Tag: Fraud

Whistleblower lawsuit leads to record-setting settlement for Adventist Health System

Adventist Health System will pay $118.7 million to the federal government and four states to settle a whistleblower lawsuit filed in December 2012.

The lawsuit alleged that Adventist paid doctors excessive compensation for patient referrals to Adventist-owned health care facilities, including hospitals, clinics and other outpatient facilities in Florida, North Carolina, Tennessee and Texas, according to a statement.

The settlement, which is the largest fraud settlement made involving physician referrals to hospitals, also covers a separate similar suit filed in 2013 with the same law firm Phillips & Cohen.

The complaint says Adventist hospitals paid for:

▪The leases of a BMW and a Mustang for a surgeon.

▪A $366,000 base salary for a family practitioner that more than doubled the salary of similar practitioners in that area, due to the extraordinarily high level of his facility fee referrals to Adventist for X-ray and CBC tests.

▪A bonus of nearly $368,000 plus salary for total annual pay of $710,000 for a dermatologist who worked just three days a week. He also received payments to cover his costs for staff, equipment, supplies and medical malpractice insurance for the remainder of his time spent on his private practice.

Adventist implemented a corporate policy that directed its hospitals to purchase physician practices and group practices or employ physicians in their surrounding areas in order to control all patient referrals in those locations, Phillips & Cohen’s complaint says.

A large part of the settlement is based on allegations involving Florida Hospital Medical Group, an Adventist-owned physician practice in Florida whose doctors worked at several Adventist hospitals and Adventist-owned outpatient clinics.

The hospitals include Florida Hospital Altamonte, Florida Hospital Apopka, Florida Hospital Celebration Health, Florida Hospital Kissimmee, Florida Hospital Orlando, Florida Hospital Waterman, Florida Hospital for Children and Winter Park Memorial Hospital.

Whistleblower Says Medicare Advantage Plans Padded Charges In Home Visits

A whistleblower case in Texas accuses a medical consulting firm and more than two dozen health plans for the elderly of ripping off Medicare by conducting in-home patient exams that allegedly overstated how much the plans should be paid.

The Texas litigation, whose details were unsealed by the court in June, is just the latest of at least a half dozen whistleblower cases that have been filed in the past five years alleging billing fraud and lax government oversight of privately run Medicare Advantage plans, which have proven increasingly popular with the elderly.

The latest lawsuit was filed in federal court in Dallas in 2014 by Becky Ramsey-Ledesma, a medical billing coder, against her former employer, CenseoHealth LLC. The Dallas-based firm has contracted with thousands of doctors who visit elderly people in their homes and evaluate their health on behalf of Medicare Advantage plans.

But the health assessments exaggerated how ill patients were, which in turn inflated Medicare payments to the health plans, according to the allegations in the suit. The suit names 30 Medicare Advantage plans in 15 states, including several Blue Cross plans and other industry stalwarts, such as Humana Inc. Humana has more than 3 million Medicare members.

The private insurance plans offer seniors an alternative to standard Medicare, which pays doctors for each service they render. Medicare Advantage plans receive a set fee monthly for each patient, based on a risk score that pays higher rates for sicker people and less for those in good health. Medicare essentially trusts health plans to report these risk scores accurately. The Medicare Advantage plans have grown rapidly in recent years, and now cover almost 17 million people.

The Texas suit was filed last year, but stayed under court seal until mid-June. It is the second whistleblower action to target Medicare Advantage home visits, which account for billions of dollars in annual revenues for health plans.

A 2014 Center for Public Integrity investigation found that home visits skyrocketed, even as federal officials struggled to prevent health plans from overcharging Medicare by tens of billions of dollars every year. Federal officials as early as 2013 were concerned the home visits could be a factor in jacking up risk scores improperly and wasting tax dollars. But when the industry objected, the officials backed off a proposal to limit the use of home visits, the investigation found.

CenseoHealth’s home visits collect data on the health status of patients, which the private health plans then use to bill Medicare. The company had no comment on the lawsuit.

The Centers for Medicare and Medicaid Services press office declined to answer written questions seeking comment on its home visit policy. The agency instead issued a statement that said the home exams can have “significant value.” That opinion is shared by the health insurance industry trade group,  America’s Health Insurance Plans. A spokesperson for AHIP called the visits “an important component of disease management activities.”

