July 1, 2004 Legislation

Massachusetts Folly

Tort Reform

Physicians

JCAHO

 Hospitals

  Health Insurance

Vaccines and Mercury

Medical Staff Independence

Licensure

Massachusetts Folly

The attempt at pork by attaching a rider to the budget to back a politically connected individual and the hospitals from competition in MRIs has failed.  The negotiators struck the amendment out of the budget.  The amendment by Democratic Senator Kujawski would have prohibited physicians from owning MRI units and had no hearing but was a sneak attack.  It would have banned those already in operation, as well as new ones.

Massachusetts is not a large state in area and the legislature has determined that they want all citizens to be within one hour of a hospital that can care for stroke patients expeditiously.  The hospitals do not need neurologists or radiologists on site but may use telemedicine to comply.  The hospital's compliance to be in the program is voluntary.  The state has but in the usual bureaucratic snags that make it harder for hospitals to comply.  It is a good program in general and should work well in the smaller northeastern states.          Top

Tort Reform

After a major company refused to come to Mississippi due to the liability climate general tort reform was enacted.  The new reforms are limits on noneconomic damages, punitive damage and venue shopping.  The trail lawyers are now focusing on the election of state Supreme Court justices who are Democrats and are pro trial lawyers.  

In Washington State the physicians have begun a petition drive to force the legislature to consider the malpractice reform next year.  The need 197,734 signatures by December 31 to achieve their goal.  The Republican Senate approved the measure but the Democratic House never voted on the measure.  If the legislature either defeat or table the bill the measure goes to the vote of the people.  If the legislature amends the bill the voters will get both versions and make the decision as to which one stands.

In Maryland the physicians and trial lawyers have come to a consensus. They have proposed to the Governor that the state would from somewhere get a pool of about $25 million to pay future malpractice premium hikes.  This is favored by the trial lawyers since it doesn't change their fee structure. Where the state will come up with the money should be interesting.  The Governor has called a special session stating the crisis can not wait until next year's session.

The Pennsylvania House has introduced an addition to a bill allowing for the Assembly to limit the recovery for non-economic damages in med-mal cases.         Top

Physicians

In Pennsylvania the Democrats are showing their true lawyer colors.  They have heard that some physicians have refused in some states to treat the trial attorneys or their families, which is their right albeit wrong.  The legislature is thinking about making it illegal to not treat someone based on their political affiliation, litigation history or profession.  If they pass this and not pass malpractice relief, it will be another nail in the coffin of the Quaker State residents as more physicians leave.        Top

JCAHO

On July 1, 2004, the new JCAHO rules regarding time-outs and markings on patients to prevent wrong side surgery go into effect.  The rules state that prior to the start of any surgery there should be a double check that the right patient is in for the correct surgery and that the correct site is being operating upon.  The physician should personally mark with initials or some other marking the correct site of the surgery.        Top

Hospitals

The Pennsylvania House has approved the whistleblower bill.  The vote was 194-0.  There would be a confidential toll free line set up and an investigation taken of all complaints.  The bill would prevent retaliation by the hospitals against those that complain about the quality of care.  The bill now goes to the Senate.  The hospital association is against it since they are the cause of the quality problems and the retaliation. Congratulations to Steve Twedt of the Pittsburgh Post Gazette for writing the articles that finally got the attention of the legislators.   I might add that the Center for Peer Review Justice in New Orleans has honored Mr. Twedt as the 2003 health news writer of the year and erected a web site to honor Steve Twedt.  The site is www.Steve Twedt.com.  I invite you to the site and read his informative articles.   

The government has released its first advisory opinion on a specialty hospital.  This one is a orthopedic, neuro specialty hospital made up of physicians and a national company that at the time of the moratorium had finished grading their site and had their papers into the authorities for continued permission to build.  The government gave the project the thumbs up.  I wonder why the government took so long on this easy case.  The delay certainly raised the price of the building.  

Florida has taken another tact.  The legislature has passed and the Governor has signed a bill banning single specialty hospital regardless of physician investment.  It also took away the CON for hospitals to open new angioplasty and open heart surgical programs.  The law now goes to a court challenge by the hospitals that already have a heart program and want to keep their exclusivity.

King/Drew dodged another bullet.  This time it was the use of taser guns to subdue psychiatric prisoners.  They were warned that if the use of the guns continue they would lose federal funds.  This is the only thing the heads of this hospital fear.  They stopped the use of the guns and now will continue to receive the funds.  The hospital deserves to be shut or be made private.  

A federal grand jury in Montgomery, Alabama, is hearing testimony regarding the rejection of Brookwood Medical Center four year attempt to purchase a MRI.  The request was opposed by HealthSouth and the hearing is about possible intertwining of the political people and Scrushy.  The former governor of the state is already indicted on healthcare fraud regarding Medicaid contracts. 

Leave it to Texas to come up with this scheme.  The legislature has asked several hospitals to be test sites for the use of fingerprinting for Medicaid patients.  The prints would need to match those imbedded into the Medicaid ID card.  The scan of the card is required at the time the patient arrives and again when they leave to prevent fraud.  The physicians are not keen on the idea as it is intrusive.  The state says treatment should not be withheld if the patient forgot the card or if the prints don't match.  If that's the case why use it?          Top

Health Insurance

California State Senator Sheila Kuehl, a poster child for term limits, has continued her foot in mouth disease.  In a state with significant problems attracting and retaining business, she continues to push the notion of California having universal health care paid by business.  The bill has passed the Democratic Senate and has now passed the Democratic Assembly Health Committee.  There is one flaw in the bill.  There is no cost report.  I believe that when that shows up the notion will either go down in flames or there will be a veto. Senator Kuehl has said if the bill his defeated, she would reintroduce it in 2005.   

A story in the Washington Post discusses the hospital billing "errors".  It is imperative that the insurance companies and the insured go over the bills.  The insurance companies don't seem to care and just pay the bill costing all consumers more in premiums.  The consumers that pay all or a part of the bill should ask for and receive an itemized bill.  If they don't understand it, they should ask for help either from the hospital patient advocate or their physician.  Also, the hospital will negotiate with the consumer for a lower cost, especially if the consumer is uninsured.    Top 

Vaccines and Mercury

As all know, the heavy metal mercury is harmful to humans.  Thimerosal is a preservative in vaccines that have been given to pregnant women and children.  It was falsely implicated in autism but is still a hazard to humans.  The California legislature is in the process of banning the use of thimerosal in all vaccines except for trace amounts.  This would limit the amount of mercury to the vulnerable children under three years of age and to the fetus.  There are no medical oppositions to this bill from any organized medical group.      Top 

Medical Staff Independence

The California Hospital Association has agreed with the California Medical Association that medical staffs are independent entities.  This agreement should lead to the state assembly passing the bill (SB1325) which will codify the self governance of medical staffs in California.  This is a direct result of the ill-fated Ventura Community Hospital case and the pressure put on by the medical staff and their allies against the evil CEO and his allies. This bill also give the medical staff the right to be represented by independent counsel at the staffs expense.  The bill further states that the medical staff dues belong to the medical staff and cannot be purloined by the hospital.       Top

Licensure

Connecticut is changing its way of investigating physicians.  The change was brought about by an anesthesiologist who turned off monitors on anesthetized patients and may have been a medication abuser.  The state had nurses doing initial looking at cases and then if something was found the case would be referred to an unpaid physician who almost never found anything wrong with the care.  One of the problems is the small size of state and the problem of most physicians knowing each other.  The other was the unpaid part.  You get what you pay for.  The legislature is now willing to pay about $300 per hour for outside physicians to review cases and testify against the affected physicians.          Top

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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.