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Elected coroners report fewer suicides than appointed counterparts

More than 1,500 counties in America elect their coroners, and that voting may play a role in their decisions on whether to classify deaths as suicides. Elected coroners report about 13% fewer suicides than appointed medical examiners, even after controlling for other factors that affect suicide rates, according to a study presented in August at the American Sociological Assn.'s annual meeting. Because people who commit suicide usually do not leave notes or other explanations for their actions, it is often left to coroners to determine based on the evidence available whether a death is due to suicide, accident or some other cause. A lot rides on the decision, as many families and survivors fear the stigma associated with suicide or may lose out on insurance benefits if the death is ruled a suicide. "Elected coroners would feel pressure because they are elected by the public at large and would be worried about antagonizing local community stakeholders who might badmouth them," s ...

Texas certificate-of-merit law ruled constitutional

Texas' certificate-of-merit law withstood another constitutional test after an appeals court validated the requirement for plaintiffs to file an expert report confirming the merits of a medical liability case. The 5th District Court of Appeals rejected arguments that the legislation amounted to an unconstitutional special law that treated medical liability lawsuits differently from other cases. Nor does a provision subjecting plaintiffs who file a deficient report to financial penalties violate the constitutional separation powers, the court said. Judges still have discretion to determine the amount of monetary sanctions and whether plaintiffs made a good-faith effort to pursue a case. The expert report requirement "rationally relates to the interest of the state to prevent medical practitioners from defending frivolous claims at a high cost to the health care system," states the Aug. 12 opinion, which reinforced past decisions on the statute. The ruling is a victory for ph ...

$1 billion spent to fight Medicare fraud in 2010

Washington -- The Medicare program spent $1 billion fighting fraud and ensuring the accuracy of payments for health care services in 2010, according to a new government study. The Centers for Medicare & Medicaid Services has expanded its anti-fraud efforts after receiving increased funding from Congress and reallocating money saved from Medicare contractor consolidations since 2006, according to a Government Accountability Office report released Aug. 29. Operations include more oversight of Medicare private insurers and drug plans, and benefit integrity activities. The health system reform law also provided CMS with an additional $350 million for fraud and abuse control efforts, the GAO said. "Curbing waste and fraud, including the tens of billions of dollars in Medicare improper payments, is a big job, and we need the right tools in place to make progress," Sen. Tom Carper (D, Del.) said in a statement on the GAO report. "Moreover, government must embrace a culture of thrift ...