Medicare Advantage is enjoying robust growth and firm political support in Congress. The industry has beaten back several attempts by the Obama administration to cut its rates as enrollment has grown to include about one in three people on Medicare. In June, the House passed a bill — sponsored by Rep. Vern Buchanan, a Republican from Florida — that appears to prevent federal officials from halting the home health assessments.

At the same time, the Centers for Medicare & Medicaid Services is drawing scrutiny over top manager Andy Slavitt’s former ties to UnitedHealth Group, which runs the nation’s biggest Medicare Advantage plan. Senate Finance Chairman Orrin Hatch criticized Slavitt’s “conflicted history” in a statement issued after President Obama nominated him for the top CMS job in July.

Bringing Back House Calls

CenseoHealth has emerged as a leader in a growing market for in-home health assessments.

Formed in 2009 by two Texans, CenseoHealth grew from four employees to 325 workers by 2013, according to its website. It has built a network of nearly 5,000 doctors who it says are “uniquely qualified to identify and diagnose health conditions.” Doctors affiliated with the company have done more than a million home visits, and in 2013 forecast that revenue would reach $120 million, according to the CenseoHealth website.

CenseoHealth’s investors include private equity firm Health Evolution Partners, headed by David Brailer, a physician and former health information technology czar under President George W. Bush. In March, Brailer was named chairman of CenseoHealth’s board of directors.

Brailer and other leaders at CenseoHealth had no comment on the case.

According to the suit, CenseoHealth used an algorithm to identify patients who might have undetected medical conditions that could raise their risk scores. The company uses marketers to contact patients and schedule doctor visits to their homes.

The lawsuit alleges that the doctors don’t provide any medical treatment. Other than taking vital signs and weight, listening to heart and lungs and checking reflexes, no physical exam in involved and no lab tests are performed, according to the suit. The doctors ask the patient a series of questions on a checklist during the visit, which takes about an hour.

“In other words, the conditions reflected on the evaluation forms are not medical diagnoses derived from a medical examination, but instead, are self-reported conditions captured from the medical history and verbally confirmed” by the patient, according to the suit.

Some of the doctors lacked medical licenses, according to the lawsuit, and others were assigned as many as ten visits a day for a flat fee of $100 each. Some faked results, according to the suit. The suit cited a test for Alzheimer’s disease in which each patient was asked to draw hands on a clock to indicate the correct time of day. “In some cases it was obvious that the same person had drawn the clock on multiple forms,” according to the suit.

Some of the diagnoses could not be made reliably through a home visit, according to the suit. Others were based on medications patients took, even when those medications could be taken for more than one condition, according to the suit.

These practices inflated risk scores, according to the suit, triggering “substantial overpayments” to the health plans.

Ramsey-Ledesma claims she was fired in August 2013, the day after she objected to the practices. According to the lawsuit, her manager told her, “we can no longer trust you.”

The other whistleblower case that targeted home visits was unsealed in 2014. It was filed by Anita Silingo, a former compliance officer for Mobile Medical Examination Services Inc., or MedXM. The company, based in Santa Ana, Calif., has denied the allegations. That case is pending.

The Department of Justice declined to join either case, which may make it more difficult for the whistleblowers to proceed with their cases and collect a large award. However, lawyers who handle these cases say more of them are moving ahead without the government.

Other whistleblower cases involving Medicare Advantage have been filed in the past five years in California, Florida and South Carolina, among other locales. These cases also allege that Medicare Advantage plans inflated risk scores and as a result were overpaid by Medicare.

Friends In High Places

As early as 2013, CMS officials said they suspected home visits improperly raise risk scores and waste tax dollars. But as the visits became standard procedure for more and more health plans, CMS apparently lost its appetite for tightening oversight.

CMS officials wrote in February 2013 that they were concerned that the primary objective of the visits was to raise risk scores and revenues “without follow up care or treatment being provided.”

In April 2013 though, facing industry pressure the officials backed off their proposal to collect data on the home visits with an eye to excluding their use in setting rates.

The following year, CMS again backed down from a proposal to exclude the visits after meeting with the industry. That decision came even though CMS said “there appears to be little evidence” that the visits led to any improvement in patient care. The insurance industry estimated that cutting out the visits would have cost Medicare Advantage plans nearly $3 billion a year.

