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First Monetary HIPAA Fine Issued

Via the Threatpost article “HIPAA Bares Its Teeth: $4.3m Fine For Privacy Violation“:

The health care industry’s toothless tiger finally bared its teeth, as the U.S. Department of Health and Human Services (HHS) issued a $4.3 m fine to a Maryland health care provider for violations of the HIPAA Privacy Rule. The action is the first monetary fine issued since the Act was passed in 1996.

A copy of a penalty notice against Cignet depicts a two-year effort in which HHS struggled with what appears to be a dysfunctional Maryland provider unaware of the potential impact of HIPAA non-compliance, and unwilling or unable to cooperate with HHS in any way.

When first reading the title I was willing to rail against HIPAA, as I’m tired of it. Then I read the post. Wow. It’s like a test case designed to see just how far you could push HHS, and frankly how incompetent you can be while pushing. Seems HHS was having trouble getting Cignet’s attention. I bet they have it now.

*This blog post was originally published at GruntDoc*

The First Emergency Physician Elected To Congress

I was unaware that Dr. Joe Heck of Nevada is the first emergency physician to be elected to Congress. Good for him! From the American College of Emergency Physicians (ACEP):

In one of the closest congressional races of 2010, Republican challenger and ACEP member Dr. Joe Heck upset Rep. Dina Titus in Nevada’s third Congressional District.  Dr. Heck is the first ACEP member and emergency physician to be elected to Congress.

I suppose that leaves me to be the first for the Senate…

*This blog post was originally published at GruntDoc*

Doctor Who Attempted To Have Whistleblowing Nurses Prosecuted Is Put On Probation

From an AP article in the Dallas-Fort Worth Star-Telegram:

AUSTIN — Texas medical regulators on Friday placed on probation a West Texas doctor involved in the unsuccessful prosecution of two nurses who complained anonymously that the physician was unethical and risking patients’ health.

The Texas Medical Board technically suspended Dr. Rolando G. Arafiles Jr. but allowed him to continue to practice medicine while on probation for four years if he completes additional training.

The board also said Arafiles must be monitored by another physician and submit patient medical and billing records for review. The monitor will report his or her findings to the board.

In the mediated order signed in Austin, the board concluded that Arafiles failed to treat emergency room patients properly, did not apply hormone therapy to a female patient appropriately and failed to document patient diagnoses and treatment plans.

The board also found that Arafiles improperly tried to intimidate two nurses who reported him to the medical board for unethical behavior.


*This blog post was originally published at GruntDoc*

Should Doctors Be Banned From Asking If A Patient Owns A Gun?

Via an article entitled “Proposed Law Would Ban Docs From Asking If Patient Owns Gun” from First Coast News:

TALLAHASSEE, Fla. — A state lawmaker has filed a bill that would ban doctors from asking their patients if they have a gun in the home.

Rep. Jason Brodeur, R-Sanford, said he has heard of a number of cases in which doctors asked their patients that question, which he thinks should be off limits.

“What we don’t want to do is have law-abiding firearm owners worried that the information is going to be recorded and then sent to their insurance company,” he said. “If they’re on Medicaid maybe it’s sent to the government. If the overreaching federal government actually takes over health care, they’re worried that Washington, D.C. is going to know whether or not they own a gun and so this is really just a privacy protection.”

Under the legislation, a doctor could face a fine of up to $5 million or be sent to prison for up to five years for asking about guns in the home.

I understand the stated intent as recorded in this news item: Gun ownership is being recorded, lots of things are reported to insurance companies and the government, and this bill is an attempt to keep this information out of those circles, at least as obtained in a doctors’ office where people still believe what they say is between them and their doctor. It should be, but lots of things should be absolute that aren’t. Read more »

*This blog post was originally published at GruntDoc*

Stick To One ER, Avoid Unnecessary Tests

Via Kaiser Health News:

On a recent Friday night at the Boston Children’s Hospital ER, Dr. Fabienne Bourgeois was having difficulty treating a 17-year-old boy with a heart problem. The teen had transferred in  from another hospital, where he had already had an initial work-up — including a chest X-ray and an EKG to check the heart’s electrical activity. But by the time he reached pediatrician Bourgeois, she had no access to those records so she gave him another EKG and chest X-ray. He was on multiple medications, and gave her a list of them. But his list differed from the one his mother gave doctors, neither of which matched the list his previous hospital had sent along.

This is excellent advice. Every ED has seen a patient, probably today, with “they saw me at the ER across town, but they didn’t do anything and I’m still sick.” While it makes some sense not to return to a restaurant that gave you a meal that wasn’t to your tastes, medicine is quite different.

If a patient gives me this history, I now have a blank slate, and need to essentially start at zero with them. So, I will do the correct workup to exclude the life threats based on the history and physical exam, which may be exactly the tests they had yesterday. I’m not going to assume they did the same tests, or that they were normal. It’s the standard of care at this time, and I have very, very few alternatives. Read more »

*This blog post was originally published at GruntDoc*

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Latest Book Reviews

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