Elizabeth Chamblee Birch, law professor and author of The Pain Brokers, exposes a coordinated healthcare fraud scheme targeting over 100,000 women. Stolen HIPAA-protected health records were weaponized by call centers in India and South Florida to convince women they needed emergency mesh removal surgery. Many women were left permanently incontinent after unnecessary procedures. The scheme involved call centers using stolen medical data, South Florida surgical operations, lawyers creating hidden liens, and litigation funders profiting from women's suffering. Birch introduces the villains: Vince Chabra (online pill mill founder), Blake Barber (travel concierge), and complicit doctors. She also highlights heroes: Barbara Bennis (defense attorney who uncovered the conspiracy) and J.R. Baxter (young plaintiffs lawyer who fought back). The episode reveals how electronic health record systems enabled massive data breaches, how private equity infiltrated the legal system, and what reforms are desperately needed to prevent future schemes.

Key Timestamps

0:53 Joe Grogan introduction

1:25 Joe asks Elizabeth about her background

1:37 Elizabeth's background: 21 years teaching mass torts

2:25 Elizabeth's MFA in narrative nonfiction at UGA

3:26 What is vaginal mesh used for?

5:21 Sharon gets intimate stolen medical data in phone call

6:00 Sharon didn't know she had mesh inserted

6:32 Call centers in India and South Florida

7:32 Alpha Law: Frankenstein firm through D.C. loophole

9:31 Outbound calls fueled by illegal stolen HIPAA data

10:12 Sharon's journey through the system

12:39 Sharon's financial devastation: $69-120K lien

13:24 Litigation funders threaten Sharon's house after settlement

15:00 Multi-district litigation vs class action

16:15 The perverse economics of the scheme

17:33 Economics: $15K vs $215K+ for removal

19:10 Women left permanently incontinent after unnecessary surgeries

21:15 Meet Vince Chabra and Blake Barber: the kingpins

26:11 Wolf of Wall Street moment: 14,000 claims for $40 million

27:45 Cold called over 100,000 women, signed 14,000 as clients

28:35 Barbara Bennis: defense attorney hero discovers conspiracy

30:37 Jerry Plummer and J.R. Baxter: young lawyer fighting back

34:36 Electronic health records enabled the data breach

36:07 Women receive $40K average settlement before fees

37:30 Data bias in medicine: gender gap in settlements

42:37 Solutions: anti-kickback statute reform

43:35 Private equity infiltrating law firms: the next frontier

Key Topics

Vaginal mesh litigation, healthcare fraud, HIPAA violations, stolen health records, call center fraud, litigation funding, private equity, women's health bias, legal reform, unnecessary surgery, settlement bias, data breach, electronic health records

Podcast: DC EKG with Joe Grogan | Episode: 139 | Host: Joe Grogan | Guest: Elizabeth Chamblee Birch, Law Professor, University of Georgia

Sponsor: Survivors for Solutions – https://survivorsforsolutions.org

Executive Producer: John "CZ" Czwartacki, DC EKG Podcast

Producer: Stay on Course Studios – https://www.stayoncourse.studio

Guest: John Bertrand, former Digital Diagnostics

Episode Description

Joe Grogan sits down with John Bertrand, a veteran healthcare technology executive who scaled Digital Diagnostics to 75 health systems and achieved the first FDA approval and CMS reimbursement for an autonomous AI diagnostic device without a physician in the diagnostic loop. Bertrand reveals the harsh realities of bringing AI innovation to market: FDA and CMS regulatory frameworks are built for traditional medical devices and physician-driven care, not autonomous AI diagnostics. The conversation covers the shocking CMS reimbursement draft that came in 40-60% below cost of goods sold, the massive first-mover disadvantage in regulated medical device AI, and why reimbursement is the true gating factor for adoption—not clinical superiority. Bertrand explains how workflow integration and financial incentives matter far more than being clinically better. The episode explores the massive gap between what entrepreneurs think should happen with new innovations and the regulatory reality. He concludes with a sobering assessment: if building diagnostic AI again, he would choose supply chain automation instead because the regulatory and reimbursement headwinds are so significant they punish innovators. Where AI is actually making an impact today is patient-facing triage agents, administrative automation, and revenue cycle management—areas with far less friction.

