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The Joint Commission has on their August 1, 2007, web site a new policy. They state in their " Good Faith Participation" policy that all members of the staff of any accredited hospital may report concerns regarding care to the Joint Commission without fear of retaliation. Hospitals will be required to educate employees and staff regarding this policy. Again the commission is leaning toward the medical staff and employees and away from administration as they did with MS 1.20 and the new Leadership sections on conflict resolution.
Another wonderful government run hospital, Greater Southeast Community Hospital of Washington, DC, is on the verge of losing Joint Commission accreditation. The hospital was found to be out of compliance in 7 of the 11 survey areas.
The hopefully will be competition for the Joint Commission. DNV has acquired TUV Healthcare to gain deeming status for CMS. Top
King Hospital in Los Angeles continues in the bad news department. An article in the LA Times tells of County prosecutors attempting to go to the Grand Jury in 2005 for a criminal investigation into deaths at King. They were rebuffed by the County DA for political purposes. The original investigation also turned up significant problems in the coroner's office that were also swept under the rug for political purposes. The current head deputy places the blame for the King mess squarely on the County Board of Stupes.
In a second article the Times reports that King has been cited for multiple radiation lapses. The people running the hospital are probably the dumbest to be found anywhere. They allowed radioactive waste to be in a diaper which was put in a waste container and sent to the dump. They had no radiation officer prior to July 19. Top
In New York, the Governor has signed legislation that limits a health plans ability to deny it had preauthorized and allows people to appeal decisions that don't allow them to see specialists outside the plan.
CMS has new rules for payments to hospitals and skilled nursing facilities. These put tighter controls on how the entities bill, allows more preventative measures and reduces hospitals payments when they replace a device at no or reduced cost. It is interesting that CMS believes that hospitals will automatically cheat on their coding patterns to get more money. CMS has taken this into consideration and instituted a prospective reduction in payments. There will be more DRG codes to more accurately determine severity of illness. CMS forecasts an approximate 3.5% increase in hospital payments over the next few years but the increase is tied to reporting requirements. If a hospital doesn't report they lose 2%. There will be no increase in payments to hospitals when the patient gets a problem while in the hospital such as an infection. Hospital associations don't like this. I didn't hear them coming to the aid of the proposed physician cuts so the physicians are not crying for the hospitals. The bill also requires all hospitals to tell patients how emergencies will be handled and if they have inhouse physicians. Physician specialty hospitals will also need to disclose their owners.
California's hearing on the complaints against Blue Cross is underway. There are about 1600 of them. Most are physicians gripes about not being paid in a timely manner. The others are the retroactive bouncing of members after they make a claim. The Department of Managed Care is also concerned about Blue Cross giving $950 million to its parent, WellPoint, while raising fees. Top