 | Hospitals |
| Physicians |
| Insurers |
| Fraud |
In the last edition of the Update I wrote about the Health Alliance of Greater Cincinnati losing their bid to force several hospitals to stay in their organization. Now they state the real reason why the hospitals were wanted was money. They implied that by eliminating jobs and shifting oversight away from the Alliance to the individual hospitals for ED work. Their greed continues.
Computers are wonderful. Northern Cochise Community Hospital of Wilcox, Arizona recently had bills to out to 587 patients for amounts up to $49 million. The hospital sends the amounts to Healthcare Management Systems in Nashville who screwed up. They sent the erroneous bills but did not do their due diligence by checking the bills for accuracy.
St. Vincent Indianapolis has compromised the privacy of about 51,000 people by placing their names, addresses and SSNs on the internet. The people have been notified and provided with a free credit report as well as free monitoring. Top
The Miami Herald had a story regarding a heart surgeon, Dr. Alex Zakharia, who was apparently summarily suspended from Cedars Medical Center while an investigation into his cases continues. He has challenged the suspension in court. He has also been accused of fraud and perjury for allegedly exaggerating his surgical experience when he testified in a med mal case. The physician apparently also suffers from memory lapses that may or may not effect his work. He continues to work at four other hospitals without any known problems.
The Wall Street Journal had a front page article that said as Medicaid payments drop less numbers of physicians will see the patients. I hope they didn't spend too many resources on the obvious.
For those physicians and their employers who do not know, you MUST write ALL Medicaid prescriptions on tamper-resistant pads. CMS has been asked by the pharmacists to delay implementation. CMS has said no. This was a small paragraph in the entire funding bill for the Iraq war.
Physicians are human and they suffer when an error is made. In a study of over 3000 physicians, 2000 said they had made errors. The other 1000 had never seen a patient or lied. Out of the 2000 truthful physicians about 60% had anxiety over possible future mistakes, 44% had less confidence in themselves and 42% had sleep problems. Only 10% stated that the hospital was supportive regarding their stress. Many hospitals won't even let physicians discuss mistakes. Sort of gives you a picture of a warm and friendly hospital administrator.
Sicko is alive and well. I saw the movie over the weekend and on Monday read an article that confirms the premise that insurers are evil. The LA Times has an article that Blue Cross, the largest private insurer in California, will unilaterally and without discussion slash the rates paid to physicians. It is my hope that many physicians who are not too afraid of their getting paid less than cost will drop the plan. They can still see the patients but the patients will pay more out of pocket to see a out of contract physician. If enough patients get angry enough maybe Blue Cross will get the message. That however is doubtful. Top
Blue Cross of California has has over 1600 complaints against it from its insured and physicians over the past three years. A hearing on the matter was supposed to happen in July but has been postponed until August because the parent, WellPoint has requested a more detailed agenda. Most of the complaints are those of Blue Cross not paying the physicians enough under their contracts nor quickly enough.
California Blue Shield has started to limit the use of erythropoietin stimulating drugs. This supposedly is because of the side effects but all know it is due to money. The change effects those on chemotherapy with lower hemoglobins needed to justify the usage and the denial of those with cancer off chemotherapy. They are waiting on a decision regarding kidney dialysis patients.
The VA is taking justifiable hits. The head has resigned, the courts have raked it and now a report shows the problems with disability payments. The report blasts the VA for not keeping track of the number of claims and the number rejected. They point out the disparity in dollars paid out per claim between states. The Congress, never known to let reasonableness get in the way of practicality, is about to shift more work on the poorly staffed VA system. Top
The feds are pushing to find and prosecute those in the healthcare field that are billing for phony care or providing excessive treatments. Medical supply companies will be required to reapply and certify that the executives are clean. Most of the fraud is in urban centers such as Miami and Los Angeles. 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.