Neurologist Accused of Sex Assault; Chiropractors Lead Anti-Vax Charge; Vax Backpay

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

Neurologist Accused of Sexual Assault

A neurologist at Beth Israel Medical Center in New York has been accused of repeatedly sexually assaulting patients over the course of a decade, but was still able to secure three jobs in three states until surrendering his license in 2017, a new lawsuit with multiple plaintiffs revealed.

The New York Times reports that Ricardo Cruciani, MD, prescribed a high volume of pain medication and then sexually abused women who relied on him for their care, even withholding the habit-forming medications if they resisted his attacks.

This pattern is nothing new, with several recent accusations against high-profile physicians who abused patients without consequences for years. James DuBois, PhD, ScD, a bioethicist at Washington University in St. Louis, told the New York Times, “One of the biggest scandals is just how often a person who offends, offends repeatedly.”

DuBois said that physicians “manage to continue practicing. Sometimes they move states to keep their license. Sometimes they just move institutions.”

That’s exactly what Cruciani did, hopping from Beth Israel in New York to Capital Institute for Neurosciences in New Jersey and finally, Drexel University in Pennsylvania.

The women who recounted their assaults also say that staff and administrators turned a blind eye to their complaints, refusing to accompany patients in his office and dismissing their accounts. Cruciani practiced for over 35 years and has yet to serve any jail time since he was arrested in 2017.

He was charged with sexual assault in Pennsylvania and took a plea deal requiring him to surrender his license and be listed as a registered sex offender. He still faces criminal charges in New York and New Jersey and is free on $1 million bail.

Chiropractors Lead Anti-Vax Charge

An Associated Press investigation found that chiropractors are leading the charge on COVID-19 misinformation by organizing, protesting, and spreading anti-vaccine falsehoods — even selling Facebook ads and leading groups that have raised hundreds of thousands of dollars for anti-vaccine political causes.

“Mainstream medicine will refer people out to a chiropractor not knowing that they could be exposed to misinformation,” Erica DeWald of the organization Vaccinate your Family told the AP. “You go because your back hurts, and then suddenly you don’t want to vaccinate your kids.”

Stephen Perle, a professor at the University of Bridgeport School of Chiropractic, said the opposition is led by an “exceedingly vocal, engaged minority,” of the practitioners.

One group organized what they called “Vax-Con ’21” a $299 (or more) event that featured a speaker known for an appearance in “Plandemic,” the video that launched a new era of mainstream misinformation. Chiropractors who attended the event in Wisconsin were able to get continuing education credits.

Another chiropractor ran a seminar and expo that raised $500,000 for anti-vaccine efforts in 2019, and others led a group that claims they killed a New Jersey bill that would have done away with religious exemptions for vaccines. More recently, the same group is gathering signatures and raising money to fight vaccine mandates for travel.

Some chiropractors have long been involved in movements for “freedom of choice” and one chiropractic association took a public stance that questioned vaccinations. Among medical professionals in Oregon (the state tracks data on healthcare provider vaccinations), chiropractors were the least likely of any licensed health professional to have been vaccinated for COVID-19, at just 58%.

COVID Shot Payments Overdue

Health centers in a handful of states have yet to see any federal reimbursement for administering vaccines. Among them are clinics in California, Mississippi, and Michigan, who told Kaiser Health News that the billing system for vaccines was too complicated, or that they were still negotiating the reimbursement cost per shot with CMS, which distributes the federal funds.

Community health centers are a hub for low-income people to get vaccinated, but they rely on federal reimbursement to pay staff and other costs. The cost of administering a vaccine during an office visit is included, but centers were holding vaccine clinics, which allow them to vaccinate large groups of people without wasting vaccine doses.

One organization with many centers called La Clínica de la Raza said it is expecting to eat the cost of at least half of the vaccines because insurance information wasn’t collected.

Some clinics are being reimbursed for a shot at a rate of about $40, but other community healthcare centers are left proposing a price and waiting for CMS to approve it, banking on retroactive payment.

In a letter to a CMS official, Barbara Ferrer, the director of the Los Angeles County Department of Public Health, called the situation “untenable given these providers’ financial restraints and tremendous outlay of resources during this historic pandemic response.”

Clinics and centers have had some funds available to them through the American Rescue Plan Act of 2021 and the Paycheck Protection Program, but they’re beginning to have problems retaining staff without the money to pay them. Regarding Medicaid payments for vaccines, Louise McCarthy, the CEO of the Community Clinic Association of Los Angeles County, told KHN, “We know they’re good for it. We know it’s coming. But it’s really hard to hire people when you don’t have cash flow.”

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