August/September 2024 Memphis Medical News

FOCUS TOPICS ORTHOPEDICS • PEDIATRICS • HEALTH LAW

August/September 2024 >> $5 ON ROUNDS

Misleading Ads Play Key Role in Schemes to Gin Up Unauthorized ACA Sign-Ups, Lawsuit Alleges The government is giving away money! So say ads on a variety of social media platforms. Consumers, the ads claim, can qualify for $1,400 or even $6,400 a month to use on groceries, rent, medical expenses, and other bills.

Some mention no-cost health insurance coverage.

But that’s not the whole story.

And here’s the spoiler — no one is getting monthly checks to help with these everyday expenses.

Such ads are now under scrutiny for the role they may play in helping rogue insurance agents and companies sign up tens of thousands of consumers for Affordable Care Act coverage — or switch them from their existing ACA plans — without their express permission.

HealthcareLeader

From Surgeon-in-Chief to President, Dr. Trey Eubanks’ Work at Le Bonheur is a Labor of Love

By JAMES DOWD

Approaching his first anniversary as president of Le Bonheur Children’s Hospital, Trey Eubanks, MD, is thankful to be practicing a career he loves, and appreciative of those whose support made it all possible.

“This job is a huge honor and a tremendous responsibility, and it’s full of wonderful possibilities and opportunities to serve our community,” Eubanks said.

“I was lucky enough to grow up in a place where you knew everyone’s name, and neighbors looked out for one another.

That’s the kind of atmosphere we have at Le Bonheur, where I’m surrounded by people whose commitment to our patients and their families inspires me every single day.”

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The Centers for Medicare & Medicaid Services, which oversees the federal ACA marketplace, also known as Obamacare, has reported at least 90,000 complaints about unauthorized enrollment or plan-switching in the first quarter of the year.

PhysicianSpotlight

Chad Campion, MD, Champions Minimally Invasive Spinal Surgery for the Mid-South

Those numbers have also caught the attention of House Republicans, who on June 28 requested investigations by the Government Accountability Office and the Office of Inspector General at the Department of Health and Human Services.

Endoscopic spinal surgery treats pain causes and allows faster recovery.

By BECKY GILLETTE Chad E. Campion, MD, a spine surgery specialist with Campbell Clinic Orthopaedics, is the only surgeon in the region to provide minimally invasive endoscopic spinal surgery and its multiple advantages. A small incision of only 8 millimeters is used to insert a camera and surgical tools to repair spinal issues.

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Surgeon-in-Chief to President, continued from page 1 Eubanks said his upbringing prepared him for a service-oriented career, and he can’t imagine a much better childhood than what he experienced as a kid in smalltown Mississippi. The future pediatric surgeon grew up in Tunica, coming of age in an era before glittering casinos dotted the landscape of the tiny southern community.

His parents, both from Batesville, Mississippi, met in high school and graduated from the pharmacy program at Ole Miss before settling in Tunica to begin their careers and start a family. It was against this backdrop that Eubanks developed a sense of service and a commitment to helping those in need.

“When my parents finished school, they started looking around in small towns for a solo drug store that they could buy once the owner retired,” Eubanks said.

“They found one in Tunica and our family enjoyed a way of life in a small Delta town that’s increasingly rare these days.”

For more than 40 years the Eubanks family owned that pharmacy in Tunica, where Eubanks worked when he wasn’t involved in sports-related activities such as playing on his high school football team.

He learned the business inside and out, and the experience motivated the teenager to pursue a career that would allow him to take care of his neighbors in a similar way.

“I saw the importance of what my family did in our community, and I wanted to make a difference in peoples’ lives like they did,” Eubanks said. “After high school I enrolled in the pharmacy program at Ole Miss, and I assumed that would be my path. Then as I got closer to completing my degree, I decided to apply to med school so that I could become a doctor and go back to Tunica to take care of the people there.”

After earning his Bachelor of Science in Pharmacy, Eubanks entered the University of Mississippi Medical Center in Jackson. After his first year in med school, an opportunity to work during the summer as an OR assistant with Tunica native Fred Rushton, MD, shaped the course that Eubanks would pursue in medicine.

Shadowing Rushton, who was a general surgeon, and assisting in the hospital proved a watershed experience for the first-year med student. As a teen, Eubanks enjoyed taking apart and putting things back together, like household appliances and his family’s VCR. He loved building things with his hands and tinkering with his motorcycle to figure out ways to improve its performance. The idea of a career that allowed him to decipher medical puzzles and assemble treatment and surgical plans to make patients better appealed to his problem-solving nature.

“Surgery made sense to me, and it was a great fit. Everything about it just clicked,” Eubanks said. “Working with Dr. Rushton made a difference in how I looked at things, and I developed a passion for helping people who really needed it.”

During his third year in medical school, Eubanks further refined his career memphismedicalnews.com

trajectory when he worked a rotation with pediatric surgeon Richard Miller, MD. Eubanks developed a deep connection with the young patients he saw daily, and over time his plans of returning to Tunica as a family physician began to shift. To pursue a practice focused on pediatric surgery, he would need to consider larger markets that offered such opportunities.

“I fell in love with pediatric surgery and that sealed it for me,” Eubanks said.

“I knew that I couldn’t go home to practice because there wouldn’t be enough patients to sustain that kind of specialty, so I started looking at places where I could be part of a robust pediatric team.”

After earning a doctorate in medicine from UMMC, Eubanks completed his residency and research fellowship at the University of Tennessee Health Science Center. Next came a pediatric surgery fellowship at the University of Texas Southwestern in Children’s Medical Center of Dallas and subsequent decisions about where he wanted to live and work.

