August 15, 2017 Recent News





 Ocare is still the law of the land but there are fewer insurers taking part and those that do are charging much more.  California, the state with the highest amount of insureds, has lost one of its top enrollers Anthem.  they are pulling back from 16 of 19 pricing regions and are leaving over 150,000 to find new insurance.  The Golden State also is seeing an average of 12.5% increase in the monthly consumer payments.   This is one of the smallest increases in the country with some states seeing rises in premiums of over 30%.    

Aetna has had its profits jump 52% and raised forecasts for the remainder of the year.  This occurred after it dropped out of most Ocare insurance.  It is still in several states and expects to continue to lose money in those states.     

Anthem is now going after Indiana and will start to not pay for ED care which is not an emergency.  This will put the patients at financial risk.  Starting October 1, the new program will swing into action.  They will start by treating 300 codes as non-emergencies.  If indeed the person has an emergency they may appeal.  The ED physicians think this may be illegal as against the Ocare rules.  Time will tell.

Kaiser Permanente has announced an increase in total revenue by over 14% in the second quarter over 2016.  Operating income is up 57% over last year.  They had a net income of $1 Billion.  

The head of the VA has removed three people from the Manchester, New Hampshire VA.  This is after receiving a dozen whistleblower alleging substandard care.  To date he has removed the Manchester VA hospital director, chief of staff and most recently the head of patient and nursing services.  

Shulkin is also attempting to fire again Brian Hawkins from the DC Va.  He was relieved of his duties and transferred.  Soon after he was fired but the Merit Board has issued a sty for Hawkins to build a defense.  Shulkin plans on abandoning the prior firing and now firing Hawkins with fresh evidence under a new law signed by President Trump in June.  

Oregon's Health Authority director, Lynne Saxton, resigned under the Governor's order from her post.  She had a tactic which was never implemented detailing how the agency intended to damage the reputation of Portland's FamilyCare Health.  

Connecticut's Access Health is warning that their remaining insurers may still pull out of the state.  They have only two left, Anthem and ConnecticutCare.  They have until September 8 to make a final decision.   

The goons at the California SEIU are at it again.  This time they are threatening to put on the ballot two propositions.  The first one is for staffing ratios in dialysis units and the second is how much these units may charge for their services.  The union also hopes to have the workers come aboard if the workers unionize.  The union has used the threat of ballot measures in the past to get their polices passed. 

England's NHS has now agreed to fund PrEP, the HIV prevention treatment for a three year trial.  This happened only after a law suit in which the court said the NHS had the money to pay for the drug.  NHS originally tried to get the local councils to fund the drug since it is preventative health.  NHS also used the tired scare tactics that if they paid for this they could not pay for cancer victims.   

It seems that England is only responsive to pressure either by the courts as seen above or the public.  After the Charlie Gard fiasco the helath service has said it will pay for a seven month old to fly to Boston for an operation that can not be done in England.  He has a cardiac fibroma.   Top


Charleston West Virginia's Thomas Memorial Hospital is instituting a co-pay policy for non-emergency patients.  If after screening it is determined they do not have a true emergency the financial people will swoop in for a co-pay.   EMTALA would not be a problem in this scenario.  The patients could be seen in the clinic fifteen feet away.  They have non-emergency patients about 30% of the time. 

Erie County Hospital was hit earlier this year with a ransomware attack.  They refused to pay the $30,000 demanded.  The total cost of this intrusion will be about $10 million.  About half is for new computers and software needed along with assistance.  The other half is for staff labor and lower revenues.  They are also spending an additional $400,000 a month to finally upgrade their antiquates systems.  Norton reports that 64% of those reporting ransomware attacks are paying the perps.  Of those only about half are getting their information back.  Healthcare and especially hospitals are vulnerable since they are not willing to spend money to upgrade until it is too late.  

The physicians at Indiana's CHS Lutheran Health Network are continuing the media fight against CHS.  The have an oped blasting CHS buying multiple hospitals only to not be able to fund the debt and need to sell hospitals.  It also blasts the quality of CHS hospitals due to financial considerations.  

Yes.  Broward Health is back again.  This time for Doris Peek, a senior vice president, who resigned while under fire for her handling of a marketing contract was given a $214,000 buy-out providing she does not sue or disparage the system.  What a terrible organization.        

Some people want to do the right thing but they get it wrong.  Wake Forest Baptist sent the belongings of a gunshot victim to her parents three months after she died but they were the blood clothes she wore at the time of the incident.  They apologized.         Top


The University of Kentucky has been rebuked.  They stripped the privileges from Dr. Paul Kearney for being "disruptive".  His fellow physicians elected him for a three year term to the College of Medicine faculty council.  He was also elected after his privilege revocation to the University Senate.  He is also suing the university for his punishment for whistleblowing on their financial practices.  

The University of Vermont has stopped lecturing at medical school starting in 2019.  They are going to "active learning" by problem solving or answer questions in small groups .  This is part of the new STEM teaching.  People are to do the homework prior to class and then discuss the information in groups.

Puerto Rico has entered the slippery slope.  They have lost about 12% of their physicians who have come to the US for better pay and working conditions.  The remaining physicians are under paid and over worked and many of them are continuing to exit the country.  They have very few specialists and they are centered in San Juan.  If things do not improve with more money spend for salaries look for a disaster. reports that physicians are spending about $40,000 per year per full time employed physician for complying with federal regs.  What a waste.  This money and resources could be used for patient care.  

California has increased their payments to physicians for seeing Medicaid patients but they still won't see them.  The money is still very small per visit and the regulations are tremendous.  



 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.