June 22nd, 2011 by Happy Hospitalist in Health Policy, Opinion
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Are government entities required to pay the hospital bills of incarcerated prisoners? This is a scenario that happens quite often. Jailed patients are admitted onto the hospitalist service through the ER for anything from patients faking seizures in the ER to chest pain to drug overdoses. When patients are under the custody of the city, state or federal system, those entities are required to pay for necessary acute health care services. I don’t know, maybe it has something to do with a prisoner’s constitutional right. You lose your right to vote, but not to get a liver transplant.
So what happens? Jailed patients get admitted and guards, sometimes, one, two or three at a time, are required to be at the patient’s bedside 24 hours a day. If the patient needs to transport to the radiology department, sometimes this must be arranged with the guards ahead of time to allow extra staffing for the transport.
As you can tell, having a jailed patient is expensive, not only for the cost of the incurred hospital expenses but also the extra labor costs of having additional guards in the patient’s room 24 hours a day. So what’s a city to do? Read more »
*This blog post was originally published at The Happy Hospitalist*
June 3rd, 2011 by DrWes in Health Policy, Humor
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From AMA Medical News:
New York physicians may have to take off their neckties, jewelry, wristwatches and long-sleeved white coats when caring for patients if a bill under consideration in the state legislature becomes law.
The bill, proposed in April in the state Senate, calls for a “hygienic dress code council” within the New York Health Dept. to consider advancing a ban on neckties and requiring physicians and other health professionals to adopt a “bare below the elbow” dress code in an effort to slash hospital-acquired infections.
Even though there’s no data that this does anything to reduce hospital acquired infections.
But that doesn’t matter.
So why stop there? I say, doctors should do the ultimate for their patients: the Full Monty.
*This blog post was originally published at Dr. Wes*
May 24th, 2011 by Stanley Feld, M.D. in Health Policy, Opinion
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There is a widespread discrepancy between the opinions of organized medical group leaders in the American Medical Association (AMA), the American Academy of Family Physicians (AAFP), the American College of Physicians (ACP), and practicing physicians. AMA, AAFP, and ACP are part of organized medicine.
These organizations supported the healthcare reform law in 2010 and continue to support the legislation. I believe they have taken this position because they want a seat at the table as implementation of the legislation moves forward. President Obama has not paid attention to them so far and there is little evidence that he will in the future.
In March of 2010, Speaker of the House Nancy Pelosi famously said, “We have to pass the [health care] bill so that you can find out what is in it.”
Most physicians are starting to realize the implications of President Obama’s Healthcare Reform Act (ACA) (Obamacare). They are terrified about the implications for the practice of medicine.
Organized medicine is still not disenchanted with President Obama’s Healthcare Reform Act. Charles Cutler, MD, chair of the ACP Board of Governors said recently, “The medical community recognizes that so much of the ACA is good.” Read more »
*This blog post was originally published at Repairing the Healthcare System*
May 15th, 2011 by Happy Hospitalist in Health Policy
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There is a huge myth being unknowingly perpetrated against the general public when it comes to their rights and responsibilities as a patient. It’s a myth that I can remember hearing as far back as my first few weeks of clinicals during medical school. It was a constant presence during my residency training and even now, as a private practice hospitalist I hear misinformation being handed down day after day, month after month.
This myth is perpetrated by doctors, nurses, and therapists of all kinds. What is this myth? That their health insurance company will not pay for the care provided if they want to leave against the medical advice of their physician.
Will my insurance company pay if I leave against medical advice (AMA)? Yes. They will pay. Medicare and Medicaid pay for services that are medically necessary. For example, if you go to the ER and the doctor recommends a CT scan of your chest and you decline, this does not mean the insurance company will deny payment for your visit to the emergency room. This is what the informed consent process is for. If you have been admitted for a medical condition that requires hospitalization and your care plan meets Medicare medical necessity muster, your care will be paid for whether you leave the hospital when your physician believes it is safe or not. Read more »
*This blog post was originally published at The Happy Hospitalist*
March 20th, 2011 by Stanley Feld, M.D. in Health Policy, Opinion
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Last year’s “Doctor Fix” was passed the last week congress was in session in 2010. This was after the medical profession was held in suspense for 9 months.
The “Doctor Fix” was supposedly the result of President Obama making a deal with the AMA for the AMA’s support. He was going to pass a real “Doctor Fix” in 2011 by repairing the defective sustainable growth rate formula (SGR). Nothing has been done about this by President Obama in 2011. The cumulative physician reimbursement reduction of 25% was suspended until January 2012.
Physicians face a 29.5% Medicare Pay Cut in January 2012. Four and one half percent was added to last year’s cumulative physicians reimbursement reduction. The reduction was calculated into the CBO’s cost score for President Obama’s Healthcare Reform Act.
Last week an official with the Centers for Medicare and Medicaid Services unveiled the 29.5% rate reduction for 2012 in a recent letter to the Medicare Payment Advisory Commission. This will become another distraction for physicians and the media as President Obama stalls for time. Read more »
*This blog post was originally published at Repairing the Healthcare System*
