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The trial lawyers won another. In Illinois, where the trial lawyer controlled Democratic party holds sway, the Legislature turned down malpractice reform. All agreed that the problem in the state had reached horrific proportions with counties not having OBs or neurosurgeons. Those have either fled to other states or just stopped doing those procedures. The original bill had some reforms but no caps on non-economic damages but that was defeated by a huge vote when all Democrats went toward their masters, the Trial Lawyers. The physicians of the state need activist leadership in order to force the issue. This includes the dropping of OB by the majority of physicians and the resignations of neurosurgeons from the hospital staffs along with the closures of trauma units in the state for lack of physicians.
In Oklahoma the Governor has signed a medical tort reform bill. There will be a $300,000 cap on non-economic damages, the venue for the suit is now restricted, the definition of an expert witness and allows full payment by one defendant if the defendant is at least 51% liable for the damage. The law also allows for physicians to express regret and condolences without that being used against them in court.
Mississippi has also passed tort reform and sent the bill to the Governor. The Governor will sign the bill. On September 1, 2004, there will be a $1 million cap on non-economic damages in non-med mal torts and a $500,000 in med mal cases. There are no exceptions nor any cost of living increases in the bill. In a separate bill the lawmakers capped the amount physicians may charge for medical records and at deposition.
The Wyoming legislature has voted to go into special session in order to tackle the medical malpractice problems o the state. The state constitution specifically prohibits limiting lawsuit awards. I wonder how that got in there?
The New Jersey governor has signed a law that creates a three year $78 million fund to provide malpractice insurance help for physicians and hospitals as well as to start a student loan forgiveness program. The law reduces from 18 to 13 the statute of limitations for birth injuries. There is nothing in the bill that will decrease premiums.
In the Democratic controlled state of the People's Republic of Massachusetts, their wonderful leaders have solved the malpractice crisis in the state. They will cut the interest on the awards to the plaintiffs in malpractice actions from 12% to 2%. The trial lawyers are fighting this usurious interest. Top
New York has fined Albany Medical Center $18,000, the largest fine allowed, for cheating in their transplant program. The hospital misrepresented the conditions of their patients so they could move up the transplant list. The two physicians, one a transplant surgeon and the other a transplant cardiologist, were suspended. The cardiologist ordered unnecessary cardiac caths according to the state. The transplant program has been closed and can not be re-opened until it hires a consultant to review the reporting and other oversight matters. The hospital was also chastised for its lack of oversight.
In California, the Democratic legislature is bowing to the nurses labor union. The House has passed a bill that will not allow hospitals to close unless they give a one year notice to employees and the public. If the closing hospital is private it would need to be sold to a hospital district if one was created via a ballot measure. The Senate is expected to reduce the period to six months. It currently is 90 days. The hospital industry asks how the hospital can stay open if they have no nurses, physicians, patients or money? A reasonable question to all but the union.
In Richmond, California, Doctors Hospital was leased to Tenet many years ago. The hospital now needs significant seismic upgrades and is a district hospital taking care of the poor in the community. Doctors was one of the hospitals Tenet let go and the hospital then reverted back to the district which couldn't make a go of it many years ago. Tenet will retain all money up to the July 30 deadline and the new owners take over August 1 with no funds. A special election was held for a parcel tax to help keep the ED open. It needed 66 2/3 vote and received 84%, a resounding success
The University of Tennessee in Memphis has been told the ACGME is considering removing it's accreditation in anesthesiology. This is due to its faculty being involved in too few research projects and they did not meet some pain control guidelines. The University hopes to have the situation remedied in two years.
The bastion of good care that just won JCAHO accreditation, King/Drew Hospital in Los Angeles, not only have had their residency programs decimated, their administrators lying, their neonatology unit scheduled for closure but now may lose it's federal funding because it uses Tasers on psychiatric patients. This is tied directly to the Board of Supervisors allowing the use of the weapons. The hospital calls the county police to subdue patients with the Taser. The JCAHO, who last month accredited the institution was surprised at the use of Tasers, since they are a form of restrain so abhorrent to the organization. This again shows the political motivation of the Joint.
Speaking of the Joint, they have reverted to their old tricks. Starting this year there were to be no more grades, just pass-fail. This must have made it too easy for the hospitals. The Joint will revert to almost the same shoddy system it had ten or more years ago and will give symbols for how the hospital did on its phony inspection. All need to strive for the gold star like you did in elementary school. Top
California has qualified for the November ballot a proposition that would provide a new state bond of $3 Billion to fund stem cell research in the state, a true cost of $6 Billion over the life of the loans. This is in direct contradistinction to the Federal ban on the stem cell research. The state is broke and the hope of the lawmakers that the possible new patents would pay off the debt is wishful thinking. There is no guarantee that there will be new patents. There would be new industry and the taxes from that industry might be helpful. The repayment would be put off for five years so the industry could start up and get taxes and royalties to self pay the loan. The initiative would specifically prohibit cloning.
On the federal level 58 bipartisan Senators have written a petition to President Bush to loosen up the federal control on stem cell research.
Other ballot propositions are the repeal of SB2, the play or pay law that would require businesses to either provide health insurance or pay into a fund that would be used to purchase insurance for the workers, an anti-business law, a $750 million bond to pay for construction expansion and equipment for children's hospital, a 1% increase in personal income tax on those with annual incomes over $1 million to fund mental health services, and a 3% surcharge on telephone bills to pay for emergency department services. It is doubtful that most of the measures that require payment by the people would pass. Top
Anti-kickback and Credentialing
The following is the verbatim paragraph relating to economic credentialing in the new 20 page supplemental report by the OIG on hospital actions;
Certain medical staff credentialing practices may implicate the anti-kickback stature. For example, conditioning privileges on a particular number of referrals or requiring the performance of a particular number procedures beyond volumes necessary to ensure clinical proficiency, potentially raise substantial risks under the statute. On the other hand, a credentialing policy that categorically refused privileges to physicians with significant conflict of interest would not appear to implicate the statute in most situations. Hospitals are advised to examine their credentialing practices to ensure that they do not afoul of the anti-kickback statute. The OIG has solicited comments about, and is considering, whether further guidance in this area is appropriate.
This is a direct slap at the AMA position and goes with the AHA position. Top
The Pennsylvania House health and Human Services Committee unanimously forwarded on to the House a bill to protect all healthcare workers from retaliation for whistleblowing. It establishes a confidential toll free line to report hospitals. The reports will be investigated by the Department of Health. Top
The legislature is this cradle of democracy has passed a law to favor a politically connected family in control of the state's MRI business. The law would prohibit doctors from referring patients to diagnostic facilities where they own an interest. It passed without any discussion, hearings or debate. This would allow Shield Medical that now owns 24 imaging centers to continue with the business. The bill was supported by the community hospitals and the radiologist association who also directly benefit from the bill. The bill which was a amendment to the budget is now at a Senate House budget negotiation session. Top
There are about 5800 hospitals in the country and most are JCAHO accredited for deeming purposes. However the Joint's worst enemy is itself. Hospitals are leaving the organization for others, most notably the Healthcare Facilities Accreditation Program (HFAP). About 1000 are now accredited by HFAP. Others have chosen the state health agency, the AOA, or ISO 9002. In a recent survey 98% of the hospitals were JCAHO approved and 78% were looking at alternatives. The hospitals are finally catching on, albeit slowly, that they don't need to spend their precious resources conforming to made up standards that far exceed what is required by the government. Top
Michigan is considering banning physician's bad handwriting. This thought came after a legislator got prednisone instead of Pravachol. The penalty for not having Palmer penmanship may be a fine of $1000 and license sanctions. 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.