“There were a few people who tried to dissuade me from doing a pediatric fellowship because it would be hard to get in, hard emotionally because I’d be seeing sick children, and I would make no money,” Eubanks said. “But I felt called to this kind of work. I loved being around the kids and their parents and I wanted to give them a chance at a better life. I wanted to make a difference.”

While living in Dallas, Eubanks received offers from hospitals there and across the Southeast, but his heart was in Memphis and near his family. He eventually returned to the Bluff City and began at Le Bonheur, where he has served for more than two decades in roles of increasing responsibility.

Eubanks was named president of Le Bonheur in late 2023, serves as Surgeonin-Chief and is UTHSC Professor of Surgery and Pediatrics and Chief of Pediatric Surgery. He is certified by the American Board of Surgery for general and pediatric surgery, is certified as an instructor for Advanced Trauma Life Support and Pediatric Acute Life Support.

“Le Bonheur really captured my heart because of what it did for kids, despite being a bit poor in resources at the time,” Eubanks said. “I had the incredible privilege of working with Meri Armour when she was CEO of Le Bonheur and worked to align doctors with the practice of the hospital,” During his time working with Armour, Eubanks began to take on more administrative and leadership duties. He became the hospital’s trauma director in 2004 at about the same time Le Bonheur embarked on a major construction project.

“Meri Armour said that Le Bonheur should be a Level One trauma center for children and that was at a time when there wasn’t one in Tennessee, Arkansas, or Mississippi,” Eubanks said. “Under her leadership we got it done and I saw the impact it had on the quality of care for all patients. If you can take care of the direst cases of trauma patients, you can help

I felt called to this kind of work. I loved being around the kids and their parents and I wanted to give them a chance at a better life.

every other patient. Working with her to make that vision a reality got me interested in leadership.”

Eubanks further developed his leadership capabilities when he led a team of healthcare providers in Haiti following the earthquake that devastated the region in 2010. While in Port-au-Prince, Eubanks spent a couple weeks as a trauma doctor taking care of patients, running the OR and overseeing hospital administrative duties.

“Working with that incredible team in Haiti gave me experience in a level of leadership that was invaluable. It was grueling work and full of challenges, but incredibly rewarding because of the positive impact we were able to offer the people who were affected by that tragedy,” Eubanks said.

“When I returned to Le Bonheur I had an entirely different perspective on life and I was eager to continue to develop new skills. My career shifted a bit again and I started taking on more administrative and leadership responsibilities, which I found very rewarding.”

Eubanks was appointed interim CEO of Le Bonheur in March 2023, a role that he assumed permanently last December.

He spends a great amount of time promoting the organization and recruiting medical personnel, while developing strategic plans for the hospital’s future.

As the father of five adult children – and grandfather to four youngsters – Eubanks is dedicated to making life better for kids. He wants to expand Le Bonheur’s cardiac, nephrology and pediatric surgery units, and improve access to care so that young patients can receive the treatment they need and return to regular activities as quickly as possible.

“Every day I hear stories about children who live somewhere that doesn’t

offer the care and services they need, but they’re able to come here for treatment and they get to go home better,” Eubanks said. “As president of Le Bonheur, I can say unequivocally that the care we provide is second to none. We have experts from all over the world and our expertise is the best in the country. I’m privileged that I get to see that every day.”

Eubanks belongs to numerous professional affiliations, including serving as chair-elect on the board of the Trauma Center Association of America. He is a fellow of the American College of Surgeons, and a member of the Memphis Surgical Society, the Tennessee Emergency Medical Services for Children, the Eastern Association for the Surgery of Trauma, the American Pediatric Surgical Association, the Society of Critical Care Medicine, the Pediatric Trauma Society, and the American Association of Physician Leadership.

While serving as interim president, Eubanks oversaw Le Bonheur’s campaign that raised more than $12 million, presided over the opening of the Seacrest Studio that allows young patients to participate in radio, broadcast, and new media programming, and led the hospital to become the first in the state to achieve the Children’s Surgical Center Level I Verification. Now that his role is permanent, he is looking forward to even more exciting opportunities to improve medical care for the children in his community.

“Simply put, Le Bonheur is a fun place to work. I consider it a great honor to work with so many dedicated people to improve medical care for our patients,” Eubanks said. “I believe this is high calling and I know that everyone who works at Le Bonheur feels the same. This is vital work, and we can’t fail at what we do.”

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Chad Campion, MD, continued from page 1 “It is a similar idea to rotator cuff and anterior cruciate ligament (ACL) surgeries. These used to be performed through large incisions. Now, they can be done using a very small incision and a camera,” Campion said. “Adapted to spine surgery, I can address problems like sciatica or a herniated disk. With a herniated disk, we make a small incision to insert the camera and a surgery tool to remove the herniation and fix that.

It takes almost no time for patients to recover. It is so much better than traditional surgery because there is less bleeding, less pain and a lower risk of an infection. It also reduces the chance of additional problems requiring more surgery.”

Pain from spinal problems can greatly diminish people’s quality of life, preventing them from working, enjoying their family and social lives, and being able to exercise in ways that promote strength and cardio health. Campion finds it very rewarding to see patients go from being disabled to quickly regaining their health and mobility.

Campion, who is on the American Board of Orthopedic Surgery, said this can be an option for people who would otherwise need fusion surgery, a procedure that links two vertebrae together to improve stability and reduce pain. But fusion surgery is not always 100 percent effective in eliminating pain and carries

more risk of infection. His partners will often send him patients who would benefit from the alternative to fusion surgery.

For older people more at risk from adverse effects from being under general anesthesia, endoscopic surgery is particularly useful.

