'Hit job' kills eye care clinic

A successful Mesa, Arizona eye surgeon with no patient complaints has
been put out of business by a federal health care agency, and many of
his medical colleagues believe he is just the latest victim in an
ongoing federal power play designed to implement Hillary Clinton's
health care plan.

In late September, Dr. Robert Gervais, founder of the Gervais Eye
Clinic in Mesa, received a surprise visit by Dr. Donna Dymond, a federal
agent from the Health Care Financing Administration. After her
inspection, the HCFA and the Arizona Department of Health Services sent
Gervais 23 pages of "deficiencies" they had found regarding his
practice. He was further instructed to correct these deficiencies within
six days or lose his Medicare certification.

Today, because he could not remediate all of the Health Care
Financing Administration's "deficiencies" in time, Gervais is out of
business. He closed his doors on Dec. 26. Case closed.

Except -- Gervais believes, but cannot prove, that he was targeted by
the Health Care Financing Administration after he attended a focus group
meeting sponsored by the Maricopa County Medical Society and HCFA to
promote a new federal pricing project for physicians in Arizona. During
the Aug. 4 meeting, physicians were asked to express their opinions
about the HCFA pilot project to a psychologist and HCFA representatives.
Several health care officials viewed the proceedings from behind a
two-way mirror.

At the conclusion of the meeting, Gervais was asked by an HCFA
official if there was anything else the agency could do for him.
Gervais, who describes himself as a libertarian, told WND that his
response was "less than politically clever." In fact, he said, he told
the official, "You can quit your job and do something productive for a
change."

Gervais says there's no way of knowing if his politically incorrect
comment prompted the surprise visit on Sept. 20, but he thinks the
timing is more than coincidental.

Having operated a successful eye clinic in Mesa since 1988, Gervais'
facility has been inspected on several occasions by Arizona Health
Department officials who oversee facilities receiving Medicare funds. In
the past, whenever deficiencies were found, Gervais quickly fixed them.
In fact, a May 7, 1998 letter sent to Gervais by the Arizona Department
of Health Services stated: "Therefore, it is determined that the
facility is now in substantial compliance with State regulations."

This time was different, however.

When Dymond arrived from the HCFA office in San Francisco to inspect
the surgery clinic, Gervais says he warned his staff that this was a
"hit job," and cautioned them to cooperate fully with the inspector.

Gervais was concerned when he learned he had only six working days to
correct 23 pages of deficiencies. Although he had been told to submit
his report to HCFA through the Arizona health department by Oct. 12,
previously scheduled out-of-town meetings prevented him from meeting the
short deadline.

The physician wrote to the department of health, explained his
dilemma and promised to provide a full report as soon as he could --
delivering his preliminary report on Nov. 5.

However, on Dec. 6, Gervais was notified that his clinic would be
"delisted" by Medicare as of Dec. 26. In a letter signed by Wayne Moon,
HCFA director of Hospital and Community Care Operations, Gervais was
told, "... the seriousness of your deficiencies limit your facility's
capacity to furnish an adequate level of quality care or services" and
that Gervais' plan of corrections "was reviewed and found unacceptable."

Moon also informed Gervais that he had the right to appeal the
decision within 60 days after receiving the letter of termination. Moon
noted, "Once terminated from the Medicare program, you may take steps to
reestablish your facility's eligibility to participate."

Gervais considers the 23 pages of deficiencies to be fairly minor
problems that could have been fixed -- but not in six days.

What kinds of deficiencies? The physician was cited for using
incorrect wording on a discharge form. He used the names of the
individuals who accompanied the patient rather than the words, "a
responsible adult," as required by the Health Care Financing
Administration. He was also cited for failure to consistently show if a
patient had been given a snack after an operation.

HCFA also cited him for failing to have a timer near a sink where he
and his assistants scrubbed down before an operation. In addition, the
agency cited him for using an anti-microbial foam instead of an
HCFA-approved disinfectant scrub. According to Gervais, the foam he uses
is used in eye clinics throughout Arizona and Texas.

