healthcare report
Blue Cross slapped with$200,000 fine
California regulators have fined Blue Cross $200,000 for retroactively canceling a woman's coverage after the policyholder required high-cost medical care. Blue Cross canceled the woman's coverage because she hadn't disclosed a corrective surgery she'd had two decades earlier, but a spokesperson for the California Department of Managed Health Care points out that she's had a clean …
... Read more...Study: Residents work too many hours
A study published in the Journal of the American Medical Association underscores the danger of overworking medical students. The study found that first year residents routinely work more than the maximum duty-hours recommended by the Accreditation Council for Graduate Medical Education (ACGME). The council requires that physicians-in-training work no more than 80 hours a week averaged over the course of four weeks, have one day off a week and not work more than 24 hours straight. …
... Read more...NC to pay back $151.5 to Medicaid
The state of North Carolina and 51 hospitals there will repay $151.5 million in Medicaid overpayments to the federal government over the next four years. Between 1997 and 2003, the hospitals received $1.2 billion as part of the Medicaid disproportionate-share program, $400 million of which was called into question when regulators investigate the program. Though there is no evidence of criminal wrongdoing or civil fraud, prosecutors say North Carolina used "an overly aggressive plan to …
... Read more...NY hospital cardiac program halted
New York State Department of Health has sent a cease-and-desist order to the pediatric cardiac unit of Stony Brook University Hospital. The order is the result of three patient deaths since May: A "one-year-old who died from a medication overdose, a seven-year-old who died after routine adenoid surgery and a premature 23-week baby with a heart defect who died after not receiving an operation," according to Modern Healthcare. Regulators say that Stony Brook lacks a full-time …
... Read more...Specialty hospitals spring up after ban ends
On Tuesday, the federal moratorium on government payments for doctor-owned, for-profit hospitals expired. Already, plans are underway in Indiana and Texas fro two new physician-owned hospitals. Cincinnati-based Prexus Health Partners is planning a 30-bed surgical hospital in New Albany, IN, and in Texas University Hospital Systems will be opening a 72-bed acute-care hospital in September.
Critics of specialty hospitals--including the AHA--say that doctor-owned hospitals have an …
... Read more...BCBS rolls out data mining program
Twenty Blue Cross Blue Shield plans around the nation will participate in Blue Health Intelligence, a massive data-mining project that will make information available on a range of health trends and measures. The object of the database is to enable employers, consumers and providers learn what type of healthcare works best based on information gathered from 79 million people. Initially, the HIPAA-compliant data will be available only to employers, but consumers and providers will …
... Read more...GAO looks at DRG changes, exec compensation
The Government Accountability Office issued two hospital-related reports Friday. The first praises proposed changes in Medicare reimbursement for hospitals. The second says large not-for-profit hospital systems are doing better at overseeing executive compensation. CMS is considering adjusting inpatient DRG payments using national average cost-to-charge ratios, rather than basing them strictly on cost data as is done for outpatient payments, a strategy that the GAO says makes sense. CMS's …
... Read more...Two bills aim at healthcare reform
Universal healthcare seems to be back in vogue, with two Congressmen proposing new healthcare bills designed to increase access to affordable care. Rep. Pete Stark (D-CA) is pitching a program which will be based on the Medicare model. Documents provided by the congressman's office say that the plan will be financed by "using the administrative efficiencies within Medicare and building on the existing coverage people receive through their jobs today." AmeriCare, as it is called, …
... Read more...Less ambulance diversion means more profit
Adding additional hospital beds to the ICU improves emergency care, reduces patient risks and increases hospital revenue. This is according to a study published in the Annals of Emergency Medicine, in which researchers spent two years monitoring the Oregon Health and Science University in Portland. The study reports that every hour of ambulance diversion time cost the hospital a hefty $1,100 dollars. But when more beds were added, the hospital earned an additional $175,000 monthly …
... Read more...Medicare to offer CDHPs in 2007
In yet another sign that consumer-driven health plans (CDHPs) are here to stay, CMS has announced that the plans will be available through Medicare in 2007. The CDHPs will be used in conjunction with medical savings accounts (MSAs) that are similar to health savings accounts (HSAs) but allow beneficiaries more flexibility. The program is designed to protect Medicare recipients from catastrophic costs and lower premiums. Medicare will even cover the amount below the deductible by …
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