Health Insurance

I don't care how long one has been in this business you always can learn something new.  In Florida and some other states have enacted in the past the Uniform Accident and Sickness Policy Provision Law.  This law allows health insurers not deny payment and coverage to anyone who is found with alcohol or narcotics in their system when seen in the emergency department or trauma system.  This law is now under attack in Florida and hopefully other states.  This law is a impediment to proper care.  Knowing that the physicians and hospitals will not be paid may influence whether or not to get a toxicology screen and blood alcohol level on any routine basis.  This does not allow any intervention to prevent future alcohol or drug related accidents.        Top

Malpractice

There is a mixed message coming out of Ohio.  The Republican House voted out of committee a tort reform bill to shorten the time of the statute of limitations and to decrease  damages.  However, the bill also would set up a new tax to help the insurance companies pay for non-economic damages.  This tax would be levied on who the Department of Insurance states it should be levied upon.  This is being attacked by consumers as an unfair payment by the people instead of the tortfeaser and his insurer.  This is a part of the bill that will potentially sink the entire bill.

After the above, a compromise bill going to the governor was passed.  This limits non-economic damages to a sliding scale with the upper limit being between $350,000 and $1 million depending on the severity of the injury.  It also limits attorney fees and allows one to pay only the percent they are found at fault.  With a new State Supreme Court justice to be named by a Republican Governor and approved by a Republican Senate, this has an excellent chance of passing legal muster.

In Nevada, the physicians have garnered enough signatures on a petition to fore the legislature to consider new stricter liability laws for that state.  The legislature now must either pass the proposal or reject it within 40 days.  If it is rejected it goes to the voters in 2004.  The new proposal deletes the exception clauses to the prior malpractice bill and limits attorney fees ala California.  

The opponents of the Nevada petition state the new requested requirements will not pass judicial muster.  The opponents state that people won't get a fair trial if the exceptions to the non-economic damage caps are removed.  This, of course, is poppycock and fostered by the trial lawyers who are seeing their golden goose getting simmered.  

In an interesting switch, a Nevada state senator is calling for a rebate of $3.35 million surplus now held by the state Board of Medical Examiners.  The Board wants to give back $1 million.  The Senator wants the money to help subsidize physicians who have a difficult time paying their malpractice premiums.  The Board wants to eliminate the fee for physician supervision of physician assistants and to pay a $200 dividend to those who have paid into the fund.

The Kentucky Legislature is considering a bill to propose a state constitutional amendment to give the legislature the power to enact significant tort reform.  It makes no sense that there needs to be a state constitutional amendment for the legislature to enact pertinent legislation, but whatever works.   Top

JCAHO

The Joint Commission has finally put out its take it or we will not survey you business associate agreement.  This is to cover their butts under the HIPAA regs.  They do not want to sign each covered entity's agreement as is usual for business associates.  The contract, which is fairly neutral, demands the covered entity put into their Notice of Privacy Practices that information may be released for healthcare operations and to get the required authorizations.  If the information is for healthcare operations no accounting for disclosures will be needed.  My question is whether the organization really is part of healthcare operations.

The Joint has also publicized its retort to the Chicago Tribune article lambasting the organization for focusing on minutia and not safety or patient outcomes. The article was especially critical of the Joint's lax requirements in infection control.  In response the Joint has convened in 2003 an infection control panel to oversee their current recommendations and recommend to the Joint any necessary changes.  They also state that they do random 5% unannounced surveys.  I am not sure that is true or they are talking about the mandated 5% state Department of Health surveys that are performed.  They state they do surprise surveys for-cause.  This I know they do but many of these are because of items the routine survey should have picked up, but didn't.        Top