Hot Topics in Healthcare Law and Regulation
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Hot Topics in Healthcare Law and Regulation
Healthcare laws and regulations change with lightning speed. Don't blink!
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When Hospitals Buy Clinics, Prices Go Up - Businessweek

When Hospitals Buy Clinics, Prices Go Up - Businessweek | Hot Topics in Healthcare Law and Regulation | Scoop.it
When Hospitals Buy Clinics, Prices Go Up
Businessweek
Hospitals have long charged more than freestanding medical offices for similar services. It's part of how they pay for higher operating expenses such as running 24-hour emergency rooms.
Joseph Rugg's insight:

Of course, they do.  Seriously, is anyone surprised?

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Tele-ICU connects rural patients to critical care doctors

Nine hospitals in Maryland are equipped with the cameras that instantly connect patients to doctors, addressing the shortage of critical care doctors in rural areas.
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Saslaw says 40 percent of rural hospitals will close in states that don't ... - PolitiFact

Saslaw says 40 percent of rural hospitals will close in states that don't ... - PolitiFact | Hot Topics in Healthcare Law and Regulation | Scoop.it
Saslaw says 40 percent of rural hospitals will close in states that don't ...
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Petitioners seek to block Massachusetts hospital takeovers - Press Herald

Petitioners seek to block Massachusetts hospital takeovers - Press Herald | Hot Topics in Healthcare Law and Regulation | Scoop.it
Boston Globe Petitioners seek to block Massachusetts hospital takeovers Press Herald BOSTON — A petition signed by 21 antitrust experts and health economists asks a Massachusetts judge to block efforts by the state's biggest health care system to...
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Navigating Medicare Policy on Physical Therapy and Other Services - New York Times

Navigating Medicare Policy on Physical Therapy and Other Services - New York Times | Hot Topics in Healthcare Law and Regulation | Scoop.it
Navigating Medicare Policy on Physical Therapy and Other Services New York Times That is changing, as a result of a 2013 settlement of a lawsuit that the center and others brought against the secretary of the Health and Human Services Department,...
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Survey Estimates Net Gain of 9.3 Million American Adults with Health Insurance | RAND

Survey Estimates Net Gain of 9.3 Million American Adults with Health Insurance | RAND | Hot Topics in Healthcare Law and Regulation | Scoop.it
Early survey evidence indicates that the Affordable Care Act has already led to a substantial increase in insurance coverage. Consistent with the ACA's design, this gain in insurance has come not only from new enrollment in the marketplaces, but also from new enrollment in employer coverage and Medicaid.
Joseph Rugg's insight:

Despite all of the many flaws in the Affordable Care Act , one has to marvel at the many positive improvements in healthcare since the ACA's passage.  I have said many times that Barack Obama's legacy will not be that he was the first African American President but that he raised the level of debate in this country on many issues, including healthcare.

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Hospitals Offer Better Food As Patient Satisfaction Becomes More Important Under Federal Health Law - Kaiser Health News

Hospitals Offer Better Food As Patient Satisfaction Becomes More Important Under Federal Health Law - Kaiser Health News | Hot Topics in Healthcare Law and Regulation | Scoop.it

Administrators say the focus on food has taken on extra importance since Medicare last year began paying them based partly on their patient satisfaction scores, a change that is part of the federal health care law known as Obamacare.

 

"Food service helps the overall experience," said Jim McGrody, director of food and nutrition at Rex, as he inspected his kitchen cold room used for brining pickles, curing turkey pastrami and fermenting cabbage into sauerkraut. Several letters of praise from former patients hang in the kitchen.

Joseph Rugg's insight:

Good healthcare, not good food, should be the focus, but sloppy unappetizing food preparation doesn't say much about the quality of the facility's healthcare.

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Online health communities improve chronic care quality

Online health communities improve chronic care quality | Hot Topics in Healthcare Law and Regulation | Scoop.it

Online health communities can be powerful tools for addressing chronic care issues as the number of people afflicted with such ailments rises, according to a study published this week in the Journal of Medical Internet Research.

 

For the study, researchers define online health communities (OHCs) as Internet-based platforms that unite a group of patients, a group of professionals, or both, using blogs, chats, forums and wikis. In this case, the researchers--from Radboud University Medical Centre in the Netherlands--illustrated using OHCs for ParkinsonNet, a professional network made for participants with Parkinson's disease in which providers deliver patient-centered care.