“It is a huge deal for people, especially older people, with stenosis, a tightness around the nerves in the back that they may have had for a long time,” Campion said. “The open surgery for that works well but requires more time to recover. People tell me that the day after endoscopic surgery, they are back to doing what they need to do. It is a big deal for people. Endoscopic surgery can even use twilight or minimal sedation. It is like you are taking a nap, and there is no breathing tube stuck down the patient’s throat. Other options for sedation can include an epidural or spinal block.”

The shorter recovery time is also critical for younger people, including those whose spinal problems like disk herniation leave them unable to work, help with children and household chores, and enjoy their recreational activities.

Endoscopic surgery is more expensive, but patients and their insurance companies are billed the same as for traditional open surgery.

“The only person who sees the increased cost for using the camera is

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Campbell Clinic,” Campion said. “We pay more to do the endoscopic surgery but are willing to absorb the extra cost because my partners and I feel this is the better way to do the surgery. Besides the additional cost, the number two reason for this not being adopted more widely is the large amount of training needed and the difficult learning curve associated with it. I had to go to several different training sessions and observe other surgeons. It is a difficult surgery to perform.

It is very different from other surgeries that we do. Once or twice a month, I go teach other surgeons how to do this.

There is still only a small community of physicians who do this kind of surgery.

Vanderbilt is the closest.”

Campion and his surgical team have been doing endoscopic spinal surgeries for two years now, operating on about 275 patients thus far—between three and ten a week. Campion said the experience he and his team have from doing this hundreds of times means better outcomes for patients.

“Everyone on my team is in tune with what I’m doing and what I need,” he said. “I’ve got a great team to work with.”

Right now, the problem is a lot of people don’t realize this option exists.

Campion believes as people become more aware of it, they will travel around the country seeking this option rather than doing the traditional surgeries.

One important advantage, Campion said, is that it can be used for patients who can’t risk traditional surgery because of medical problems. “My partners send me people they otherwise can’t operate on,” Campion said.

Campion sees patients in three Campbell Clinic locations: Germantown, Arlington, and Oxford. He operates at the Campbell Clinic Wolf River outpatient surgery center as well as numerous area hospitals.

Top: Chad Campion in surgery Bottom: Chad E. Campion preparing patient for endoscopic spine surgery Campion graduated from the Rutgers-New Jersey Medical School in 2015 and did his orthopedic residency at the Campbell Clinic from 2015-2020.

Following residency, he did a fellowship in spine surgery at Norton-Leatherman Spine Center, Louisville, Kentucky.

Campion grew up in a small town in New Jersey and finds Germantown not that different. “Now it is home,” he said. “It is where I have lived for the past ten years. It was not a big change for me from the small town in New Jersey where I grew up.”

Campion and his wife, Mary Katherine, live in Germantown with their son, Wells, who is one, and they are expecting a daughter, Lane, to be born at the end of the year. In his free time, he enjoys spending time with his wife and son, and visiting his family in New Jersey.

He enjoys hunting and playing golf. He makes it a priority to exercise regularly, including working out with weights and running to stay in good shape and release some stress.

8/23/24 2:14 PM memphismedicalnews.com

Misleading Ads Play Key Role in Schemes to Gin Up Unauthorized ACA Sign-Ups, Lawsuit Alleges

By JULIE APPLEBY

The government is giving away money! So say ads on a variety of social media platforms. Consumers, the ads claim, can qualify for $1,400 or even $6,400 a month to use on groceries, rent, medical expenses, and other bills.

Some mention no-cost health insurance coverage.

But that’s not the whole story.

And here’s the spoiler — no one is getting monthly checks to help with these everyday expenses.

Such ads are now under scrutiny for the role they may play in helping rogue insurance agents and companies sign up tens of thousands of consumers for Affordable Care Act coverage — or switch them from their existing ACA plans — without their express permission.

The Centers for Medicare & Medicaid Services, which oversees the federal ACA marketplace, also known as Obamacare, has reported at least 90,000 complaints about unauthorized enrollment or plan-switching in the first quarter of the year.

Those numbers have also caught the attention of House Republicans, who on June 28 requested investigations by the Government Accountability Office and the Office of Inspector General at the Department of Health and Human Services.

Fraud — including from unauthorized switches by brokers, as reported

by KFF Health News in recent months and noted in the congressional requests — might be part of the problem, House members wrote. They cited an analysis from a conservative group that estimated that millions of people — or their brokers — reported incorrect financial information to qualify for large ACA tax credits.

Whether advertising efforts will be part of any such investigation is unknown.

Details on how an alleged scheme used misleading ads are included in a Florida lawsuit filed in April. The suit claims that several marketing and insurance sales firms used misleading ads as part of a collaborative effort to gin up questionable, commission-earning business. The firms named in the case say the allegations are meritless.

“Telling someone they are going to get $6,400 a month in a cash card for rent or groceries or whatever else, that is a lie, that’s fraud, even if you put in a small boilerplate on the bottom trying to say something different,” said Jason Kellogg, one of two attorneys who filed the complaint in U.S. District Court for the Southern District of Florida. memphismedicalnews.com

Here’s how it worked, according to the suit and interviews with the attorneys who filed it: When consumers responded to the ads by phone, they were not connected with a government program.

Instead, they were linked directly to insurance call centers, which paid the lead-generating firms placing the ads to transfer the calls.

