Parkland hospital has screwed their taxpayers. They did not pay the fine of $750,000 when it was due in September. The fine was from the state of Texas for egregious lack of care in the facility. The fine was actually for $1 million but if Parkland paid it by September and made other changes they might avoid the additional money. They did not do either but now have written a check for the $750,000. The state is considering if they should charge the hospital more.
California has fined 12 hospitals for either serious injury or death of a patient. Four of the 10 were Kaiser facilities. The South Bay facility gave the wrong med causing death and was fined $50,000. The Oakland facility was fined $100,000 for a death in a patient undergoing laser lip surgery. The San Diego Kaiser allowed a physician to remove the wrong kidney. This cost $75,000. The Marin County Kaiser left a foreign body in a patient. This was $50,000. Methodist Hospital in Arcadia was fined $50,000 for leaving a foreign body in the patient that required a second operation to remove. UCSF got its sixth fine in five years for giving a wrong medication. Kaweah Delta Hospital in Visalia let a women bleed to death instead of calling for backup. That was $50,000. The same hospital then got a second fine for death post pancreatectomy and not checking the glucose closely. The hypoglycemic death cost $75,000. The Mission Hospital in Mission Viejo left a sponge in a patient due to their wanting to hurry to clear the room for the next case. This cost $100,000 and is their fifth penalty. Also at the Mission hospital the surgeons operated on the wrong side of the spine in a scoliosis patient. the physician and the staff did not follow protocol. This sixth penalty was another $100,000. At Orange Coast Hospital they had to do a second surgery to remove a sponge that caused an abscess and a bowel perforation. This little mishap cost $50,000. At Sutter Coast Hospital the surgeon used a cautery too close to oxygen and burned the patient. The fine was only $10,000 due to a state law that allows less of a fine in small rural hospitals.
CMS is showing who is naughty or nice. The hospital bonuses or reductions based on both following easy standards of care and patient satisfaction will begin in January. The most money will go to a physician owned hospital, Treasure Valley Hospital in Boise will get o.83% more per patient. Auburn Community Hospital in Syracuse will get the biggest loss of 0.9% per Medicare patient. This is part of Obamacare which states payments will now be a popularity contest. The amount of money involved is small enough that it will be no more than a rounding error. Top
Starting January 1, Obamacare taxes started. The first is an increase by 0.9% in Medicare tax for hospital payments plus an additional 3.8% for those who make from any source earned or unearned over $200,000 as an individual or $250,000 for a couple. Also is the tax on Medical Devices of 2.3% to be paid by the manufacturer. This tax may still be cancelled as both sides of the aisle do not like it. Also the medical deductions now will start at 10% of AGI as opposed to the current 7.5%.
The IRS has put out regs that state that those employers that must cover their employees under Obamacare must also cover the employee's dependent children until the age of 26. They do not have to cover the spouse as that is not in the law. The employers must also pay $2000 per year per employee if more than 30 employees receive government assistance to purchase health insurance. The employer may not have the employee pay more than 9.5% of their income. This may lead to more businesses to switch to either fewer employees (under 50) or more people working under 30 hours per week. Watch for this in the franchisee businesses. Top
Sorry, but by the time you read this your options are gone. You had until the end of the year to get out of Medicare completely. As you know the 30% decrease in Medicare payments took effect on the first of the year. Kicking the can down the road only delays the angst. As it exists the average FP will lose about $27,000 in Medicare payments in 2013. There will be even greater loss since private insurers peg their payments with Medicare. The ACP recommends that physicians get a line of credit, temporarily reduce staff, stop seeing daily non-urgent Medicare patients until the problem is solved.
The ever vigilant AMA has warned physicians not to have divided loyalties. The physician's only loyalty should be to the patient and not let their employer's money concerns get in the way of doing what is best for the patient. The AMA, always a pie in the sky organization and not very practical, says referrals should be to the person who will do the best job for the patient not who is employed by the hospital. Can you imagine a Kaiser physician referring his/her patient to physicians outside Kaiser knowing that Kaiser will not pay. 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