 

ParkinsonNet utilized community managers; in this case, it was a marketing and communications expert. The community manager distributed posters, information pamphlets, and "business cards" to patients and health professionals as part of educating people about the OHC.

Joseph Rugg's insight:

Online care which produces healthier patients needs to be factored into how healthcare are to be compensated. 

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Serious Medicine Strategy: House Majority Leader Eric Cantor Shifts the Paradigm on Healthcare--From Cuts to Cures.

Serious Medicine Strategy: House Majority Leader Eric Cantor Shifts the Paradigm on Healthcare--From Cuts to Cures. | Hot Topics in Healthcare Law and Regulation | Scoop.it

House Majority Leader Eric Cantor (R-VA) said on Wednesday:  "If you cure disease, you no longer have to spend dollars towards treating the symptoms ... of those diseases."

Bingo.  Of course, cures are cheaper than care.  It's cheaper to beat than to treat.  That was the lesson of polio.  A cure is cheaper than care. 

If we want to "bend the curve" on healthcare costs--and we all do--this is the right way to do.  Also the only humane way.

Joseph Rugg's insight:

One has to wonder where the Congressman and this blogger have been for 3 years.  This is what Obamacare is all about -- preventive care in order to avoid the excessive costs of untreated illnesses that need expensive urgent care.  These Rip Van Winkles need to wake up and smell the Affordable Care Act coffee.

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Family Physicians Lead In EHR Adoption -- InformationWeek

Family Physicians Lead In EHR Adoption -- InformationWeek | Hot Topics in Healthcare Law and Regulation | Scoop.it

More than two-thirds of family physicians (FPs) had adopted electronic health records by 2011, and the adoption rate is likely to surpass 80% this year, according to a new study in the Annals of Family Medicine.

The data came from the American Board of Family Medicine (ABFM), which surveys all candidates applying for its maintenance of certification exam, and the National Ambulatory Medical Care Survey (NAMCS). The results of the two surveys showed EHR adoption among family doctors doubled to 68% between 2005 and 2011.

Joseph Rugg's insight:

Family physicians and other primary care givers are being asked to take on the most significant roles in health care reform -- preventive care to keep their  patients healthy.  EHR is critical for that to happen.  Hopefully, the specialists will soon catch up.

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Health care reform support grows

Health care reform support grows | Hot Topics in Healthcare Law and Regulation | Scoop.it

Des Moines, Iowa - Once largely united in resisting the Obama administration's new health care overhaul, a growing number of Republican governors are now buying into parts of the system as the financial realities of their states' medical costs begin to counterbalance the fierce election politics of the issue.

Joseph Rugg's insight:

One step at a time for progress -- as thick skulled as some of these governors are, they seem to be learning (even the neanderthal Florida Governor Rick Scott) that it just doesn't pay to be standing in front of the train that your consituents are on.

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USDOJ: US Attorney's Office - Western District of MO

KANSAS CITY, Mo. – Tammy Dickinson, United States Attorney for the Western District of Missouri, announced that a psychologist practicing in the Lebanon, Mo., area was sentenced in federal court today for engaging in a $1 million scheme to defraud Medicare and Medicaid.

 

“Those who defraud the government are stealing from the pockets of law-abiding taxpayers,” Dickinson said. “This psychologist flagrantly abused the system to enrich himself for more than three years, but today he is being held accountable for his actions.”

 

Rhett E. McCarty, 67, of Lake Ozark, Mo., was sentenced by U.S. District Judge Howard F. Sachs to three years in federal prison without parole. The court also ordered McCarty to pay $1 million in restitution to Medicaid and Medicare.

 

McCarty was a licensed psychologist and private practitioner who provided psychotherapy services to recipients of both Medicare and Medicaid in their homes in the Lebanon area. On Aug. 16, 2012, McCarty pleaded guilty to health care fraud and to forgery.

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Couple sentenced in Medicare fraud

Former Baton Rouge business owners Young Okoro Anyanwu and Beatrice Anyanwu were sentenced Friday to federal prison after admitting they defrauded Medicare and an insurance company of a combined total of $485,552.

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Online access: Portals connect patients with their medical info - Insurance News Net

Online access: Portals connect patients with their medical info
Insurance News Net
Patients need tools to manage their health between doctors' visits.
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Concern mounting over Prime Healthcare pursuit of Bay Area hospitals - San Jose Mercury News

A controversial Southern California-based hospital chain that buys financially struggling hospitals has surfaced as a bidder for the beleaguered Daughters of Charity Health System, which operates four Bay Area hospitals that serve the poor.