At best, consumers who respond to the ads might find out they qualify for ACA tax credits, which vary in size, to help offset the premiums for zero-cost or low-cost coverage. Those payments, though, are sent directly to insurers. At worst, according to allegations in the lawsuit, consumers wind up with coverage they didn’t select and that might not meet their needs, or their existing coverage is switched to a new plan, which might have a different network of doctors and hospitals or higher deductibles and copays. The suit alleges much of this was accomplished without consumers’ “proper knowledge and consent.”

Depending on how it’s done, creating ads and gathering names to sell to insurance sales firms is not illegal, but deceptive ads are.

The Federal Trade Commission defines a deceptive ad as one that “contains a misrepresentation or omission that is likely to mislead consumers acting reasonably under the circumstances to their detriment.”

Even that isn’t always clear-cut.

“I get into talks with attorneys all the time,” said Bonnie Burns, a consultant with the nonprofit California Health Advocates. “Is this language I’m seeing that I think is fraudulent — does it actually meet that test? It’s frustrating and maddening as hell.”

After looking at several ads that have appeared recently on social media — but not specifically the ones included in the lawsuit — one marketing expert had no doubt.

“This clearly crosses the line to deception,” said Charles R. Taylor, a professor of marketing at Villanova University. “It is a form of bait and switch, by leading people to think they are going to get cash payments.”

In the U.S., oversight of advertising historically falls to the FTC. “Investigating deceptive lead generation and marketing practices is a big part of what we do around consumer protection,” said Elizabeth Scott, an FTC attorney who has worked on several recent cases, including a $195 million judgment against Florida-based Simple Health Plans, which the FTC

Steps to Protecting a Child with Disabilities Key Takeaways • Government benefits like Supplemental Security Income and Medicaid, although helpful, may impact other aspects of your strategy.

• The purpose of a special-needs trust is to provide supplemental and extra care for a child with special needs.

• All affected family members should be involved in the decision-making process, if at all possible.

Raising a child is expensive and can cost over a quarter of a million dollars, excluding college. For a child with special needs, that cost can more than triple. If you're the parent of a child with special needs, it's vital to ensure your child will continue to be provided for after you're gone. It can be difficult to contemplate, but with patience, love, and perseverance, a long-term strategy may be attainable.1,2

consider whether to make property transfers to your child with special needs.

Chirag Chauhan, AIF®, CFP®

You should also make sure you have an up-to-date will that reflects your wishes.

Consider creating a special needs trust, the assets of which can be structured to fund your child’s care without disqualifying them from government assistance. Using a trust involves a complex set of tax rules and regulations.

Before moving forward with a trust, consider working with a professional who is familiar with the rules and regulations.

Involve the Family All affected family members should be involved in the decision-making process. If at all possible, it’s best to have a unified front of surviving family members to care for your child after you’ve passed on.

Envisioning a Life After You Just as every child with special needs is unique, so too are the challenges families face when preparing for the long term. Think about the potential needs of your child. Will they require daily custodial care? Ongoing medical treatments?

Will your child live alone or in a group home?

Can family members assume some of the care? Answers to these and other questions can help form the vision of what may need to be done to plan for your child's care.

"You should also make sure you have an up-to-date will that reflects your wishes."

Preparing Your Estate Without proper preparation, your child’s lifetime needs can quickly outstrip your funds. One resource is government benefits, such as Supplemental Security Income (SSI) and Medicaid, which your child may qualify for depending on their situation. Because such government programs have low-asset thresholds for qualification, you may want to

Identify a Caregiver In order for a caregiver to make financial and health care decisions after your child reaches adulthood, the caregiver must be appointed as a guardian. This can take time, so start setting this in motion as soon as you are able.

To do this, you can write a “Letter of Intent” to the caregiver and family to express your wishes along with information about your child’s care. This isn’t a legal document, but it may help communicate your desires. Store this letter in a safe place, alongside your will.

Outlining an approach for a child with special needs can be complicated, but you don’t have to do it alone. Working with loved ones and qualified professionals can help you navigate the various facets of this challenge. If we can help, please don’t hesitate to reach out.

1. Investopedia.com, December 14, 2023 2. AmericanAdvocacyGroup.com, 2024 The content is developed from sources believed to be providing accurate information. The information in this material is not intended as tax or legal advice. It may not be used for the purpose of avoiding any federal tax penalties. Please consult legal or tax professionals for specific information regarding your individual situation. This material was developed and produced by FMG Suite to provide information on a topic that may be of interest.

FMG, LLC, is not affiliated with the named broker-dealer, state- or SEC-registered investment advisory firm. The opinions expressed and material provided are for general information, and should not be considered a solicitation for the purchase or sale of any security. Copyright FMG Suite.

Chirag Chauhan, MBA, AIF®, CFP® is the managing partner of Bluff City Advisory Group in Memphis, Tennessee. For more info, please visit bluffcityadvisory.com.

(CONTINUED ON PAGE 6) AUGUST/SEPTEMBER

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Misleading Ads, continued from page 5

GrandRounds

alleged used misleading advertising and sales tactics to sell consumers low-quality coverage when they thought they were buying comprehensive health insurance.

But states also have regulatory authority. They issue licenses to insurance agents and oversee insurance carriers. Most of this crop of ACA ads, however, are from lead-generating companies, which, under some states’ rules, fall into a gray area.

An FTC spokesperson would not comment on whether the agency was looking at any such advertising issues currently.

CMS does not have regulatory authority over marketing entities doing advertising but is working with other federal agencies that do, said Ellen Montz, deputy administrator and director of the Center for Consumer Information and Insurance Oversight at CMS. It does, however, have authority over agents and brokers, who can be barred from using the federal ACA marketplace if they are found to have broken rules, including using “leads generated from advertisements that an agent or broker knows is misleading or coercive,” Montz said.

