November 15, 2002 Legislation

Fines

Malpractice

Pharmacy

Insurance Power

Universal Medical Care

Physician Medicare Payments

Trauma

Licensure

Physicians v Hospitals

Fines

Connecticut has fined New Haven's Hospital of St. Raphael $250,000.  The fine was for patient safety where an oxygen mask was hooked up to nitrous oxide in error.  This is the highest fine ever for a hospital in this state. The hospital has settled one of three claims against it for the error.  The error caused the death of several patients.  

Cigna has agreed to pay a fine of $200,000 to New Jersey for delayed payments.  They also agreed to fix the system problems that they claim caused the delayed payments.  This encompassed 84,000 claims and lack of payment of the mandatory 10% late fee.  Of course, when you think about the number of claims and the use of the money by Cigna, it would come to many multiples of the fine.  

The Central Montgomery Medical Center in Lansdale, Pennsylvania has been put on probation and fined $26,800 by the State.  The hospital did not follow protocol and tell the state when a patient in restraints died.  Also a anesthetized person fell off an operating room table and a donor bone graft was dropped on the floor during surgery. Where was the JCAHO and their wonderful accreditation process.  Looking at whether the eyes were dotted in a bylaws piece of paper.  They were given accreditation with requirements for improvement in 2001(score 89) and full accreditation on July 29, 2002 (score 94).  They were faulted for initial assessment procedures, family education, strategic planning department leadership and availability of patient specific assessment.  All very important in the outcomes of the patients.    Top

Malpractice

The Nevada physicians are continuing to push for greater tort reform. The want the newly enacted $350,000 limit on pain and suffering to not have loopholes.  It now is per plaintiff and per claim.  This encourages multiple plaintiffs and multiple claims.  The also want subrogation, where the patient has insurance deducted from the award, the voiding of the joint and severable clause, graduated attorney fee payments and periodic payments.  The physicians have already collected enough signatures to get it placed on the 2004 ballot if the legislature turns down the measure.        Top

Pharmacy

Listen up People's Republic of Massachusetts.  The state of Washington beat you to the punch by limiting how much pharmacists could be paid for Medicaid prescriptions.  About 20 smaller independent pharmacies in the state have stopped accepting Medicaid prescriptions which will reduce their volume by 1/3 but not necessarily reduced the bottom line.  There are now less employees in those pharmacies and less red tape for the pharmacies. The Medicaid recipients are now going 50 miles for their prescriptions and combining this with other shopping.  Top

Insurance Power

The Maryland Supreme Court upheld the power of the insurance commissioner to order medical insurers to pay for medically needed procedures.  A law passed in 1998 gave the people the power to appeal when they believed they were being denied medically necessary care.  The commissioner sends the case to an independent panel and then can force the insurer to pay for the care.          Top

Universal Medical Care

The Oregon electorate saw the fallacy of the Universal Health Care initiative on the ballot and defeated it by a 80-20 vote. It was to be a cradle to grave free care to every Oregon resident costing many billions of dollars.  This would be paid by a large tax on business that would be passed on to consumers and a huge increase in state income tax (Oregon has no state sales tax).         Top 

Physician Medicare Payments

CMS has realized their was a mistake in its methodology in determining the amount of money physicians will be paid in 2003.  They have therefore put a hold on the 4.4% drop in payments until the error can be corrected.  No date has been set.        Top

Trauma

Maryland legislators are trying to get more money for the non-university trauma centers.  The state has two university centers and three non university centers.  Now most of the money for trauma goes to the two university ones.  The legislators may have found a loophole to pay those on-call physicians who are in house for 24 hours but not those who must come in within a certain time frame.  If the hospitals can not afford the surgeons they will have to close their centers.        Top

Licensure

The State of Oklahoma Nursing Board has sought the license of Charles Hill, anesthetist.  He has been accused of unprofessional behavior due to the frequent re-use of needles in a pain clinic with potential for Hepatitis C exposure.  To date 52 patients in the clinic have been determined to be Hepatitis C positive.          Top

Physicians v Hospitals

Ohio legislators have introduced a bill to not allow physicians in the state to open competitive hospitals.  The Hospital Assn is behind the bill to increase the state's rule that physicians can not refer to hospitals where they have a financial interest.  It is legal under the Federal Stark rules.  Since the Ohio Medical Association is against the bill, it will be a test to lobbying strength.      Top

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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.