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President Hugo Chavez said Tuesd ...

Posted Nov 10 2008 4:24pm


President Hugo Chavez said Tuesday his government will nationalize
Venezuela's privately owned hospitals and clinics if they fail to
reduce health care costs.

"If the owners of the private clinics don't want to obey the laws,
then the private clinics will be nationalized," Chavez said in a
nationally televised speech. "They will become part of the public
health service."




Venezuela has a two-tiered health system in which wealthier, insured
patients often can afford prompter, better treatment at private
hospitals.

"This is the evil of capitalism," Chavez said of the
health care costs at private clinics. "We have to regulate this
progressively, transforming the savage capitalist market into a market
of solidarity."




Nice to see this alternative coming to the US.  BD

Hip resurfacing, a popular alternative implant to total hip replacement for younger patients disabled by hip failure, is about to become competitive.

The Corin Group of Britain and Stryker said yesterday that the Food and Drug Administration had approved the Cormet hip resurfacing implant by Corin, thus giving American consumers an alternative to Smith & Nephew ’s Birmingham hip resurfacing system for the first time since the F.D.A. approved that device in May 2006.

Although total hip replacement has become a common and exceedingly successful operation for patients whose natural hip has been irreparably damaged by illness or injury, resurfacing has attracted surgeons and many patients because it preserves more of a patient’s thigh bone. That makes it easier to replace the original implant with a total hip in the future if necessary, which is often the case for active patients who have their artificial hips for 15 or 20 years.

F.D.A. Approves a Hip Resurfacing Implant - New York Times

Interesting article on one person's opinion on what has changed since Universal care was proposed in the 90's.  BD

In 1993, two unlikely public policy leaders took to the airwaves and in less than one minute helped to scuttle a health care reform bill that had been at the center of national debate. Broadcasting from their kitchen table, "Harry and Louise" leafed warily through a stack of documents representing the Clinton administration's universal health care proposal, commenting on its lack of individual choice and seemingly endless bureaucratic complications. "They choose, we lose," the two concluded.

What's Different Now?

The public, employers and the provider community are increasingly disillusioned by rising costs and increasingly complex plans. Employers, especially, are at a tipping point, and that might make a difference this time around. "As the cost of insurance rises, employers are shifting the increase to employees, and employees are getting angry.  Although employers are generally reluctant to cede power to government, they might be willing at this juncture to put the monkey on someone else's back."

The health care landscape is changing, too, with the recent introduction of a universal health care plan in Massachusetts and a highly publicized debate on the subject in California.  If health care reform does come in the U.S., it might be through a series of state-based initiatives, "Massachusetts is not an easy model to replicate; it's a state with adequate resources and a liberal outlook. A plan that works in Massachusetts wouldn't necessarily play in Kansas." Still, the fact that key states are moving in the direction of universal health care shows that there is substantial support for the ideal of reform -- and that will likely affect national as well as state-level politics.

"We have a very complicated health care delivery and payment system that has evolved over a long period of time. There are a lot of powerful vested interests, so change won't come easy.  Incremental change is far more likely. "It's probably the only way to get there from here. Given our history, politics and national character, sweeping health care reform would be too big a pill to swallow. But change in some form certainly seems inevitable; there's just too much dissatisfaction with the current situation." Try as they might, Harry and Louise -- or their current counterparts -- won't be able to hold on to the status quo indefinitely.

'Harry and Louise,' the Sequel? The Universal Health Care Debate Is Back - Knowledge@Wharton

 

Blue Cross and the hospital sent letters out to patients this month informing them they would have to seek nonemergency hospital care elsewhere if a new contract wasn't reached.

The Madera County hospital -- the only children's hospital between the Bay Area and Los Angeles -- mailed 5,000 letters June 22 to families.

Officials with Children's Hospital Central California and Blue Cross of California agreed to a 30-day contract extension Friday that allows the hospital to continue treating thousands of poor children covered by the HMO while the two sides try to work out a long-term agreement.

FresnoBee.com: Business: Children's, Blue Cross reach deal

If a health facility does not perform enough heart transplants by Medicare standards, then the funding may not be available, such as this example who is declining transplants for Medicare patients only, although their normal transplant procedures will continue for other patients.  BD

University of Kentucky Chandler Medical Center has stopped performing Medicare-funded heart transplants after failing to meet requirements for reimbursement for the procedure.

