The Columbus, Ohio shootout between the hospital systems and their physicians who have agreed to put up a boutique hospital has spread. The disagreement relating to the hospitals not allowing the physician competitors on staff have caused a rift between the Ohio Hospital Assn. and the Ohio Medical Assn. The AHA wants to close the ability of the physicians to refer to hospitals which they own. This is currently allowed under Stark. The Ohio Hospital Assn. is attempting to put the same limitation in on a state basis. The Ohio Medical Association is conflicted on this issue as it represents both the physicians who want to invest and those who are afraid the boutique hospitals will decrease their hospitals ability to provide care due to decreases in funding. The Medical Association is pushing for a compromise that would allow the hospitals but also mandate disclosure to the patients of their financial interests. This rift between the two organizations may be the thing the trial lawyers need to defeat the medical malpractice tort reforms.
In Indiana a group of 60 Orthopods are putting up a 60 bed specialty hospital in Indianapolis. The local hospitals are not doing the same thing as they did in Ohio. They realize the amount of money it will cost to fight and also the amount of ill-will created by the fight. Top
The physicians suing St. Paul for exiting the West Virginia malpractice scene and then attempting to extort additional payments from the physicians to purchase their tail insurance, state that the lowering of the Charleston Trauma Center from a Level I to Level III is directly related to the pull out.
Gov. Wise of West Virginia believes the legislature would give more power to the medical board to get rid of incompetent physicians. He did not define the term.
Sarasota's Doctors Hospital is closing their OB program due to an increase in malpractice premiums to the hospitals of 32%. The hospital was faced with continued increasing premiums and decreasing reimbursements and decided on the only sensible solution.
In Port Charlotte, Florida the medical staff voted to no longer require malpractice insurance and the hospital Board approved. It now goes to HCA. There is no OB unit in the hospital. This will leave only one HCA hospital in two counties to have a birthing unit.
USA Today had a recent story regarding the new muscle flexing of physicians to stem the tide of malpractice increases. They gave the examples of lobbying and dropping services. They also used the example of physicians all going to a conference on the same day. The physicians are targeting Republicans for fund raising since the Democrats are already in the Trial Lawyer's pocket.
Ohio physicians should be ashamed of themselves. They held a rally at the statehouse for tort reform and only got 50 physicians and a small story in the Cleveland paper. If they want change, they need to show it and fight for it.
In Mississippi the tort reform package may die due to business wanting to also get into the act. By wanting to also being protected under the liability malpractice shield, business will probably kill it for all.
In a current special session on health tort reform the legislature picked the $1 million cap on pain and suffering. Of course the cap is meaningless since a judge can override the law if they determine in their judgment the malpractice was egregious. Top
A new AMA poll shows that about 25% of the nations physicians will decrease their participation due to the recent 10% decrease in payments. The physicians are also looking at an additional 12% cut over the next three years.
The Medicare HMOs continue to dwindle closing out about 200,000 more individuals from coverage. Aetna is cutting more of its HMO business but is adding PPOs in three states, Pennsylvania, Maryland and New Jersey. Dallas, Texas will end up with no HMOs. The American Association of Health Plans is griping about the reimbursement but in fact they do nothing for their pay. They are only middlemen performing no service between the employer and provider and they rake 25% off the top. The senior organizations are also against the providers getting any more money before there is a pharmacy benefit. They don't realize that there are less and less physicians willing to take Medicare patients due to the 10% already in reduced reimbursements and an additional 7% in the next few years. Seattle already has a shortage of physicians taking Medicare patients. About 50% of the physicians are taking new Medicare patients, down from 75% in 1997. In Cleveland, Phoenix, Miami Indianapolis and Orange County about 15% of the seniors had difficulty with finding or obtaining prompt care. There will be no one to write the prescription. In California two HMOs have dropped counties in the north, leaving no HMOs available for the seniors. Remember HMO is not an entitlement but a privilege that can be removed. Top
In the fight between the Massachusetts legislature and the private pharmacies over cuts in Medicaid pharmaceutical payments, Walgreens has refused to give the legislature the information they requested. The information is proprietary and none of the business of the legislature. CVS and Brooks, the other two of the big three, have not made a decision as yet. However, in typical People's Republic fashion the spokesperson for the state said that any information received by the state would be posted on the Web. This gives alot of incentive not to supply any information. Stupidity, as usual, reigns supreme in that state.
The pharmacies state they might give up their information providing the state will guarantee its privacy. This would be highly unlikely in this state.
Occasionally the Republic gets it right. They have found they have more health mandates than any other state and these cost more money. A new law requires a fiscal impact report on all laws relating to health care. This may cut down on some of the idiotic bills passed and signed by the state "leaders". Top
There are two sides of every argument depending on which spin one wants to use. Kaiser in Oregon sent an email to its member physicians asking who would participate as the attending physician in a legal assisted suicide. There was a member patient who requested assisted suicide but whose primary care doctor refused to participate. The HMO is looking to help obey the law. The anti assisted suicide groups are thrilled that no physician could be found and are stating that the HMO would rather kill the patient than pay for their treatment, a fairly insulting declaration. Kaiser physicians are paid a salary no matter how much money the patient costs. Top
Several states have provider taxes. This is a tax on services rendered and money collected. It usually only applies to health related business including physicians. This tax can not be passed on to the insurance company and so the provider eats it. West Virginia has had a tax since 1986 and it may be a reason the state cannot attract physicians. The state is slowly phasing out the tax in order to give the legislature a chance to find other Medicaid funding. When this tax is gone, Minnesota will be the only state left with a provider tax. Top
About half the nurses at Eden Hospital in Castro Valley, California have refused to continue to wear electronic tags. These tags tell the central office where they are and can be used to communicate. The nurses feel this is an intrusion into their privacy and also creates a problem when they are communicating with a patient and a voice tells them they have a phone call. The hospital states that this technology is the future and there will be no turning back. The hospital also stated that the badge would be utilized to record response times and for disciplinary action. 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.