Archive for the ‘Healthcare News’ Category

New Insurance Requirements for Arizona Docs

Arizona Medical Malpractice Expert Sean MintzIn October 2013, the Arizona legislature passed a measure that changes insurance requirements for many doctors in Arizona. Under this new provision, doctors contracted with the state Medicaid system are now required to carry sexual abuse and molestation insurance coverage.

eQuoteMD caught up with an expert in the field of Arizona medical professional liability insurance to find out more about the rule change. Sean Mintz of Centurion Medical Liability Services filled us in on the details: [Read more →]

A Medical Malpractice Reform Roundup

medical malpractice reformDespite then Senator Barack Obama’s support for medical malpractice reform in 2006, when he co-authored an article for the New England Journal of Medicine with Hillary Clinton highlighting its importance, the healthcare reform bill that we ended up with does little to nothing to address malpractice reform.  On one hand, that is frustrating to many of us in the healthcare industry who want to see stronger protections for doctors, and a more equitable system for addressing malpractice costs.  On the other hand, though, passage of the ACA has seemingly spurred some states toward pursuing their own malpractice reforms, whether because of incentives in the ACA itself, or just because it is now clear that for the time being malpractice reform is a state issue.

That said, there is at least one buzzworthy story at the federal level when it comes to malpractice reform. On February 27th, Reps. Andy Barr (R-KY) and Ami Bera (D-CA) introduced a bipartisan bill, H.R. 4106, or the Saving Lives, Saving Costs Act, in the House that would introduce a safe harbor model for Medicare and Medicaid providers.  Under the provisions of the bill standards of care would be developed by a panel of experts, and doctors, by documented adherence to these standards, could shield themselves from liability.  The bill was referred to the Energy and Commerce Committee and the Judiciary Committee for consideration.  While we expressed some reservations about a safe harbor system in a recent post, at least as a magic bullet solution to the problem of defensive medicine, it will be interesting to see if this bill gets any traction and, if so, how it performs.  You can read more about the bill here.

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The Future of Healthcare

The Doctors Company Releases Study Surveying Doctors on the Future of Healthcare: Uncertainty and Frustration with Healthcare Reform Clear Stand Outs

The Doctors Company, one of the nation’s largest medical malpractice insurers, has released the results of a survey they did in which they asked over 5,000 physicians from across all 50 states a series of questions about the future of healthcare in the United States. The survey represents surgical specialty, non-surgical specialty, and primary care doctors relatively evenly. Respondents were 80% male and 20% female, and the age distribution was under 40 – 6%, 41-50 – 17%, 51-60 – 34%, 61-70 – 31%, and over 70 – 12%. Survey respondents were, of course, unpaid. In addition to multiple choice questions, the doctors had the option of writing in personal comments, which over 3,500 of them did, providing the surveyors with a great deal of helpful information with which to get a good sense of the mood within the healthcare community. And the mood is not especially positive, particularly when it comes to healthcare reform and the other areas it touches on—doctor patient relationships, compensation, and regulatory issues to name a few. The twin themes seem to be uncertainty and frustration.

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Managing the Risks of HIPAA Rules & Regulations

Earlier this year, the U.S. Department of Health and Human Services (HHS) announced the final rule that strengthens the HIPAA laws and regulations and puts in place many conditions of the HITECH Act. Obviously, it’s been every medical provider’s goal to be compliant to the HIPAA rules from the very beginning; so why the panic over the HIPAA compliance deadline of Monday, September 23rd? Simply put: It’s overwhelming.

Physicians and their office managers are trying to get up-to-speed, but they do not have the time or manpower to dedicate the hours needed to achieve compliance. The hospitals and larger private practices usually have a compliance officer on their team to get these things done, but the small or mid-sized practices cannot afford that luxury. So it’s up to office managers and administrators to get the practice in line with the new regulations. But even if the office has done its part and implemented all the correct policies and procedures, HHS can still come in and audit the practice and potentially find problems. The fines and penalties associated with HIPAA are significantly higher with the new rule: Up to $1.5 million! [Read more →]

HIPAA Goes Into Effect on 9/23/2013 – Are You Ready?