In one citation, HCFA says that Gervais performed "laser cataract
surgery" without a nurse anesthetist present. In his response, Gervais
says he is unaware of any FDA-approved procedure called "laser cataract
surgery" and is further unaware of any medical center requiring the
services of a nurse anesthetist for the kind of laser operation he
performs. Gervais does not perform invasive surgeries on his patients.

WND contacted Dr. Donna Dymond for her comments. After initially
agreeing to an interview, Dymond later referred WND to Janice Caldwell,
a regional administrator at HCFA in San Francisco. Caldwell refused to
be taped for the interview, but was willing to speak in general terms
about Gervais' case.

According to Caldwell, Gervais was subjected to a routine inspection
by the Arizona Health Department, but failed the inspection.

"He did not submit an acceptable plan of correction and did not meet
the initial deadline," said Caldwell. "He finally did get it in 20 days
after the deadline, and it was not acceptable even then."

When asked about Gervais' having been cited for using an unapproved
foam scrub, Caldwell said that, according to HCFA's standards, this foam
does not meet operating room standards. She refused to discuss his
citation for having sterile packs stored at 80 degrees.

"I don't want to get into a contest over degrees," said Caldwell.

She said the results of the inspection must be viewed in the "sum
total of non-compliance," not in single citations. Gervais was
decertified from Medicare because of deficiencies that would directly
affect patients and for "potential hazards" to patients.

Caldwell says Gervais has the right to appeal HCFA's decision,
although a legal appeal would be handled by another department at the
same agency. Caldwell says there is no way of telling how long the
appeal process might take.

Is the goal to shut down clinics?

Gervais, a member of the Association of American Physicians and
Surgeons, believes the federal government is attempting to shut down
surgery centers all over the U.S. The goal, says Gervais, is to drive
independent physicians back into hospitals where they can be more
effectively controlled.

Jane Orient, M.D., president of the Association of American
Physicians and Surgeons, believes that what has happened to Gervais is
part of a larger effort by some in Congress to implement Hillary
Clinton's health care plan in a piece-meal fashion. The recent media
blitz detailing hospital hazards and mistakes is aimed at generating
support for a new federal agency that would monitor all health care in
the U.S., all medical records and all doctor's offices, she said.

On Dec. 6, 1999, Sen. Ted Kennedy, D.-Mass., announced his plan to
introduce legislation to establish a federal agency that will collect
data on medical mistakes and develop recommendations to avoid them.

According to Orient, this is just another "pretext for federal
control of medicine." She noted that Health and Human Services Secretary
Donna Shalala recently announced regulations that will affect how
medical records are handled. However, Shalala's efforts to protect the
privacy of medical records is misleading, said Orient. When the federal
government gains access to everyone's medical records, this will assure
that "any agency, or quasi-private entity the federal government
approves of, has carte blanche to get everybody's medical records."
This, says Orient, was part of Hillary Clinton's health care plan.

Another part of the effort to federalize health care is being
implemented through aggressive inspections of health care facilities to
find errors. Federal health officials have recently increased the number
of inspections supposedly meant to root out Medicare fraud.

The effort to expose fraud has had negative consequences on the
medical profession. According to American Medical Association President
Nancy Dickey, M.D., the government's fraud initiative "sets up an
adversarial tension in every patient-physician encounter."

Dr. Roland Summers, president of the Medical Association of Georgia
notes that the fraud effort "is making us look like criminals, when more
than 99 percent of us have no intention of doing anything but taking
care of patients for their medical needs."

Dr. Raymond Garrett, a kidney specialist in Colorado, lost his
practice on July 1 due to an HCFA inspection. Garrett was charged with
over-billing Medicare for $25,000 over a two-year period. Garrett was
nearly bankrupted in defending himself against HCFA. After an appeal,
HCFA reversed its decision on July 15, but by then Garrett was ruined
and out of business.

Interviewed by the Denver Rocky Mountain News on Aug. 22, Garrett
observed, "They've already ruined my practice. The question is, how many
other practices are they going to ruin, and how many Medicare patients
won't get care?"