Chanting "Kill the bill," thousands of conservatives rallied at the Capitol on Thursday against the Democrats' healthcare overhaul plan, labeling it a government takeover of the nation's medical system. The protest attracted many of the so-called Tea Party demonstrators angry with increased spending and an expanded government role under the Obama administration. Their signs ranged from the harsh, "Waterboard Congress," to an echo of the rallying cry at August town halls with lawmakers, "Vote no to government-run health care." One protester carried a placard reading, "Bury Obamacare with Kennedy," a reference to Sen. Edward Kennedy, D-Mass., who died of brain cancer this past summer.
Dallas County health officials spent Thursday figuring out how to get people with insurance more 2009 H1N1 flu vaccine, even as they continued to vaccinate the uninsured. Almost 3,100 people received vaccine during the second day of the county's first large-scale walk-in vaccination clinic, bringing the two-day total to about 6,700. But plans announced by Texas officials on Wednesday may send thousands of doses a week to the county health department. And large clinics like the one this week that basically closed the department to anything but swine flu vaccinations just aren't practical very often, county health department director Zachary Thompson said.
The Federal Trade Commission is investigating some of CVS Caremark Corp.'s business practices, the company said Thursday. The drugstore chain and pharmacy benefits manager did not disclose the details of the "nonpublic investigation," but said it has not violated any antitrust laws. CVS suggested the FTC inquiry is connected to complaints made by the Change to Win coalition of labor unions. Change to Win has said CVS Caremark's size and buying power is bad for consumers, and accused CVS of a stocking expired products and violating patients' privacy, among other issues.
The Centers for Medicare & Medicaid Services has announced final changes to policies and payment rates for services to be furnished during 2010 by over 1 million physicians and nonphysician practitioners who are paid under the Medicare Physician Fee Schedule. The 2010 Medicare Physician Fee Schedule will recalculate estimated utilization rates for imaging equipment—raising it from 50% to 90%—which will lead to significant reimbursement cuts for cardiologists, radiologists, and other specialists. The money CMS saves will be used to boost payments to primary care doctors by 5%-8%.
Employment discrimination lawsuits have doubled in the past 10 years, due largely to provisions of the 1991 Civil Rights Act that give juries a say in financial settlements. Among the headlines: Publix supermarkets got slapped with an $82.5 million class-action sex discrimination settlement and Coca Cola paid nearly $192.5 million in 2000 to settle a class action.
We could cite many examples, but the point is that juries are ready and eager to shower aggrieved litigious former employees with millions of dollars at your business' expense.
"Plaintiffs don't win a huge percentage of lawsuits, but that percentage goes up a lot if there is a jury trial," says Michael D. Malfitano, attorney at Florida-based Constangy, Brooks & Smith, LLP (CBS). "After 1991, when jury trials came into play, the percentage of plaintiffs' wins increased and the dollar amounts increased."
"Most jurors are working people with family members who may have had problems with employers at some point," Malfitano says. "So there is a natural empathy with the working person who is the plaintiff."
The good news is that because of their relatively small size and close working relationships, physician practices are less likely than larger healthcare entities, such as hospitals and nursing homes, to find themselves in an employment suit, he says.
So what can you do to reduce your potential liability? Malfitano and his colleague, CBS attorney Cherie L. Silberman, have identified three pre-employment mistakes, errors committed during the recruiting and hiring process:
1. Failure to conduct an adequate background check on potential employees. Did you conduct a criminal background check, contact the references, ask about previous convictions, but not arrests, and check his or her driver's license?
2. Inconsistent recruiting and hiring practices. Are you thorough in the hiring process with some employees but not others? "When employers don't apply policies consistently, it looks to a juror like they may be discriminating," Silberman says.
3. Inappropriate interview questions and comments. This is a real minefield. Although you want to be thorough in your hiring process, you also have to be careful about what questions you ask. For example, you can ask about criminal convictions, but not arrests. You cannot ask about the status of military discharge, and questions about education must be thoroughly screened. Avoid questions related to religious or social issues, as well as those related to physical or mental health.
"Where employers get in trouble is where it may not seem so harmful, say in casual chatter," Silberman says. "[For example], if someone says they're moving into town and you ask if it's so they can be closer to their husband. The intent doesn't matter."
This article was adapted from one that originally appeared in the November 2009 issue of The Doctor's Office, a HealthLeaders Media publication.
House leaders will hold a rare Saturday vote on the expansion of the U.S. healthcare system. Democrats are still locking down support among a handful of holdouts, with the biggest bloc dissatisfied with the measure's handling of abortion. In other news, a bill that Republicans expect to offer as an alternative to the Democratic package received its assessment from congressional budget analysts, who concluded that the proposal would barely dent the ranks of the uninsured.