Earlier this year, CMS handed the industry a major victory when it ruled out excluding the home visits. Instead, CMS urged the industry to adopt a set of “best practices” for the visits. The new policy “enhances the value of in-home assessments so they are used to support care planning and care coordination and improve enrollee health outcomes.”

The press release quoted then-CMS deputy administrator Slavitt saying the proposals “would reward providers of high quality, consumer-friendly care” for Medicare Advantage.

Slavitt is a former executive of Optum, a subsidiary of UnitedHealth Group. In July, President Obama nominated him to take over CMS permanently.

CMS officials declined to answer questions about Slavitt’s role in the decision making process for home assessments, but said:

“CMS believes that in-home assessments can have significant value as care planning and care coordination tools. In the home setting, the provider has access to more information than is available in a clinical setting.”

Former CFO heads to prison on Meaningful Use fraud

The former chief financial officer of a now closed Texas hospital, Joe White, has been sentenced to federal prison after admitting to meaningful use fraud, U.S. Attorney John M. Bales announced June 17.

U.S. District Judge Michael Schneider sentenced White, 68, to 23 months in prison.

White, of Cameron, Texas, pleaded guilty on Nov. 12, 2014 to making a false statement that Shelby Regional Medical Center in Center, Texas, was a meaningful user of electronic health records, when the hospital did not meet the requirements of the federal EHR Incentive Programs.

Schneider also ordered White to pay restitution in the amount of $4,483,089 to the meaningful use program, administered by the Centers for Medicare & Medicaid Services.

According to information presented in court, White was the CFO for Shelby Regional Medical Center in Center, Texas, in addition to other hospitals owned and operated by Tariq Mahmood, MD.  White oversaw the implementation of electronic health records for the hospital and was responsible for attesting to the meaningful use of electronic health records in order to qualify to receive incentive payments under the incentive program, according to a U.S. Attorney news release.

On Nov. 20, 2012, White knowingly made a false statement to falsely representing that the hospital was a meaningful user of electronic health records, when the hospital did not meet the meaningful use requirements.  As a result, Shelby Regional Medical Center received $785,655 from the program. In total, hospitals owned by Mahmood were paid more than $16 million under the incentive programs.

According to reports, the hospital continued to rely on paper records even as White attested to meaningful use .

White was indicted by a federal grand jury on Jan. 22, 2014.

“The granting of EHR funds to individual and institutional providers was intended to modernize medical record storage and access,” said Mike Fields, special agent in charge of the Dallas region’s HHS Office of Inspector General, said in a press statement. “Unfortunately, there are individuals and institutions like Mr. White and his hospital whose only intent for EHR funds was to enrich themselves.”

“The EHR Incentive Program was designed to enhance the delivery of excellent medical care to all Americans and especially for those citizens who live in underserved, rural areas like Shelby County,” U.S. Attorney Bales added. “There is no doubt that Mr. White understood that purpose and yet, he intentionally decided to steal taxpayer monies and in the process, undermine and abuse this important program.”

The case was investigated by the U.S. Department of Health and Human Services’ Office of the Inspector General, the Texas Office of the Attorney General Medicaid Fraud Control Unit and the FBI.

OIG has periodically called attention to the potential for fraud in the Meaningful Use EHR Incentive Program. In October 2012, the agency announced it would look at incentive payments CMS made beginning in 2011 to identify payments to providers that should not have received incentive payments  – those that did not meet the meaningful use criteria.

Doctors Administrative Solutions offers hand-held Quality Reporting Assistance Plans for both Meaningful Use and PQRS. Inquire with a Region Manager today, and learn more about how DAS helps doctors get back to being doctors again.

Documents Reveal Secret Legal Battle Over Medicare Overbilling

Federal officials have spent years locked in a secret legal battle with UnitedHealth Group, the nation’s biggest Medicare Advantage insurer, after a government audit detected widespread overbilling at one of the company’s health plans, newly released records show.

The audit found that Medicare paid too much for nearly half of a sample of patients enrolled at PacifiCare of Washington state, a subsidiary of UnitedHealth Group. The audit was part of a cache of heavily redacted documents released to the Center for Public Integrity through a court order in a Freedom of Information Act lawsuit.

Matt Burns, a UnitedHealth spokesman, declined comment on the audit documents. However, during more than three years of confidential — and previously undisclosed — negotiations, the insurer argued that the audit was unfair and the results were flat out wrong.

