The highest-paid state employee in California last year, a prison surgeon who took home $777,423, has a history of mental illness, was fired once for alleged incompetence and has not been allowed to treat an inmate for six years because medical supervisors don’t trust his clinical skills. Since July 2005, Jeffrey Rohlfing, MD, has mostly been locked out of his job — on paid leave or fired or fighting his termination — at High Desert State Prison in Susanville, state records show. When he has been allowed inside the facility, he has been relegated to reviewing paper medical histories, what prison doctors call “mailroom” duty. Rohlfing’s $235,740 base pay, typical in California’s corrections system, accounted for about a third of his income last year. The rest of the money was back pay for more than two years when he did no work for the state while appealing his termination. A supervisor had determined that Rohlfing provided substandard care for two patients, according to state Personnel Board records.
Blue Cross Blue Shield of Michigan’s small business customers with up to 49 employees who renew insurance policies this fall will see average rate increases of 7.4%, the insurer said Tuesday. The rate hike is the lowest increase in six years for the Blues and less than last fall’s average 13.1% jump. “By introducing new products, improving cost controls through our innovative partnerships with doctors and hospitals to improve quality and efficiency, and driving administrative savings, we were able to effectively lower our rate increases,” John Dunn, vice president of middle and small group sales at Blue Cross, said in a statement. Many small business customers last year faced 15% to 20% rate hikes, said Karl Albrecht, president of Action Benefits in Southfield, which provides support to health insurance agents who work with small businesses.
When Jeffrey Piccirillo, MD, moved to the small college town of Grinnell, IA the Joliet, IL surgeon had been sued multiple times over allegations of malpractice, personal injury and negligence. In 2003, less than a year earlier, he had filed for bankruptcy. Things didn't go much better for Piccirillo in Iowa. Within a few years, he was battling another lawsuit, this time from a knee surgery patient alleging that he failed to properly diagnose a fracture and prevent it from worsening, according to court records. Then the Iowa Board of Medicine charged Piccirillo with “professional incompetency.” Eventually, he signed an agreement with the board that placed his license on indefinite probation and prohibited him from practicing surgery in Iowa. A similar agreement with Illinois followed. Now Piccirillo, 48, has started over again as one of Illinois’ and Iowa’s few “Lyme-literate” doctors — physicians who are willing to treat the dubious diagnosis of chronic Lyme disease.
The emergence of a strain of gonorrhea that can thwart the last antibiotic effective in treating the common sexually transmitted disease was bound to happen, experts say. The new, super-resistant strain is called H041, and so far, only a handful of cases are known in Japan. But don't count on it staying that way. Experience has shown that once a resistant strain of gonorrhea appears, it steadily displaces those that can be killed with antibiotics. It happened in the 1970s and 1980s with penicillin and tetracycline and more recently with a class of drugs called fluoroquinolones, such as Cipro.
New York’s prestigious teaching hospitals could lose more than $1 billion a year as part of President Obama’s plan to reduce the deficit, which the hospitals say will lead to drastic reductions in services. The cuts would reduce the Medicare subsidy for training doctors and for providing intensive medical services like trauma centers and burn units and sophisticated equipment that the teaching hospitals offer. The plan would apply to teaching hospitals nationwide but would have its most profound impact in cities like New York and Boston, where medical schools and their affiliated hospitals have a significant presence. The subsidy, which dates to the 1960s, has helped make New York State the world capital of medical education, training about 16,000 doctors a year, or 14.5% of the nation’s total, more than any other state.
Although the Centers for Medicare & Medicaid Services made changes to the billing of concurrent therapy and higher levels of therapy at skilled nursing facilities that were supposed to be budget neutral, Medicare payment rates increased by $2.1 billion, or 16%, between the last six months of 2010 to the first half of 2011, said a report from the Department of Human Services’ Office of the Inspector General. In a letter to CMS, the OIG noted that CMS made changes to how SNFs billed for concurrent therapy, believing that those billing changes would cause a decrease in billing for higher therapy. However, for the first half of 2011, SNFs billed for higher levels of therapy and billed less for concurrent levels of therapy, which caused an overall increase in payments. Other CMS billing changes, such as for extensive services and for high levels of assistance with activities of daily living, resulted in decreased payments.