Are you ready for September 23, 2013? That’s when full enforcement of the Omnibus Rule modifying HIPAA goes into effect. While there are many areas of compliance contemplated under this watershed shift in regulation one of the most important to consider, whether you are a private practice, a hospital, an insurance broker, or even just someone who works with any of these groups is the new regulations regarding Business Associates Agreements (BAAs).

You probably already know that BAAs are essentially contracts designed to ensure compliance with the law, and responsible behavior with the handling of Private Health Information (PHI). These agreements require, for instance, an insurance broker to contractually agree to handle any PHI of the practices they represent in accordance with all legal stipulations under HIPAA and other applicable laws and regulations. Further, they provide security for the originator of the PHI, creating a situation in which failure to comply with the law on the part of a business associate with whom a BAA exists means that liability rests with the business associate as opposed to devolving back to the practice.

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What to Expect from the Affordable Care Act

Like it or not, the Patient Protection and Affordable Care Act (PPACA) appears to be here to stay, and it’s going to mean changes for just about everyone. Across the entire medical industry – from patients to doctors, from hospitals to groups, and from insurers to brokers – change is coming. What are some of the biggest shifts that are being discussed?

More People Are Getting Insured

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The State of Disclosure

A surgeon at a St. Louis hospital performed a “right-sided craniotomy procedure,” when instead he should have performed a “left-sided craniotomy bypass” in April 2013. A wrong-sided surgery that left the 54-year old patient crippled and dependent on around-the-clock care. The correct surgery was performed six days later but the damage was done. The surgeon, an employee of the hospital, apparently confessed his mistake quickly, but a lawsuit was filed the first week of May 2013 coupled with a sensational media story. A few days later the CEO of the hospital publicly apologized for the wrong-side surgery, but, again, the damage was done. Why wasn’t disclosure and apology including fair, upfront compensation addressed immediately after the wrong-side surgery? Why did the hospital wait almost 30 days? Why did the family have to file a lawsuit? And many other questions.

You can read the entire story including the video coverage here.

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Physician Shortage Puts Pressure on U.S. Healthcare System

A waiting room at a doctor’s office is full of patients. The Nurse Practitioner on vacation this week, the office manager squeezes in several unscheduled patients before Noon followed by a lunch meeting with the malpractice insurance broker. Meanwhile a pharmaceutical rep hovers in the hallway waiting for a signature, and the current patient in room 4 is complaining because he had to wait 30 minutes for a 5 minute visit.  Sound familiar?  This is a typical, stress-filled day for most busy physicians in private practice.

Now add 32 million previously uninsured patients looking for healthcare to that scenario – how will doctors keep up with the demand?  And where will patients find care if doctors can’t keep up?

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What’s Next on the Affordable Care Act Timeline?

Your opinion of the Affordable Care Act (ACA) probably depends on what role you play in the U.S. healthcare system.

  • Physicians and other healthcare providers seem to fear each and every new provision as it’s unveiled and are anxious about how to implement the requirements placed upon them.
  • Hospitals are trying to stay ahead of the game (and their competitors) by forming Integrated Health Systems and Accountable Care Organizations, and purchasing physicians’ private practices.
  • Consumers are attempting to navigate the system to take advantage of improved health insurance coverage or to obtain it for the first time.
  • Businesses of all sizes are looking for interpretations of what the law says about employee benefits.
  • Health insurance companies are evaluating in what ways they will participate and what that participation (or lack of) will mean to them in the future.
  • States are trying to decide if they will accept federal money to expand Medicaid and Medicare coverage within their borders.

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National Practitioner Data Bank Removed from Public View

Should information about a physician’s medical malpractice claims and disciplinary actions be made public?  You would think that the answer is a simple, yes, of course, but the question is being hotly debated right now in the news media.  The controversy began when the Health Resources and Services Administration (HRSA) removed the National Practitioner Data Bank’s (NPDB) public use file from its website on September 1st.  Now journalists are asking the director of HRSA and members of Congress to make the database public again

What’s the Big Deal?

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