October 15, 2014 Recent News





Physicians want to share health information but are being stymied by technology says the New York Times.  Individual physicians who install their own EHR usually can not share patient information with either the local hospital or other physicians.  The makers of the EHR are terrible in allowing interconnectivity between makers.  EPIC has had so much problem with this that they have taken to hire a lobbyist at Capitol Hill.  If Obamacare had any positive goals this was one and it is being blocked by the software makers.  The statistics show that only less than half of hospitals can transmit a patient document and only 14% of physicians can exchange patient data with outside hospitals or other physicians.  This is after the feds have spent over $24 Billion on subsidies.  Even if capable of sending information to another maker Epic and others may charge a fee for the interconnectivity which is a barrier to care and policy. 

Insurers are ramping up the patient costs with high deductible plans and increased co-pays.  This means more potential lost revenue for the physician.  Most physicians use debt collectors but they have no idea what the collectors tell their patients.  Also insurers will continue to all they can to not pay claims. This includes the famous disclaimer that authorization is not a guarantee of payment.  Physicians usually eat the bills but may not have to.  If the patient did not pay the premiums for several months prior to the service the insurer may be on the hook for payment due to their negligence.  Wake up Doc.         Top


The Denver VA has shut down its operating rooms because of a sterilization problem.  They are offering patients scheduled for surgery the option to wait for the VA operating room to reopen or go to a civilian hospital.  

Cedars-Sinai had a major medical record breech this past summer.  Originally they said that the information on 500 patients had been compromised due to the theft of a stolen unencrypted lap top computer from an employee's home.  They have now raised that to 33,000.  

The Texas Health Presbyterian Hospital screwed up their EHR for the sake of money.  The travel history is in the nurses notes so they can give immunizations and not in the physician notes therefore the travel from Africa was missed when a patient went to their ED for symptoms consistent with Ebola.

The Texas hospital has been accused of a breach of protocol in the infection of a second person in Dallas.  The CDC said in order for the health care worker to get the disease from Duncan there must have been a breach of protocol and this may be in the removal of the protective gear.  The mode of spread is by direct contact with an infected person and a port of entry into the host.

Today the worst fears of the CDC has come to fruition.  A second person at the Texas hospital has been found to be Ebola positive.  Bad but worse is she just the day before the diagnosis flew with 135 others on a plane from Cleveland to Dallas.  The contacts must be isolated.  This can not be allowed to continue.  The public health demands quarantine.

Ascension is going two faced.  They do not like the new specialty distributors of  chemo drugs from Genentech so they are not banning the drugs but are banning the the reps.  The hospital system wants to get the drugs cheaper and is using this as a club.

Illinois Blue Cross/Shield has stated they will not deal with affiliated hospitals as one unit, only with merged hospitals.  This is directly related to the affiliation between Silver Cross Hospital and Advocate Health Care.  This may also impact the joint agreement between Adventist and Alexian Brothers.  This is the insurers way of attempting to lower premiums and costs.

California Daughters of Charity have finally announced what all knew, they are selling their six hospitals to Prime.  The price, according to the San Francisco Business Times, will be $300 million in cash and an additional $450 million in capital improvements.  Prime has agreed to follow state law and keep all hospitals open for five years.  They will also take of over the medical foundation (physicians) and a separate philanthropic foundation. The deal has to be approved by the state and the Vatican.

Dallas' Baylor University Medical Center has been threatened with loss of Medicare and Medicaid funding due to lapses in their hospital.  The main problem was psychiatric patients walking away from the ED prior to treatment being started.  The problem is a limitation of psychiatric beds in the area.  Baylor is building a new 72 bed facility which will open in February.  The hospital will hire "sitters" to stay with the patients and consider telepsychiatry due to limited number of psychiatrists on staff. 

Everyone though it was great, the merger of Oakland Children's Hospital and UCSF.  Turned out the physicians at Children's have not been happy campers.  They are paid and treated like the distant cousins.  They have filed claims against the hospital with the NLRB via the union which has been denied and will now be appealed in the courts.  They want equal pay with the San Francisco residents and a larger slush fund that is used to pay for patient treatment when needed and not paid by insurance.  This may hurt Children's with the new crop of residents.        Top


I came across a great article in Oncology Times regarding unintended consequences.  It describes how the government does not think things through and creates the very thing they are trying to prevent.  In this case the feds made a rule called the 340B program which allowed only hospitals to purchase chemo drugs at a discount for outpatient use.  This has caused directly the hospitals purchasing oncology practices which are more economical and bring the chemo therapy into the hospital via the new physician offices.  This allows the hospital to make much money so they can "do good for the community" at the expense of the government.  Horsefeathers!  

Insurers are notifying patients that their old plans that to not comply with Obamacare rules will be null.  These thousands of people will then be engaged in sticker shock when they need to new policies.  Obama said they could keep their policies until 2016 but the insurers may decide otherwise.  Most insurers have decided not to extend the old non-compliant plans.  The Obamacare plans will cost more and therefore the insurers will make more.  

Obamacare is making more waves.  The LA restaurants are taking a tip from the San Francisco ones and are adding surcharges to the bill.  San Francisco added surcharges for the city health tax and now LA is adding 3% for the Obamacare medical insurance.  By doing this they can maintain their slim profit margin and still give their employees health insurance.  

About one third of Americans say that Obamacare has hurt and not helped them.  This includes an increasing number of Democrats.  

The nations largest employer has also joined other large employers in stopping healthcare insurance to some employees.  The part timers will be allowed to join Obamacare exchanges to obtain the type of insurance they want.   

The VA has fired four top execs.  One for a purchasing scam.  One for his role in the Legionnaire's Disease problem at the Pittsburgh VA. Two for their roles in the recent scandals.  However, one had already announced his retirement.

Jahi Mcgrath is back in the news.  The 13 year old brain dead youngster wants to come back to California but with Medicaid.  The court appointed physicians has stated that she is still brain dead and is not convinced otherwise by the New Jersey physicians declarations.  Her attorney now wants a one month delay in the hearing so the physicians can talk.  It is doubtful that the outcome will change in that time period.         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.