So far, the Florida lawsuit filed in April remains the most public challenge to the ACA-related advertisements.

The case was filed by Kellogg, along with attorney Jason Doss of Georgia.

It alleges that several marketing firms, insurance brokerages, and privately held ACA enrollment websites knowingly relied on misleading advertisements — and told their call center staffers to be vague about the subsidies they promised.

“It’s not about selling people health insurance. It’s about tricking people into enrolling in health insurance,” Doss said.

Consumers often didn’t know they were being signed up for coverage, the lawsuit alleges, and some were switched multiple times. While unscrupulous agents or call centers then gained the monthly commissions, consumers faced a range of financial and other problems, including losing access to their doctors or treatments, the suit claims.

Named as defendants are TrueCoverage and Enhance Health, which operate insurance call centers in Florida and other states; Speridian Technologies, a New Mexico-based limited liability company; and Number One Prospecting, doing business as Minerva Marketing, which is also a leadgenerating company. The lawsuit also names two people: Brandon Bowsky, founder and CEO of Minerva; and Matthew Herman, CEO of Enhance Health. TrueCoverage and Speridian Technologies are separate, wholly owned subsidiaries of Speridian Global Holdings.

TrueCoverage spokesperson Catherine Riedel told KFF Health News the firm approves all ads from lead-generating marketing firms and “has not knowingly approved any misleading content.” Furthermore, “in our research, we

Mid-South Internal Medicine Welcomes Benjamin Jones, MD

6 > AUGUST/SEPTEMBER 2024

haven’t found anyone who got enrolled connected to misleading content.”

Olga Vieira, an attorney representing Enhance Health, said in a statement to KFF Health News: “This lawsuit is without legal merit and we will vigorously defend against these baseless claims.” Attorneys representing the other defendants did not respond to requests for comment.

The suit was filed on behalf of agents who lost business when their clients were switched and consumers like Texas resident Angelina Wells, who responded to an advertisement she saw on Facebook in November that touted $6,400 cash cards.

“Wells never received the cash card she was promised,” the lawsuit says, “and she did not recall enrolling into the health plan at all.”

From November to January, call center agents switched Wells at least three times, to three insurance carriers, without her consent, the lawsuit says.

Doss said agents, armed with only a person’s name, date of birth, and state of residence, can make switches through private-sector direct enrollment websites that integrate with the federal healthcare.gov marketplace.

While dozens of these enrollment sites operate with CMS approval, the lawsuit focuses mainly on two: Benefitalign, which was developed by the parent company of the defendant TrueCoverage, and Jet Health Solutions, which was purchased by the other call center defendant, Enhance Health, in mid-2023.

Having access to proprietary enrollment platforms allowed the call centers to sign up “the maximum number of consumers in the shortest amount of time without outside scrutiny,” according to the lawsuit. TrueCoverage spokesperson Riedel said all transactions on private enrollment sites “are audited and logged” by the federal marketplace, so “it is not true” that such transactions lack scrutiny. Enhance Health didn’t provide specific comments on this topic.

The lawsuit says Enhance launched in 2021, not long after receiving a $150 million capital infusion from Bain Capital Insurance, a private investment firm. Initially, it planned to market and sell Medicare Advantage policies, but it switched to ACA policies after rules went into effect in 2022 allowing low-income people to enroll in coverage year-round.

“The biggest problem is that these agencies are trying to do a high-volume ACA business model that targets poor people,” Doss said, based on assertions made in the lawsuit. “In order to get those people to enroll, they have to entice them using false advertisements.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism.

Mid-South Internal Medicine is pleased to announce the addition of Dr. Benjamin Jones to our practice. Jones graduated from Mississippi State University with Benjamin a Bachelor of Science Jones degree in Biochemistry.

He followed that with medical school at the University of Tennessee College of Medicine in Memphis, after which he completed his residency at Resurrection Health Family Medicine.

Jones is certified by the American Board of Family Medicine. He has over 10 years’ experience in primary care for all ages. Jones has been recognized as a Diplomat of the American Board of Family Medicine. His medical interests include family medicine, primary care, sports medicine, and women’s health, among others.

When he is not working, Jones enjoys playing the blues guitar, participating in his church’s worship team, sketching, and many active, outdoor sports.

MSIM is excited to have Jones join our practice. He began seeing patients in June at Mid-South Internal Medicine located at 7550 Wolf River Boulevard, Suite 102.

Patients can schedule appointments on our website www.midsouthinternalmedicine.com

Susan Cooper Participating in Prestigious Global Nursing Leadership Program

Regional One Health Senior Vice President and Chief Integration Officer Susan Cooper, MSN, RN, FAAN, has been selected by the International Council of Nurses (ICN) to be part of the prestigious Global Nursing Leadership Institute (GNLI) program.

The GNLI program brings together nurses in senior or executive Susan level positions from Cooper across the world. The participants are selected through an extremely competitive application process. This year’s group of GNLI scholars includes 34 nurses from 33 different countries. Cooper is the only person selected to participate from the United States.

Cooper is no stranger to policy and public health. Cooper first served as a Special Policy Advisor to Governor Bredesen and was subsequently appointed in 2007 to serve as the Commissioner of the Department of Health, State of Tennessee. She is the only registered nurse to have served in this capacity. Before joining

state government, Cooper was a faculty member and assistant dean at Vanderbilt’s School of Nursing. She has experience in clinical, academic, governmental, and public health nursing.