The hospital has been unable to perform the 12 heart transplants annually required by Medicare. Over the past decade, the hospital has performed 14 heart transplants annually but recently began to see a decline in numbers.

The U.S. Centers for Medicare and Medicaid Services sent letters Friday telling hospitals in Texas, Minnesota and Indiana that they have 30 days to overhaul their heart transplant programs. Over the past two years, the hospitals have performed too few transplants to maintain the proficiency required by Medicare.

The need for heart transplants has declined because of advances in medication and other surgical procedures, UK doctors said.  UK's heart transplant program will continue, but not with Medicare recipients.

Kentucky.com | 07/04/2007 | UK hospital quits Medicare heart program

I truly hope this is not becoming a reality.  BD

According to a new review in American Journal of Transplantation, people who donate their kidney or part of their liver to help someone else may themselves encounter difficulty with life and health insurance, despite insurance companies saying otherwise.

"Insurance companies, when surveyed, stated they would insure living kidney donors, and would usually not charge higher premiums," says review author Robert Yang, a research fellow in the Kidney Clinical Research Unit at the London Health Sciences Centre. "Despite that, 3-11 percent of donors still experienced insurance problems."

Potential live donors worry about possible insurance problems in the future. As many as 14 percent of potential donors, from various countries with different social support and health care systems, expressed concern with their insurability if they were to donate an organ. Some research indicates that these concerns may lead a potential donor to reconsider donating.
Yang suggests that physicians should provide all information to patients before they make the important and life-altering decision to donate. "Even if donors are willing to accept the risks of non-insurability and/or higher insurance premiums, transplant professionals still have an ethical obligation to protect donor freedom of choice while ensuring that donors do not suffer unnecessary stress or financial penalty," says Yang.

Potential Organ Donors Fear Losing Insurance - 1 In 7 Organ Donors Concerned About Life & Health Insurance

 

The first baby to be created from an egg that had been matured in the laboratory, frozen, thawed and then fertilised, has been born in Canada. Three other women are pregnant by the same process. The research was presented to the 23rd annual meeting of the European Society of Human Reproduction and Embryology.
The baby girl was born to one of 20 patients with polycystic ovarian syndrome (PCOS) or with ovaries that had been detected to be polycystic by ultrasound (U/S), who took part in the trial at McGill Reproductive Center, Montreal, Canada. The baby is progressing well.
Dr Hananel Holzer, who led the team, is an assistant professor at the Center and coordinates the fertility preservation programme there [1]. He said: "Freezing a woman's eggs (or oocytes) has become an important and integral part of fertility treatment, and the introduction of new freezing techniques such as oocyte vitrification has increased significantly both oocyte survival and resulting pregnancy rates. However, to date, the pregnancies reported have been the result of fertilisation of frozen or vitrified and then thawed oocytes that had been collected after ovarian stimulation. Unfortunately, some patients seeking fertility preservation may not have enough time to undergo ovarian simulation, or may suffer from a medical condition deemed by some oncologists as a relative contraindication to hormonal stimulation, such as oestrogen-receptor-positive breast cancer.

First Baby Is Born And 3 More Women Are Pregnant After Oocytes Were Matured In The Lab And Frozen

 

INDIANAPOLIS —  Unhealthy habits could cost Clarian Health employees a healthy chunk of money as the company tries to rein in rising health care costs.

Starting in 2009, Clarian will begin charging workers extra for insurance if they let health risks such as smoking, obesity or high cholesterol go unchecked.

Questionnaires and screenings will be used to detect health risks. Workers who fail to measure up in five areas — including body mass and blood pressure, will have up to $30 deducted from each biweekly paycheck if they can't prove they're working to improve their health. Workers who smoke will pay $5 extra every two weeks starting in 2008.

The law allows employers to use financial incentives in wellness programs to motivate workers to adopt more healthy lifestyles, said Mike MacLean, a partner at Indianapolis law firm Baker & Daniels.

