In October, the Office of Inspector General (OIG) issued a report on Fraud and Abuse Training in Medical Education, finding that 44 percent of medical schools reported giving some instruction in the anti-kickback statute and related laws, even though they weren’t legally required to do so. (As an aside, do we really live in such a nanny state? Over half of all medical schools don’t teach their students anything about this issue — because nobody’s making them — even though it is an issue that looms large in the practice of medicine.)
On a more positive note, about two-thirds of institutions with residency programs instruct participants on the law, and 90 percent of all medical schools and training programs expressed an interest in having dsome instructional materials on the subject of the anti-kickback statute, physician self-referrals (Stark) rules and the False Claims Act.
So in November, the OIG released a Roadmap for New Physicians – A Guide to Avoiding Fraud and Abuse, available on line and as a PDF. It’s a good 30-page primer on the subject. While some of the examples given are specific to newly-minted physicians, anyone in the health care industry would benefit by reading it. The document offers a window into the thinking of the OIG, its perspective on the wide range of issues summarized within, and is a good touchstone for any individual or organization seeking to structure a relationship that needs to stay within the bounds of these laws. Read more »
You want to see a doctor? You’re going to have to wait. And I don’t mean like an hour in the office. I mean like 53 days.
It’s not some doomsday story from the future. It’s happening today here in Massachusetts. Massachusetts — the state whose 2006 law was the model for the federal healthcare reform law. Massachusetts — home to some of the world’s best medical centers and doctors. And, as the Boston Globe’s “White Coat Notes” blog reports, Massachusetts — home to doctor shortages and long waits to see a doctor:
When primary care patients do secure an appointment for a non-urgent matter, they have to wait to get in the door, the survey found. The average delay is 29 days to see a family medicine doctor, down from 44 days last year, and 53 days to see an internist, up from 44 days last year.
The report said shortages also exist in dermatology, emergency medicine, general surgery, neurology, orthopedics, psychiatry, urology, and vascular surgery.
But what about costs? If you make sure everyone’s covered, you’ve got the foundation for real cost control, right? Unfortunately, no. Healthcare costs have been booming in Massachusetts:
Costs are rising relentlessly for both families and for the state government. The median annual premium for family plans jumped 10% from 2007 to 2009 to $14,300 — again, that’s a substantial rise on top of an already enormous number. For small businesses, the increase was 12%. In 2006, the state spent around $1 billion on Medicaid, subsidies for medium-to-lower earners, and other health-care programs. Today, the figure is $1.75 billion. The federal government absorbed half of the increase.
So what are the lessons for the future of American healthcare? Read more »
*This blog post was originally published at See First Blog*
Thanks to Scott Hensley over at Shots, NPR’s Health Blog, for highlighting this sad but funny video on where we’re going with healthcare. Scary what happens when theory meets reality:
-WesMusings of a cardiologist and cardiac electrophysiologist.
*This blog post was originally published at Dr. Wes*
Who doesn’t need insurance reform? Why, the insurers like Aetna, Cigna, and BCS Insurance, that’s who! From Emergency Physicians Monthly:
By threatening to raise health care premiums by 200 percent or threatening to drop coverage altogether, the companies got the Department of Health and Human Services to cave. Now the companies have our government’s blessing to continue offering “insurance” to their employees that is capped at a few thousand dollars per year instead of the $750,000 required in the health care law.
“I am not an Obamacare fan, and would like it repealed, with smaller, more focused Bipartisan fixes, but if the government is going to pass something then roll over this easily to special interests… it’s already worse than useless.”
-WesMusings of a cardiologist and cardiac electrophysiologist.
*This blog post was originally published at Dr. Wes*
Recently the [state of] New York signed a law requiring hospitals and doctors to discuss breast reconstruction options with the patient prior to her undergoing cancer surgery. It troubled me that this law was needed. Is it not the duty of the physicians and surgeons to educate the patient on the options available?
We need to make sure the patient and their family know of the treatment options which may vary depending on the diagnosis and stage: Radiation, chemotherapy, surgery (lumpectomy, mastectomy, axillary dissection) — a combination of treatments.
Even if the patient and her physicians don’t chose to do immediate reconstruction, isn’t the discussion and information part of the discussion? At least inform the patient of the option.
Do we physicians and surgeons need another law to ensure we do right by our patients? Read more »
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