Some Medical Travel Can Expose Companies to Patent Infringement Risk

Touted as "new", or novel, the "Meet and Treat" practice of U.S. surgeons meeting patients in foreign countries where facility charges are lower to perform surgery was once novel and new...about 15 years ago. That's already a "been there - tried that" and has been eclipsed by U.S. hospitals and surgery centers in the news that compete aggressively all over the map.

A recent New York Times article that was given a boost by Becker’s Hospital Review caught our eye because it was about Ashley Furniture needlessly sending patients to Mexico and having to buy “extra” insurance for complications to get “deals” on knee surgery.

Dr Maria Todd, our key opinion leader on medical travel program development added her comments on the Becker’s site, and also on a different post by author Richard Krasner a proponent of medical travel for workers’ compensation cases on his blog on LinkedIn. 

Her comment on Becker’s was as follows:

Two questions: 

1. Why is a Denver-based company named “North American Specialty Hospital” sending patients and exporting surgeons to other countries to perform cheaper surgery pricing?

2. I read the pricing. U.S. facilities charge as low as $14,990 for a total knee replacement, implant included, as a transparent bundled case rate. Services are in the USA with USA malpractice insurance at no additional cost, cheaper, shorter flights, no passport required, services in English at AAAHC accredited facility with an infection rate of 0.037% (national avg 2.6% and who knows what the numbers are for Mexican hospital infection rates!)

A few other points to consider about this story… perhaps the author did not research adequately.

3. “… to alleviate concerns about quality of care” … is pure and utter nonsense. In Mexico, nurses have no requirement for continuing education credits and are considered non-professional. in Mexico, doctors may attend CME at a beach resort, sign in, leave the event, go take a vacation and come back in time to sign out. Med carts are unlocked Rubbermaid rolling carts as there is no countersignature for narcotic waste required in Mexican law, few have automated medication dispensing systems such as Pyxis. Quality of care is far more about all the other aspects of care delivery not just where the surgeon is from. And truth be told, the surgeon spends the least amount of time with the patient during the episode of care, overall.

4. As for giving the patient $5000 and waiving deductible and copayment to cross the US border, that business model requires a fee to be paid to patent holder for patent number US8160897 (… causing the fee to the employer to be priced higher to cover the licensing fee, if they want to remain legal. If NASH or the employer didn’t pay the licensing fee, they are at risk for patent infringement. Since 2010, more than 23,000 companies—many with revenues of less than $100 million a year—have been sued for infringing a patent they never knew existed. Damages can be 8-9 figures although most cases don’t force tiny firms like NASH to pay. But Ashley Furniture is much larger and has deeper pockets and knew or should have known the consequences for not paying the licensing fee to the patent owner. None of that risk exposure exists if the case remains in the USA. Companies waive deductibles and copayments, pay all the travel, and many share the savings with plan participants as an HSA contribution, rather than give cash that’s not tax protected. After she pays taxes on that $5000 what’s left?

And finally, this is not new. The practice has been active for the last 18 years that I am aware of. NASH wasn’t even in existence then. I know because NASH came to me for pre-launch consultation a few years back. UCLA physicians have met patients for cardiac and gynecological and interventional radiology procedures in Thailand since the early 2000s, one Miami urologist, Arnon Krongrad MD has been meeting patients in Mexico, Trinidad, Israel and elsewhere for about 11 years and had an entire squad of surgeons who did this through his Manny Mobile brand. Many California physicians meet patients in Mexico and have done so for the past 15 years that I am aware of.”

She then added a slightly different perspective on her LinkedIn response because Krasner opened the door on political commentary.

“And lastly Richard, your next to last paragraph is a stretch. “The whole point of my advocacy for medical travel and workers’ comp was so that American workers and their dependents like Donna could travel abroad and see what the world is really like, so that political, hate-filled rallies and incidents we are seeing everyday since the election of a white supremacist to the presidency, would not take place.”  There are anti-this and that protests DAILY all around the world. They are posted daily by United HealthCare and the U.S. State Department and are free to research and monitor.  In all seven of the medical tourism firms I’ve owned, we monitored them. And now, SurgeryShopper does as well because these protests and hate crimes happen in most medical tourism destinations. Also, when did you personally visit Galenia in Cancun and Bumrungrad in Thailand and inspect them… and what criteria did you use?”

Her comments on Krasner’s LinkedIn article have attracted feedback from others on LinkedIn in what appears will be a lively discussion. So many posts on LinkedIn simply don’t generate any activity.

The last point she made has to do with a daily update sent out by UnitedHealthcare that highlights travel risks in the USA and abroad, which we use at SurgeryShopper to monitor what’s happening in or near places our clients are headed or have already arrived at a treatment destination.  It is called “Daily Security Hot Spots” and you can subscribe without cost through UnitedHealthcare Global

Security Threat Level Explanation
Security threat levels range from 1 (Very Low) to 5 (Very High) and are determined using a comprehensive system that utilizes both qualitative and quantitative analysis. The primary factors used to determine a location’s security threat level are Armed Conflict, Crime, Demonstrations/Strikes, Ethnic/Sectarian Tensions, Graft/Corruption, Kidnapping, Political Instability, Government Restriction and Terrorism.

At SurgeryShopper, we are always excited to find new articles about “Corporate Medical Tourism”, but when we see something that isn’t responsible reporting or inadequately researched information presented as “facts”, we can’t simply turn a blind eye.

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