The PacifiCare audit offers a rare look at government oversight of the popular and fast growing Medicare Advantage industry. These privately run alternatives to the basic fee-for-service Medicare program treat more than 17 million Americans at a cost topping $150 billion a year.

These audits test the accuracy of a billing tool called a risk score, Medicare uses risk scores to pay health plans higher rates for sicker people and lower rates for those with few medical needs. But federal officials concede that some health plans may overstate how sick their patients are, a practice known as “upcoding” that wastes billions of tax dollars every year. The audits are designed to recover those overcharges.

It is clear that officials at the Centers for Medicare & Medicaid Services knew years ago that risk scores rose much faster among Medicare Advantage plan members than for people who remained on traditional Medicare, a worrisome signal of creeping billing abuse. A major 2009 government study that was not made public suggested some plans “gamed” the system by exaggerating how sick patients were, for instance.

So in June 2008, officials picked five health plans, including PacifiCare of Washington, Inc., for pilot audits. Details on the four other audits appear to have been redacted in records released to the Center for Public Integrity. CMS officials said only that the pilot audits “recovered” $3.4 million.

Under the audit rules, two sets of auditors combed over medical records for 201 patients to confirm they had the illnesses the government had paid to treat. If these conditions are not properly documented in the medical charts, Medicare asks for a refund. By contrast, plans can get credit when underpayments are discovered.

Among the PacifiCare audit findings:

  • Medicare paid the wrong amount for 128 of the 201 patients, an error rate of nearly two thirds. Payments were too high for 98 of the patients, too low for 30 of them. In total, the plan was overpaid by $381,776 out of $3,795,527 in payments in 2007.
  • One in five medical conditions could not be confirmed, and most of these errors triggered higher payments than justified. CMS officials blacked out large chunks of the audit documents released, including the names of the medical conditions.
  • Auditors cited a “lack of sufficient documentation of a diagnosis” most often as the cause for either denying or slashing payments. However, in more than a third of the errors, payment was denied because the medical file was missing the required signature of the doctor who treated the patient.

CMS records show that the audit dragged on for years because officials changed some rules in the middle of the game and set up a lengthy and bureaucratic appeals process for health plans to follow.

CMS shared “preliminary” audit findings with the company in December 2010, but took nearly two years more to present a final version.

In a letter on Aug. 21, 2012, CMS officials said UnitedHealth owed the government $381,776. CMS said that it would deduct the money from upcoming payments to the plan, and reminded the company it could appeal.

Scott Theisen, UnitedHealth Group chief financial officer, filed an appeal in a Sept. 20, 2012, letter. He argued that the audit ample was too small and that the insurer didn’t give the company enough time to secure sufficient medical records to justify its billing.

“Thus the amount of the overpayment claimed to be due by CMS cannot be accurate,” Theisen wrote.

On March 14, 2014, a CMS hearing officer remanded the case to the agency for further negotiations.

CMS wouldn’t say what happened next. In a statement, the agency wrote: “CMS takes seriously program integrity and payment accuracy in Medicare Advantage, and is taking steps to protect taxpayers, Medicare beneficiaries and the Medicare program. CMS is exploring how to make RADV hearing officer decisions public in such a way that safeguards the protected health information of Medicare Advantage enrollees.”

Back in 2008, CMS had announced that it would start applying penalties known as “extrapolation,” which have been widely used in other types of Medicare fraud investigations.

This meant that the billing error rate found in the sample of 201 patients would be applied to the PacifiCare of Washington plan. That could have dramatically boosted the extrapolation penalty.

But somewhere between 2008 and 2012, officials changed their mind and let Medicare Advantage plans off the hook.

CMS officials have never explained fully why they decided against extrapolating the audit findings.

But a confidential CMS presentation dated March 30, 2011, perhaps offers a clue. One slide estimates payment errors in Medicare Advantage at $13.5 billion for 2010, and notes that health plans “have an incentive to submit more diagnoses” in order to raise their payments.

When CMS sought opinions on the audits in December 2010, the presentation notes, it received more than 500 comments. “These comments express significant resistance to the implementation of the [Risk Adjustment Data Validation] audits and payment recovery based on extrapolated payment error estimates,” the presentation states. “Successful payment recovery based on payment error identified in these RADV audits will depend on CMS’ ability to address the challenges raised.”

One slide said that CMS was “expecting to respond to the comments and finalize the payment error calculation methodology and overall strategy shortly.”

