Healthcare Regulations

Pennsylvania's hospitals are fighting to sideline a bill which would make them report on hospital-acquired infections (HAIs) through a single statewide electronic system. Establishing such a system is one of a group of health reform initiatives Governor Ed Rendell (D) is trying to implement. Rendell has said that HAIs generated $3.5 billion in charges last year. According to the state's Health Care Cost Containment Council, 19,000 patients suffered from HAIs in 2005, or about 1 percent of …

Troubled by a recent case in which a woman died awaiting treatment in its emergency department, at least one Los Angeles County supervisor is pressing Martin Luther King Jr.-Harbor Hospital to train its staff better. Supervisor Yvonne Burke wants to see the hospital, which treats many indigent patients, require customer service training for key employees. Officials are responding to the recent death of Edith Isabel Rodriguez, a 43-year-old woman who died in the emergency department lobby …

As anyone reading FierceHealthcare knows, diabetes drug Avandia came under heavy fire this week when a New England Journal of Medicine study suggested that it significantly raised the risk of heart failure. Now the expanding controversy has reached the FDA's doorstep. Consumer advocacy group Public Citizen has released an internal FDA memo from 2002 citing 25 Avandia-related heart failure cases, contending that the FDA's Center for Drug Evaluation and Research should …

More or less by default, many hospitals have left their charity care policies to be determined by financial managers. However, with state and federal regulators taking a hard look at whether hospitals are earning their tax-exempt status, this approach won't cut it anymore, says attorney T.J. Sullivan, a partner with Drinkler Biddle & Reath. Sullivan, who spoke at the VHA Inc's national conference in Denver this week, noted that federal legislators are challenging the basis for many hospitals' tax-exempt status.

What's more, a number of states--notably Illinois--are taking an aggressive stance on the tax-exemption issue. To address this problem, everyone involved in a hospital's management has to take part in setting community benefit policies, she says. "It has to be elevated to a board level, and all of your senior executives have to be involved," she said. "It can't just be the finance people."

These execs can take a number of steps to make sure their tax-exemption remains intact, she said. These include making sure the value of your community benefits at least matches whatever profits you show, assessing charity care value at cost to avoid claims of price-related inflation and touting the benefits you provide in the media to avoid perceptions that you aren't doing enough. She also recommended that hospitals team up with local advocacy organizations, which could become friends rather than critics if you demonstrate that you're really making a community impact. Meanwhile, hospitals should brace themselves for the installation of a new IRS commissioner, which could change federal income tax exemption policy for hospitals in unpredictable ways, she warned.

To learn about this issue:
- check out how the Michigan Hospital Association pitched its members' community contributions

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UnitedHealthCare has settled a series of Nebraska charges by paying the largest fine ever imposed by the state's insurance regulators. UHC agreed to pay the Nebraska Department of Insurance $650,000 to settle a barrage of complaints, largely related to its claims handling process. This follows a previous settlement in 2005, in which United paid a total of $62,500 to settle another series of complaints. Regulators had said that UHC had violated 18 Nebraska laws more than 800 times between …

A new Connecticut law which will make health plans define "medical necessity" in policies is headed to the state's governor for signature. In reality, the bill isn't much of a ground-breaker--insurers typically offer standard medical necessity in policies--but it comes as part of a more aggressive longer-term effort to make insurers defend their medical necessity decisions. Under the original bill, if a member appealed a rejection, the insurer would have had to demonstrate why a treatment …

Hoping to fend off potential sanctions and additional regulations, health plans have unveiled a program designed to eliminate questionable Medicare enrollment marketing practices. The plans are responding to charges that independent sales reps, employed only during peak enrollment periods and often loosely trained, were not following the rules set forth by federal authorities. Seniors have complained that these reps show up without invitation and lie about plan details to force an …

An FDA panel has recommended that the agency set prescribing limits for two popular anemia drugs, after concluding that these drugs raise safety concerns. The panel targeted Amgen's Epogen and Aranesp, along with Johnson & Johnson's Procrit (licensed from Amgen). These drugs are prescribed to more than 1 million people in the U.S. each year. Collectively, the drugs sold about $10 billion last year, with Epogen and Aranesp accounting for a staggering 47 percent of Amgen's revenue. The …

A bill is progressing through the North Carolina legislature that would force the state's public hospitals to disclose pay and benefits for their executives. The bill has drawn protests from Carolinas HealthCare, which operates 19 hospitals in the state. The health system says that while in theory it doesn't object to disclosing its top execs' compensation, it regards these numbers as part of an employee's private personnel file. The hospital chain also argues that disclosing such numbers …

A new survey has drawn the buzz-worth conclusion that only six medical schools in the U.S. aren't influenced by pharmaceutical companies. The study, by the American Medical Student Association (AMSA), looked at medical school policies regarding drug makers, including whether they allowed drug reps on campus and whether they allowed the pharmas to offer gifts to students and doctors. Only six medical schools banned both practices, including Stanford University, the University of …