KEY TIMESTAMPS

0:40 Joe introduces John Bertrand and his healthcare tech background

1:28 John clarifies he recently left Digital Diagnostics for supply chain work

2:40 John's career: 13 years at Epic Systems across multiple roles

6:10 What does Digital Diagnostics' AI device do? Automating retinal imaging

7:56 First FDA approval and first CMS reimbursement for autonomous AI diagnostic

9:02 Joe's threshold question: shouldn't better innovation be easily adopted?

9:50 Reality: workflow integration and reimbursement matter more than clinical quality

11:50 The adoption curve: all successful FDA-approved AI devices have CMS reimbursement

14:10 FDA experience: desire to help but frameworks built for old technology

15:40 FDA scrutiny on AI exceeds scrutiny on human clinicians

18:05 FDA guidance changes every 6-12 months, creating constant pivoting and delays

20:08 Shifting to CMS: the shocking draft reimbursement story

20:45 Draft came in at $10 per test, needed $30+ to be viable

22:42 Four months of negotiations with CMS to shift value argument

24:40 Process not codified: each company follows unique regulatory path

28:04 Six years at Digital Diagnostics: was it worth it?

28:44 John would not recommend diagnostic AI to new founders

33:02 Turning down multiple diagnostic AI opportunities post-Digital Diagnostics

34:19 AI hype vs reality: where are patients actually seeing life improvements?

34:19 Patient-facing triage agents are the second inning of real AI opportunity

36:25 Reimbursement for chat-based triage: who gets paid?

38:23 Autonomous vs assistive AI: the regulatory gap that exists

40:31 Could Digital Diagnostics have done physician-in-loop from the start?

41:33 Real opportunity: clinical practices deploying their own AI

42:20 State licensing nightmare: deploying AI across 50 states

44:55 The real concern: RCM automation becoming a zero-sum AI bot battle

45:20 Dead Internet Theory applied to healthcare revenue cycle

47:38 Closing: a tour de force on AI healthcare reality

Key Topics

AI in healthcare, FDA approval process, CMS reimbursement, autonomous AI diagnostics, Digital Diagnostics, diabetic retinopathy, regulatory frameworks, first-mover disadvantage, workflow integration, reimbursement strategy, patient-facing AI, healthcare innovation, regulatory friction, adoption barriers, state licensing, RCM automation, healthcare AI reality

About the Guest

John Bertrand is a veteran healthcare technology executive with over 20 years of experience. He spent 13 years at Epic Systems in analyst, product manage

This is a legacy episode recorded in January 2026. At the time of recording, Naomi Lopez was founder of Nexus Policy Consulting and a leading voice in healthcare policy, healthcare AI, and state health reform.

Joe Grogan sits down with Naomi Lopez from Nexus Policy Consulting to recap the first Healthcare AI Policy Summit held in December 2025 in Washington, DC. They discuss big themes shaping healthcare AI, HHS approaches to AI adoption, and what regulatory clarity could look like. The conversation covers new federal initiatives like ACCESS and TEMPO that may reshape chronic disease management for Medicare patients. They unpack HHS Deputy Secretary Jim O'Neill's vision for AI in government, including using large models to improve physician productivity, payment integrity, and care coordination. They dig into ACCESS Medicare payment model and FDA TEMPO initiative, explaining how these pilots test AI tools in real-world chronic disease management for hypertension, diabetes, musculoskeletal pain, and depression. The discussion widens to physician burnout, interoperability, rural care, states and federal preemption, and what tech companies becoming Medicare Part B providers could mean for healthcare innovation.

