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Electronic banking could save health system $4.5 billion
A new Centers for Medicare & Medicaid Services regulation sets a framework for electronic fund transfers that should cut down on administrative time and money spent on processing paper checks, officials said. The Jan. 5 CMS interim final rule would create a new standard for electronic fund transfers between health plans and financial institutions, and specify the data content for sending payments to physicians and hospitals. Using a standardized format would allow billing and accounting systems to track payments for services electronically. Creating an environment that encourages electronic transfers of payments instead of paper checks could save doctors and hospitals between $3 billion and $4.5 billion over 10 years in reduced administrative costs, the rule projects. The agency also noted the potential environmental benefits from saving an estimated 400 tons of paper by sending checks electronically. "The less time a physician has to spend on paperwork is that much more time [Read more]
Ohio high court: Expert witnesses required in cases alleging lack of informed consent
Patients who sue doctors over lack of informed consent must obtain expert medical testimony before pursuing their claim, the Supreme Court of Ohio has ruled. The decision, which overturns an appeals court ruling, prevents more lawsuits against physicians and strengthens tort reform protections in place in Ohio, said Bret C. Perry, an attorney for the Academy of Medicine of Cleveland & Northern Ohio. The academy submitted a friend-of-the-court brief in the case. The high court's decision "reaffirmed the longstanding precedent that a claim for lack of informed consent constitutes a 'medical claim' requiring plaintiffs to produce competent expert medical testimony establishing what a reasonable medical practitioner would have disclosed to his patient about the risks" of a proposed treatment, Perry said in an email. In the case, Robert White was treated by Hilliard, Ohio-based neurological surgeon Warren Leimbach II, MD, in 1998 for back pain. The doctor diagnosed White with a her [Read more]
Disparities in reproductive health care linger
Women who are younger, economically disadvantaged or undereducated used fewer reproductive health services in recent years, highlighting disparities that persist despite decades of progress expanding access to such care. The gaps in utilization can contribute to teenage pregnancies and more sexually transmitted diseases, says a study published online Dec. 15, 2011, in the American Journal of Public Health. They are consequences nurse practitioner and lead study author Kelli Stidham Hall sees in the community adolescent health clinic where she practices in Princeton, N.J. "I am seeing these trends play out in my clinical practice," said Hall, a postdoctoral research associate with the Office of Population Research at Princeton University. "It is devastating to see the drop in service use and see the women come in with an unintended pregnancy. You can really see the need." Researchers examined 2002-08 data on 4,421 women 15 to 24 years old, with an average age of 19. More than h [Read more]
Maine faces $220 million Medicaid budget deficit
Maine Gov. Paul LePage's remedy for a $220 million, two-year Medicaid budget deficit is a package of eligibility and coverage cuts that the state's medical association warns would only shift health care costs to a different part of the health system. The state expects to spend $120 million more on Medicaid than budgeted in fiscal 2012 and $100 million more than expected in fiscal 2013. It could run out of Medicaid funding by April 1, said State Sen. Richard Rosen, chair of the chamber's Appropriations and Financial Affairs Committee. In December 2011, LePage proposed closing the deficit in part by ending Medicaid eligibility for childless adults, all 18- and 19-year-olds and certain parents. LePage also would end Medicaid funding for private non-medical institutions. These facilities provide residential and medically necessary services to more than 5,500 Medicaid patients who are not at the level of care for a hospital or nursing home but still need continuing care, LePage said. [Read more]
Medicare kicks out 1 in 5 new medium- and high-risk suppliers
More than 20% of new medical suppliers who are deemed at medium or high risk of being fraudulent had their Medicare billing privileges revoked during the first year of enrollment, federal investigators found. Illicit businesses can bilk the Medicare program for hundreds of thousands of dollars before being discovered, according to a December 2011 report from the Health and Human Services Dept.'s Office of Inspector General. The report found some medium- and high-risk medical equipment suppliers going several months before their first post-enrollment site visits, which ensure that a supplier is running a legitimate business. For instance, one supplier had received $800,000 from Medicare before its first site visit seven months after getting approval to participate in Medicare. The Centers for Medicare & Medicaid Services removed 21% of high- and medium-risk suppliers that were studied in the report, which reviewed claims from 2008 through 2009. The suppliers were paid a total of a [Read more]
Make human research data publicly available, bioethics report says
Patients participating in federally funded scientific studies generally are protected from avoidable harm and unethical treatment. But there is significant room for improvement to increase accountability and, in turn, reduce the chance of volunteers being harmed or treated unethically, a new report says. In the December 2011 report, the Presidential Commission for the Study of Bioethical Issues called for the improvements. Those include: creating public online access to basic data from human subjects research projects; treating volunteers for research-related injuries and compensating them for harm; and developing courses in bioethics and human subjects research at the undergraduate, graduate and professional levels. President Obama asked for the study after an October 2010 discovery showed that the U.S. Public Health Services ran experiments in Guatemala in the 1940s that exposed people to sexually transmitted diseases. Commission members said abuses like those in Guatemala w [Read more]
Private insurers forming their own health insurance exchanges
Commercial health plans are betting that private health insurance exchanges can out-compete public ones for most employer-sponsored coverage. Like other small businesses, physicians offices could be wooed by health plans and other groups running private exchanges. It also may mean that state-based exchanges won't be the only choice for uninsured patients looking for coverage in 2014 and beyond. Generally, there are two types of private exchanges: one kind that allows a consumer to choose from a variety of types of health coverage from one company, and the kind that gives a choice of plans from several companies. Shoppers may be using their own money or spending a set amount from their employer. A health plan might host the exchange on its website, or an independent company may host the exchange and deal with collecting premiums. Large insurers have invested in private exchange start-ups with the idea that they can offer a better insurance marketplace for employers and workers [Read more]
UTI prevention fails to keep pace with other anti-infection efforts
Most hospitals say the Centers for Medicare & Medicaid Services' no-pay policy for hospital-acquired conditions has pushed them to make greater efforts to prevent health care-associated infections. But a study says preventing one item on the no-pay policy has gotten less of a push: catheter-associated urinary tract infections. Nearly all hospitals have implemented practices aimed at reducing the incidence of central-line associated bloodstream infections and ventilator-associated pneumonia, says a study published online Dec. 6, 2011, in the Journal of General Internal Medicine. But less than half of hospitals are taking similar action against the nosocomial infection patients are likeliest to contract -- a urinary tract infection associated with the use of indwelling urinary catheters. "Urinary tract infection is the Rodney Dangerfield of health care-associated infections because it gets no respect, even though it's the most common," said Sanjay Saint, MD, MPH, professor of inter [Read more]
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