Company Too Big to Ban?

Despite decades of misbehavior -- from overbilling to violating kickback laws -- Medicare has never banned Lincare, the largest distributor of home oxygen equipment in the U.S., .

In 2023, HHS placed Lincare on probation -- a "corporate integrity agreement" with a "death penalty" provision. Yet Lincare was already under that form of probation and had been on and off it for years. The company regularly violated the terms of probation with little punishment, according to ProPublica.

Part of the reason Lincare has gotten away with this for so long is because Medicare fraud is so rampant that a lot of bad behavior gets through. Plus, the company has a near-monopoly, begging the question whether it's too big to ban, the article stated.

In addition, paying multimillion-dollar legal settlements has been affordable to the company. "As long as that [settlement] check is less than the amount you stole, it's a good business proposition," Lewis Morris, former chief counsel to HHS' Office of Inspector General, told ProPublica.

Lincare customers aren't pleased with the services they receive; it only has a 1.3 out of 5 on the Better Business Bureau site, with one reviewer writing that Lincare is "running a scam where they have guaranteed income" and that "the customer can't do a thing."

ProPublica's reporting found "a dismal picture of a company with a sales culture that depends on squeezing infirm and elderly patients and the government for every penny."

Problematic Algorithm Cuts Mental Health Care

A major insurer used algorithms and gaps in regulation to cut off mental health care to the patients who needed it most, according to a .

For nearly a decade, insurance giant UnitedHealth Group has been using algorithms to identify providers offering too many services, and then cut off reimbursements. This is referred to as 'overutilization' -- when patients are getting what UnitedHealth deems as too much care, like having therapy sessions twice a week.

California sanctioned UnitedHealth for this algorithm-driven practice back in 2018, but the company only had to apply its corrective actions to California-based plans. Massachusetts and New York also found the system illegal but faced similar issues where their power ended at state lines.

Every jurisdiction where UnitedHealth operates would have to successfully bring a case against it for these practices to end, the article stated. One former UnitedHealth employee told ProPublica he felt like "a cog in the wheel of insurance greed."

ProPublica details how UnitedHealth and its subsidiary, Optum, which handles mental health coverage, have slipped through the cracks of patchwork regulation.

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    Rachael Robertson is a writer on the ѻý enterprise and investigative team, also covering OB/GYN news. Her print, data, and audio stories have appeared in Everyday Health, Gizmodo, the Bronx Times, and multiple podcasts.