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The JCAHO is finally getting it right, at least on one aspect. They will begin to do unannounced inspections starting in 2006. These will still be tri-annual and so the hospitals will still know about when it will be. As all know, hospitals gear up for inspections and then become lax again. The new inspections will also be more computerized and self-reporting. If the JCAHO wanted to really look at quality, the inspections should be truly random and unannounced. However, this would not make for happy campers in the hospitals and they might flock to other organizations that could accredit them, like the AOA or the State Health Department. This would cost the JCAHO money and this is about what they are, above all else. Top
This will be the topic of my quarterly article to be published on June 1.
Congress has a bill introduced by the physician's friend Pete Stark. The bill would extend the Stark regulations to specialty hospitals, unless the investment opportunity would need to be open to all comers. This came after hearings at the FTC. The AHA backed the bill and the AMA was against it. The decision had been made prior to the hearings. The AHA gives much more money to Stark than the AMA does. The same bill has been introduced by AHA money chasers in five states. The proposed federal law would not effect those hospitals opened prior to July 2001. It does not address those that have opened in the past two years. They would need to be divested of physician ownership.
Washington state has just introduced a bill to require specialty hospitals to have a 24/7 ED. It passed the Senate and now sits in the House Committee. The hospitals talk via the sides of their mouth when they state they are the ones giving charity care. In fact, physicians also give charity care not as much in absolute dollars but probably greater as a percentage of gross. Top
The Smallpox vaccination program has dwindled to nothing after the deaths of three or four people from an MI. There have also been heart inflammations post shot. To shore up the program the Congress has passed a bill to pay $50,000 a year to those sustaining disability post vaccination and a death benefit of $262,000. This is hardly enough for a program that was ill conceived in the first place. Top
A bill has been introduced in the Congress to allow medical need as a legal defense to federal prosecution of marijuana cases. This would help the states that have given the OK for that defense in state courts and bring all into parity. Top
Pennsylvania, where the legislature is controlled by the trial lawyers, has rejected a cap on malpractice non-economic claims. A task force set up by the Governor only recommended further research on the matter. The Governor is now threatening the physicians who have a job stoppage set for next month. This is fine if he wants to be a one term governor.
The Florida Senate has passed a bill very different from the House. The Senate bill has no caps but limits awards for emergency services. The Senate also requires a significant roll back in malpractice premiums by the insurance companies. This bill now needs to be reconciled with the House version. Top
California has warned HMOs not to terminate drug coverage for a class when one becomes available over the counter. This is a direct slap at the HMOs that pulled all the anti allergy meds off their formulary after Claritin went non-prescription. It does allow for tiering ( paying more for medications) and other managed cost containment methods. 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.