lawmakers

SPOTLIGHT: Broader health coverage could reduce disparities, lawmakers say

Fri, 13 Jun 2008 06:59:52 -0400

SPOTLIGHT... Broader health coverage could reduce disparities, lawmakers say
While it wouldn't eliminate health disparities entirely, proposals to expand health insurance to all U.S. residents could reduce those disparities, according to a group of lawmakers and healthcare experts who spoke this week at a House Ways and Means Health Subcommittee hearing. Right now, they noted, women and racial and ethnic minorities often have less access to care, receive lower quality care, and have more negative outcomes than other groups, something that is influenced, though not entirely created, by a lack of health insurance. Article

CA lawmakers push for tougher plastic surgery rules

Tue, 27 May 2008 06:59:54 -0400

Driven in part by the death of the mother of hip-hop star Kanye West, who was getting liposuction and breast implant surgery, California physicians and lawmakers are pushing to tighten up regulation of the cosmetic surgery industry in the state. Right now, such surgeries are increasingly being done in outpatient clinics, where doctors don't face rigorous reviews. However, as with doctors in other states (such as Florida), California legislators would like to see tougher oversight of doctors performing such procedures.

Legislators are being forced to take such steps despite their already being rules on the books designed to prevent safety problems during outpatient cosmetic surgery. More than 10 years ago, the state passed a law requiring cosmetic surgery centers to be recognized by the state, have resuscitation equipment and have procedures to transfer patients to a hospital. However, critics say the law hasn't been effective.

To learn more about this initiative:
- read this Los Angeles Times piece

LA bill offers legal protections for MD care during emergencies

Tue, 20 May 2008 06:59:55 -0400

The Louisiana state legislature is close to passing a package of bills that would protect medical professionals from lawsuits arising from care delivered during declared emergencies. Two of the bills are inspired and backed by Dr. Anna Pou, the New Orleans doctor who was accused of euthanizing patients after Hurricane Katrina. (Pou still faces civil suits related to the deaths in question.) The bills would provide protection against lawsuits for paid medical professionals who aren't covered under the existing Good Samaritan Act, which offers immunity from civil lawsuits for providers who voluntarily offer care to an emergency victim in need. This immunity would protect medical personnel from suits relating to simple negligence, but would still leave room for suits related to gross negligence. The protection would apply only to individual workers, not only to owners of medical facilities.

To learn more about the bills in question:
- read this item from The Times-Picayune

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Serious nursing home quality problems still exist

Fri, 16 May 2008 06:59:57 -0400

According to new Congressional testimony by officials from the HHS inspector general's office, care at many nursing homes is actually dangerous to patients, despite ongoing efforts by CMS to identify and expose such problems. Lewis Morris, chief counsel to HHS' inspector general, told the House Energy and Commerce oversight and investigations subcommittee that at least one in five nursing homes delivers care that is directly harmful to patients.

At the same hearing, the Government Accountability Office released a report suggesting that state nursing home inspectors routinely miss life-threatening problems such as whether homes ensure proper nutrition and hydration.

Meanwhile, at the same hearing, Connecticut Attorney General Richard Blumenthal described how difficult it was to force nursing home owners into compliance even when their quality problems were known. His particular battle with nursing home operator Haven Healthcare demonstrated to him that with the complex ownership structures employed by such homes' operating companies, it could be almost impossible to win this kind of battle, Blumenthal said.

Despite having failed to address nursing home issues for more than 20 years, Congress is expected to respond to these and other reports with new rules sometime this year.

To learn more about the nursing home investigation:
- read this Modern Healthcare article (reg. req.)

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Study: Nursing homes benefit from culture changes

Mon, 12 May 2008 06:59:54 -0400

Nursing homes that change their culture to make care more resident-directed, foster staff autonomy and make the facility function more like a home than hospital do better on several measures of success, according to a new study from the Commonwealth Fund. The study, which looked at a representative sample of 1,435 nursing homes between February and June 2007, classed about 31 percent of nursing homes as "culture-change adopters," 25 percent as "culture-change strivers," and the remaining 43 percent as traditional homes.

Of the "adopters" group, 58 percent allowed residents to set their own schedules, compared with 22 percent of traditional homes. Also, 59 percent of homes that had adopted a changed culture included direct-care workers and even residents on the senior management teams, while only 24 percent of traditional nursing homes did so. Researchers found that 78 percent of homes implementing seven or more culture-change initiatives improved their competitive advantage in the market. Such homes also improved operational costs, staff retention and occupancy rates, the Fund said.