Key Timestamps

0:00 Intro and why the Healthcare AI Policy Summit matters

2:00 Summit recap: big themes and regulatory pressure points

6:00 Jim O'Neill at HHS: regulatory clarity and adoption inside government

12:00 ACCESS explained: Medicare chronic disease management payment model

18:00 TEMPO explained: FDA's risk-based approach for chronic care tools

24:00 Wearables, remote patient monitoring, and virtual ICU models

30:00 Privacy, de-identification, and re-identification risk

35:00 AI inside HHS and FDA: productivity, payment integrity, care coordination

41:00 Reducing admin burden and physician burnout

47:00 Rural healthcare: scaling diagnostics and access with AI

52:00 Interoperability and data sharing: APIs, friction, and incentives

58:00 State AI laws versus federal preemption

1:04:00 2026 outlook: tech companies as Medicare Part B providers

1:09:00 Wrap-up and what to watch next

Key Topics

Healthcare AI, ACCESS payment model, TEMPO initiative, FDA regulation, Medicare reimbursement, chronic disease management, AI in government, physician productivity, care coordination, wearables, remote patient monitoring, privacy and de-identification, rural healthcare, interoperability, state AI regulation, federal preemption, healthcare innovation, payment integrity

About the Guest (at time of recording, January 2026)

Naomi Lopez is the founder of Nexus Policy Consulting and a leading voice in healthcare policy, healthcare AI, and state health reform. She co-founded a healthcare AI working group and co-hosted the inaugural Healthcare AI Policy Summit in December 2025 in Washington, DC. Her work focuses on how regulation, Medicare and Medicaid policy, and state law shape healthcare innovation, access, and affordability.

Podcast: DC EKG with Joe Grogan

Host: Joe Grogan

Guest: Naomi Lopez

Sponsor: Survivors for Solutions

Executive Producer: John CZ Czwartacki, DC EKG Podcast

In this "REFILL" episode, Joe Grogan sits down with Jackson Hammond from Paragon Health Institute to unpack what the latest CMS National Health Expenditure data says about where U.S. healthcare is headed. They break down spending trends from $5.2 trillion to projections of $8.6 trillion, explaining what changed, what didn't, and what it means for affordability, Medicare, Medicaid, and long-run fiscal pressure. The conversation connects spending outlook to Jackson's work on CMS Innovation Center reform and debates whether CMMI is bending the cost curve or adding bureaucracy without accountability. Jackson argues we should aim for healthcare so affordable you barely need insurance, exploring how choice and competition could reshape the system.

Key Timestamps

0:55 Jackson's background and how he got into health policy

3:39 Focus areas: Medicare, hospitals, drug pricing, PBMs, and 340B

5:14 What the NHE report is showing

6:14 Healthcare spending trajectory: $5.2T to $8.6T and why it matters

8:00 Why health spending is not really optional

10:11 Where the money goes: payer mix and per-enrollee costs

12:23 Medicaid costs, provider taxes, and state financing tactics

15:58 Medicare spending pressure and fiscal risk

21:06 Misconception: coverage equals care

26:18 Why provider payments keep rising after COVID demand and consolidation

33:01 Rural care, consolidation, and rural emergency hospital models

40:08 Drug pricing: retrospective versus prospective MFN approaches

49:20 2026 outlook and closing thoughts

Key Topics

National Health Expenditure, healthcare spending, CMS reform, CMS Innovation Center, Medicare spending, Medicaid costs, hospital consolidation, rural healthcare, drug pricing, PBMs, 340B program, provider payments, patient-centered care, healthcare affordability, choice and competition, fiscal policy

About the Guest (at time of recording, January 2026)

Jackson Hammond is a Senior Policy Analyst at the Paragon Health Institute focused on health spending, CMS policy, and reforms centered on choice, competition, and patient-centered care. He authors Paragon's Paragon Prognosis analyses and has written extensively on CMS Innovation Center reform and strategies for making healthcare more affordable through competitive market approaches.

Podcast: DC EKG with Joe Grogan

Host: Joe Grogan

Guest: Jackson Hammond

Sponsor: Survivors for Solutions

Executive Producer: John CZ Czwartacki, DC EKG Podcast

Joe Grogan sits down with Ryan Long, healthcare policy expert and senior research fellow at Paragon, to discuss three critical healthcare policy issues facing Congress. First, the Congressional Budget Office's landmark analysis of the 340B drug pricing program, which revealed the program increases federal spending, drives up premiums, and channels most benefits to wealthy hospitals rather than those serving low-income patients. Second, the enhanced premium tax credits set to expire at the end of 2025, which have been plagued by fraud and fraudulent enrollment. Long explains how unscrupulous brokers have exploited the system, enrolling people without their knowledge, with billions in improper payments going to insurance companies. Third, the Inflation Reduction Act's devastating impact on Medicare Part D, including premium increases from thirty to sixty dollars monthly, coinsurance replacing copays, and seniors paying higher out-of-pocket costs despite the legislation's promise to lower drug costs.