FOXNews.com - Company to Charge 'Unhealthy' Workers More for Insurance - Health News | Current Health News | Medical News

 

BC Life & Health revoked 1,880 individual health insurance policies in California in 2004 and 2005, and a state agency that examined a sampling says it found that more than half the cases it reviewed were improperly handled.
The Department of Insurance said it studied 83 sample cases and issued citations in 49 of them, alleging 67 violations of fair-claims handling laws.

When coverage is rescinded, it is as if the policy never existed, leaving the policyholder and healthcare providers to settle outstanding charges.

"A rescission can be a financial death sentence when you're ill," Poizner said in an e-mail. "In my view, even one improper rescission is one too many. When it comes to rescissions, we are acutely aware that these are people's lives. They're not just numbers to us."

A spokesman said that the department was looking at rescissions industrywide and that BC Life was one of several companies under the microscope. The others include Blue Shield, HealthNet, Cigna and Aetna. 

"We've got verification from another department doing its own investigation that this is happening consistently," Liang said. "Clearly, the system is broken…. Patients are getting harmed left and right, and nothing is getting done."

Health insurer cited in policy cancellations - Los Angeles Times

 

University of Chicago Medical Center and police are investigating whether three patients, including two who died, were somehow given insulin overdoses, officials said.

Suspicions were raised after insulin levels hundreds of times too high were found in a comatose hospital patient less than three weeks after a similar case.

"We haven't necessarily tied it to anyone. We don't know if it's medical error or product integrity or defective test results," hospital spokesman John Easton said Tuesday. "We just don't know yet

Chicago Police Probe High Insulin Levels - Forbes.com

As pay for performance expands, this is not necessarily good news either as this seems to be one of the top reasons for patient non-compliance with treatment plans.  BD

TUESDAY, July 3 (HealthDay News) -- As employers and insurance companies shift more of the cost of prescription drugs onto consumers, actual spending on these medications declines, new research finds.  For each 10 percent increase in cost-sharing, prescription drug spending went down by 2 percent to 6 percent.

For people with certain chronic medical conditions, this means more money is probably spent on expensive medical services and health outcomes worsen down the line, the researchers add.  But increases in pharmacy spending have caused insurers and employers to try to move some of that cost onto the consumer.

For patients with congestive heart failure, lipid disorders, diabetes and schizophrenia, higher cost-sharing meant more use of medical services.

"There is some evidence that cost-sharing costs insurers more down the road, suggesting that the best strategy is to give people their medicine for free," Goldman continued. "Some insurers are actually moving toward that for certain chronic diseases."  Once the consumer knows what the cost is, she can have a conversation with her physician about costs versus benefits. This gets her more invested in her own course of treatment, which will promote greater compliance with the entire gamut of treatment."

As Costs of Drugs Shift to Consumers, Spending Drops - Forbes.com

 

Doctors were able to reattach one of the feet of the 13-year-old Louisville girl who had both feet severed on a ride at Six Flags Kentucky Kingdom on June 21, according to a statement from the family released late this afternoon.
Kaitlyn Lasitter, known as Katie to her friends and family, remains in stable condition at Vanderbilt University Medical Center in Nashville, Tenn.

Doctors have reattached one of injured girl's feet

 

PUNTA GORDA: Punta Gorda city employees could be paying more for health insurance if a new plan goes into effect. The city claims tax reform has forced them to make major cuts in their budget.

One man who spoke with us didn’t want to be identified for fear of being reprimanded for speaking to the media.

Up until now, city employees had the option of choosing either a PPO or an HMO plan and the city paid the entire bill for the average employee with no dependents.

As the city plans to slash costs, the city will only pay for the HMO plan. Those workers who want to keep the PPO, will have to pay the difference, which could be as much as $70 a month. Those who want to stay with the HMO won’t have to pay anything.

"We would pay for the employees HMO as the primary coverage," said Punta Gorda City Manager Howard Kunick.

The health care change will save the city almost $300,000 a year.

NBC2 News Online - City scales back employee benefits, blames tax reform

 

The health of California's hospitals is better than it was in the 1990s, although there is a wide gap between those that are doing well and those that are not. Over one-third of California general acute hospitals have very strong operating margins and good bond ratings.

But the financial health of almost half of the facilities qualifies them for junk bond status at best. This affects their ability to borrow funds to modernize, which can impact the quality of care they provide.