But the overture by Prime Healthcare Services isn't playing well with local hospital employee unions, who say the chain's checkered history shows it will turn its back on low-income patients and slash workers' pay and benefits.

Joseph Rugg's insight:

So, we know this is the way that healthcare is going -- consolidation into bigger and bigger organizations.   In the short run quality should go up and costs should go down. Hopefully.  In the long run, I'm not sure bigger is better for anything.

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Florida hospitals drop challenges to HCA trauma expansion - Tampabay.com

Florida hospitals drop challenges to HCA trauma expansion
Tampabay.com
The contentious battle over the expansion of trauma care in Florida ended quietly Friday as Bayfront Health St. Petersburg, Tampa General and St.
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Winnebago IHS Hospital loses contract and funding from Center for Medicare ... - KTIV

Winnebago IHS Hospital loses contract and funding from Center for Medicare ... - KTIV | Hot Topics in Healthcare Law and Regulation | Scoop.it

WINNEBAGO, Nebraska (KTIV) - A hospital in Northeast Nebraska will lose their Medicare funding within the week.

The U.S. Centers for Medicare and Medicaid Services says their Medicare agreement with Winnebago Indian Health Services will end June 4.

After that, the hospital won't be reimbursed for treating elderly or disabled patients enrolled in the health care program.

The CMS says the hospital isn't in compliance with Medicare regulations in their public notice.

John Blackhawk, chairman of the Winnebago Tribe, says the hospital is working with the federal agency to avert the cutoff.

Earlier this month, the hospital was warned of this possibility after an investigation found that inadequate care caused the death of a patient in April.

 

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FSSA will maintain Medicaid coverage for 360 kidney transplant patients - WTHR

FSSA will maintain Medicaid coverage for 360 kidney transplant patients - WTHR | Hot Topics in Healthcare Law and Regulation | Scoop.it
FSSA will maintain Medicaid coverage for 360 kidney transplant patients WTHR Indiana's Family and Social Services Administration now confirms it has the approval of the Centers for Medicare and Medicaid Services to continue coverage for end-stage...
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Health Care Nightmares

Health Care Nightmares | Hot Topics in Healthcare Law and Regulation | Scoop.it
Obamacare is doing just fine. But America is not, thanks to the ugliness brought out into the open by the debate on health reform.
Joseph Rugg's insight:

The members of the flatworld society will not stop until healthcare reform is dead.  It's sad and it's a horrible waste of money, not to mention the real harm being done to the uninsured and the poor. They still rejoice at having made Galileo recant his view that the world revolves around the sun -- their last real success. 

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Thousands Of Mississippi Consumers May Not Be Offered Insurance Subsidies - Kaiser Health News

Thousands Of Mississippi Consumers May Not Be Offered Insurance Subsidies - Kaiser Health News | Hot Topics in Healthcare Law and Regulation | Scoop.it

Tens of thousands of uninsured residents in the poorest and most rural parts of Mississippi may be unable to get subsidies to buy health coverage when a new online marketplace opens this fall because private insurers are avoiding a wide swath of the state.

 

No insurer is offering to sell plans through the federal health law’s marketplaces in 36 of the state’s 82 counties, including some of the poorest parts of the Delta region, said Mississippi Insurance Commissioner Mike Chaney.

 

As a result, 54,000 people who may qualify for subsidized coverage would be unable to get it, estimates the Center for Mississippi Health Policy, a nonpartisan research group.

Joseph Rugg's insight:

Private commercial insurance companies are making this decision to deny healthcare coverage to thousands of poor rural Mississippians.  This is not the fault of Obamacare.  What is the solution - to give those people access to healthcare or not.  State legislatures can no longer ignore the poor -- the point is why should the private healthcare insureres be allowed to pick and choose like this - if they want to be licensed in Mississpippi, they should be required to provide coverage throughout the state.

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New direction for Medicaid in Alabama

MONTGOMERY— About 120,000 Medicaid patients in the Shoals and Tennessee Valley will receive most of their health care from a network of willing providers within a 10-county region beginning in late 2016

 

The new direction for the state agency is part of a plan legislators approved earlier this year to control Medicaid’s ballooning costs.