Saint Francis Medical Partners Surgeon Robert Wegner, MD, Earns Focused Practice Designation in Metabolic and Bariatric Surgery

Saint Francis Medical Partners surgeon Robert Wegner, MD, has earned a focused practice designation in metabolic and bariatric surgery from the American Board of Surgery (ABS). Wegner

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GrandRounds serves as Medical Director of the Saint Francis Center for S u rg i c a l We i g h t Loss at Saint Francis Hospital-Memphis.

The designation, Robert Wegner which was first introduced in 2022, is achieved through a combination of fellowship training and/or clinical practice dedicated to the treatment of obesity.

Developed in conjunction with the American Society for Metabolic and Bariatric Surgery, the new designation defines the standards of practice, participation, and knowledge that are required to be identified as a surgeon who focuses their practice on metabolic and bariatric surgery.

Focused practice designations recognize surgeons who have concentrated their practice on one aspect of a field of medicine or surgery – such as metabolic and bariatric surgery – that is not already recognized by specialty or subspecialty certification. Certification in general surgery is required to apply for the ABS Metabolic and Bariatric Surgery Focused Practice Designation Examination, which is designed to evaluate a surgeon’s knowledge of metabolic and bariatric surgery principles and applied science. General surgery certification must be

maintained to keep the designation.

Wegner, who is board certified in general surgery, joined the Saint Francis Center for Surgical Weight Loss in 2010. He completed his general surgery residency at the University of Illinois at Chicago and his fellowship training in bariatric surgery at the University of Iowa.

For more information about the bariatric program at Saint Francis Healthcare, visit our website.

OrthoSouth’s Dr. Stephen Waggoner Attains Certified Physician Status through Tennessee Bureau of Workers’ Compensation

OrthoSouth is pleased to announce that Dr. Stephen Waggoner, board certified orthopedic surgeon who practices general orthopedics with a subspecialty in spine surgery, has received certification as a Certified Physician through the Tennessee Bureau of Workers’ Compensation.

The Certified Physicians Program (CPP) is a relatively new voluntary program designed to train and certify physicians “to perform all of the tasks that the Tennessee Workers’ Compensation Law requires,” per the Tennessee Department of Labor website. The program has two main goals:

Dr. Samantha Ouyang

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Dr. Marie Thompson

Dr. David Yanishevski

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GrandRounds increasing access for injured workers to trained physicians, and reducing the number of days that injured workers are out of work. A physician who completes voluntary CPP training has demonstrated a willingness to take on the extra responsibilities that come with providing care for patients injured at work.

Dr. Waggoner sees patients at OrthoSouth clinics in Bartlett, Germantown, and East Memphis.

For more information about the workers’ compensation services provided at OrthoSouth please visit https://orthosouth. org/memphis-orthopedic-services/ employer-services/

Assistant Dean of Student Affairs Chosen for UT Health Science Center College of Nursing

Assistant Professor Christie Manasco, PhD, RN, CNE, has been named Assistant Dean of Student Affairs for the UT Health Science Center College of Nursing.

In her position as Assistant Dean of Student Affairs, Dr. Manasco will report directly to College of Nursing Dean Wendy Likes, PhD, DNSc, APRN-BC, FAAN, FAANP. Her primary responsibilities will be student recruitment

and engagement and operations in the college’s Student Affairs Department.

Since joining the college in July, 2020, Dr. Manasco has been very Christie Manasco active in research and teaching. She is the principal investigator for a three-year, $1.5 million Health Resources and Services Administration (HRSA) grant called “Training and Education to Advance Critical Health Equity Readiness Using Simulation,” or TEACH US. She is coinvestigator on the $3.98 million HRSA grant for the UTHSC Nursing Mobile Health unit. In that role, she has led the rural education segment for students in the Bachelor of Science in Nursing (BSN) program.

In addition, she is co-investigator on the three-year, $1.5 million HRSA grant to expand Sexual Assault Nurse Examiner (SANE) training in West Tennessee. Dr. Manasco earned the DAISY Award for Extraordinary Faculty in 2022.

West Cancer Center & Research Institute’s Head & Neck Oncology Announces New Surgeon

Dr. R. Grant Muller, a board-certified

Ear, Nose, and Throat (ENT) oncology surgeon has joined West Cancer Center & Research Institute’s Head & Neck Oncology department on August 1, 2024.

Muller has over 36 publications, posters, and presentations featured in prestigious publications, national, and international Head & Grant Muller Neck conferences.

With a bachelor’s degree from University of North Carolina-Chapel Hill, Muller earned his Doctor of Medicine from the University of TN Health Science Center School of Medicine in 2018, completed his residency at Case Western Reserve University-Department of Otolaryngology in Cleveland, OH, followed by a Head and Neck Oncology & Microvascular Reconstructive Surgery fellowship at Northwestern University in Chicago.

Muller’s addition to the Head & Neck Oncology department at West Cancer Center will further define West as the leader for patients facing a cancer diagnosis.

OrthoSouth’s Dr. Robert Lonergan Achieves Certified Physician Status through

Tennessee Bureau of Workers’ Compensation

OrthoSouth is pleased to announce that Dr. Robert Lonergan, board certified orthopedic surgeon specializing in sports medicine and minimally invasive joint restoration, has received certification as a Certified Physician through the Tennessee Bureau of Workers’ Compensation.

The Certified Physicians Program (CPP) is a relatively new voluntary program designed to train and certify physicians “to perform all of the tasks that the Tennessee Workers’ Compensation Law requires,” per the Tennessee Department of Labor website. The program has two main goals: increasing access for injured workers to trained physicians, and reducing the number of days that injured workers are out of work. A physician who completes voluntary CPP training has demonstrated a willingness to take on the extra responsibilities that come with providing care for patients injured at work.

