February 1, 2017 Recent News






The CBO states that spending on Ocare if it remains unchecked culd reach almost $2TRILLION over the next decade.  This includes the subsides and Medicaid expansion.

Yet another article has surfaced regarding the problems with patients getting bills from out of network providers that they did not choose.  The hospital based physicians may not belong to an insurance plan that the patient belongs to and so bill for their usual and standard fees which is much more than standard low Medicare fees.  Per usual there was no solutions proposed.

The feds have warned 21 Medicare Advantage plans to either fix their provider directories or stop enrolling patients.  Of course this is after the open enrollment period.  Patients have until February 14 to un-enroll and join traditional Medicare or they are stuck.

A judge has said that Aetna, which grew by 5% last year, put a nail in its case to merge with Humana by pulling out of exchanges for financial reasons.  The judge believed the pull out was due to litigation posturing and not finances.  

A study has surfaced that shows prostate cancer treatments started to decrease just before the USPSTF made their uninformed decision regarding PSA.  Since that time fewer treatments for cancer have been done.  The study makes no mention of whether or not higher grade cancer is found later on nor if the survival statistics or quality of life have changed.        Top


Soon after being criticized by Wayne State, the CEO of Detroit Medical Center was replaced.  Tenet which controls the hospitals  wanted to streamline operations and they believe this will help.  The new CEO is Tony Tedeschi, MD.

Summa continues to be in the news for not good reasons.  Within weeks after getting a no confidence vote for disrespecting staff opinion, the CEO has ousted another independent physician organization.  This time it is the hospital's critical care specialists.  The physicians have been replaced by nurse practitioners.  Should Physicians want to practice in a hospital that does not respect them and cares more for money than patient care?  I would think not.

In more idiocy, Lawrence+Memorial Hospital in Connecticut has spent $30 million just to get an electronic medical system.  If you add all the money taken out of the health system for this electronic stuff it may add up to some significant scratch.  This hospital also had 50,000 hours of staff training.

There is a report that Beth Israel Deaconess Hospital and The Lahey Clinic are pursuing a merger.  This will put them competitive with Partners Healthcare.        Top


A report has found that about 30% of HIPAA breaches are caused by third parties vendors.  This shows the importance of good contracts with the business associates.          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.