This graphic snapshot focuses on the financial health of California's 355 general acute care hospitals, including data on how they are owned, how they are used, who pays for hospital care, and their relative financial strength. The snapshot provides an overview of the major findings of the full report Financial Health of California Hospitals, produced by PricewaterhouseCoopers, which is available under Document Downloads below. (This study is an update of a 2001 Shattuck Hammond Partners report that looked at hospital performance for 1995 to 1999, which is also available below.)

Some key findings of this study include:

  • Over 60% of California hospitals are affiliated with multi-hospital systems.
  • Most California hospitals are nonprofit entities, representing 67% of all hospital beds in the state.
  • California's hospital resources are used more efficiently, with fewer emergency department visits, hospital admissions, and days of hospital care per 1,000 population than the U.S. average.
  • Large numbers of Medicare and Medi-Cal patients served generally have a negative impact on a hospital's performance because these payments don't cover the cost of providing care. Private insurance generally pays more than the cost of care to offset the loss.

Financial Health of California Hospitals - CHCF.org

 

The first group of participants must earn less than 100 percent of the federal poverty level.

The program is slated to expand in September, opening to low-income patients who are already seen by the public health department or at other city-supported nonprofit community clinics. In January, the city plans to open it up to everybody who lives in San Francisco, is uninsured and doesn't qualify for other government health care programs, such as Medi-Cal. Only adults qualify because children are covered under a separate San Francisco program.

So have the city's elected leaders, who in a rare display of unanimity agreed last summer to begin providing health care to all San Franciscans. At a time when the broken state of the health care system is at center stage -- in the race for president in 2008 and at movie theaters where Michael Moore's documentary "Sicko" is filling a lot of seats -- San Francisco is the first city in the country to try to tackle the problem itself.

Healthy San Francisco is estimated to cost $200 million a year and will be paid for through a mix of public funds, participants' premiums and co-payments and employer contributions.

The city is mandating that employers who don't currently offer health insurance to their employees contribute to Healthy San Francisco starting Jan. 1. The Golden Gate Restaurant Association has sued to block this component of the program, saying small business owners simply cannot afford it. Both sides are due in federal court Aug. 31.

You can't call San Francisco 'sicko' / City's universal health care initiative signs up its first applicants in Chinatown

Interesting analysis...BD

STANFORD GRADUATE SCHOOL OF BUSINESS — California Gov. Arnold Schwarzenegger has proposed setting up a universal health coverage system, arguing that caring for the uninsured has prompted health care providers to shift the burden to private payers as a type of “hidden tax.”
Citing a study by the New America Foundation, Schwarzenegger argues that private payers are handing over 6 to 11 percent more in order to cover the cost of caring for those without health insurance.


Not so, counters economist Daniel Kessler. The higher premiums are being driven by the decreased funding for public insurance programs such as MediCal and Medicare, not by the cost of caring for the uninsured.
In a recent paper, titled “Cost Shifting in California Hospitals: What Is the Effect on Private Payers?” Kessler, a professor of economics, law, and policy, concludes that the impact on private insurance premiums is much less significant than critics are arguing.

Health care costs for those without insurance led to a 1.4 percent increase in private premiums, compared to a whopping 10.8 percent escalation due to uncovered costs of MediCal and Medicare, Kessler writes.

www.exduco.net - Graduate schools and programs guide

 

ALBANY, N.Y. (AP) _ Regulators in New York approved a 14 percent increase in medical malpractice insurance rates on Monday and Gov. Eliot Spitzer formed a task force to find ways to rein in the high cost of the coverage.
The state Insurance Department said the latest rate hike was lower than insurance companies wanted and "is necessary to avoid further financial deterioration of the companies and perhaps an irreversible crisis in an already severely distressed market."

Hike in NY medical malpractice insurance rates approved - Newsday.com

This is an article about file sharing, but makes a point about the popularity of the movie and the number of people viewing, and after it was removed once, it appeared again on Google Video.  BD

It is believed that tens of thousands of copies of Moore's documentary about the health care industry were downloaded without authorization during the past two weeks. The movie has also gone up on YouTube and Google Video, and was viewed by thousands before being removed. As the movie played on theater screens across the country this weekend, the film returned to Google Video and was watched more than 2,000 times.