In addition to seeing work injuries, Dr. Lonergan specializes in shoulder, hip, knee, and ankle arthroscopy as well as joint replacement. He practices at OrthoSouth offices in East Memphis and Bartlett.

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GrandRounds the workers’ compensation services provided at OrthoSouth please visit https://orthosouth. org/memphis-orthopedic-services/ employer-services/.

West Cancer Center & Research Institute’s Dr. Michael Ulm’s New Appointment

Dr. Michael Ulm, Gynecologic Oncologist at West Cancer Center & Research Institute has been elected as Surgery Department Chairman at St. Francis Healthcare. Michael Ulm The appointment will begin on January 1, 2025.

West Cancer Center & Research Institute Names New Director of Radiology

West Cancer Center & Research Institute is proud to announce Dr. Allen Ardestani’ s new role as Director of Radiology. Dr. Ardestani earned his residency at Cedar Sinai Medical School and fellowship at UCLA , both strong Allen programs at renowned Ardestani institutions. With his expertise as a board

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certified Neuroradiologist and Diagnostic Radiologist, coupled with his tenure at West since 2018, he’s well-positioned to lead the Radiology department forward. This appointment underscores West’s commitment to maintaining a high standard of care in oncology imaging.

Methodist Le Bonheur Healthcare Graduates Largest Class Ever of Newly Trained Employees Methodist Le Bonheur Healthcare’s career advancement program is not only offering employees a path to grow their careers, it is meeting the growing demand for healthcare workers in key positions.

The accredited advancement program helps the healthcare system fill vital roles like emergency department technicians, certified nursing assistants, medical assistant limited scope X-ray operators, in addition to positions in administration and management.

Any employee in good standing is eligible to participate after six months of employment. Employees can explore advanced education degrees and certifications at their own pace and with little or no out-of-pocket expense.

For more information on MAAP and career opportunities at Methodist Le Bonheur, please visit MethodistHealth.org/careers

Regional One Health Foundation Names Executive Director Samuel McCrimmon, J.D., brings extensive experience to the Regional One Health Foundation as the new executive director.

McCrimmon has over 20 years of successfully leading advancement and development teams in both university and healthcare settings.

Samuel McCrimmon comes McCrimmon from Mercyhurst University in Erie, Pennsylvania, where he served as vice president for advancement and external relations. During his tenure at Mercyhurst University, he led significant milestones in fundraising, alumni relations, government and foundation relations, public relations, and career advising.

Prior positions include associate vice president of advancement at Le Moyne College in Syracuse, New York, where he oversaw the successful completion of the $100 million Always Forward Campaign. He also held

leadership positions at the University of Toledo, University of Pittsburgh School of Medicine, UPMC Health System, and University of Detroit Mercy.

The American Society of Clinical Oncology honors Baptist Cancer Center’s Osarogiagbon

Dr. Raymond Osarogiagbon, chief scientist for Baptist Memorial Health Care and director of the Multidisciplinary Thoracic Oncology Program and the Thoracic Oncology Research Group at Baptist Cancer Center, has been named a fellow of the American Society of Clinical Oncology.

FASCO recognizes ASCO members for their extraordinary volunteer service, significant contributions to the specialty of oncology and extraordinary dedication to improving outcomes for cancer patients. Osarogiagbon was one of 50 members worldwide to earn the FASCO designation in 2024.

Osarogiagbon has been a member of ASCO since 2002. His roles with ASCO have included serving as chair of the ASCO Research Committee from 2023–24 and chair of the 2024 ASCO Quality Symposium.

At Baptist, Dr. Osarogiagbon spearheads the Mid-South Miracle, continued on page 10 >

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GrandRounds a multifaceted initiative comprising seven components to reduce lung cancer deaths in the Mid-South 25 percent by 2030. A community oncologist, Osarogiagbon serves as primary investigator for the Baptist Memorial Health Care/Mid-South Minority Underserved NCI Community Oncology Research Program. He is also a research professor at Vanderbilt University.

New Law Adds Rapid Genomic Testing for Rare Diseases to Covered Care for Tennessee Youth

A new law that went into effect in Tennessee July 1 will increase the speed of diagnosis for children showing signs of a rare genetic illness, with the intention to improve the medical outcomes for these patients.

Terri Finkel, MD, PhD, a tenured professor and the interim chair of the Department of Pediatrics at the University of Tennessee Health Science Center and Pediatrician-in-Chief at Le Bonheur Children’s Hospital, was the primary physician advocate before the Tennessee Legislature for the groundbreaking legislation that requires TennCare coverage for rapid whole genome sequencing (rWGS) of children when certain criteria are met.

“This is a life-changing event for Tennessee children and families – a benefit for the youngest citizens of Tennessee that will save many lives,” Dr. Finkel said. “This also affirms the importance of access to rapid whole genome sequencing, which delivers quick results for our sickest children, allowing physicians to begin treatments earlier.”

Rapid whole genome sequencing, she explained, would quickly give physicians the needed information to diagnose babies who are showing signs of possible genetic diseases and reduce the potential pain, suffering, and needless expenses resulting from months and possibly years of testing to get a diagnosis.

“The rapid whole genome

sequence allows us to know when there are variants in known genes, whether there are specific proteins that are not working in a child who has a critical illness,” Dr. Finkel said. “Sequencing a child’s genome can translate to earlier and faster diagnosis and treatment.”

Most often, this testing would apply to critically ill children in the neonatal intensive care and pediatric intensive care units. The eligibility criteria for a child’s genomic sequencing covered by this new law includes the presentation of an acute or complex illness of unknown cause, abnormal laboratory results or chemistry profiles suggesting a genetic disease, or birth defects involving at least two organ systems.