Key Timestamps

1:20 Welcome to DC EKG and introduction of Ryan Long

2:15 Congressional Budget Office analysis of 340B program

4:06 Why CBO conducted the 340B study

4:25 How 340B increases federal spending and premiums

4:58 Studies showing 340B drives higher-cost drug utilization

5:30 Will CBO analysis lead to legislative reform efforts

6:15 Program expansion from 90 to 2,600 participating hospitals

8:06 Timeline for 340B reform legislation

10:43 340B program growth from two billion to sixty-six billion annually

11:52 Why insurance companies support limiting 340B

12:20 Enhanced premium tax credits and ACA credits expiring

14:22 Difference between baseline and enhanced ACA credits

16:34 Zero-dollar plans and fraud mechanisms

18:19 Broker fraud and fraudulent enrollment schemes

21:09 How fraudulent brokers exploit free plans and commission structure

22:53 Paragon study showing four times over-enrollment in Florida

25:30 Misleading polling about ACA credits expiring

28:18 Groups pushing misleading messaging on enhanced credits

29:31 Political dynamics and Republican position on credits

33:17 Government shutdown politics and Democrat strategy

36:09 Elevance exiting standalone Medicare Part D plans

38:03 Migration from Part D to Medicare Advantage due to IRA

39:15 How IRA's out-of-pocket cap restructuring increased premiums

40:34 Coinsurance replacing copays and cost shift to seniors

42:20 IRA using fictitious list price to calculate negotiated savings

44:47 Multiple factors causing Medicare Part D premium increases

Key Topics

340B program, Congressional Budget Office, drug pricing, hospital consolidation, enhanced premium tax credits, ACA fraud, fraudulent enrollment, broker fraud, government subsidies, Medicare Part D, out-of-pocket costs, coinsurance, Inflation Reduction Act, pharmaceutical pricing, program integrity

About the Guest (at time of recording, September 2025)

Ryan Long is a Senior Research Fellow at the Paragon Health Institute and affiliated with the USC Schaefer Center for Health Policy and Economics. He is a healthcare policy expert with extensive experience on Capitol Hill, including service as a staffer on the House Energy and Commerce Committee and chief health policy advisor to Speaker Kevin McCarthy. Long specializes in healthcare reform, pharmaceutical pricing policy, Medicare and Medicaid issues, and legislative strategy.

Podcast: DC EKG with Joe Grogan

Host: Joe Grogan

Guest: Ryan Long

Sponsor: Survivors for Solutions

Executive Producer: John CZ Czwartacki, DC EKG Podcast

This is a legacy episode recorded in January 2026. At the time of recording, Michael Cannon was Director of Health Policy Studies at the Cato Institute, a leading voice on healthcare reform, the Affordable Care Act, and market-based health policy solutions.

Episode Description

Joe Grogan sits down with Michael Cannon from the Cato Institute to discuss short-term, limited-duration insurance (STLDI), also known as "Obamacare-exempt" plans, and why they can be significantly cheaper than ACA exchange coverage. Cannon explains how renewal guarantees work and why allowing more consumer choice can reduce pressure on exchange risk pools. The conversation covers the politics of pre-existing conditions, how ACA rules change insurers' incentives, and why coverage debates often miss the real drivers of cost, access, and quality. They also discuss public trust in healthcare following the Brian Thompson murder and explore how policy choices shape what insurers can and cannot do.

