E139 | Elizabeth Chamblee Birch on The Pain Brokers
DC EKG
Elizabeth Chamblee Birch, law professor and author of 'The Pain Brokers,' exposes a coordinated healthcare fraud scheme targeting over 100,000 women using stolen HIPAA-protected medical data. Call
Key takeaways
- Stolen medical data was weaponized through cold calling to manipulate women into undergoing unnecessary surgeries.
- The scheme leveraged legal loopholes allowing non-lawyers to form law firms, enabling fraudulent lead generation and litigation funding.
Main topics
- Healthcare fraud
- HIPAA data breaches
Notable quotes
"These third party litigation funders began to realize that a case with the product in place was worth a whole heck of a lot less than when the product had been removed."
"You have this product that needs to be removed immediately. You're going to die if it doesn't happen."
Conclusion
The episode underscores a deeply entrenched system where stolen medical data, legal loopholes, and
Transcript preview
Speaker 1 (0:00) Importantly, these third party litigation funders began to realize that a case with the product in place was worth a whole heck of a lot less than when the product had been removed. And so the whole scheme here was to convince women who had the product still in place, not only to sue, but also to have the product removed. in order to jack up the settlement values for the doctors, for the funders, and ultimately for the lawyers. Speaker 2 (0:30) This is DCEKG, exploring the intersection of politics and healthcare by diagnosing Washington and prescribing solutions. We take a deep dive into the legislation, regulation, and innovation impacting policymakers, providers, and patients. Now, America's health policy expert, Joe Grogan. Speaker 3 (0:52) Welcome back to DCEKG. I'm your host, Joe Grogan. Today, we're joined by Elizabeth Chambly-Birch from the University of Georgia, author of this fantastic book, The Pain Brokers, which I couldn't put down and made my blood boil and was really well-written and fascinating on a number of different levels. So, Beth, thanks so much for joining DCEKG. Speaker 1 (1:22) Absolutely. I'm so thrilled to be here. Thanks for having me. Speaker 3 (1:25) So before we get into the story, which is incredibly compelling and important, tell us a little bit about yourself and your background and how you ended up writing books. Right. Speaker 1 (1:38) Yeah. So I am a law professor. I've been teaching in the law school for, gosh, I guess this is my 21st year. And I write about mass torts. So things that go wrong on a massive scale, the opioid epidemic, the BP oil spill, those are all examples of mass torts. And I've been writing about this ever since I graduated from law school in 2004. And so little has changed in this world in the last 20 years that a number of years ago, I decided to go back to school and get an MFA in narrative nonfiction so that I could write a book for general audiences and educate the public about what's going on and hopefully create the kind of change that doesn't happen through boring law review articles. Speaker 3 (2:22) Where'd you get your MFA in? Yeah, Speaker 1 (2:25) so I went to UGA. I think it's the only narrative nonfiction MFA in a journalism school in the country. But it was great because I got to go for free. So even better. Yeah. Speaker 3 (2:38) Well, they did a pretty good job because I was struck. A lot of liars can't write good books. And to your point, they write them like well-reviewed articles. But this is great and a page turner. So I want to start with Sharon, the first patient you introduce in the book. Sharon is at home and gets a phone call from somebody who has a ton of personal information and personal medical information about a vaginal mesh that she had had inserted into her body. Maybe we'll start is what is a vaginal mesh inserted for? Let's start there. And then let's talk about Sharon's phone call. Speaker 1 (3:26) Sure. Yeah. So vaginal mesh is used to deal with incontinence. It's used to deal with pelvic organ prolapse. So as we age, it's not just our skin that tends to sag. It is our internal organs. And mesh was designed to essentially perform a hammock function for those internal organs and to prevent them from sagging. The phone call that Sharon got, you know, oftentimes I like to. try to put us in Sharon's position. So imagine that you're in your kitchen one evening, you're fixing dinner. And you get a phone call and the person on the other end of the line knows an inordinate amount of information about you. They know your name. They know your birthday. They know that you had this medical implant. They know the name of your doctor, the name of your hospital. So all the things that normally would give us red flags to say, oh, gosh, this might be a scam. They already knew all of that information. And then they told Sharon that she has a ticking time bomb in her. And if she doesn't have her mesh removed immediately. that she's going to die. One of the reasons that I start with Sharon is that I think she looks like a lot of us. She has a master's degree. She is in charge of special education in Horry County, South Carolina. She is not somebody that you think of as gullible or someone who can fall for scams. But when you're told that your life hangs in the balance and the person on the other end of the line knows all of this information about you. It sounds very legitimate. And she actually thought that it was Boston Scientific, which was the manufacturer of her mesh, that was calling her to recall the product. You know, just like you might get a postcard in the mail recalling your sunroof on your car and saying, hey, come by, we're going to fix this for you. The people on the other end of the line said, hey, don't worry, we're setting up appointments in two weeks. We just need you to fly down to Florida and we'll take care of everything. Speaker 3 (5:21) One thing that you mentioned, it seemed