“The law is user friendly in the sense that we can use our experience as physicians to assess children who are most likely to benefit from this test, especially if they are not responding to treatment as anticipated,” Dr. Finkel said.

A pediatric rheumatologist, Dr. Finkel is passionate about diagnosing, treating, and easing the suffering of infants and children with rheumatological and other childhood diseases.

State Rep. Brock Martin and state Sen. Richard Briggs were the sponsors of the legislation, House Bill 1826 and Senate Bill 1762.

“They asked me to write a justification based on what we knew from three other big studies, one in California, the one in Michigan, and one in Florida, which had all passed this bill,” she said. “Based on those studies, it showed that not only was this test cost effective, but it saved and generated money.”

In other words, the cost of the test is offset by the fact that you have children in the hospital fewer days and they need less expensive painful prolonged testing,” she said.

Dr. Finkel wrote letters summarizing the cost data, underscoring the message that the legislation would save lives without excessive costs to

the state. She was invited to address the House and the Senate in her capacity as a physician who cares for infants and children who could benefit from the testing.

Dr. Finkel said the next step is getting policy and procedures in place to implement the law

OrthoSouth Welcomes Orthopedic Spine Surgeon, John J. Eager, MD

OrthoSouth is pleased to announce the addition of Dr. John Eager to its team of esteemed physicians. Eager is now available to see patients at the practice’s East Memphis, Germantown, and Bartlett locations.

Eager is a dualfellowship trained orthopedic spine sur- John Eager geon with a deep expertise in the diagnosis and treatment of spinopelvic disorders.

His specialties include degenerative spine surgery, spine trauma, tumors of the spine, adult spinal deformity, revision spine surgery, and minimally invasive surgery techniques.

Additionally, Eager brings significant experience in surgical management of bone and soft tissue sarcoma, skeletal and spinal metastatic disease, complex limb salvage, and hip/knee arthroplasty.

Eager completed his spine surgery fellowship at Houston Methodist Texas Medical Center and his musculoskeletal oncology fellowship at Emory University. He earned his medical degree and completed his orthopedic surgery residency at the University of Texas Health Science Center at Houston. His extensive experience and dual-fellowship training equip him to handle a wide range of orthopedic conditions, with a particular focus on complex spinal disorders and oncological issues related to the musculoskeletal system.

For more information or to

make an appointment, please visit https://orthosouth.org

West Cancer Foundation Grant to Fund Oncology Education at UTHSC College of Nursing

The University of Tennessee Health Science Center’s College of Nursing has received a $144,469 grant from the West Cancer Foundation that will support innovative educational opportunities to prepare nurses and nursing students to meet the specific needs of oncology patients.

The project, Providing the Oncology Workforce Education and Resources (POWER) for Nursing Program, will enhance oncology education in nursing in four ways.

It will fund a Distinguished Visiting Professorship in Oncology Nursing; it will support the development of an oncology elective in the Bachelor of Science in Nursing (BSN) program at UT Health Science Center; and it will fund two students as oncology nurse scholars and two students as oncology research nurse scholars.

The Oncology Scholars programs are one-year courses open to traditional BSN students, which will take place in the last year of their BSN degrees. Students in the Oncology Scholars programs will have paid clinical or research opportunities in diverse oncology settings in the Mid-South.

They will also do oncology coursework to gain more knowledge in the field and agree to work in an oncology setting upon graduation, according to College of Nursing Dean Wendy Likes, PhD. The BSN oncology elective and both Oncology Scholars programs are scheduled to go into effect in 2025. The Bernie Crook Distinguished Visiting Professorship in Oncology Nursing will take place on February 3, 2025, at the FedEx Event Center.

The free event will offer continuing education units, and a registration link will soon be available at cenow.uthsc.edu.

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Your patients deserve nothing less than a 5-star experience from OrthoSouth.

What does that look like?

URGENT CARE

Patients with urgent injuries or in acute pain may be sent directly to our Urgent Orthopedic Care office at 6286 Briarcrest Ave. in Memphis.

WALK-IN READY

Patients in acute pain needing to see a provider the same day may be seen by walking in to one of our 3 walk-in clinics, or by making a same-day appointment at any of our 8 convenient locations.

CONVENIENT HOURS

Early, weekend, lunchtime, and after hours, your patient’s time is our time.

ONLINE BOOKING

SCAN TO LEARN MORE

Use our convenient Book Online portal to book your patient’s visit before they leave your office.

VIP TREATMENT

From streamlined processes to comfortable waiting spaces and personable team members, the OrthoSouth experience is designed to provide fast, friendly, and convenient care to the most important person in the room - your patient.

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or t h os ou t h . org | 901.641.3000

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Take your life back with minimally-invasive spine surgery.

Endoscopic spine surgery is a minimally-invasive surgical procedure that effectively relieves back and leg pain related to nerve compression. Dr. Chad Campion is a fellowship-trained orthopaedic spine surgeon who specializes in minimally-invasive techniques, including endoscopic spine surgery.

“

I firmly believe that surgery should be the last option for treating spine issues. That’s why my team explores all the non-surgical options available for each patient. And when you do need surgery, we’re with you every step of the way. We’ll guide you through the surgery, rehab, and into a future free from pain.”

Chad E. Campion, M.D. Fellowship-trained Spine Surgery

Neck Pain, Back Pain

Spinal Stenosis

Robotic Spine Surgery

Degenerative Disc Disease

Spinal Tumors

Adult Scoliosis and Spinal Deformity

Additional back, neck, and spine specialties include:

Schedule an appointment with Dr. Campion at CampbellClinicSpine.com or at (901) 759-3111.

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