If Moore's film has been harmed by file sharing, the damage is hard to find.

Hollywood hates pirates, but can it use them? | Tech News on ZDNet

Very good points in this thread on physicians and email, little or no reimbursement.  BD

Patients who consult with their physicians via e-mail are less likely to visit their physician and less likely to call their doctor’s office, according to data from the Kaiser Permanente Center for Health Research, the Portland Business Journal reports.

You have to understand that I am a very tech-savvy physician.  We have been on EMR for over 10 years.  I am at home today, but just spent an hour logged in at work answering questions and finishing documentation.  I give talks around the country about the adoption of technology in medical practice and have personally succeeded where many have failed: increasing income while improving quality using an EMR in a small-office setting.  Yet we do not use e-mail with our patients.

Margins are already very tight.  Doctors are not much use to their patients if they have to close their offices.

There are ways around this problem, such as having physicians charge for e-visits or charge a global fee for access via e-mail.  But Medicare won’t allow physicians to charge above and beyond what they pay for, so to implement this a physician needs to either exclude Medicare patients, or stop seeing them altogether.

The main issue in this case is not physicians’ slowness in accepting technology, nor is it simple greed.  For there to be real change in this area, there must be a change in the way physicians are reimbursed.  Until that happens, expect the low adoptions rate to persist.

Musings of a Distractible Mind » Blog Archive » News Flash: Free care makes no money

Hat Tip:  Kevin, MD

 

Minnesota Department of Health officials on Wednesday announced that all health care providers and insurers in the state will be required to file their claims electronically in a standard format beginning in 2009, the Minneapolis Star Tribune reports. State Health Commissioner Diane Mandernach cited a study by America's Health Insurance Plans that showed electronic claims cost 85 cents each, compared to $1.58 for claims submitted on paper. Mandernach, said, "We anticipate many positive results including more efficient care and lower costs."

Minnesota To Require Insurers, Providers To File Claims Electronically

 

 As of yesterday, New Mexico law not only permits the medical use of marijuana, but provides state oversight of medicinal pot's growth and distribution.

Officials in New Mexico -- the eleventh state to legalize medical marijuana, but the first to regulate its production -- are still trying to figure out whether health department employees could potentially face federal prosecution, as users do.

Among the conditions for which pot use is permitted are cancer, glaucoma, multiple sclerosis, epilepsy and HIV-AIDS. Patients in hospice care are also covered.

Wired Science - Wired Blogs

 

Among the seven suspects arrested for terrorist attempts in London and Glasgow last week, two are doctors who work in the UK: 1. Dr. Bilal Abdulla, from Iraq, was arrested in Glasgow at the scene of the attempt on Saturday. 2. Dr. Mohammad Asha, from Jordan, was arrested while driving with his wife on the M6 motorway. Dr. Asha's father has told the UK media he is sure his son is innocent - he has called on the King of Jordan to intervene. He described his son as pious, but not extremist.
Dr. Asha works at North Staffordshire hospital, Hartshill, Stoke-on-Trent, England, in the neurology department. He is registered to work in the UK until 2008.

Two Doctors Arrested In UK Terror Investigation

In short, it appears no E-prescribing, no pay is proposed on the agenda if the exemption is eliminated.  There is a link on this page to sign up for free e-prescribing at no cost to the physicians.  BD

Medicare Program; Proposed Revisions to Payment Policies Under the Physician Fee Schedule, and Other Part B Payment Policies for CY 2008; Proposed Revisions to the Payment Policies of Ambulance Services Under the Ambulance Fee Schedule for CY 2008; and the Proposed Elimination of the E-Prescribing Exemption for Computer-Generated Facsimile Transmissions.

Physician Fee Schedule

 

Campus police are investigating how 22 health care workers at UCI Medical Center got bogus certificates in cardiopulmonary resuscitation, hospital officials said Wednesday.

The discovery of a phony certificate at a training class in May sparked an internal review, completed Friday, of all 2,000 employees with CPR certification.

Hospital officials would not detail how the employees were disciplined, other than to say they were removed from directly caring for patients.

Article - News - Fake CPR certificates spark new UCI inquiry

 

The response in Orange County has been mostly disappointing, said Rhea Jones, vice president of HeartCharger, a Santa Ana company that sells and maintains defibrillators. Jones says many gym owners are either ignorant of the law, or opposed to it.

