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Can Patients Commit Medicaid Fraud?

We hear so much about health care fraud and how much it costs us all in terms of higher Medicaid, Medicare and private insurance costs, and if we could just rein in this fraud we could make our health care system pay for itself.

My trusty Mac widget dictionary defines fraud as:

  • a person or thing intended to deceive others, typically by unjustifiably claiming or being credited with accomplishments or qualities and
  • wrongful or criminal deception intended to result in financial or personal gain.

Well, I’m wondering, what is actually considered fraud?

Let me give some examples, and help me understand whether or not this is fraudulent behavior. The examples are purely hypothetical and do not represent any known individuals, living or dead, or specific situations in any known emergency department, living or dead. Read more »

*This blog post was originally published at Emergiblog*

Nurse’s Life Changed By Twitter

Dear @Twitter,

I so totally know how this sounds to write to a service, but I must confess: your little wings have changed the trajectory of my life and – for the most part – I think it’s been for the best.

I’ve been around for over 40 years, have seen many things, met all sorts of people and have – mostly – enjoyed my life. But I think every several hundred years, a tiny and almost insignificant tool comes out of nowhere and changes the world – like the wheel and zero, both of which are truly “nothing” (both are each shaped the same way). And yet the each not only changed the course of civilizations but also created them. Read more »

*This blog post was originally published at Phil Baumann*

Online ER Booking: Is There A Real Emergency?

This is so wrong.

You can’t make this stuff up.

It seems an emergency department in Memphis, Tennessee is now taking online reservations for their services. Yes, you heard that right, you can now hop online and select the time you would like to be seen for your “emergency”. Just pay $15.00 and you can give your chief complaint, your medical history and your list of medications ahead of time, saving you time and trouble when you pop in with your pesky problem!

What if the problem is serious?

The computer won’t let you register and flashes a “Call 911″ sign at you.

But wait! There’s more!

If you are not seen within 15 minutes of your scheduled time, you money is cheerfully refunded!

I’m not kidding. Read more »

*This blog post was originally published at Emergiblog*

Nurse Anesthetists: Allowed To Work Without Doctor Supervision?

New Jersey’s state health department is considering a rule that would allow nurse anesthetists to work without a doctor’s supervision, as long as there’s a plan to reach one in case of an emergency. New Jersey would join the 30 states that allow nurse anesthetists to work without direct supervision.

On the other end of the country, a California court upheld the state’s decision to opt out of a Medicare requirement that doctors be present while a nurse anesthetist works in order to be reimbursed. The Centers for Medicare and Medicaid Services have allowed states to opt out of that requirement since 2001.

Since then, there has been no evidence of increased inpatient deaths or complications, researchers reported in the August 2010 issue of Health Affairs. Earlier this month, the Institute of Medicine reported that nurses should have a larger role in medical care, including anesthesiology.

*This blog post was originally published at ACP Internist*

Nurses And Policemen, Rapid Response Teams, Useful Apps, And Photography

So who hasn’t heard about The Policeman vs. Nurse? A nurse was pulled over for speeding, told the policeman that she hoped he would never end up as her patient, and was subsequently fired when the policeman complained to the hospital she worked at.

Really? I have the utmost respect for the police of course, but put on some big boy undies and get over it. Should the nurse have made that comment? No. Not in front of him, at least. That was pretty dumb. But being fired for saying it is ridiculous in my opinion. Does that cop go complain to the pimp when the hooker he’s arresting makes a sassy comment? Nurse and Lawyer had a pretty good discussion about the whole situation.

Next up: Rapid Response Teams Sign of Poor Bed Management. Really? I think GruntDoc summed it up best in his tweet about it. The article states that rapid response teams (RRTs) are utilized due to overcrowding because sometimes patients aren’t placed in a unit that is appropriate for their needs. Therefore, their condition worsens and they need help. Read more »

*This blog post was originally published at code blog - tales of a nurse*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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