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Concord Hospital in New Hampshire has been fined by the state $225,000. They dumped their hazardous waste into the normal trash. It is required to separate hazardous waste and dispose of it in a particular way.
California has fined 13 more hospitals in the state for safety violations and medical errors. Four of the fines occurred in Northern California. One was at Kaiser Oakland for $75,000. this was the second one in that institution. They allowed a patient to die due to alarm fatigue, not following physician orders and a shortage of nurses. The other was for the same amount at Santa Clara Valley Memorial where an untrained nurse in the ED disconnected a ventilator from a tracheostomy and allowed the patient to be transported to a floor. This patient also died. Kaiser in San Francisco for a retained foreign body and Chinese Hospital in San Francisco for incompetence in insertion of a NG tube were also fined $75,000 and $50,000 respectively. The only hospital in the state fined $100,000 which means three or more violations was Southwest Healthcare in Murrieta for incompetency in monitoring fetal heart tones. Also fined were Community regional Hospital in Fresno for killing a patient with an overdose of heparin, Mad River Community Hospital for leaving a towel in a patient's abdomen, Keck Hospital at USC for failure to remove a foreign body (a tip of a coagulator) necessating another surgery, Chapman Medical Center for failure to protect a patient from a sexual assault by a nurse, UCSD for discharging a patient from the ED causing immediate respiratory failure due to negligence, Motion Picture and Television Hospital for failure to remove a foreign body in a knee reconstruction and Kaiser San Diego for leaving in a retained foreign body (a towel). Top
The Washington Post has a story about physicians and hospitals losing medical records at an alarming rate. This is important since before when paper records were accessed only one person was hurt. Now when electronic records are accessed millions may be hurt at one time. They then went on to tell the story of a hospital medical technician at Howard University used her position to obtain and then sell information to others to use for identity theft. The hospital has notified about 34,000 people about the theft of information on a stolen laptop several weeks before the above story. The story went on to talk about the recent loss of laptops with patient information at Utah (800,000) people and TriCARE (5million). It has only been very recently that the government has started to fine for these losses. (See Recent Legal) Top
According to the AMA, more physicians are being investigated by the state boards of medicine due to greater powers being granted to them by the state legislatures. It gave an example of Texas cracking down on pill mills by allowing the board to utilize prescription overuse as a method of discipline. The usual idiot who speaks on this subject disagrees. He wants more and yet more and even more physicians disciplined. Fortunately he has no control only a mouth. Some Boards such as Delaware were given the power to immediately suspend a license. When it did two of every three suspended were reinstated. That is an unacceptable error rate. Top
Federal Medicaid authorities are not happy with New Hampshire's Medicaid program. The state has reduced the amount of money it is paying to providers and hospitals. The feds are afraid this may reduce access. The feds are correct. Ten of the 13 hospitals in the state are suing the state due to the cuts. The feds have given the state a 30 day deadline to show the cuts have not reduced access. This will be very hard to do since the hospitals have cut staff since the state is paying less. The feds could withhold the money it gives to the state yearly for Medicaid which would hurt the state but hurt the patients more. What is truly behind the problem is the tax levied on hospitals by the state so they can get matching federal funds. In the past this money has been returned to the hospitals in the payments. This year the money has gone to balance the general budget and not to the hospitals.
As I reported in the last Recent Legislative Update, CMS has revised the COPs. As part of the revision hospitals are required to have physicians on their boards and are prohibited from having a single medical staff if they have a health system. This screws up many hospital entities. They do not want the people who admit to them and take care of the patients to have any say in the running of the hospital. The hospitals have set up single medical staffs so the physicians would be easier to control. Now they will have to undo all that. The AHA, to nobody's surprise, has sent a long letter to CMS pleading with them to revise their terrible COPs. I must agree with the AHA that these changes should not have appeared for the first time in the final rule. There should have been a comment period. The only valid point the hospitals make in their comments about a physician on the board is that the board is elected or community appointed. These arguments can be defeated by stating the medical staff will elect or appoint a physician to be on the board. Being a physician on the board is a double edged sword. The good is that the physician can bring the physician side into the discussions. The bad is that the physician may have to recuse him or her self due to conflicts of interest when a vote comes up. As far as the medical staff issue there is no reason to not have each hospital with a solo medical staff and a MOU for credentialing. The California Courts have already spoken on the inability of one medical staff to rely on the discipline of a practitioner on another staff. Each staff, even in the same system must individually look at the practitioner in their own hospital. Look for a lot more press on these issues in the future.
The GOP is blasting the administration for a contemplated rise in spending of 7.4% after the full Obamacare law is implemented.
CMS has a new four year project. They will pay certain practices in five areas $20 per Medicare patient per month assuming the practice has EHR and coordinates with other practitioners. CMS considers this to be above basic services.
HHS knows how to spend money. They gave $39 million to consumer assistance programs and got $18 million in consumer savings. With that kind of loss one would think they would stop. But not the government. They just gave another $30 million and we will see how much they lose on this.
The government is looking into hospitals purchasing of physician practices. The antitrust division is making sure the buying of doctors are not to get more money for the hospital, which of course is the reason. The hospitals say it is for quality but all knows this is not true.
Maryland has a bill introduced that would fund the return of retired physicians (more than two years) into practice by giving them re-training and paying for credentialing as well as malpractice insurance. The physicians would need to work for two years at a community based, VA or school health center.
New York state has put in a regulation that physicians and pharmacists need to check a database before prescribing or filling prescriptions for certain drugs such as addictive painkillers. Certain drugs will be required to be ordered by electronics and not paper. The state now has a prescription drug database and this new regulation will go into effect in two years.
As a omen of potential things to come in this country, England's NICE has made the decision that denosumab, which is used in this country for bone mets from breast or prostate cancer can no longer be used in England for prostate cancer. The rationale given for the reversal is cost effectiveness. 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.