As of last month, more than four years later, that still hasn’t been done.

The secrecy surrounding Medicare Advantage payments has prompted a stern rebuke from Senate Judiciary Committee Chairman Charles Grassley.

“The public’s business ought to be public, with few exceptions. An agency shouldn’t withhold internal deliberations unless there’s a really good reason for it, like a risk to national security. It seems to me that a discussion of a Medicare overpayment problem and what to do about it ought to be public,” the Iowa Republican said in an email.

“What is CMS worried about disclosing and why?” Grassley added.

Last month, Grassley wrote to Attorney General Loretta Lynch and CMS administrator Andrew Slavitt asking how many of the risk score fraud audits had been launched over the past five years and their results.

In a separate letter, Sen. Clare McCaskill, the senior Democrat on the Senate Aging Committee, asked CMS officials what’s being done to curb billing fraud and abuse alleged by Medicare Advantage whistleblowers, calling it “an issue that must be investigated further.”

Congress authorized the use of risk scores starting in 2004. It’s essentially an honor system in which health plan doctors assess every patient’s health risks (and thus the associated payments) based on specific medical conditions they have, such as diabetes. Exactly what’s permissible under the billing rules, however, remains confusing even to many health plan professionals.

“I think there’s really not a very good understanding of how this works,” said Holly Cassano, a medical coding consultant in Florida.

This piece comes from the Center for Public Integrity, a nonpartisan, nonprofit investigative news organization.

Former HMA Hospitals Settle Medicare Fraud Case

Two Florida hospitals –Lehigh Regional Medical Center  and Santa Rosa Medical Center in Milton — are part of a nearly $16 million settlement involving allegations of false Medicare claims, according to a news release from  the U.S. Department of Justice.

Among the 16 hospitals included in the False Claims Act lawsuit, 14 were owned by HMA, including the two in Florida, the Fort Myers News-Press reports. The false claims came from services administered between 2005 and 2013.

FL Doctor, NJ Senator Indicted

Sen. Bob Menendez, the son of Cuban immigrants who rose to become one of the highest-ranking Hispanic members of Congress, was charged Wednesday with accepting nearly $1 million in gifts and campaign contributions from a longtime friend in exchange for a stream of political favors.

Menendez predicted he would be “vindicated” and, in a defiant statement before reporters and cheering supporters Wednesday evening, said, “This is not how my career is going to end.”

“I am not going anywhere. I’m angry and ready to fight because today contradicts my public service and my entire life,” he said.

A federal grand jury indictment accuses the New Jersey Democrat of using the power of his Senate seat to benefit Dr. Salomon Melgen, a wealthy Florida eye doctor who prosecutors say provided the senator with luxury vacations, airline travel, golf trips and tens of thousands of dollars in contributions to a legal defense fund.

The indictment from a grand jury in Newark contains 14 counts — including bribery, conspiracy and false statements — against Menendez and also charges Melgen, a political donor to Menendez and other Democrats.

Menendez is scheduled to appear Thursday in federal court in Newark. Melgen’s attorney did not immediately return a call seeking comment Wednesday.

The criminal charges cloud the political future of the top Democrat — and former chairman — of the Senate Foreign Relations Committee, who has played a leading role on Capitol Hill on matters involving Iran’s nuclear program and U.S. efforts to improve ties with Cuba. Menendez said Wednesday he would temporarily step aside from his role as top Democrat on the committee.

Senate Minority Leader Harry Reid, D-Nev., thanked Menendez for stepping down and said he “should not be judged until he has his day in court.”

The indictment will almost certainly lead to a drawn-out legal fight between Menendez and a team of Justice Department prosecutors who have spent years investigating his ties to Melgen. It will require prosecutors to prove that a close and longtime friendship between the men was used for criminal purposes and is likely to revive the legal debate about the constitutional protections afforded to members of Congress for acts they take in office, which Menendez has already signaled as a possible line of defense.

The indictment marks the latest development in a federal investigation that came into public view when federal authorities raided Melgen’s medical offices in 2013.

Menendez had already acknowledged that he had taken several round-trip flights to the Dominican Republic on Melgen’s luxury jet that, initially, were not properly reimbursed. But the 68-page document spells out many additional gifts, such as a Paris hotel stay and access to a Dominican resort, that prosecutors say were never reported on financial disclosure forms.