To learn more about the study:
- read this Modern Healthcare piece (reg. req.)

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IA bill exempts some hospitals from CON process

Mon, 05 May 2008 06:59:55 -0400

Iowa lawmakers have approved a bill that would strike down the state's certificate of need rules, at least as they apply to the state's 82 small, rural hospitals. The bill, which certainly makes the state's hospitals happy, includes language similar to that in a proposal issued by the Iowa Hospital Association. State legislators who shepherded the bill through Iowa's legislature have argued that the CON process is unduly burdensome for small hospitals. The bill is still subject to a veto from the state's governor, and it's not clear whether he'll sign it or not. At present, there's still some controversy over the nature of the bill's passage, which apparently got through without much public attention. However, a growing number of states have already limited or removed CON rules, so there is precedent for this measure.

To learn more about the Iowa CON bill:
- read this Associated Press item

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College group urges ban on drug, devicemaker freebies

Mon, 28 Apr 2008 06:59:58 -0400

The association representing U.S. medical colleges has come out with a proposed ban on pharma and device-maker gifts on medical college campuses. The group, the Association of American Medical Colleges, would like to prevent drug and medical device companies from handing out free food, gifts, travel and ghost-writing services on these campuses, not only to doctors, but also to staff members and students. To protect patients who need free samples, it's recommending that medical schools set up centralized systems for accepting the samples.

The group also thinks med schools should discourage their faculty from participating in industry-funded speaker's bureaus, under which doctors get paid to promote the benefits of key drugs and devices. While any of the nation's 129 medical colleges would be free to ignore the proposal, most are likely to follow its lead, observers say.

To learn more about the proposal:
- read this article in The New York Times

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RI reviews med equipment CON process

Thu, 24 Apr 2008 06:59:55 -0400

Apparently concerned that something is lacking in how the process works, a group of Rhode Island lawmakers have set up a commission to study whether state health officials are managing the CON process correctly. Right now, state law dictates that hospitals need to obtain CONs before buying high-cost medical equipment--in an effort, of course, to cut down on medical cost inflation. Apparently, legislators aren't satisfied that current legislation is getting the job done. The commission study, which will be presented in May 2009, is part of a larger effort in which the state is taking a fresh look at its entire CON approach. In so doing, Rhode Island actually is taking a less aggressive approach than several other states, some of which are dropping CON rules entirely or thinking seriously about doing so.

To learn more about the commission:
- read this Modern Healthcare article (reg. req.)

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NJ officials say more hospital closures are OK

Thu, 10 Apr 2008 06:59:56 -0400

Things look bad for many New Jersey hospitals. Four have closed in the last 18 months, four others are planning to close, five filed for bankruptcy protection and about half of the others are losing money. Despite the carnage in the industry, state health officials say that things are working out the way they should. State Health Commissioner Heather Howard told lawmakers that the industry can't strengthen financially until some hospitals close, a stance that seems based on similar premises as policies in neighboring New York state.

This is part of a larger shift in New Jersey politics, under which leaders now are pursuing a "sink or swim" strategy in which sick hospitals are allowed to die. Gov. Jon Corzine's proposed 14 percent cut in state hospital aid should only continue the process, completely eliminating state aid for 26 hospitals and less for 37, says the New Jersey Hospital Association.

To learn more about New Jersey's plans for its hospitals:
- read this Philadelphia Inquirer piece

Related Articles:
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OK offers nursing home ratings

Tue, 08 Apr 2008 06:59:55 -0400

The state of Oklahoma has launched a website rating nursing homes on 10 quality factors. Ratings include factors such as nursing turnover and retention, the home's compliance with state surveys, nursing staff per patient day, Medicare utilization and resident/family satisfaction. Consumers who are familiar with a given home can provide rankings ranging from one to five stars.

In an unusual twist, meanwhile, the higher the home scores on the consumer survey, the greater their incentive payment through Medicaid, ranging from 1 to 5 percent per patient. If nothing else, this certainly is a different approach than CMS's "shame them till they change" effort in which it publishes the names of the worst-quality homes it finds.

To learn more about the state program:
- read this article in The Oklahoman

Related Articles:
CMS to publish names of worst-quality nursing homes. Report
U.S. lawmakers want new nursing home regulations. Report
Congress to investigate investor-owned nursing homes. Report
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Trend: Nursing home investors cut costs to the bone. Report
Senator urges creation of nursing home watch list. Report