Investigative Roundup: Unsanitary Practices in Med Spas, Transgender Youth Healthcare Challenges, and Secret Rules Restricting Rehab Care

8 January 2024

A collection of investigative reports uncover concerning issues in the healthcare industry, including the rise of dangerous infections in med spas, the lack of appropriate care for transgender youth in hospitals, and the use of secret rules to restrict rehab services.

In this edition of Investigative Roundup, we delve into three distinct yet interconnected issues plaguing the healthcare industry. First, we explore the alarming rise of dangerous infections linked to unsanitary practices in med spas. Next, we shed light on the challenges faced by transgender youth in receiving appropriate healthcare during periods of crisis. Lastly, we uncover the use of secret rules by UnitedHealth Group to restrict access to rehabilitation services for Medicare Advantage patients. These investigations reveal the urgent need for improved regulations, resources, and training to ensure the safety and well-being of patients across the country.

Unsanitary Practices in Med Spas: A Growing Concern

Unregulated med spas employ unlicensed workers and unsanitary practices, leading to a rise in dangerous infections.

The med spa industry has experienced a surge in popularity in recent years, generating billions of dollars in revenue. However, an NBC News investigation reveals that this growth has come at a cost. Some med spas are employing unlicensed workers to administer injections of unapproved products in unsanitary conditions. This alarming trend has led to a rise in dangerous infections among customers.

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One customer, Bea Amma, shared her harrowing experience after developing sores at over a hundred injection sites following a visit to a med spa. She tested positive for Mycobacterium abscessus, a bacteria associated with unsanitary conditions. Amma’s story highlights the potential risks associated with these unregulated facilities.

While there are no federal regulations governing med spas, state-level oversight typically requires the presence of medical professionals on staff. However, experts warn that enforcement of these regulations is rare. The American Med Spa Association, a professional society, has attempted to fill this regulatory gap by offering resources to ensure proper operation. Despite these efforts, the number of patients experiencing adverse effects from med spa services continues to grow.

Challenges in Transgender Youth Healthcare

Hospitals lack the necessary training and resources to appropriately treat transgender youth during periods of crisis.

An Associated Press investigation reveals the challenges faced by transgender youth in receiving appropriate healthcare during periods of crisis. Hospitals across the country find themselves caught between political efforts to ban gender-affirming care and the urgent medical needs of this vulnerable population.

North Carolina serves as a microcosm of this issue, with legislators enacting new limits on gender-affirming care. Hospitals in the state struggle to provide adequate resources for treating pediatric mental health conditions, particularly for transgender youth. The lack of appropriate care during these critical periods often compounds the trauma experienced by patients.

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Callum Bradford, a patient interviewed for the investigation, recounts his regrettable experience at a UNC hospital. After a prescription drug overdose, Bradford needed to be transferred to another facility due to a lack of available beds. However, the hospital planned to place him in a girls’ mental healthcare unit, disregarding his gender identity. This oversight triggered a severe anxiety attack, highlighting the importance of validating transgender youth from the moment they seek medical help.

UnitedHealth’s Secret Rules Restricting Rehab Care

UnitedHealth Group used secret rules to deny access to rehabilitation services for Medicare Advantage patients, until increased scrutiny prompted a sudden change.

STAT News’ investigation uncovers UnitedHealth Group’s use of secret rules to restrict access to rehabilitation services for patients enrolled in Medicare Advantage plans. These rules were implemented without informing doctors or patients of the criteria used to make these decisions.

The review of internal documents revealed that these restrictive rules were in place until November, when clinician reviewers were instructed to stop following them. This abrupt change coincided with increased scrutiny of Medicare Advantage plans from federal legislators and CMS officials.

Clinicians working for UnitedHealth’s subsidiary, NaviHealth, reportedly used these rules to deny rehab care referrals, particularly for patients living in nursing homes. Employees of NaviHealth claim that these restrictions lacked clinical evidence and were often applied to deny referrals automatically. Similar practices to restrict access to care by NaviHealth, such as the use of algorithms to screen referrals, have been previously reported.

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These investigations shed light on critical issues within the healthcare industry. The rise of dangerous infections in med spas underscores the need for better regulations and enforcement to protect patients. The challenges faced by transgender youth in accessing appropriate healthcare during periods of crisis highlight the urgent need for training and resources for hospitals. The use of secret rules by UnitedHealth Group to restrict rehab care raises concerns about transparency and patient access. As we navigate these complex issues, it is vital to prioritize patient safety, well-being, and equitable access to quality healthcare for all.

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