 

State leaders plan to turn Medicaid from its current fee-for-service model to a managed care approach, beginning in fiscal 2017.

To make the transition, Medicaid officials are splitting the state into five areas where Regional Care Organizations — largely run by healthcare providers — will operate.

 

“The (Regional Care Organizations) came about because we’ve been on a fee-for-service type system with Medicaid, which doesn’t encourage providers to maximize efficiencies,” said Rep. Ed Henry, R-Hartselle, one of several lawmakers on Gov. Robert Bentley’s Medicaid study commission.

 

“This reform measure is to try to put efficiencies in Medicaid,” he said. “We pay providers a set amount per patient and if they deliver that care for cheaper, they make money. If they don’t, they lose money.”

 

David Spillers, CEO of Huntsville Hospital, said the regional organizations, or RCOs, will be a complete change in how Medicaid providers are reimbursed. The Huntsville Hospital system includes 12 medical facilities in north Alabama, including Helen Keller Hospital in Sheffield.

Joseph Rugg's insight:

The Medicaid crisis in Alabama (and the other 49 states) was not caused by Obamacare.  But for the first time, there is a national debate on how to make healthcare more effective AND more cost-efficient.  Obamacare has forced legislatures and Governors to face the horrible problems of increasing healthcare costs and poor healthcare and to solve those problems in some way other than to ignore them.  Many have not been up to the challenge.

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Doctors and Social Media: Legal Aspects and Bottom Line | HealthWorks Collective

Doctors and Social Media: Legal Aspects and Bottom Line | HealthWorks Collective | Hot Topics in Healthcare Law and Regulation | Scoop.it
The health care social media legal series continues here on Healthin30, and legal expert, David Harlow, Esq, Health Care Attorney and Consultant at The Harlow Group, LLC in Boston, answers a series of questions focusing on the legal aspects of...
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New restrictions on hydrocodone stir debate among patients, doctors and policymakers - Tampa Bay Times

New restrictions on hydrocodone stir debate among patients, doctors and policymakers - Tampa Bay Times | Hot Topics in Healthcare Law and Regulation | Scoop.it

A proposal would forbid prescription refills. TAMPA — By the time they see Dr. Benito Torres, cancer patients just out of surgery need a strong painkiller. A pain specialist on staff at H. Lee Moffitt Cancer Center, Torres typically prescribes medication like Vicodin or Lortab, which both deliver the powerful drug hydrocodone.

 

What happens after the pill bottle is empty, but the pain continues? Torres can phone in refill orders to pharmacies. But that would change under a proposal to put new restrictions on painkillers containing hydrocodone.

Facing an unrelenting prescription drug abuse crisis, the U.S. Food and Drug Administration may reclassify hydrocodone into the most restricted category of legal drugs. The move would prohibit refills, meaning patients would have to return to their doctors for a new prescription.

 

Supporters say the move is long overdue, arguing it will force doctors to think twice before handing out a potentially addictive drug that is the most-prescribed painkilling medication in the nation.

 

Joseph Rugg's insight:

The typical legislative over reaction to "solving" a problem -- make life harder for those who have done nothing wrong because it's too hard to address and solve the real problem.

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Editorial: Idaho health care exchange foes must face reality - The Spokesman-Review

Editorial: Idaho health care exchange foes must face reality - The Spokesman-Review | Hot Topics in Healthcare Law and Regulation | Scoop.it
The quixotic battle against the Affordable Care Act continues in the Idaho Legislature, but at least more legislators have stopped tilting at windmills.
Joseph Rugg's insight:

"We believe health care reform needs some changes, especially in the form of cost containment, but refusing to acknowledge its existence solves nothing."


The editorial writers are correct -- listening to others' howling at the wind gets old when there are problems to solve.

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USDOJ: US Attorney's Office - Northern District of Texas

USDOJ: US Attorney's Office - Northern District of Texas | Hot Topics in Healthcare Law and Regulation | Scoop.it

DALLAS — On the day his trial was to begin in U.S. federal court, Dr. Daniel K. Leong, 59, who owned South Dallas Community Medical Center (SDCMC) on Martin Luther King Blvd., in Dallas, pleaded guilty to one count of conspiracy to commit health care fraud. Leong, who is in federal custody, faces a maximum penalty of five years in federal prison, a $250,000 fine and restitution. Sentencing is set for May 1, 2013, before U.S. District Judge Ed Kinkeade.

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