While every health club is required to register their defibrillators with the county, only 12 out of about 200 have done so, said Dr. Sam Stratton, medical director of Orange County Emergency Medical Services. Stratton said he's supportive of the law, but concerned it doesn't go far enough.

"There's not a lot of authority that we have over compliance," Stratton said. "There's no funding to go out and survey the clubs to make sure they have them."

Even without laws requiring them, hundreds of defibrillators are scattered throughout the county at stadiums, airports, courthouses, golf courses and beaches.

Gil Yurly, who owns BodyWise Fitness in Newport Beach and Holy Spirit Gym in Costa Mesa, said he hasn't yet bought defibrillators, which cost about $1,500. He gives the law a thumbs-down "from a gym owner's standpoint who's still looking to get over the top."

Article - News - Heart defibrillators now required in gyms by law

 

Different arrangements may need to be made if the family is enrolled in a health maintenance organization (HMO) -- which typically covers emergency treatment, but not other care, outside of the service area.

"If their parents are in a tightly controlled HMO, the students may not be able to get the care they need unless they come home to get it," says Sandy Praeger, the Kansas insurance commissioner and president-elect of the National Association of Insurance Commissioners.

Tom Richards, senior vice president of products at Cigna HealthCare, recommends that families enrolled in such an HMO find out whether their students can get "guesting privileges," which would enable them to use a different doctor near their college.

Depending on the HMO's policy and on the school location, some families may want to switch from an HMO to a PPO during the next benefits-enrollment period.

Another option, especially if the student is likely to need medical care not available at the college infirmary, is to get a student health-insurance policy.

College Medical Coverage - WSJ.com

Bring in the attorneys from the Legal Aid Society....sad it has evolved to this point of legal aid just to get medical care when needed.  The education process portion sounds like a good idea as part of the program, but there are so many areas for one to research these days, it gets a little confusing.  BD

Doctors and lawyers are teaming up in a new effort to improve health care for poor Central Virginians.

White said that the program uses the legal system to make sure low-income residents and their children receive public benefits including food stamps and Medicaid, to identify mental health issues and to achieve family stability.

Called the HEAL Project, the program is a partnership between the Lynchburg-based Virginia Legal Aid Society and the Lynchburg Family Practice Residency Center - both groups that serve low-income populations free of charge.

“Low-income people have lots of obstacles to living healthy lives,” said David Neumeyer, executive director of the Legal Aid Society.

A similar program began about 10 years ago at a Boston hospital and is now used in about 50 localities across the country. In Virginia, a partnership between the University of Virginia Hospital, UVa. Law School and Charlottesville’s legal aid branch began only about 18 month ago.

Neumeyer said the program is just beginning to take off in the United States, and Canada is not lagging far behind.

NewsAdvance.com | HEAL Program seeks health care for area poor

One big question - how do the recognized in-network providers handle referrals, claims, etc.  How does this work with the in-house VA system?  It appears the VA physicians might now get some exposure to some additional administrative functions with claims and encounter information, which has all been handled in house by the VA for years.  BD

HARTFORD, Conn.--(BUSINESS WIRE)--Aetna (NYSE:AET) announced today that it is the first national health plan to sign a participating provider agreement with the Department of Veterans Affairs (VA) for Aetna members who are also enrolled and receiving health care services from the VA. Health care providers participating with the VA now are recognized as in-network participating providers for all health plans administered by Aetna.

VA has 153 hospitals, 881 outpatient clinics, and 135 Nursing Home Care units and is the largest integrated health care system in the United States. The agreement also includes employed and contracted physicians, including dental and behavioral health providers, in the United States and Puerto Rico.

“Aetna is committed to helping our members achieve optimal health and access cost-effective, quality care,” said Allen Karp, Aetna’s vice president of Health Care Delivery. “We are pleased that through this agreement with VA, we can offer members greater choice of health care options and in particular, services that are relevant to veterans.”

Aetna is First National Health Plan to Contract with the Department of Veterans Affairs

 

(07-02) 04:00 PDT Washington -- Fraudulent Medicare billings submitted by medical equipment suppliers in the Los Angeles area and south Florida are the target of a pilot program to be announced today by the Department of Health and Human Services.

