Medicine & Health articles from May 2007

Medicine & Health archives from May 2007

Malpractice suits don't drive doctors away, researchers find: but defensive medicine may cost up to $28 billion per year.(Medical Malpractice)
May 7, 2007... Proponents of legislation limiting the scope of malpractice suits argue that an excess of lawsuits forces doctors away from high-risk procedures, unnecessarily limiting patient access to medical care. But a new analysis of the Pennsylvania...

Mistake-proofing medical care: would anyone notice? Patients struggle to distinguish between unsafe care and poor service.(Errors)
May 7, 2007... Mistakes in the health-care industry can cause injury and even death, but those mistakes occur much less frequently than patients think they do, according to a new study in the Joint Commission Journal on Quality and Patient Safety. While...

Evidence-informed case rates promise a more precise payment method: new payment system mediates the downfalls of FFS and capitation plans.(Reimbursement)
May 7, 2007... Patients from Philadelphia to San Francisco may soon pay for health care using a plan developed by the nonprofit Prometheus Payment under which patients pay a flat rate for the treatment of a given health condition without worrying about the...

Insurers need to watch out for these pitfalls in managing on-site health clinics: employers are looking to insurers to manage these facilities, but should they take responsibility?(Health Plans)
May 7, 2007... While most on-site clinics are run by independent organizations, some employers want insurers to manage on-site health centers, rather than outsourcing the service to a third party. Roughly 22 percent of large employers in the United States...

New bill would cut healthCare costs with e-records.(Industry Notes)
May 7, 2007... The "Medicare for All" bill would help the some 46 million Americans currently without health insurance and at the same time provide incentives to providers for nationwide adoption of e-health records, reports Government Health IT. Sen....

Humana makes a promise to employers to lower insurance costs.(Industry Notes)
May 7, 2007... Humana's new SmartResults program promises to slash health-care costs for employers, or else they get (some of) their money back. SmartResults is a three-year program offered to self-funded U.S. employers with 300 employees or more,...

More doctors can say 'I'm sorry' without legal worries.(Industry Notes)
May 7, 2007... The new wave of "I'm sorry" laws for medical malpractice lawsuits is gaining momentum in even more states. Bills in Rhode Island and eight other states are now up for consideration, the Associated Press recently reported. The bills would...

Workers are happy with their health insurance, survey says.(Industry Notes)
May 7, 2007... Even with rising health care costs, employees are happy with their insurance benefits. In fact, employees consider health insurance to be the most important benefit made available by their employers, according to a survey by the National...

Why med mal plaintiffs may be lucky to get a cash settlement in certain states.(Industry Notes)
May 7, 2007... A startlingly low percentage of medical malpractice claimants actually receive cash in seven states, according to a new U.S. Department of Justice study. But if a med mal claimant takes his case to trial instead of seeking a settlement, the...

Health plans in Florida want electronic prescribing.(Industry Notes)
May 7, 2007... Managed-care organizations in Florida are banding together with PPOs to push for electronic prescribing, the Tampa Bay Business Journal reports. Traditional paper prescriptions often result in error and unneeded extra paperwork, which is...

FDA Revitalization Act passes Senate amidst controversy: bill promises to reduce prescription-drug risks, but researchers remain skeptical.(Legislation)
May 14, 2007... The Food and Drug Administration Revitalization Act passed the Senate on May 9, 2007--not a minute too soon--with pet owners lambasting the FDA for its failure to inspect pet food and the Vioxx recall still fresh in the public memory. But a new...

Picking on the poor: hospitals charge uninsured patients more: self-pay patients pay 3 times more than Medicare-allowable costs.(Hospitals)
May 14, 2007... Only two weeks after the Commonwealth Fund held its fifth-annual "Cover the Uninsured" week, a new study in Health Affairs reveals that hospitals target the uninsured, asking them to pay higher prices than patients represented by health...

76 scientific breakthroughs that could save billions: FDA calls for extensions of generic-drug production.(Prescription Drugs)
May 14, 2007... The Food and Drug Administration has approved a record-breaking number of generic drugs in each of the past three years but has issued a new report that calls for extending that growth even further by creating generic versions of drugs such as...

Providers have until May 2008 to include referring docs' new numbers: but the new drop-dead NPI deadline may be as soon as July.(NPIs)
May 14, 2007... The Centers for Medicare & Medicaid Services announced earlier this month that because providers and other covered entities aren't ready to use National Provider Identifier numbers on their Medicare claims, it was extending the NPI deadline for...

CareFirst and Baltimore unite to improve minority health.(CareFirst BlueCross BlueShield joins Baltimore Medical System)(Brief article)
May 14, 2007... In an effort to improve the health of Baltimore's community, CareFirst BlueCross BlueShield and the Baltimore Medical System have teamed up on an $800,000 initiative that focuses on improving the health care of Baltimore's minority citizens,...

Plus: NC and SC residents can now get child-only health plans.(Health Insurers)
May 14, 2007... Aetna Gives The Uninsured Of NC And SC New Hope For Coverage Effective May 15, North Carolina and South Carolina citizens will be able to purchase the new Aetna Advantage Plans directly through Aetna or through independent agents or...

Texas insurers work for lower medical costs with wellness programs.(Health Insurers)
May 14, 2007... How can health insurers fight the astronomical costs of health care due to chronic conditions like diabetes and high blood pressure? They can try to nip the problem in the bud with wellness programs, industry leaders say. That's what Cigna...

CMS lets physician-ownership cat out of the bag: new ASC rule may cap doctors' payments at office rates.(Specialty Hospitals)
May 14, 2007... Physicians who own or operate a specialty hospital could find themselves specializing in trouble. In the wake of the scandal in which a Texas hospital called 911 for a patient who was having an emergency, the Centers for Medicare &...

