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The US Senate could not defeat the cloture by the Democrats and get the needed 60 votes. The motion was to limit damage in lawsuits against OBs. The vote was 48-45 mostly along party lines. The Republicans plan on continuing to bring up the liability issue for political and legislative reasons. They will add ED physicians to the bill. They want to show the Democrats up in their districts. This would be very important if Edwards is on the Democratic ticket, as he is a trial attorney.
Missouri has picked up the pace. The new malpractice tort reform bill that is sailing through the House has removed all the issues that caused a veto last year. It does reduce non-economic damages from $557,000 to $400,000 and eliminates inflationary increases. The trial attorneys decry the venue protections in the bill. The Kansas City area alone has lost 45 physicians in the past year, not all do completely to the malpractice premiums.
The New Jersey Senate passed a bill to make mandatory reporting of all hospital and provider adverse events. This would shield all information generated by a hospital's internal committees.
The Mississippi Governor has urged the state legislature to pass a bill that caps the economic damages for all business at $250,000, limit punitive damages and eliminate joint and several liability.
Maryland is considering "rate compression" as outlined by the trial lawyers. What this means is do nothing with tort reform but charge the high payors less and the low payors more. This will also do nothing to help the other entities that pay malpractice premiums, such as hospitals.
Utah's Senate has passed a bill allowing those who wish to arbitrate medical malpractice claims to present their case to a three member panel. The panel would be one chosen by the patient, one by the provider and one jointly selected. This is in response to Intermountain Health Care's policy of forcing all elective patients to sign mandatory arbitration agreements or not be seen. Since that proclamation, IHC has rescinded its policy. Top
The Illinois Department of Revenue revoked the tax exempt status of Provena Covenant Medical Center in Urbana, Illinois. The rationale is that the hospital was no longer considered a charitable institution. The Catholic affiliated, non-profit hospital was found to have used law suits and other nasty things to collect money from the patients that used their hospital. The hospital had been warned that if they sued to collect, they would not be considered to be a charitable institution. They did it anyway and are now having to pay about $1 million in property tax now and more going forward. The hospital stated that in 2003 they gave $2.9 million in charitable care. They did not state what percentage of the collections this amounted too. They state they lost $700,000 on operations, but we all about hospital creative accounting.
On the heels of this decision the HHS and the OIG stated the nation's hospitals would not be prosecuted for giving discounts to uninsured patients, reducing the Medicare cost-sharing for those patients who could not afford to pay full freight. The OIG specifically stated the Anti-Kickback bill and the Social Security Act delineating what the costs are do not prohibit the reductions. These have been used as the excuse for hospitals going after non-insured or indigent patient with law suits or liens for either their full share or the full costs when all know the true costs are unknown to the hospitals and the charges have no relation to cost. Physicians have been reducing the amount that patients pay commiserate with the patient's ability to pay for many years. The difference is that most physicians have a heart, if the circumstances are made available to them. The ruling sort of shocks the community based belief that hospitals are foisting off on the public and media to bolster their claims that specialty hospitals are taking away their ability to continue to serve the public good. Top
Florida physicians, the people that gave us Stark and anti-Kickback, is at it again. Now it's office based surgery. In view of eight deaths, the state rightly put a 90 day moratorium on office based combination abdominoplasty and liposuctions. The new rules require a 14 day window between the two procedures. In the past, the office based surgery abuse led to accrediting of offices and mandatory reporting of adverse incidents as well as credentialing of surgeons. Top
Maryland wants Congress to lessen the HIPAA requirements for its physicians. They want their own standards to remain in force in the state. The Democrat sponsoring the bill doesn't understand. He states that it limits communication between providers and makes it more difficult to administer care. None of that is true. HIPAA allows providers to talk about treatment without patient consent. If Maryland wants their laws to be the ones in place, then they need to make them more stringent in the field of patient privacy than the federal law. In fact, the real problem with HIPAA is not the law but the consultants that are hired who recommend expensive computer systems and non-reasonable rules.
CMS has instructed its Medicare carriers and fiscal intermediaries to slow payment of electronic claims that are not HIPAA compliant. The claims are to be paid in 27 and not 14 days beginning July 1. This is the first step toward not paying non-compliant claims at all. Top
The FDA has issued a regulation to require all hospital pharmacies use the bar system to prevent medication errors. The system would allow the patient's wristband to be scanned ad that would tell what meds the patient needs and when. The meds are then scanned and if there is no match a computer signals an alarm. The first thing to occur would be the manufacturers to label all meds with bar codes to allow hospitals to adopt the system. Top
The Florida Nurses Assn. has asked the Florida legislature to beat back what they see is physician backed legislation. They are against a bill that would require a visit to the dermatologist to be seen by the physician and not a lower echelon person on the first visit. They also don't like a bill that creates an anesthesia assistant who would be licensed even though they have less training than nurse anesthetists. As part of the same gripe they want the requirement that a physician be present when a nurse anesthetist administers anesthesia to be eliminated. The nurses also want advanced registered nurse practitioners be given the ability to prescribe controlled substances under delegation as well as their current ability to prescribe regular meds. Top
Michigan is proposing to increase taxes on hospitals in order to increase the amount of federal money that comes into the state as matching funds for Medicaid patients. All hospitals would be taxed but those who treat the most Medicaid patients would receive the lion's share of the money when it comes in. Those hospitals who do not treat many Medicaid patients would probably lose money on the deal. This boondoggle has also been done in Illinois and many other states as well. Top
The People's Republic of Massachusetts legislative house has passed a new law that allows "victims" of malpractice and their attorneys to attend hearings of the medical licensure board to make a victim impact statement. This has already passed the state senate. The House version states that the state will not pay the victim's attorney bill and the Senate version states it will. The bill won approval of the medical society after the attorney role was limited and the state would pay the fees. Apparently the attorneys and the "victims" will be allowed to stay for the whole session but under the House bill the people may be excused for some closed sessions. In Kentucky almost all decisions are reached in settlements since the entire proceedings are open to the press and the entire public. 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.