The two-year program, which was developed by the Centers for Medicare and Medicaid Services, will concentrate on fake bills or overcharges sent by suppliers of prosthetic limbs, orthotics, diabetic supplies and durable medical equipment, which includes such items as wheelchairs and nebulizers.

"In the Los Angeles area, there are over 4,800 durable medical equipment suppliers. Because there are so many suppliers and such a high number of beneficiaries, it creates an opportunity for this kind of fraud," said Kimberly Brandt, Medicare's director of program integrity.

The U.S. attorney in Los Angeles has a special unit of four prosecutors devoted to filing criminal cases, and the office uses civil lawsuits to seek reimbursements for improper billing.

Medicare to clamp down on fraudulent suppliers

Nice short presentation on the EO Tuf Tab.  The Tuf Tab is a heavy duty version of the EO UMPC.  The small size and semi rugged design makes the unit a perfect solution for those wanting a UMPC for portability, but need the extra support in the case design.  The unit also has a couple new features that are not on the standard unit as well, worth checking out.  Great companion for electronic medical records.  BD

Ultra Mobile: TabletKiosk eo TufTab v7112XT

 

ANAHEIM, CA (UroToday.com) - The groups from UC Irvine and Columbia presented their experience with a new affordable, portable laparoscopic training device, the EZ Trainer System, which is suited for use at home. This system utilizes a webcam to provide the optical signal in combination with the trainees own laptop computer to act as a viewing monitor. The face and content validity of this device was documented, with 96% of the participants indicated that the EZ Trainer provides a realistic training format. The EZ trainer was easy to use and could provide a good training system for laparoscopic surgery.

UroToday - AUA 2007 - Content and Face Validity of a Cost-Effective Personal Laparoscopic Trainer Designed for At Home Use

 

New research on alcoholism shows that there are five types of alcoholics in the U.S., and more than half of alcholics are young adults.  (CBS/AP)

"When most people think of alcoholics, they think of middle-aged men with a profile similar to our chronic severe subtype. Our data shows that alcoholism is more a disorder of youth than previously suspected."

(WebMD)  New alcoholism research identifies five types of alcoholics and shows that young adults account for more than half of U.S. alcoholics.
The high percentage of young adults among alcoholics was unexpected, notes researcher Howard Moss, M.D., the associate director for clinical and translational research at the National Institute on Alcohol Abuse and Alcoholism (NIAAA

Study Finds 5 Types Of Alcoholics, Research Also Shows More Than Half Of U.S. Alcoholics Are Young Adults - CBS News

This is the second story this week about patients being forced to change physicians based on HMO contracts.  Hope this is not a trend, especially when the government has to get involved such as the story below.  BD

The California Department of Managed Health Care has reached a settlement with PacifiCare that ends, for now, a months-long saga for hundreds of Peninsula residents to find medical care after the insurer dropped physicians from its network.

And it's patients who get caught in the middle when the relationship ends between insurers and providers.

"It was almost like I didn't have any insurance," said Irene Meyer, a receptionist in a Belmont physicians' practice who had to visit the emergency department for crippling pain after her family's doctor of 17 years was cut from the network.  The May 17 cease-and-desist order found that more than 500 people enrolled with a small physicians' group associated with Sequoia Hospital in Redwood City were "deceived, or otherwise misled" into believing their primary care doctor was still part of PacifiCare's network when they enrolled or re-enrolled with the insurer last fall.

The order requires that PacifiCare allow the patients to immediately return to their original physician until the next open enrollment period in the fall. At that point, they'll still need to find either a new health plan or a new primary care physician.

A PacifiCare representative, Cheryl Randolph (no relation to the state spokeswoman), said the insurer adamantly disagrees with the state agency's finding of fraudulent marketing actions.

PacifiCare's Randolph also said the doctors were offered an option to switch to other PacifiCare plans, enabling them to keep working with their patients. Only two doctors, she said, elected not to move to other groups.

"Nonsense," responded Dr. Sidney Marchasin, a primary care physician in Belmont who was dropped by PacifiCare.

