Horizon Blue Cross Blue Shield of New Jersey said it will terminate in-network coverage of about 3,000 current and retired state employees at Capital Health's Helene Fuld hospital, prompting Gov. Jon Corzine to propose state intervention in the contract negotiations. The breakdown in contract talks follows several weeks of unsuccessful negotiations between Horizon and Capital Health.
A health clinic in Vallejo, CA, is saving local hospitals thousands of dollars in emergency-room visits by treating uninsured patients who suffer only non-urgent ailments. A watchdog group is now calling on county officials to cut funding for clinic patients who can't prove they are in the U.S. legally. A provision in the House's healthcare overhaul bill rules out federal funding for illegal immigrants.
A screening program conducted by the Cedars-Sinai Medical Genetics Institute is a unique attempt to make broad-scale genetic testing more efficient by targeting ethnicity, a concept called ethnogenetics. Organizers hope to test at least 10,000 of the 30,000 Persian Jews in Southern California for four disorders that are especially prevalent in the ethnic group.
James Madara, MD, has announced that he will resign as chief executive officer at University of Chicago Medical Center. He will return to the faculty on Oct. 1, stepping out of a spotlight in which he faced criticism over his plan to redirect patients with less severe illnesses and injuries to a network of community hospitals and clinics. Known as the Urban Health Initiative, Madara's program drew the ire of some doctors inside the hospital, two national physicians groups, and Rep. Bobby Rush, who called for congressional hearings.
Thirty thousand legal immigrants have begun receiving letters informing them that their state-subsidized health insurance is ending Aug. 31 and will be replaced by a patchwork system of care until Massachusetts officials can piece together a more comprehensive plan for the most critically ill. The state's interim plan only covers emergencies and other limited services, leaving advocates worried about the welfare of these immigrants. Under the plan, immigrants will be receiving emergency care in hospitals and a limited number of other services through community centers under two state programs.
When a senior vice president for Boston-based Caritas Christi Health Care discovered that a competitor was wooing three of his doctors earlier this year, he reacted viscerally. "You have fired the first shot," Timothy J. Crowley, MD, said in a voicemail to James Blakeley, the recruiter at Mount Auburn Hospital. "And trust me, you don't want to go to war with me. I'll take everything you got and everything you love and kill it." Crowley told the Boston Globe that the voicemail, while "unfortunate," was intended as a "light-hearted" joke between two longtime friends. But an executive at Mount Auburn complained to Caritas, and that led to Crowley's departure from the hospital chain May 29.
British politicians and citizens are racing to defend the honor of the country's National Health Service against perceived attacks from the Americans. The rush is a response to claims about the alleged inefficiency and poor quality of the U.K. system made by critics of President Barack Obama's proposals on healthcare reform. Opponents of the proposals claim the president intends to nationalize healthcare and point to purported weaknesses in the U.K.'s service as a warning of what could happen in the U.S. Prime Minister Gordon Brown and opposition leader David Cameron each have interrupted their summer holidays to weigh in.
When the Senate Finance Committee unveils its healthcare reform bill in several weeks, one idea that will most likely not be included is the much-debated end-of-life provision that is in the House bill.
Sen. Charles Grassley (R-IA), the ranking minority member on the panel and a member its “gang of six" senators that has been working on the bill's provisions, slammed the House bill (HR 3200) on Thursday as "so poorly cobbled together that it will have all kinds of unintended consequences." In particular, he took aim at the section on end-of-life care.
"There's a big difference between a simple educational campaign, as some advocates want, and the way the House committee passed bill pays physicians to advise patients about end-of-life care and rates physician quality of care based on the creation of and adherence to orders for end of life care," he said in a statement.
The issue came under the spotlight this week in part when former Alaska Gov. Sarah Palin suggested that Obama and other Democrats wanted to set up "death panels" to decide who will or will not get medical services. The issue has come up repeatedly in town hall meetings this week with President Obama and congressional representatives.
The current language in question in the House bill (Section 1233) stated that it would amend how Medicare is paid for providing end-of-life counseling. In 1990, language was inserted in the Social Security Act, which governs Medicare, that defined an "advance directive" to be "a written instruction"--such as a living will or durable power of attorney--recognized under state law and "relating to the provision of such care when the individual is incapacitated."
The 1990 language called for healthcare providers and organizations to "maintain written policies and procedures with respect to all adult individuals receiving medical care by or through the provider or organization." The provision also required legal documents, such as advance directives, to be kept "in a prominent part of the individual's current medical record" and to provide "education for staff and the community" on advance directives. This was done without payment to providers.
