investigations

This isn't an easy time to be a California-based health plan. In recent times, the plans have been under heavy fire from state regulators, who have imposed large fines and launched ongoing investigations into potential violations of state law. The health plans are also taking a beating from the media and facing a raft of lawsuits. What's more, this is only the beginning. As the state inches toward healthcare reform, insurers should continue to be in the spotlight, according to one analysis. Article

An investigation by the Senate Finance Committee has concluded that drug makers are using their financial clout to improperly influence Continuing Medical Education programs. The investigation also found that the pharmas were promoting drugs for off-label uses, an illegal practice which could land them in hot water with federal regulators. The Senate report said that about one-quarter of CME program providers have violated standards set by the Accreditation Council for Continuing Medical …

A Kaiser transplant surgeon is under investigation due to allegations that he purposely hastened a patient's death in order to harvest his organs for transplants. San Luis Obispo police and the Medical Board of California are examining whether Dr. Hootan Roozrokh gave high doses of a strong painkiller to Ruben Navarro, the patient. Another surgeon--Dr. Arturo Martinez--is also under investigation.

Navarro was in a long-term care facility when he was found unresponsive and taken to …

CMS has let four more heart transplant centers know that they may lose Medicare and Medicaid funding in 30 days due to the low volume of transplants they've done in recent years. The hospitals include Sutter Memorial Hospital, Hartford Hospital (CT), Washington Hospital Center (Washington, DC) and BryanLGH Medical Center East (Lincoln, NE). CMS has been particularly aggressive in threatening low-end programs of late, in part after a recent investigation found that a fifth of 236 heart, …

A Los Angeles hospital's decision to turn over instrument sterilization to insiders may have cost some infants their lives, state officials have ruled. In early December, White Memorial Medical Center was forced to close its busy neonatal ICU after an outbreak of Pseudomonas aeruginosa made five babies sick and lead, most likely, to the deaths of two of those infants. A follow-up investigation by the California Department of Health Services has concluded that staffers charged with …

Officials at Los Angeles-based White Memorial Medical Center plan to reopen its neonatal unit, having concluded an investigation into the source of a recent round of Pseudomonas aeruginosa infections which may have contributed to the deaths of two infants. White had closed its neonatal intensive care unit on December 4th after five babies got sick; it then closed its pediatric intensive …

Nobody is suggesting that you shouldn't take HIPAA complaints seriously. But it might be a relief to know that less than 25 percent of the complaints lodged with HHS were ultimately found eligible for additional investigation--and that none have been targeted for formal action. That's the conclusion drawn by an analysis from Melamedia, an industry research firm, which examined 22,664 complaints received by HHS from April …

Press Release: Less Than 25% of Medical Privacy Complaints Merit HHS Investigation

If you haven't heard of Morgellons disease, you may soon. Fueled by a popular website outlining its symptoms, thousands of patients are reporting that they have the as-yet undocumented illness. Centers for Disease Control and Prevention launched an investigation of the phenomenon after patients flooded the agency with claims of having Morgellons. The CDC plans to conduct its investigation in California, which along with Texas and Florida has served as a focal point for alleged disease. …

The level of charity care not-for-profit hospitals provide is under fire once again. In an in-depth study of 10 charity hospitals, Senate finance committee investigators have found that although charity hospitals offer free care, they often don't inform patients that assistance is available. Some charity hospitals also charge poorer patients more for care while charging well-off patients with coverage less. Additionally, hospital CEOs enjoy expensive perks, which calls into question …