The Washington Post reports that as the cost of Ocare insurance continues to rise more unsubsidized people are not taking the policies. The amount of people subsidized has risen from 23% over the unsubsidized people in 2014 to 61% in 2017. This means the feds are paying for the program.
Where and when will it end? Another hospital is charging huge prices for CT Scans. This time it is a clinic owned by North Mississippi Medical Center. Jimmie Taggart had back pain and a urine showed blood. He had a CT ordered but refused until he was assured by the clinic that it was covered. After that assurance he agreed and after he was referred to a urologist for "kidney" stones. He received a bill for $4051. The CT bill was for $3878 over 11 times the cost for the scan at an outpatient facility. The actual amount billed was $5171 and the insurance discount was $1292 leaving the $3878. He had a $5000 deductible but the allowable amount by his carrier Aetna was $338. He is waiting to see if the hospital will sue him in court where they would have to explain their charges.
A law suit against Baylor St. Luke's Medical Center prompted an article in the Houston Chronicle about the decline of the transplant program. The suit by Ernest Keys states that post heart transplant he had significant complications which left him with a brain injury and he can not speak or walk. The May Chronicle article detailed the large amount of transplants with deaths and the loss of surgeons. CMS is now investigating the program and they are stopping the payment for Medicare patients at the program. They recently had surgical mishaps with major veins being stitched closed accidentally.
Porter Adventist Hospital in Colorado has suspended their transplant program for up to one year due to staffing shortages. This will force almost 250 people to find a new hospital. The hospital says this is separate form the closure of its spinal program due to unsterile instruments.
About half of the Comprehensive Pain Specialists in 12 states will or have shuttered after their CEO was indicted for fraud. The company is mostly in Tennessee and has 40 clinics throughout the country. There may be about 10 left after the shakeout. The CEO John Davis was indicted for allegedly accepting bribes for the filing of illegal clams to the feds.
Kalispell Regional Healthcare in Montana is being investigated by the feds for kickbacks. They have set aside about $21 million in anticipation of money the fed will get under any settlement.
The VA is back in the news. This time it is for canceling CT, MRI and other radiological procedures that have not been performed within 60 days as required. There is also a disagreement between some as to the regs require that a radiologist or the ordering physician must assess the continuing need for the exam prior to canceling them or whether the hospital administrator can cancel it and notify the radiologist of the cancellation.
The percentage of physicians that are now self employed has dropped from 35% to 25% between 2001 and 2015. This is not surprising as most who come into practice go either with a hospital or with a medical group. The earrings between the two are now almost the same and the median annual earning for self employed went from $223,000 to $250,000 and for employed went from $179,000 to $200,000. The use of the word "physicians" is defined in the study to include pharmacists, physical therapists, chiropractors, podiatrists and optometrists.
The physician who broke away from Atrium Health and sued for the ability to do so have dropped their suit. Atrium has also said that they will lay off 150 workers due to switching their anesthesiology contract. The new contractor is banned from hiring the old workers by noncompete clauses.
Dr. Johnny Delashaw, the Seattle Swedish Health Neurosurgeon, got his medical license back with caveats. He must have three years of medical oversight and can not be employed in any leadership position. He also must pay $10,000 and get a disruptive physician evaluation along with the complying with the recommendations.
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