Less than 2 months remain for physicians to win 1.5-percent bonus: practices need to educate their staff and perform a test run soon.(Quality Reporting)
May 14, 2007... Time is running out to prepare for the Physician Quality Reporting Initiative. Physician practices that start too long after the July 1 launch date probably won't report enough quality codes to make the 1.5-percent bonus, officials from the...

Physician quality data could lead to comparison shopping.(Industry Notes)
May 14, 2007... The quality data physicians provide to the Centers for Medicare & Medicaid Services for the Physician Quality Reporting Initiative could soon end up in the hands of beneficiaries. Medicare patients could soon use PQRI data to...

Medicare Payment Advisory Commission.(In Other News ...)
May 14, 2007... * Only about 2,200 physicians have joined the Competitive Acquisition Project for Part B drugs, according to testimony at the April meeting of the Medicare Payment Advisory Commission. That number represents a huge increase from the 300 doctors...

Some carriers weren't applying Medicare's revised policy for bariatic surgery properly, according to CMS Transmittal 1233.(In Other News ...)
May 14, 2007... Some carriers weren't applying Medicare's revised policy for bariatric surgery properly, according to CMS Transmittal 1233. The transmittal clarifies that Medicare won't cover vertical-banded gastroplasty, sleeve gastrectomy or open adjustable...

The House Energy & Commerce Health Subcommittee held an April 18 hearing on improving Medicare quality and efficiency.(In Other News ...)
May 14, 2007... The House Energy & Commerce Health Subcommittee held an April 18 hearing on improving Medicare quality and efficiency. Acting CMS administrator Leslie Norwalk testified about physician quality reporting and other initiatives to improve payment...

HHS Office of Inspector General.(In Other News ...)
May 14, 2007... * Medicare overspent $718 million for the 47 percent of mental-health services that didn't meet coverage requirements in 2003, according to a report from the HHS Office of Inspector General (OEI-09-04-0220). Problems included poor...

Federal regulators are questioning MA plans' marketing methods; insurers have to make sure their marketing techniques are in compliance now more than ever.(Medicare Advantage)
May 21, 2007... Aggressive marketing tactics are getting some insurers into big trouble. Enrollment in Medicare Advantage plans has continued to climb from last year, and experts predict that enrollment will continue to grow rapidly during this decade,...

Doctors' back taxes could come out of their Medicare pay; one provider calls new bill a 'horrible injustice.'.(Legislation)
May 21, 2007... A doctor's personal finances could have a huge impact on a medical practice's future if one bill passes. Two influential senators have proposed a law that would hold back some of a physician's Medicare payments if the doctor owes back...

Insurers on guard for these litigation nightmares: why insurers are in heavy legal debates with providers.(Health Plans)
May 21, 2007... Some health insurance companies are coming under legal fire for denying coverage, refusing payments, and even racketeering. A landmark case--that's what Ervin A. Gonzalez, lead attorney for a group of Miami-based pathologists, is calling...

'Everything causes cancer,' surveyed Americans say: Bonus: drug spending skyrockets during 8-year period.(Data & Statistics)
May 21, 2007... The first nationwide survey in nearly two decades regarding cancer prevention reveals American's lack of education and feelings of helplessness and confusion. And this confusion is leading many Americans to stop trying to prevent cancer. ...

Change is in the air for physicians billing Medicare: Medicare could soon single out expensive doctors, bundle more services.(Physicians)
May 21, 2007... Drastic moves to slash at the growth of physician spending could be on the way. A recent hearing of the House Ways & Means Health Subcommittee considered some fixes, including: * Putting one physician on the spot for all the care each...

Medicare proposes higher SNF payments; CMS wants to update the market basket's old info.(SNFs)
May 21, 2007... In an April 30 announcement, the Centers for Medicare & Medicaid Services proposed a payment increase to nursing homes of approximately $690 million. This 3.3-percent increase would affect payment rates to nursing facilities that furnish...

U.S. health-care system becomes more transparent and more competitive.(Industry Notes)
May 21, 2007... Health and Human Services secretary Mike Leavitt has made substantial headway in pushing his Value-Driven Health Care Initiative, which aims to make health-care quality and cost information available to consumers, as well as to promote heavier...

Medicaid LTC programs to move elderly out of institutions.(Industry Notes)
May 21, 2007... The Centers for Medicare & Medicaid Services awarded a second round of grants to 13 states and the District of Columbia to further its goal of emphasizing home- and community-based services for the elderly instead of traditional institutional...

Norwalk out, Weems in at CMS.(Leslie Norwalk, Kerry Weems, Centers for Medicare and Medicaid Services )(Brief article)
May 21, 2007... President Bush has nominated HHS official Kerry Weems to be permanent administrator of CMS. Currently Leslie Norwalk is acting administrator, but she declined to be considered for the permanent position, according to press reports. Weems...

Tufts Health Plan expands coverage for weight-loss surgery.(Industry Notes)
May 21, 2007... New England insurer Tufts Health Plan has begun to loosen its grip on weight-loss surgery, amid criticism for the company's earlier restrictive policies. Tufts' original policies on weight-loss surgery required patients to have a body mass...

New survey gives insight into employers' health-care wishes.(Industry Notes)
May 21, 2007... In a 2007 employer survey from United Benefit Advisors, companies of all sizes have voiced their health benefits "wish list" for the future. These wish-list items include: employee decision-support tools (projected out-of-pocket costs for...

Feds crack down on validity of IRF admissions; facilities need to tighten preadmission-screening procedures.(Audits)
May 21, 2007... Medicare inpatient rehabilitation facilities may want to take another look at the patients they're admitting. The HHS Office of Inspector General released on May 1 two reports (of Whitier Rehabilitation Hospital and Catholic Medical Center...