January 1, 2018 Recent News





CMS has now decreed that physicians will no longer mandate participation in bundled payment models for hip fracture and cardiac care.  No more delays but actual cancellation.  CMS is going to go the voluntary and not mandated route.  This is much better.

CVS Pharmacy has agreed to purchase Aetna for $69 BILLION.  The pharmacy is going to get more into the medical field by making their 9700 stores into community medical hubs for primary care and basic procedures.  Aetna has 22 million members nationwide that would be funneled into these storefronts.  They want to manage post hospitalization patients by reviewing and managing meds and helping them stay out of the hospital.  This would also help CVS against the looming threat of Amazon getting into the pharmacy business.

Some fringe medical groups are asking the state insurance regulators to go against the administration ruling to allow individuals to purchase non Ocare full benefit products.  Hopefully, the state insurance companies have more sense than the fringe medical groups.

A study by UCLA asking teens how others at school view you regarding gender.  They were given choices of very masculine, very feminine, mostly masculine, mostly feminine, or equally masculine and feminine.  The researchers then arbitrarily said those who were male and in the mostly or very feminine groups and vice versa for females were highly non-conforming and those in the equal group were androgynous.  They then jumped to the conclusion that the 25% in these groups are gender non-conforming and published.  They want financial and emotional help for this group.

Who can we blame?  With the huge spike in overdose and deaths from same every state, city, town and hamlet and anyone else who can muster a filing fee is suing the drug companies for this epidemic.  Are they blameless?  No.  Are they the sole reason?  Also no.  The suits will be in the thousands soon.  These drug companies have tried to stem the tide of narcotics and are regulated by the FDA, who also must share some blame.  Their pills are dispensed by both legitimate and illegitimate physicians who also must share the blame.          Top


The Rhode Island Department of Health has ordered Memorial Hospital to stop admitting patients.  A month ago the hospital closed its ICU and has said it would no longer accept emergency patients.  The hospital contract with their anesthesiologists has also expired.  The nurses union is not happy as they want the hospital to continue to pay the nurses while it is shut down.  Right!

The USA Today reports that the VA routinely and knowingly hires physicians with malpractice or other legal problems.  This is part of an investigation by the paper into the VA's hiding of problem physicians for years after they have left the VA and not reporting them to the NPDB.  Legally the VA may not hire physicians whose licenses have been revoked but they do.  

Samaritan Medical Center in Watertown, NY is losing its only neurosurgeon.  They were supposed to hire a second neurosurgeon but did not and so after spending $1 million on a new department they will have no one.  

Dignity Health and Catholic Health are merging.  Both are faith based hospital systems and the merger makes sense.  However, both are struggling financially and if you are losing money you do not make it up on volume.  

Aurora Health Care and Advocate Health Care are also going to merge.  They are the largest healthcare systems in Wisconsin and Illinois respectfully.  This will be looked at by the feds and state for antitrust concerns.  A bigger concern is what they will do with competing EMR systems.  This is the second try for Advocate which had its last attempt at a merger with Northshore University stopped by the feds.

CMS has penalized 751 hospitals by lowering their payments due to them having patient injuries.  About half of them were also on the list last year.  Many are teaching hospitals who have the most infections since they treat the most immunocompromised patients.       Top


Yet another study has shown the toll that EHR enacts on physicians.  It showed that physicians spend about 30 hours per month after their normal working hours with this problem.  This takes up nights and weekends and leads to major burnout.

DaVita Medical Group ius being purchased by UnitedHealth Optum for the princely total of $4.9 Billion.  This will add about 300 medical clinics. This will also make the shareholders of DaVita very very rich.

A report predicts that by 2030 over 800,000,000 people globally will be displaced from work by AI.  This is especially true in those doing repetitive jobs and accounting.  Medical work however will increase with an aging population.

Medscape has named the worst physicians in 2017.  They are Christopher Duntsch in Dallas sentenced to life for maiming a woman in a spinal operation, David Ming Pon in Jacksonville sentenced to 10 years for fraud by telling patients they needed surgery to repair eye conditions and faked the treatments, Gary Marder of Palm Beach diagnosed skin cancer where there was none, Larry Nassar of Michigan who was sentenced for criminal sexual conduct with the USA gymnastics team, Aria Sabit of Detroit sentenced to 20 years for fake and unnecessary surgery, John Couch of Alabama sentenced to 20 years for prescribing narcotics with no legitimate reason, Jacques Roy of Rockwell Texas, sentenced to 35 years for a home health scam, Ronald Wheeler a urologist who diagnosed and treated protate cancer without a biopsy, Bernard Greenspan in River Eagle, New Jersey, sentenced to 41 months for accepting bribes, Abdul Haq of Ypsilanti for prescribing narcotics, Roberto Fernandez in Miami sentenced to 97 months for accepting money from kickbacks and Elizabeth Wettlauffer of Ontario, Canada, a former nurse who killed eight people with insulin.

Anthem has decide it will only pay 75% of the usual payment for services rendered at the time of a wellness exam or other procedure.  Originally they were only going to pay 50% but the AMA fought that and a compromise was reached.  This will start on March 1, 2019 in California, Colorado, Connecticut, Indiana, Kentucky, Maine, Missouri, Nevada New Hampshire, New York, Ohio and Wisconsin.  It will take place in Georgia and Virginia after contract renewal.        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.