New York, California, and 13 other states are accusing biotech giant Amgen Inc. of offering kickbacks to medical providers to boost sales across the country of its anemia drug Aranesp. In a suit filed in federal court in Massachusetts, the states accuse Amgen sales representatives of encouraging doctors and other healthcare providers to bill insurers for Aranesp that the practitioners received free from the company, according to a statement issued by New York Attorney General Andrew Cuomo. The practice allegedly cost taxpayer-funded Medicaid programs and other insurers millions of dollars in overpayments.
Among some libertarians and conservatives, the most troubling aspect of the pending healthcare reform bills is the prospect of a federal requirement that Americans buy insurance. Defenders of limited federal power foresee a constitutional challenge to the mandate to buy insurance based on the claim that Congress' power to regulate commerce does not extend to forcing citizens to buy a commercial product, the Los Angeles Times reports.
Massachusetts' 2006 healthcare overhaul law provided the model for the national legislation now under construction in Congress. Now state officials are working to make sure the federal proposals do not undermine the state's system, and that Massachusetts is not penalized financially for being first, the Boston Globe reports. Under some versions of the federal legislation, Massachusetts could face pressure to reduce the subsidies it now provides to low- and middle-income residents who get insurance under the state system, a study commissioned by the Blue Cross Blue Shield of Massachusetts Foundation found.
Future doctors and nurses are learning about alternative medicine along with anatomy and physiology at a growing number of medical schools, the Associated Press reports. The government has spent more than $22 million to help medical and nursing schools start teaching about alternative medicine. Additional tax money has been spent to recruit and train young doctors to do research in this field, launching some into careers as alternative medicine providers.
A nursing union locked in contentious contract negotiations says Philadelphia-based Temple University Hospital is trying to infringe on the free-speech rights of the union and its members. The Pennsylvania Association of Staff Nurses and Allied Professionals, which represents 1,500 nurses at Temple, said it had filed a complaint with the Pennsylvania Labor Relations Board claiming the hospital was demanding that a gag clause limiting public criticism of Temple or its managers be included in the new contract.
Plans by two popular primary care doctors to leave Boston-based Caritas Christi Health Care for Mount Auburn Hospital led to a dispute over who keeps their patients' medical records that landed in court. The two doctors asked Superior Court Judge Christine M. Roach for a temporary restraining order to stop Caritas Christi from taking 3,000 to 4,000 records from their Watertown, MA, office. The disagreement highlights the intense competition among hospitals in the Boston area to hire and retain established physicians, especially primary care physicians, the Boston Globe reports.
Massachusetts health officials are prohibiting a new insurance company from offering coverage to the general public under the state's universal health law because it does not yet have enough medical providers in its network. The insurer, CeltiCare Health Plan of Massachusetts, was scheduled to begin selling insurance coverage Nov. 1. But the Connector Authority, which regulates programs created under the 2006 Massachusetts health law, informed CeltiCare that it must delay its offerings for three months while increasing the number of healthcare providers in its network.
All 214 Illinois hospitals have been toiling since April to ready themselves in case the H1N1 virus sickens a large percentage of the population, the Chicago Tribune reports. To prepare for a possible rush at emergency rooms and clinics, hospitals are holding drills, refining emergency plans created after Sept. 11, 2001, and making sure they can tap into local, state and national stockpiles of medical provisions. Hospital administrators also have been studying reports from the winter flu season in the Southern Hemisphere from June to August. In Australia and New Zealand, H1N1 patients clogged emergency rooms and put nearly overwhelming demands on intensive care units.
For the past two weeks, thousands of people have been calling doctors' offices in Washington, DC, Maryland, and Virginia, bombarding doctors' offices with queries even though doctors don't know when they will get more, or any, of the H1N1 vaccine. Officials say they divvy up supplies among pediatricians' offices, obstetricians and others who can reach those most at risk the fastest. Virginia officials have been allowed by the federal government to order more than half a million doses so far, although the state wants more than 4 million.
HHS published in the Federal Register today (October 30) the HITECH Act enforcement interim final rule, standard procedure of the February 17, 2009 HITECH Act.
The interim rule includes no amendments to the enforcement provisions in HITECH, according to the rule itself.
The interim final rule becomes effective November 30. HHS has invited public comments, which will be considered if received by December 29.
The HITECH Act calls for greater penalties for HIPAA violations and increased enforcement through "periodic audits." The civil monetary penalties increased greatly, with a maximum penalty of $1.5 million for all violations of an identical provision.
However, HHS' enforcement plans are unclear. OCR, the HHS entity that oversees HIPAA privacy and security, named regional education and outreach coordinators and promised audits. But exactly how much enforcement, when and to whom is unknown.
At September's HIPAA Summit conference, Sue McAndrew, the OCR deputy director for Health Information Privacy, told HealthLeaders Media she did not know the process by which HHS will conduct audits.
OCR may build on existing types of audits or perhaps partner with the Inspector General, McAndrew speculated.
"We are basically in the process of doing some scanning and weighing our options of what kinds of audit programs are out there and what turns out to be the most effective," McAndrew said then.
HHS this week says the HITECH enforcement measures will "strengthen the HIPAA protections and rights related to an individual's health information."
The remaining HITECH provisions, which have yet to become effective, will be addressed in the next few months in forthcoming rulemakings.
