Twelve California hospitals have been fined for medical errors. The hospitals are USC University Hospital for errors of medication overdoses causing harm, Citrus Valley Med Center for leaving a foreign body in a patient, Southwest Healthcare System received its seventh fine, this one for leaving a retractor in a patient, Western Medical Center-Santa Ana got its third fine, this for inoculating patients for tetanus and Hepatitis B with vaccines that were improperly stored and therefore potentially ineffective, Kindred Hospital Westminster for a patient getting bed sores, Placentia-Linda Hospital for using the wrong knee replacement on a patient, Scripps La Jolla for a surgical towel left in a patient, Palamar in Escondido for allowing an ICU patient to fall, UC San Francisco got two fines as did California Pacific Medical Center both in San Francisco Hanford Medical Center received one fine as did Petaluma Valley Hospital.
Another six hospitals in California have been fined for patient privacy breaches. Pacific Hospital of Long Beach was fined $225,000 because a technician illegally accessed nine charts to open accounts with Verizon. Children's Hospital or Orange County was fined $25,000 when a worker accessed a co-worker's child's chart. Kern Medical Center was fined $310,000 for two incidents. The first was keeping records in an outdoor unlocked storage locker and the second was for unauthorized access by employees. Delano Medical Center was fined $60,000 when an employee accessed a in-laws record. Biggs Gridley Memorial Hospital in Butte County was fined $5,000 for unauthorized access by employees on several occasions. Oroville Hospital was fined $42,500 when an employee not only talked about a patient on her cell phone in the ED but also published information on MY Space. Someday hospitals will really clamp down on employee access. Top
Medicare has announced the the final 2011 physician fee schedule. Fees to physicians will be reduced 25% on December 1, 2010 and an additional 2% on the first of the year. Watch for a drop in access at the same time. They have also increased by 10% payments to primary care physicians and surgeons in rural areas. They have put payments to radiologists down 50% for each test done the same day after the first ultrasound, CT or MRI.
Health Net has been fined $375,000 in Connecticut for HIPAA violations.
California has continued to fine insurers. This time for not paying promptly hospitals and providers. The fines are small potatoes compared to the harm caused by the insurers. Anthem Blue Cross and Blue Shield each received a fine of $900,000, UnitedHealth/PacifiCare was fined $800,000, Health Net and Kaiser each were fined $750,000, Cigna was fined $450,000 and Aetna was fined the least $300,000. The fines were determined by the amount of business in the state and the severity of the violations of the law. The plans must pay besides the fines o the states the monies owed the hospitals and other providers.
HHS has reversed itself and is allowing employers to switch health insurance carriers without losing special "grandfathering" under Obamacare. This assumes that the switch does not mean a significant increase in cost or decrease in benefits to the employees. Top
Dr. Kevin Peterson of Los Vegas set up an on line blood pressure clinic. He spoke to each patient and then wrote a prescription for their high blood pressure. He charged $50 per session. There is a disagreement between the physician and the board as to what the law actually states.
Illinois is poised to pass a law that prohibits health care workers that have been convicted of a sexual offense not to eligible for another license for a minimum of five years. The law would not mandate the loss of a license, only if it was removed it could not be reinstated for the time. Top
A new Federal Rule goes into effect December 1 that will restrict experts draft notes from being discovered. Full discovery will be allowed for experts opinions and the facts or data used to support them. All drafts will now be protected as attorney work product. The exceptions to the rule is the compensation being paid to the expert, facts or data provided by the attorney to the expert and attorney assumptions that the expert relied upon. Also treating physicians will not have to submit a report as they are not experts but the attorney will have to disclose the content of the testimony. Top
The administration has come out with a quality plan for Medicaid and Medicare. It will entail eight states primary care physicians to better coordinate care. It will also target federal health clinics. It really says nothing about the care per se only about coordination.
Both sides of the aisle have been pushing HHS to change the loss ratios of insurance companies to be less dogmatic in what counts for medical loss.
CMS has stated that all hospital patient visitors have equal privileges as per the patient wishes. The hospitals must have written procedures to make sure that if patients want to have certain visitors, they will be allowed.
Medicare is now re-looking at Provenge, the new prostate cancer treatment that is FDA approved. The treatment is very expensive, over $90,000 and the benefit is for an additional several months of life. This is the first drug to be evaluated for cost/benefit and potential rationing.
After studying Provenge, a subcommittee of the CMS has agreed to allow the medication to be used by Medicare recipients.
Two Senators, a Democrat from Oregon and a Republican from Massachusetts, will introduce legislation allowing states opt opt out of the individual mandates requirement. This is the first bipartisan salvo in reforming Obamacare. It gives more flexibility to the states and less one size fits all that the original Obamacare bill mandated. The original law allowed opt out in 2017 if the states meet minimal requirements. This new legislation will set the date at 2014, when the law goes into effect. This allows the states an opportunity to not have to set up the regulatory rules and later dismantle them.
It took one day for the Senate to pass a bill delaying the SGR for one month. The House has agreed. The AMA wants a 13 month delay to give the legislators an opportunity to come up with a permanent fix. However, legislators are attorneys and attorneys never do anything today they can do tomorrow.
HHS has outlined the rules for insurers spending that begins 1/1. They are for the most part the same as the original where they need to spend 80% or 85% on health care. Taxes are now part of health care and not administrative. Also the "mini" health plans won their battle and are exempt from the rules. If they weren't they would have dropped their plans. The spending ratios will be on a state and not a national basis.
The Senate has not agreed upon the removal of the onerous tax reporting rules. The Democratic plan received only 44 of the needed 67 votes. the Republican plan received 61 votes. The Senate hopes to revote soon since both parties agree on the concept.
Both sides of the aisle are going after the ability of employers of not deduct taxes on the payments of health insurance for employees. They both think that this is wages and should be taxed as such. This will also potentially allow the individuals to consider the spending of their money. The unions are against this.
Maine is poised to repeal its universal health insurance. It was the first plan in the nation even before the People's Republic. It covers only 3400 people. Top
DISCLAIMER: Although this
article is updated periodically, it reflects the author's point of view at the
time of publication. Nothing in this article constitutes legal advice. Readers
should consult with their own legal counsel before acting on any of the