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The Identity Resource Center reports that in the US there has been an increase of 26% in the number data breaches to date this year. To no one's surprise healthcare leads the way with 36% of the breaches. This means over 14 million records were put at risk this year alone. To put that into perspective government/military had only 56 data breaches but that represents 12 million people. Business has exposed 2.5 million people and banking only 26,000.
The NYT reports in a story that first comes the emergency then comes the surprise out of network bill. A recent NEJM article said that just over 20% of visiting the ED will get an out of network bill due to the ED physician not being a part of their plan. These surprise bills come more often in some parts of the country rather than others. The article came only from one insurer. The physicians do not join the insurer panels due to the offered very low rates.
The feds are not paying the insurers anything this year on their risk corridor provisions. This is due to already having shortfalls for the prior year. The plans are suing the feds for millions due. The Obama administration is hoping they lose so the insurers will be paid out of other funds and therefore stay with the program. However, the first case as gone in favor of the administration in the lower court.
Those who run "sanctuary cities" may be in trouble. President elect Trump has threatened to cut funding from the feds to these areas. The worst of the offenders is San Francisco. They now get $478 million from the feds directly and another $550 million via the state. How much of this is in the form of grants over which he has direct control is unknown. Top
Lake Health of Concord, Ohio, has reported a $30 million loss due to problems converting IT. This is due to delayed billing and collections that they may not be able to recoup.
Pascagoula, Mississippi, hospital Singing River Health closed the office of an employed neurologist who had been there for about 30 years. The hospital fired the staff of Dr. Terry Millette and he is no longer on the staff. This was abrupt and without warning to the patients. The hospital said it was a patient care issue regarding how he diagnosed and treated MS patients. A county supervisor is asking for the CEOs resignation over this matter. The medical staff leaders have voiced approval for the office closing.
Florida's Lehigh Regional Hospital ha one, yes one, physician servicing their ICU. The physician stopped taking emergency room calls. All patients requiring ICU will be sent elsewhere. The hospital said it is seeking two physicians that will take the position. It should take a long time to credential but with the need they will probably short circuit it and get someone not qualified. The CEO is interviewing. I hope the medical staff credentialing also is involved.
Saint Agnes Medical Center in Fresno, California, has found the perfect loophole or unethical stance one could find. The state ordered them to pay $2.1 million to a charity to maintain its charitable status as an non-profit. The paid $1.6 million to their own Saint Agnes Home Health and Hospice plus an additional $125,000 to three other real charities. Top
The people of Louisiana are about to get screwed by their governor. He is proposing to help with the state's budget shortfall to delay Medicaid payments to physicians. He has proposed to shift the payments to next year. That means more physicians will not see the patients. He is also cutting aid to education and his own department. This is the second year this deferral has occurred. Why should the physicians lose the time value of money due to the state's mismanagement?
Many have seen the television ad with Alan Alda and other TV ED physicians telling patients to get annual checkups. The ad was placed by Cigna. When I saw it I thought it was well done and very funny. However, I am not the American College of Emergency Physicians who obviously do not have a great sense of humor. They put out another video with real ER physicians telling about the horrors of insurance companies and their interference with medicine. 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.