The language in the new healthcare reform House bill would make changes--requiring that Medicare reimburse physicians and other providers for consultations that provide information on issues, such as living wills and power of attorney. No provision on this is included in the bill passed by the Senate Health, Education, Labor and Pensions Committee.
On the Senate Finance Committee, Grassley said they "are working very hard to avoid unintended consequences by methodically working through the complexities of all of these issues and policy options."
"We dropped end of life provisions from consideration entirely because of the way they could be misinterpreted and implemented incorrectly," Grassley said. "Maybe others can defend a bill like the Pelosi [House] bill that leaves major issues open to interpretation, but I can't."
The Office for Civil Rights (OCR) named the regional delegates for HIPAA privacy and security guidance and education in an announcement on its Web site today.
The Health Information for Economic and Clinical Health (HITECH) Act required the secretary of HHS to designate by next week the regional coordinators who will provide "guidance and education to covered entities, business associates, and individuals on their rights and responsibilities" related to the HIPAA Privacy and Security Rules.
Robinsue Frohboese, the acting director and principal deputy director for OCR, will lead the regional directors out of the Washington office. Contact information or the regional delegates can be found on the OCR Web site.
"I think it is a good thing," says Chris Simons, RHIA, director, UM & HIMS and the privacy officer at Spring Harbor Hospital in Westbrook, ME. "Two big criticisms of HIPAA are that it is not always well understood by providers, and that even if it is understood, there is little to no enforcement. That has changed a bit recently with some high profile fines for breaches, and I think this signals the administration's desire to focus more on both education and enforcement in the months ahead."
The regions break down as such:
Region I: Boston (Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont)
Region II: New York (New Jersey, New York, Puerto Rico, and Virgin Islands)
Region III: Philadelphia (Delaware, District of Columbia, Maryland, Pennsylvania, Virginia, and West Virginia)
Region IV: Atlanta (Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, and Tennessee)
Region V: Chicago (Illinois, Indiana, Michigan, Minnesota, Ohio, and Wisconsin)
Region VI: Dallas (Arkansas, Louisiana, New Mexico, Oklahoma, and Texas)
Region VII: Kansas City (Iowa, Kansas, Missouri, and Nebraska)
Region VIII: Denver (Colorado, Montana, North Dakota, South Dakota, Utah, and Wyoming)
Region IX: San Francisco (American Samoa, Arizona, California, Guam, Hawaii, and Nevada)
Region X: Seattle (Alaska, Idaho, Oregon, and Washington)
Six months from now, another regulation from HHS is due per the HITECH's Section 13403, "Education on Health Information Privacy." It calls for OCR to develop and maintain a "multi-faceted national education initiative" to increase public transparency on the uses of PHI, including:
Programs to educate individuals about the potential uses of their PHI
Buying equipment and training nurses for safe patient handling costs money. But done well, such efforts can save cash through reduced sick days and workers' compensation claims.
With this in mind, it behooves CEOs to keep an eye on the regulatory horizon, because several developments point to safe patient handling becoming an increasing focus of regulators.
Some states, including Washington, Texas, New Jersey, Minnesota, and Rhode Island, have enacted safe patient handling laws, and several other states have pending bills.
On the national front, U.S. Rep. John Conyers (D-MI) has introduced a safety patient handling bill, numbered H.R. 2381. As of this week, the proposed legislation remained in committee.
If passed, the Conyers bill would direct the secretary of labor, likely through OSHA, to "issue an occupational safety and health standard to reduce injuries to patients, direct-care registered nurses, and all other healthcare workers by establishing a safe patient handling and injury prevention standard."
It also mandates that hospitals purchase safe lifting devices and train healthcare workers annually on how to properly lift patient and prevent injuries.
This is the third time since 2006 that Conyers has introduced a safe patient handling bill, and some stakeholders believe this latest effort will be successful because Democrats control Congress and the White House.
"We support Representative Conyers' efforts," says Anne Tan Piazza, assistant executive director of governmental affairs and operations at the Washington State Nurses Association.
The American Nurses Association has "endorsed the Conyers bill, and we support any and all efforts to reduce musculoskeletal injuries to registered nurses. We're certainly hopeful President Obama recognizes this great risk for registered nurses and healthcare workers," Piazza says.
Meanwhile, Obama's interim OSHA head, Jordan Barab, helped develop the agency's ergonomics standard, which was published during the final days of the Clinton administration in late 2000.
When President Bush took office in 2001, the Republican-led Congress subsequently withdrew the standard before it took effect.
If Barab becomes the permanent OSHA head, "having someone like that in there who understands the issues could make [safe patient handling] a priority," said Guy Fragala, PhD, PE, CSP, advisor for ergonomics at the U.S. Department of Veterans Affairs' (VA) Patient Safety Center of Inquiry in Tampa, FL.
