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The ACGME has finally stated that residents in the medical programs can not work more than 80 hours per week. They also must get at least 10 hours off between on-call and working a shift. This takes effect July 1, 2003. The residents state that their is an enforcement loophole. The rules state that the resident may extend the 24 hour shift limit by six hours. This is still better than the 120 hours a week that many work now. Although this is a voluntary organization almost all residency programs belong to it. Top In Maryland the funds for trauma are short. The larger centers will go to a lower status and the lower ones out of business. The physicians are getting less than half of their billings and are dropping out of the system. In Lee County, Florida, where there has been a problem with the funding, the county commissioners may let the $1.5 million dollar loan die on the vine. This means the only trauma center for many miles will go out of business. This means people will die needlessly. Top The Nevada physicians had passed an initiative petition to give stronger tort reform to the state. The legislature has ignored the petition. The physicians have a bill with the same wording as the petition ready to go and will be introduced in the Senate Judiciary Committee as Senate Bill 97. The Georgia Legislature is hearing a bill on the $250,000 tort reform issue. The State Bar has testified that in their opinion this would unfairly limit access to the civil justice system. Poppycock!! All this means is that for emotional damages the limit would be capped. For all other damages such as economic there would be no cap. The legislature is also considering a bill to limit punitive damages on product liability to the same $250,000. The State Bar is opposed to this as well. They are opposed in Georgia like in remainder of the United States to anything that hurts their pocketbook. They do not care about the people. Top Washington state is considering a bill that would end the requirement for insurance companies to cover every category of provider. The insurance companies are paying out more to chiropractors and massage therapists than pediatricians. The alternative care providers killed the goose that laid the golden egg. Top The Accreditation Council for Continuing Medical Education is considering banning all speakers that have a true conflict of interest. An example of this is a person that receives money to speak on a product that they are receiving money from. This could shut down all pharmaceutical speakers who now disclose their connection with the commercial firm. This is a bad rule and deserves more thought. Top Many states are looking at their medical boards to determine if they are strict enough on physicians. This is the flip side by the attorneys to counter the medical malpractice tort reforms that are being adopted across the country. Most states that are looking at this are adding medical error data and public disclosures of disciplinary actions. Texas is looking at competency exams but it is unclear how one gives a competency exam to a psychiatrist on general medicine or urology. The push is by a group used as a front for the Texas Trial attorneys. In Virginia the physicians can be disciplined for simple and not just gross negligence and can be issued non-discoverable letters of reprimand. Top Maryland has fined CareFirst Health Plan $400,000 for violating various state laws and regulations. CareFirst agreed and signed a consent decree. This include wrongly denying claims and failing to process a majority of HMO claims within the required 30 days. This manipulation is the basis for the class action law suit now before Judge Moreno in Miami. Top HHS IG Rehnquist has recommended that hospitals outpatient and ASC cases be paid the same. The hospitals are not trilled with this and will lobby Congress hard on the issue. This change would same over one billion dollars a year. It would also be the death knell for the argument between hospitals and specialty clinics. The hospital are saying they should get more than ASCs since they are open 24/7. They may be open 24/7 but their outpatient surgical department isn't. Top The JCAHO has proposed an entire revision of the Medical Staff Section of the Standards. This will potentially take away all the protections the physicians have regarding the bylaws. Also the OIG has reached an agreement with Keystone Health Plan on a model credentialing policy which may be applicable for all plans and hospitals. It will put more burden on institutions to make sure their practitioners are truly who they say they are and are credentialed correctly. As an aside, the leaders of the Credentialing and Peer Review Section of the American Health Lawyers, a group top heavy in hospital and system attorneys, have attempted to talk to JCAHO regarding new Medical staff standards but have been rebuffed by its members. The JCAHO has reopened for a short time the comment section. Now those attorneys who believe in physicians rights will be given a chance to respond. 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.
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