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An Orthopod in Chesterfield, Missouri, wants to put up a facility where post operative patients could spend as much as 72 hours. Needless to say the local hospitals are set against this since they would lose money to the more efficient center. They gave the usual bull about how they are better able to care for patients and they have to abide by all the rules. However, if the hospitals had thought of this first they could have done the same thing but as usual they were complacent and did not think. California has fined 14 hospitals for safety violations. The worst one was Kaiser San Francisco who got a $100,000 fine, the maximum allowed. Two hospitals in Southern California, USC and Motion Picture Hospital were fined for foreign bodies left in patients. The majority of violations were for medication errors. Kaiser gave a patient an insulin pump which the patient could not use and he died. Kaiser South San Francisco left a foreign body in a patient that required two operations to fix. Other hospitals named were St. Mary's where a patient died after a portable heart lung machine became disconnected, St. Francis for a foreign body, Stanford for having an untrained person remove stitches from a trach tube which dislodged and caused death and Menlo Park Hospital for using surgical equipment erroneously causing a patient's bladder to rupture. Top The Medical Board of California is going after the license of Dr. Jeanette Martello, a plastic surgeon. She has broken the law by balance billing patients seen in the ED for their insurance companies not paying the usual and customary charges. The law in California states that any dispute arising in the ED must be settled by the insurer and the physician. Dr. Martello made the error of going after the patients with liens on their houses and other illegal activities. A judge has ordered her to cease her aggressive tactics and the Board is also coming after her. She worked at Huntington Memorial Hospital in Southern California but no longer works there. The physician's attorney says her balance billing was legal since the patients were stable and not an emergency so as a plastic surgeon and not an ED physician she was legally able to balance bill. This has some merit but she will in all probability get hung out to dry. There is a difference of opinion between the self proclaimed overseer of physician discipline and the Texas Medical Board. One thinks the Board does not discipline enough physicians and the other believes it is doing a good job. I have to admit Texas has one of the worst medical boards in the country but it is for over discipline not under. Top The CBO has reduced the estimate of the amount of money that will be spent on Medicare over the next decade. This is due to the continuing recession and the lower prices for all aspects of health. Although the estimate is $169 billion lower over the next decade it is not enough to forestall the demise of Part A by 2024. The CBO also reduced the estimate on government spending on Medicaid due to the Supreme Court ruling that states can opt out of the increased spending for Medicaid. CMS has released Stage 2 meaningful use. One of the main points is the encryption of data which will interfere with communication with patients. This is due to the massive amounts of privacy breeches in the past several years. There have been over 50,000 in the past three years. This means all must do significant risk assessments under the new rules. This is delayed until 2014. If there is no reporting of clinical quality measures by either physicians or hospitals they will be slapped with a financial penalty. CMS has again delayed the dreaded ICD-10 for another year. The new date is October 10, 2014. This will cost significant money for practices and hospitals and major snafus. Please help us from solutions that make medicine practice harder. 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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