St. Lazarus Family Practice

05/29/2026

https://www.facebook.com/share/1HAHGg2mci/?mibextid=wwXIfr

The nation's largest physician specialty group is so frustrated by the harmful impacts Medicare Advantage plans have on their practices, it is asking CMS for major policy reforms in nine key areas.
https://www.medpagetoday.com/publichealthpolicy/medicare/121343

05/10/2026

Happy Mother’s Day to all of the wonderful mothers out there.

Feliz Día de las Madres a todas la mujeres maravillosas!

05/05/2026

Make sure your services are provided by a M.D. on the premises of the clinic.

She walked into a place that called itself a medical spa. Three months later she was still in the hospital, and the prosecutor told her: you went there of your own volition. What did you expect.

The person who almost killed her had no medical training. She had ordered the product off Alibaba. It was contaminated with mycobacterium. She had no malpractice insurance. She had no license to lose. No prosecutor would touch the case. No lawyer would take the civil suit, because there was no money to recover.

That is the aesthetics industry in 2026. It is a 20 billion dollar business. As big as the NFL. And almost nobody is checking who is holding the needle.

Last year, people in 11 states landed in hospitals from fake Botox ordered off the internet. A woman in Texas died at an IV bar when an unlicensed person hung potassium and ran it into her arm like a martini order. There were HIV cases out of an unlicensed spa in New Mexico. None of this is fringe. This is happening in strip malls and hair salons and weekend pop-ups in every state in the country.

And the people doing it often have no idea they are practicing medicine without a license. They took a two-day course. The course promised them a medical director on paper. Now they are independently injecting strangers' faces with whatever they could order online.

Kate Dee is a board-certified radiologist who left breast imaging for aesthetics ten years ago and watched the industry explode around her. She wrote a book called "Med Spa Mayhem" because she could not keep quiet about what she was seeing in her own field. The way she puts it: physicians worry about losing their license if they do something wrong. If you don't have a license, you don't have one to lose.

So here is what to ask before anyone touches your face, your skin, or puts a needle in your arm. Who am I seeing today, and what is their license. Who is the medical director, and can I see them. Is the person holding the needle qualified to do a good faith exam. If the answer is "an RN comes by once a month," walk out.

Send this to the friend who just booked Botox at a place she found scrolling Instagram. Send it to your sister who keeps mentioning the IV bar that opened next to her gym. Send it to anyone you love who walks into a "medical spa" assuming the word medical means something there.

Listen to the full conversation on The Podcast by KevinMD. Link in the comments.

What is the most concerning thing you have seen or heard about a med spa or IV bar in your community.

04/30/2026

Three of the country's largest health plans are now in active class action litigation for using algorithms to deny medically necessary care. The legal exposure is no longer theoretical.

Here is where the major cases sit right now.
1. UnitedHealth Group. The class action over the nH Predict AI tool used on post-acute care reviews survived a motion to dismiss in February 2025. Discovery is underway.

💥 Plaintiffs allege the tool produced a 90 percent error rate on appealed denials, meaning nine out of ten denials were ultimately reversed on appeal.

👉 Senate investigators separately documented that UnitedHealth's post-acute denial rate climbed from 8.7 percent in 2019 to 22.7 percent in 2022, and skilled nursing denials increased ninefold over the same window.

2. Cigna. In March 2025, a federal court allowed the class action over the PXDX algorithm to proceed. Internal records cited in the complaint show PXDX was used to deny more than 300,000 claims over a two-month stretch in 2022, with an average denial time of 1.2 seconds per claim.

👉 The court ruled that a medical director "pushing the button" on an algorithmic output does not satisfy the contractual medical necessity review obligation.

3. Aetna/CVS
The Senate Permanent Subcommittee on Investigations released a 54-page report documenting that UnitedHealth, Humana, and CVS systematically targeted post-acute care for AI-driven denials.

👉 CVS rolled out a Post-Acute Analytics project in 2021 that was initially projected to save $10 to $15 million on skilled nursing spend. Internal projections were later revised to $77.3 million.

The common pattern across all three.
💥 Algorithmic denial at scale.
💥 Post-acute care as the deliberate financial target. Internal records that read like a cost reduction plan, not a medical necessity review.

For ASCs, IRFs, and LTACHs, the practical implication is this.
👇
Courts are no longer treating algorithmic denial as a routine administrative process. That changes what is reasonable to demand in your contract language, your dispute provisions, and your appeal rights.

DM me if you want to talk through where your contracts stand on these issues.

03/22/2023

Please support physician led care.

Help speak out to increase Texans' access to medical care from physicians. YES to HB 2556.

12/09/2022

Definitely a read. We are a small medical practice here to help our patients and keep them safe from the practice of corporate medicine.

Patients should be very nervous about Amazon buying One Medical.

08/21/2022

I am supporting the MS Drive! Please give to support a cure for this horrible disease!!

The National MS Society's vision is a world free of MS. The Society mobilizes people and resources so that everyone affected by MS can live their best lives as we stop MS in its tracks, restore what has been lost and end MS forever.

08/04/2022

While this is supposed to be funny, it is spot on. Patients take note. The doctors are not the ones making the money in healthcare.

Jimothy learns about Pharmacy Benefit Managers!

07/24/2022

Some of you may have heard about the monkeypox outbreak. It is more common than you think. Please continue to use precautions.

The World Health Organization has declared monkeypox a public health emergency of global concern. From how it spreads to preventive measures, here's what you need to know about the disease.

07/18/2022

Happy Monday! We are proud to introduce our newest staff member, Miss Fabiola (pronounced Fa-bee-o-la). She has taken over the role of office manager here at St. Lazarus and we couldn’t be more excited. Please show her some love ❤️!