New York Attorney General Andrew M. Cuomo has been conducting an industry-wide investigation of doctor ranking programs, concerned that the insurers use their ranking system to steer their insureds to doctors who cost the insurers less but are not as well qualified to treat the insured as physicians who are more expensive for the insurer to pay. This investigation has led to an agreement, announced earlier this week, with healthcare industry leader, CIGNA Healthcare, regarding its doctor ranking programs.
Investigations performed under the leadership of the Attorney General show that consumers cannot rely on these programs blindly. Previously, in letters … Read the rest
According to the New York Times, nursing home facilities owned by private equity firms receive worse scores than the national average in twelve of the fourteen indicators that regulators use in tracking the ailments of nursing home residents. The Centers for Medicare and Medicaid state that residents of nursing homes owned by private investment firms suffer from higher rates of depression, mobility loss, and the loss of the ability to bathe and dress themselves. Facilities of these companies are also restrain residents for long periods of time more often than facilities that are not privately owned.
The report in the … Read the rest
The Appellate Division, Second Department of the New York State Supreme Court has ruled that an unmarried woman who underwent an abortion can recover punitive damages from the medical clinic where the procedure was performed for the clinic’s wrongful disclosure to her mother of private information from which the girl’s mother was able to deduce that the girl had undergone a abortion. The case is J. v. Long Island Surgi-Center, decided on September 25, 2007.
The appellate court was reviewing a jury verdict awarding the plaintiff $65,000.00 in compensatory damages for emotional distress and $300,000.00 in punitive damages. The … Read the rest
Both New York City and New York State have joined together and, following the example of various other states, including Louisiana Mississippi and Utah, have filed suit against Merck& Company.
It is alleged that Merck not only defrauded consumers but also defrauded the state Medicaid program and other government insurance programs by purposefully concealing the dangerous side effects of Vioxx.
Vioxx was prescribed to patients for the treatment of migraines and arthritis but caused a high increase in heart attacks and strokes, and was pulled off the market in September of 2004.
Medicaid claims that had Merck been forthcoming of … Read the rest
Many patients of health maintenance organizations (“HMO”) are unaware of their legal right to appeal a decision denying their requested treatment. The desired treatment is normally denied deemed as”medically unnecessary” or “experimental.” The law also only provides for a mere 45 day deadline in which one can file this appeal.
The ignorance of various patients of their ability to appeal is particularly problematic in light of the fact that, according to the New York State Insurance Department, approximately 42.6 and 49.4 percent of the cases that are appealed are in fact reversed.
Therefore, it is important that patients are made … Read the rest
On September 7th, 2007, the New York City Health and Hospitals Corporation (NYCHHC), the nation’s largest public health system treating 1.3 million patients a year, began publicly releasing data on infection and death rates at its 11 hospitals and 4 nursing homes.
The safety and performance information is posted on the hospital corporation’s Web site, www.nyc.gov/hhc. The Web site allows the public to see the overall death rate, the rate of deaths after heart attacks, preventable bloodstream infections and pneumonia cases, among other measures, at the 11 hospitals.
Information on the Web site also includes what the NYCHHC considers to … Read the rest
There appears to be a growing trend of “body snatching,” which includes illegally removing human tissue from cadavers and selling the tissue to firms that process it for medical facilities and researchers. As a result, the usual safety screening procedures that take place for the donation of body parts are not performed and there is a growing concern that the procured tissue is tainted.
In fact, this black market business has caused many tissue recipients to receive infected and diseased tissue. Both the FDA and the Centers for Disease Control and Prevention are insisting that those who have received tissue … Read the rest
Medicare, in a significant policy change, will no longer pay the extra costs of treating preventable errors, injuries and infections that occur in hospitals, which the government says could save lives and millions of dollars.
Under the new rule, effective October 1, 2007, and applicable to discharges occurring on or after that date, Medicare will not pay hospitals for the costs of treating certain conditions that could reasonably have been prevented. Significantly, under the new rules, the hospital cannot bill the beneficiary for any charges associated with the hospital-acquired complication.
The Centers for Disease Control and Prevention estimates that patients … Read the rest
The news last week was filled with various reports concerning the manner in which pharmaceutical manufacturers market their products, such as OxyContin, anemia medicines, and atypical psychotics, including ways in which doctors are encouraged to prescribe their products, even to children. The U.S. Senate passed, by a vote of 93-1, a bill that gives the Food and Drug Administration additional authority to regulate drug advertising, among other powers such as the ability to order changes in drug labels.
The bill was passed in large part as a reaction to the experience with Vioxx, where it took 14 months to change … Read the rest