Key Timestamps

0:23 Michael Cannon joins and what STLDI is

2:27 STLDI explained: Obamacare-exempt plans, renewal guarantees, and lower premiums

6:00 ACA history: why STLDI was restricted

7:46 International comparisons and pre-existing conditions incentives

12:10 Why healthcare stays broken: regulation, lobbying, and government-designed systems

16:59 Subsidies and the politics of pre-existing conditions

22:22 Renewal guarantees, employer tax exclusion, and Medicare history

30:37 Public trust after Brian Thompson's murder and Cannon's letter

41:56 Wrap-up and key takeaways

Key Topics

STLDI insurance, short-term limited-duration plans, ACA coverage, renewal guarantees, risk pools, pre-existing conditions, insurance regulation, healthcare costs, consumer choice, affordability, public trust, healthcare policy, market-based reform, junk insurance debate, employer-based coverage, Medicare policy

About the Guest (at time of recording, January 2026)

Michael Cannon is the Director of Health Policy Studies at the Cato Institute and a leading voice on healthcare reform, the Affordable Care Act, health insurance regulation, and market-based health policy solutions. He is a policy expert focused on expanding consumer choice and reducing the regulatory barriers that limit access to affordable coverage options.

Podcast: DC EKG with Joe Grogan

Host: Joe Grogan

Guest: Michael Cannon

Sponsor: Survivors for Solutions

Executive Producer: John CZ Czwartacki, DC EKG Podcast

This is a "REFILL" episode recorded in September 2025. At the time of recording, Dutch Rojas was a healthcare entrepreneur, founder of multiple direct contracting companies, and board member of Physician Led Healthcare for America, with a growing following on social media advocating for market-based healthcare solutions.

Joe Grogan sits down with Dutch Rojas, healthcare entrepreneur and social media advocate, to discuss his journey from accounting to building direct contracting companies that revolutionize employer healthcare. Rojas explains how direct contracting allows employers to negotiate directly with physicians, bypassing insurance middlemen. The conversation covers his experience building ambulatory surgery centers, certificate of need laws, self-funded employer plans, and his critique of not-for-profit health systems. Rojas argues that academic medical centers masquerade as not-for-profit organizations while receiving seventy-four subsidies annually from taxpayers, acquiring massive real estate holdings, and avoiding property and federal taxes. He advocates for policy changes on not-for-profit tax status and site-neutral payments, arguing these represent unfair advantages that harm independent physicians and patients.

Key Timestamps

0:18 Joe introduces Dutch Rojas and asks who is Dutch Rojas

1:32 Dutch's background, career path, and journey to social media

2:22 Physician-led Healthcare for America and PHA board

4:32 Starting in accounting, real estate investment trust, and ambulatory surgery centers

5:14 150 ambulatory surgery center deals and certificate of need experience

7:34 Building a practice in Scottsdale and expanding to 16 states

9:30 First direct contracting company in 2009 and how direct contracting works

12:45 Self-funded employer plans and 106 million Americans not covered by insurance

15:22 Deals with banks and large employers in New York City

18:09 The difference between clinical medicine and business in medicine

22:15 Building insurance products on top of physician-led care

28:30 How direct contracting saves employers money

32:18 The three companies Dutch has started and sold

38:45 Healthcare as a percentage of GDP and rising costs

42:10 Regulatory hurdles and state-level barriers

46:54 Not-for-profit tax status and academic health systems

48:07 How health systems receive subsidies but claim non-profit status

48:22 Academic medical centers owning four to five percent of city real estate

49:21 Site-neutral payments and payment disparities between settings

50:28 Dutch's social media reach and audience impact

Key Topics

Direct contracting, healthcare economics, physician-led care, ambulatory surgery centers, certificate of need, self-funded employer plans, not-for-profit health systems, tax exemptions, site-neutral payments, healthcare regulation, real estate holdings, academic medical centers, employer negotiations, insurance reform, market-based healthcare

About the Guest (at time of recording, September 2025)

Dutch Rojas is a healthcare entrepreneur with over 25 years of experience in healthcare economics and business. He started in accounting and real estate investment, then moved into healthcare, developing over 150 ambulatory surgery centers. Rojas founded multiple direct contracting companies that help employers negotiate directly with physicians, bypassing traditional insurance intermediaries. He serves on the board of Physician Led Healthcare for America. He has built a significant social media following on X (formerly Twitter), sharing his analysis of healthcare policy and economics. Rojas is the author of the Rojas Report and hosts a YouTube channel and Substack focused on healthcare reform and market-based solutions.

Podcast: DC EKG with Joe Grogan

Host: Joe Grogan

Guest: Dutch Rojas

Sponsor: Survivors for Solutions

Executive Producer: John CZ Czwartacki, DC EKG Podcast