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Insurance companies are beginning to turn down applicants or rate them if they had prior C-Sections. This increases the odds that the person will get another section. Of course if the woman is older or not had children for some time or was sterilized the prior section would not matter. This is true for those with individual coverage instead of group. The section rate is now the highest due to med mal concerns at 31%. Sections cost almost $3000 more than vaginal deliveries.
The universal health care of the People's Republic of Massachusetts is doing what it said it wanted to do, increase insurance coverage. About 86,000 people paid the state's penalty rather than take their insurance. An additional 62,000 did not take the insurance and were not penalized. The insured like the program and the uninsured do not. The taxpayers must love it since the cost has jumped dramatically for the republic.
The Republic insurers are putting physician ranking on the web. They are not waiting for the result of the law suit against the use of rankings that are skewed. There has been no suit to obtain a TRO against Navigator, the company that makes up the figures. Top
The Joint Commission has bowed to it's payees, the AHA, and suspended the current MS 1.20. The task force made up of equal numbers of hospital people and physician advocates with one neutral chair, voted to suspend and consider changes such as what is meant by the term organized medical staff. The committee is now to report to the JC in August. This means any changes will be a long time coming. Top
Prime Healthcare has added three hospitals from Tenet in the Orange LA County area of California. Prime is the company that when it purchases a hospital cancels all managed care contracts so they can charge usual and customary rates. This makes insured patients go to other hospitals so they can lose money on the insured patients. Prime gets its patients via the EDs. They now have 12 hospitals in the area, as many as Kaiser. They also have a 15% profit per hospital.
Chicago's Michael Reese Hospital was once one of the premier hospitals in the city. It had great teaching and was known for its ability to attract top notch students for post graduate training. It then was purchased by the University of Chicago and the focus changed. Instead of attracting good paying patients they attracted Medicaid and no pays. Over the years the hospital deteriorated and is now to close and be the site of the hoped for 2016 Olympic village.
Franklin Regional Medical Center in Tennessee is getting its federal funding removed due to poor care of its patients. They basically killed one patient a 76 year old man scheduled for knee surgery. He happened to also have typical heart symptoms on active nitro therapy and this was ignored pre op as the surgeon was not told. Several days post op he died from the heart disease. He had a very high potassium which was not told to the nurse for several hours and was never told to the physician prior to the death of the patient. There were other problems with the hospital as well with pre op exams not done on ortho patients. One physician who resigned in 2006 over the problems at the hospital said that administration was only interested in making a profit and not quality of care. It should be noted that this hospital is a for profit owned by HMA of Naples, Florida. Top
The Czech Parliament has decided to allow children aged 6 and under to escape the brutal copays of 30 crowns ($1.60). The union are going to have a strike over the copays and the change from state run communist style healthcare to private for profit companies.
Physicians in a group practice in Clarksville, Tennessee had an audit performed by a Medicare contractor. The contractor found a few problems and then did their usual extrapolation saying the clinic owed over a $1 million. The clinic appealed and then Medicare stopped paying them. When the clinic finally won the appeal it had cost them $150,000 in legal fees that were not being reimbursed and $850,000 of Medicare fees owed that were reimbursed. This type of audit will lead more physicians to consider whether to take Medicare patients or not. Top
UC Irvine students had their identity stolen and fraudulent tax returns filed so the thieves could collect refunds. This was due to a screw up by UnitedHealthcare. The insurer will pay for credit monitoring and "would assist them in other ways." The University has agreed to loan money if needed to the students.
Walter Reed Hospital has screwed up again. They have lost via a security breach the medical information on about 1000 patients. They found out about the breach by someone working on another site. They have begun the notification process. And one wonders why physicians have not run to the EMR. Try stories like this, cost and time management.
Kaiser has teamed up with Microsoft to put medical records on the web. The guinea pigs will be those Kaiser patients who are employees and volunteer to have their records on the web. Microsoft is already doing pilot projects with Mayo Clinic and New York Presbyterian Hospital. Google is also doing it and is now working with Cleveland Clinic and Beth Israel Deaconess Medical Center. 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
information presented.