August 15, 2011 Recent News

HIPAA

Healthcare

Physicians

Hospitals

HIPAA

AHIMA believes the new HIPAA regs allowing them to know who accessed their health record are a significant burden.  The rule is for uses and disclosures no matter the reason. Most systems do not have the capability of getting this information.  The other problem is that the information would be available to plaintiff attorneys in med mal cases.  This is a potential problem since the attorneys could then subpoena those people and ask if they saw anything wrong when they saw the record.  They could also sue for breach of privacy since there is no private right to sue under HIPAA.        Top

Healthcare

The great compromise on the debt and the ceiling may lead to an additional 2% decrease in pay to both physicians and hospitals by Medicare and Medicaid.  This is on top of the 30% decrease scheduled to go into place on January 1.  The additional 2% would begin on January 1, 2013.  

Politico states the obvious, that the debt ceiling agreement could come back and defund Obamacare.  If the Super committee does not come up with the money then the automatic cuts will probably affect Obamacare as part of the across the board cuts.  

Just as the Obamacare exchanges are starting up the US chief of the exchanges has either quit or been fired.  He unexpectedly left his job and the reasons are not known.   

In the People's Republic of Massachusetts the attorneys that file med mal cases are not doing their due diligence prior to filing cases.  About half of the cases filed are dropped by the plaintiff.  This wastes money and takes its toll emotionally on physicians.  On the average it takes three years for a suit to be dropped so you can imagine the angst and defense money costs.  

The Hill states that new Medicaid patients entering the program will cost more the first year and then come into line with the remainder of the recipients.   This is due to the uninsured lack preventative care and therefore will be sicker when they enter the program under Obamacare.       Top 

Physicians

In another study I hope no money was expended on since the conclusion is so obvious, Health Affairs reported that Canadian physicians spend less money than US physicians on administrative costs.  The difference was about three times as much.    

Time magazine reports on pediatricians who are dropping patients whose parents refuse to have their children vaccinated.  They believe it is a risk to their other patients and to the community as a whole. It is reported that the number of pediatricians now excluding un-vaccinated patients  is up to 25%.     Top

Hospitals

The Duluth Tribune has a story about a neurosurgeon at St. Luke's Hospital and how the hospital allowed the physician to practice despite multiple warnings.  Dr. Stefan Konasiewicz, has recently been disciplined by the Minnesota Medical Board for unethical and unprofessional conduct.  He worked at St. Luke's between 1997 and 2008.  People, including seven physicians, had complained about the physician's practice directly to the Board, CEO and Chief of Nursing.  Nothing changed since he brings to the hospital so much money.  In fact, the hospital went from the red to the black during his tenure.  The CEO blamed the MEC for not disciplining the physician and the MEC blamed the CEO as the ultimate authority on employed physicians.  The physician was paid based on the number of surgeries he did, a bad formula. He made up to $1.3 million per year.  He had so many med mal suits against the hospital that they were forced to take out a special malpractice policy with larger amounts and used it frequently.  The paper will have more articles on the problem at a later date.

The hospitals in the People's Republic of Massachusetts love Obamacare and it's loopholes.  CNBC reports that they are getting an additional $575 million at the expense of the rest of the nation's hospitals.  The unbiased AHA supported the change that allows hospital to game the system.  All this is due to the Byzantine structure of how hospitals get paid under the leadership of Sebelius and Obamacare.

Salem Hospital in Oregon has a major problem with its medical staff.  The hospital is lying to its staff regarding the hospitalist program.  Salem hospital has 65 employed physicians and 434 total providers.  In the past Salem Hospital refused to let the non-employed OBs provide back-up.  That problem was resolved but they no longer do OB at the hospital, only gynecology.  They then replaced the non employed physician in charge of the non-invasive vascular lab with an employed physician.  Now the hospital has hospitalists.  At first they refused to allow the non-employed physicians to sign out on a part time basis to the hospitalists.  They finally allowed the partial sign out but are now charging the non-employed physicians money to sign out.  They are lying when they tell their physicians that this is required by law.  It is not.  The other hospitals in not only the immediate area but across the country do not charge to sign out.  In fairness, most hospitals depending on the size, do not allow partial sign outs to hospitalists.  This does, as the hospital states, make staffing a problem as they do not know how many hospitalists need to be on duty at any one time.  Salem may soon lose some of its physicians to other more physician friendly hospitals in the area or afar.   

Kaiser Permanente, the combination of Kaiser health plan, hospitals 2nd quarter profits went up 64% according to the San Francisco business Times.  They made $663 million in the quarter versus $404 last year during the same period.  Their operating revenue went from $11 Billion to $11.9 billion (8% increase).  Their investments did a lot better than mine.  They made 300% more this time than last year.  In the first 6 months their total operating revenue went from $22 billion to $23.9 Billion.  They have a year to date operating margin of 4.3%.  None of these numbers included the Permanente for profit physician arm which does not report.     Top

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  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.