February 15, 2020 Recent News




I am in awe of the media churning up the public about Coronovirus.  They say it is the scourge of the earth.  What they are not saying is that this year alone the regular flu has infected 19 million, caused almost 200,000 hospitalizations and killed 11.  To date the C Virus has killed 11, all but one in China.

In a scathing piece the NYT blasts the country's major chain pharmacies.  They show how unsafe the major chains may be due to the overworking of the pharmacists and lack of oversight by the pharmaceutical boards.  In fact they say that some boards even have members of the pharmacies on them, a real conflict of interest.  The pharmacies have metrics that the pharmacists and the technicians must meet in order to get bonuses or even to stay employed.  These create havoc and time crunches as well as a danger to the patients.  Pharmacists must contact a certain number of physicians to get 90 day supplies of meds even if this is contradicted by good medical practice.  In some cases they do this without the patient's authorization.  State boards do not require error reporting and there is no such thing as investigation as to why the error happened.  When thee are errors the pharmacies want to know if the person harmed is apt to go to the media and if so they will expedite the settlement and NDA.   

Here's an interesting idea, send your patients to Mexico for their expensive meds.  That is what Utah is doing.  People in the Public Employees Health Program who use meds on a specific list are sent to San Diego, cross to Tijuana and pick up a personal supply of the med and fly home.  This saves the state a bunch of money for this small group of employees.  

Several insurance companies are doing a pilot program to allow physicians to immediately see if the meds they order or the procedures planned are ones that require pre-authorization and submit information and receive responses via new portals.

Patients are starting to change the hospital financial and treatment forms to limit their liability if billed for out of network services.  This may give the patients some leverage in court fights over bills.  This is best used in emergencies and not with elective surgery.  

Aetna is automatically downcoding office visit EM codes.  They do this when they audit a practice and find the apparent overcodes are 50% or higher.  physicians may then file appeals with the loss of time and money.

Ochsner Health is beginning a program to pay for the medical education of 30 physicians if they will commit to work for the system for at least five years.  This is for primary care and psychiatry.      

UnitedHealthcare is dropping physicians in New Jersey from their Medicaid program to refer these patients to physicians owned by Optum, an arm of UnitedHealthcare.  UnitedHealth says this is  a cost control strategy and is keeping the physicians to see non-Medical patients.  An arbitration procedure is in the offing.

The first flu vaccine specially made for us old people has been approved by the FDA.  it is called Fluad Quadravalent.      Top


Kaiser Permanente has done it again.  Their net income continues to soar.  In 2019 its operating income went up 6% and added about over 81,000 new members.  Its expenses also went up somewhat but its net income tripled from $2.8 Billion to $7.4 Billion.  

Detroit Medical Center went the other way.  They lost their appeal to the ACGME and will lose its neurosurgery residency on July 1.  This means 12 residents will be looking for new positions.  This is partially due to its problems with Wayne State University.

Dr. Mark Tsuchiyose stood up in a public meeting regarding the fate of Daly City, California Seton Medical Center and blasted the owner Dr. Patrick Soon-Shion.  He accused Soon of not fulfilling his promises to the hospital and community.  The hospital may soon by acquired by another company and potentially sold for the land.    

Mayo Clinic screwed up royally.  They mailed 364 letters of acceptance for their medical school.  They have places for 46.  They sent withdrawals to all those who received the originals acceptance letters.  

Hahnemann University hospital has finally agreed to do the right thing.  The hospital teamed up with its insurance carrier and between them are paying for the tail coverage for their residents who were removed from the program due to the closure of the hospital.          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.