Inside Bay Area - State intervenes in PacifiCare coverage dispute

I guess like it or not, we may all have a chip someday, just like Fido our dog has, but wit a lot more information.  This is truly a busy year for the AMA compared to years past.  BD

 

VeriChip Corporation, provider of RFID systems for healthcare and patient-related needs, announced recently the American Medical Association’s (AMA) Council on Ethical and Judicial Affairs has adopted a policy stating that Implantable radio frequency identification (RFID) devices may help to identify patients, thereby improving the safety and efficiency of patient care, and may be used to enable secure access to patient clinical information. VeriChip has the only FDA-cleared RFID implantable microchip for patient identification and health information purposes. VeriChip anticipates that the AMA’s recommendation will enhance the Company’s marketing efforts by accelerating the adoption by hospitals of the VeriMed Patient Identification System and increasing the profile of the VeriChip among the medical community.

RFID Healthcare: VeriChip Corporation Announces American Medical

Hospitals are not purchasing larger MRI machines for obese patients, but rather choosing for machines with better diagnostic features.  Want an MRI, be sure you are less than 350# is the obvious answer here.  BD

When Dr. Susannah Cornes' patient came in with paralysis and numbness, she wanted an MRI to look at the spinal cord. But the machine couldn't handle someone of her patient's size -- more than 350 pounds.

Absent that option, Cornes, a UCSF resident in neurology, recommended exploratory surgery. The patient declined, choosing instead to live with the numbness and limited movement.

When the opportunity to buy a new machine comes up, hospitals opt for machines that give better images rather than systems that handle larger patients. And that rankles some people.

The average CT is of no use for people who weigh more than 450 pounds, and most MRIs can't handle people who weigh more than 350 pounds. With both machines, the table that carries the patient into a small tunnel, or bore, where the images are taken can't support the weight. In some cases, the bore is too small.

BAY AREA / Hospitals flummoxed by patients too big for MRI machines

The first line of this story tells all, something we face here too in the US.  BD 

The bigger you are as a jurisdiction, the tougher it is,” said Alvarez.

Still, if Ontario makes electronic health records a priority they could “overtake the rest of the country,” he said.  Ontario isn't making enough progress and is falling behind, said Ms. Cavoukian.

Without immediate access, doctors and their staff have to get on the phone seeking the information and test results they need, said Dr. Willett, who adds she spends about 15 per cent of her time tracking down patient information.

globeandmail.com: Ontario chided over health records

 

The proposed form would ask nonprofit hospitals to detail how much money they spent on a number of specific areas, such as charity care, unreimbursed Medicaid costs and health professions education.

Schedule H also asks nonprofit hospitals to describe their collection and billing practices and seeks details as to their joint ventures, such as specifying the ownership interests of doctors in any for-profit activities.

The form comes as more attention has focused on whether nonprofit hospitals are carrying out effectively their charitable missions, as well as how they bill uninsured patients.

AMNews: July 9, 2007. Proposed IRS form revision irking nonprofit hospitals ... American Medical News

 

Three medical associations and two other health care organizations in Massachusetts have asked the state's Dept. of Public Health to exercise careful consideration and hold a public hearing before waiving certain clinic requirements in favor of MinuteClinic, the Minneapolis-based operator of retail-based health clinics.

MinuteClinic asked the state for exemptions from several requirements, such as providing receptacles for soiled linens and having examination rooms of a certain size, in preparation for its plans to open clinics in Boston-area CVS pharmacies.

AMNews: July 9, 2007. MinuteClinic seeks waivers of Massachusetts public health rules ... American Medical News

Good article about physicians using mobility not only with patient consultations and office visits, but also to keep on top of medical journal events and reading material.  Just like newspapers, printed journals also are facing a short life in the future as online information is current.  BD

One way the Internet is influencing medicine is at the point of care. About 25% of physicians are accessing the Internet during patient consultations, while use of the Internet between patient consultations is up 11% since last year, Abreu said.
Physicians who go online during patient consultations are more likely to:

  • Be in a group practice;
  • Have an electronic health record in the practice; and
  • Spend more than 10 hours online per week.

Also, the use of offline medical journals has dropped 14%, while the use of online journals has jumped 27%. Replacing print journals, online journals "almost becoming the new norm for physicians," Abreu said.

Mobile, M.D.: Wired Doctors Bringing Technology to Treatment - iHealthBeat

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