In exchange for those and other gifts, prosecutors allege, Menendez sought to smooth approval of the visa application process for several of Melgen’s foreign girlfriends, worked to protect a lucrative contract Melgen held to provide cargo screening services to the Dominican Republic and intervened in a Medicare billing dispute on the doctor’s behalf worth millions of dollars.

In 2013, in an email exchange one day after Melgen and Menendez had golfed together in Florida, Menendez told his chief counsel to contact U.S. Customs and Border Protection in an effort to stop them from donating shipping container monitoring and surveillance equipment to the Dominican Republic, according to the indictment. Melgen had a contract to provide exclusive cargo screening in Dominican ports, and the CBP plan would have hurt his financial interests, prosecutors say.

In advocating for Melgen’s business interests, prosecutors say, Menendez pursued meetings with the heads of executive agencies and tried to solicit the help of other U.S. senators.

Menendez has acknowledged taking actions that could benefit Melgen, among them contacting U.S. health agencies to ask about billing practices and policies. But the lawmaker has said he did nothing wrong and that the interactions he had with the doctor were reflections of a close friendship dating two decades.

“We celebrated holidays together,” he told reporters last month amid news reports of a looming indictment. “We have been there for family weddings and sad times like funerals and have given each other birthday, holiday and wedding presents, just as friends do.”

Melgen himself came under renewed scrutiny when government data last year showed he had received more in Medicare reimbursements in 2012 than any other doctor in the country.

An aide to Sen. Amy Klobuchar, D-Minn., said Wednesday night that she would return campaign donations she received from Menendez and Melgen. Klobuchar matches the description of a lawmaker called “Senator 1” in the indictment, though she was not accused of wrongdoing.

According to the Senate Historical Office, Menendez is the 12th senator to be indicted and the first since the late Sen. Ted Stevens, R-Alaska, was indicted in 2008 on charges of not reporting hundreds of thousands of dollars’ worth of home renovations. Stevens was found guilty but the Justice Department later dismissed the case and said prosecutors withheld evidence that would have been favorable to the defense.

Menendez is also the second New Jersey senator to be indicted. Harrison Williams Jr., a Democrat, was indicted in 1980 on corruption charges and convicted of bribery and other counts the following year. Williams resigned before the Senate could vote on whether to expel him.

Menendez, 61, joined the Senate in 2006 after serving more than a decade in the House of Representatives.

Enter code DAShealth to view video.

Enter code DAShealth to view video.

Enter code DAShealth to view video.

Please complete the sign in form below.

[contact-form-7 404 "Not Found"]

Please complete the sign in form below.

    Enter code DAShealth to view video.

    Enter code DAShealth to view video.

    Enter code DAShealth to view video.

    Enter code DAShealth to view video.

    Enter code DAShealth to view video.

    Enter code DAShealth to view video.

    Enter code DAShealth to view video.

    Enter code DAShealth to view video.

    Enter code DAShealth to view video.

    Enter code DAShealth to view video.

    Enter code DAShealth to view video.

    Enter code DAShealth to view video.

    Enter code DAShealth to view video.

    Enter code DAShealth to view video.

    Enter code DAShealth to view video.

    Enter code DAShealth to view video.

    Enter code DAShealth to view video.

    Enter code DAShealth to view video.

    Enter code DAShealth to view video.

    Enter code DAShealth to view video.

    Enter code DAShealth to view video.

    Enter code DAShealth to view video.

    Enter code DAShealth to view video.

    Enter code DAShealth to view video.

    Enter code DAShealth to view video.

    Enter code DAShealth to view video.

    Enter code DAShealth to view video.

    Enter code DAShealth to view video.

    Enter code DAShealth to view video.

    Enter code DAShealth to view video.

    Enter code DAShealth to view video.

    Enter code DAShealth to view video.

    Enter code DAShealth to view video.

    Enter code DAShealth to view video.

    Enter code DAShealth to view video.

    Enter code DAShealth to view video.

    Enter code DAShealth to view video.

    Enter code DAShealth to view video.

    Enter code DAShealth to view video.

    Enter code DAShealth to view video.

    Enter code DAShealth to view video.

    Enter code DAShealth to view video.

    Enter code DAShealth to view video.

    Enter code DAShealth to view video.

    Enter code DAShealth to view video.

    Enter code DAShealth to view video.

    Enter code DAShealth to view video.

    Enter code DAShealth to view video.

    Enter code DAShealth to view video.