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The People's Republic of Massachusetts has done something right. they have asked the two parties in the nursing ratio debate what they want. The two sides decided to go against California and its poor law with absolute requirements and make a flexible law instead. The State Department of Public Health would set the regs. This allows easier changes if any are necessary. Top
To those that believe electronic medical records should be mandated into physician offices, a touch of realty. New York City has allotted $27 million to help 1000 physicians in the city have EMRs by 2008. An additional $13 million will be given by community health centers. That makes a total of $40 million for 1000 physicians. That is $40,000 per physician to change to EMR. Is it worth it? Top
In South Carolina, the Republican governor has made himself unpopular in one county. The state has a CON process but the legislature attempted to circumvent it when they voted to allow a heart program in a hospital in the county. The Governor vetoed the bill stating the state has a process and it should be obeyed and not gone around. The people of the county want the heart center so they don't have to travel far to get cardiac care. I agree with the governor that one should respect the process but that process should be reasonable and CONs are never reasonable. Top
It seem those who take the feds at their word of not prosecuting providers who do not follow HIPAA are "forgetting" to safeguard patient privacy. Only 40% of the hospitals are in full compliance, the same percentage as three years ago. Those that were under 85% compliant rose from 9% to 15% in one year. The main problem seems to be lack of resources in training new staff. Patients are beginning to ask more questions and more in mid size institutions were refusing to sign any release of information forms. Top
In Connecticut the legislators seem to think they know more about the economics of medicine than the medical insurers and maybe they do. They have capped the co-pays for MRIs and CTs at $375 a year for both combined and $75 per test. PETs would be limited to $100 per test and $400 peer year. This would only apply if the patient gets the test done at a facility that is in their health plan. It would not apply if there is a self insured plan. This is a direct slap at the insurers who charge the patient a huge co-pay for cancer needed tests. The legislators continued after the insurers with the passage of a bill that requires the insurer to post the charges they pay on the fifty most common procedures billed by that physician or group.
San Diego County wants to make a trauma like system for cardiac events. The ambulances would only take patients to specified hospitals where they are equipped to handle all cardiac events. This would take away the usual take to the nearest hospital way of doing things. There is no question that trauma Centers save lives and this may do the same. The problem in San Diego is the criteria is going to be so lax that almost all hospitals will be part of the system. The politics of hospital turf continue to cost lives. They should at least meet the national standard of numbers of cases and time from door to catheterization. There is no surgical backup required in the proposed guidelines.
The Maryland Medical Society has asked the state to investigate the monopoly of CareFirst Blue Cross. This came after the unilateral reduction of payments to the physicians of the state. This happened, according to CareFirst, because they were losing some clients with lower fees for ancillary services. In Maryland the insurers pay close to Medicare rates while the national payments are usually about 20% above Medicare. The Maryland physicians showed in their fight over med mal that they have no backbone. They are doing it again now. Top
The US Senate has again taken med mal reform off the table for the rest of the year. Three Republicans voted with all the Democrats to put the issue to rest. Top
CMS has announced that it will survey both specialty and community hospitals about physician investments. It is also redefining the payments for certain procedures for all hospitals. It also wants all specialty hospitals to accept, if necessary, transfers of EMTALA patients. The AHA is not happy that CMS is going after all hospitals and not just physician owned hospitals. They started the war, they need to take the heat. Top
There is trouble in River City. Those that pay the extravagant fees to the unneeded Joint Commission are not happy with them. The AHA and FHA have sent a letter to the Joint reprimanding them for going outside their boundaries of expertise. They forget that the Joint does this routinely and it is this time they are hitting the hospitals. The Joint has proposed that the hospital boards be more collaborative with the administration and the medical staff. The hospitals doesn't mind the boards and administration being simpatico but they object to the people that bring the patients to them to be involved. If the Joint backs down on this due to it not being an accreditating function then they may have to actually do the same for their other forays out of their domain. Of course, for that to happen the hospitals would need to complain and that won't happen. The physicians are mostly ignorant of what happens to the good old boy network.
In an interesting side note, the hospitals that sent their people to become the leaders of the Joint, are not accredited by the Joint. The have gone to other deeming organizations such as the state. The reason is lack of confidence in the Joint. 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.