The federal government has been spending $20 billion annually to reimburse these hospitals—most in poor urban and rural areas—for treating more than their share of the uninsured, including illegal immigrants. The healthcare law will eventually cut that money in half, based on the premise that fewer people will lack insurance after the law takes effect. But the estimated 11 million people now living illegally in the United States are not covered by the healthcare law. Its sponsors, seeking to sidestep the contentious debate over immigration, excluded them from the law's benefits.
Into the maelstrom of debate over whether Medicaid should cover more people comes a new study by Harvard researchers who found that when states expanded their Medicaid programs and gave more poor people health insurance, fewer people died. The study, published online Wednesday in The New England Journal of Medicine, comes as states are deciding whether to expand Medicaid by 2014 under the Affordable Care Act, the Obama administration’s healthcare law. The Supreme Court ruling on the law last month effectively gave states the option of accepting or rejecting an expansion of Medicaid that had been expected to add 17 million people to the program’s rolls.
Exeter Hospital is under investigation by the federal Centers for Medicare and Medicaid Services because of deficiencies in its infection control procedures. These deficiencies are related to the hospital's current hepatitis C outbreak, but the federal agency is not disclosing the specific deficiencies. According to Centers for Medicare and Medicaid Services spokeswoman Helen Mulligan, the New Hampshire State Survey Agency conducted a substantial allegation survey on June 6 in response to a complaint against the hospital. According to a July 23 letter the state Department of Health and Human Services sent to Exeter Hospital, the hospital has 45 days to come into compliance with the Medicare Conditions of Participation or face termination of their provider agreement on Oct. 11.
A group of Dallas surgeons fired one of their billing experts because she refused to aid them in a "massive and pervasive health-care fraud scheme," according to a lawsuit filed this morning. Cortez Mills is suing Texas Vascular Associates and its nine doctors, saying they pressured her to commit "criminally illegal acts" against patients, insurance companies and Medicare, the federal insurance program for seniors. Among the alleged practices: double billing, "upcoding", "balance billing", and "drive-by billing" (charging patients when a doctor merely watches another doctor work).
In the month of June alone, safety monitors observed 756 instances in which Parkland Memorial Hospital staff violated infection-control standards by failing to use proper hand hygiene. The monitors also found that "critical vacancies" remain in the troubled psychiatric department, including permanent physicians to oversee mental-health patients seeking emergency care. And they reported that the hospital still lags behind schedule in efforts to ensure safe supervision of resident doctor trainees. Those are among several troubling signs in a June report card for the Dallas public hospital as it enters a critical stretch of its regulatory probation.
Dr. David Blumenthal, one of the nation's leading health information technology experts, will leave Partners HealthCare at the end of this year to head The Commonwealth Fund based in New York City. Blumenthal is a professor at Harvard Medical School and chief health information and innovation officer at Partners. He was US National Coordinator for Health Information Technology under President Obama from 2009 to 2011, with the charge of building a nationwide health information system. Previously, he worked as a primary care doctor and health policy expert at Massachusetts General Hospital and other Partners institutions for more than 30 years. He returned to Partners just seven months ago.