like not only do they have data, but it seemed to me like they even had the physician's notes about symptoms and her description of what she was going through in deciding to get the vaginal mesh inserted. So it wasn't just like birthdates or whatever. So it was really intimate knowledge and almost reflecting. her her most intimate symptoms and what she was dealing with. So that takes it to another level than just the data that was being relayed back to her. Speaker 1 (5:59) It really does. And in Sharon's case, she wasn't even really aware that she had mesh inserted. She had a partial hysterectomy and her doctor decided in the midst of surgery to include mesh. And, you know, sort of told her about it in the fog after surgery under anesthesia, mentioned it to her husband. So it really wasn't until she talked with her husband after this phone call that she realized, yes, gosh, you know, I do have mesh in me and this might actually be a problem that I need to take care of. Speaker 3 (6:29) And who was it who called her? Speaker 1 (6:32) So the call center, it's kind of an open question. There was a data breach in India as medical records were being outsourced and converted to electronics through private health care companies. Some of these Indian call centers realized that they were sitting on a mass tort gold mine, and they began cold calling the women. But they were also partnering with an outfit in South Florida, in Orlando, that is at 1000 Corporate Drive. It's this kind of plastic sounding company. And they had over 200 people there on 1000 Corporate Drive who were also cold calling the women. So in Sharon's case, this was not somebody who had a foreign accent. It sounded like someone domestic. It was likely. someone down in South Florida. Speaker 3 (7:20) And when that class of telemarketer in your narrative, remind me what you call them. You call them originators or are they the legal in name only? Is that the legal in name only or is that the originator? They're a little Speaker 1 (7:32) bit of both. So they're all kind of in cahoots together. But these are lead generation companies. And in this case, they had teamed up with what I call sort of a Frankenstein law firm. So there was this law firm called Alpha Law. It was created through a loophole in Washington, D.C., which was the only jurisdiction at the time that allowed for non-lawyers to form law firms with lawyers. And so there were a couple of lawyers who had been licensed in D.C. They were operating out of Texas. They agreed to create this kind of Frankenstein firm. with this lead generation company. And so the lead generation company was cold calling women to get clients for Alpha Law. Speaker 3 (8:18) Alpha Law is in a class of, I had this in my head, but you tell me if I'm wrong. Alpha Law is in a class of soliciting law firms in a way, like you're driving down I-95 and you see, I'll just use my own name because there's probably one with a name I would make up. Like say it's Grogan and Grogan. call 1-800-4-LAW or we love law or something or get paid and that you call that and they will triage you based upon what's going on and they'll refer you to somebody else, right? Do I have that right? Speaker 1 (8:54) So, yes, I mean, there is a difference between legitimate advertising, which, you know, you can say what you will about billboard lawyers, but people are calling into those law firms. These law firms were in Alpha Law's case. This wasn't a billboard scenario. They were actually cold calling the women and saying. you have this product that needs to be removed immediately. You're going to die if it doesn't happen. So, you know, there's the type of advertising that we may not like, but that we tolerate. And then there's the type of illegal advertising, which is based on private health data that should have been protected by HIPAA. Speaker 3 (9:31) Right. So outbound calls fueled by illegal stolen data is what we're talking about. Speaker 1 (9:37) Not okay. Right. Not Speaker 3 (9:38) okay. Bad. Very bad. So then Sharon. And I'll defer to you if you want to generalize it, because you talk about other patients here, too, by name and very compelling stories. I don't want to minimize their stories. What happens to Sharon as she's moving through the system now? She thinks she's speaking with the mesh manufacturer, the company responsible for making the mesh to begin with. How does she move through the system? and 1,000 corporate drive down in Fort Lauderdale. Speaker 1 (10:12) Yeah, so she waits a couple of weeks. It's the middle of Christmas. So she waits until after Christmas has happened and she flies down to South Florida. As part of that, they have sent her a DocuSign packet. And I think we can all kind of identify with signing DocuSign. In her case, the DocuSign packet was programmed to jump her to the signature page. So she signed what she thought was routine. HIPAA forms, patient consent forms, and then it auto-populated her signature and her initials throughout the DocuSign packet. Now, what was buried in that DocuSign packet was an attorney-client retainer agreement, as well as a lien against her future settlement proceeds. So when she got down to the outpatient center, which It was kind of a creepy twilight zone. It was owned by a chiropractic clinic. She walked in and it didn't have any signs. It didn't have any indication about what it was. When she got there and talked to the woman at the desk. The woman said, oh, no, you don't need to give us your health insurance information, which she had very good insurance as a teacher. We'll take care of everything. And in her mind, she thought, well, that makes a lot of sense because this is Boston Scientific and they're going to take care of everything. It wasn't until afterwards where they take her to the pharmacy. She's I should mention that she's picked up at the airport. She's taken to a hotel. She has to have a plus one. She's brought her niece. They're