Healthcare Reform - Medical Justice

Defensive Medicine: Real and Expensive! Here’s the Solution!

August 15, 2024July 12, 2010 by Jeffrey Segal, MD, JD

The Archives of Internal Medicine recently published an article, “Physician’s Views on Defensive Medicine: A National Survey.” The results were clear and conclusive. Doctors decidedly do order tests which are not medically necessary in order to protect themselves from frivolous lawsuits… and the public pays for them, a part of the cost of receiving healthcare. In order to narrow results down to something conclusive and useful, the doctors surveyed were asked to respond to two statements, shown below. The first proves that 91% of all physicians surveyed order those extra tests and procedures to protect themselves. The second demonstrates that the considered opinion of the doctors surveyed is that they will not stop practicing defensive medicine until they are protected against unwarranted litigation by other means (such as Tort Reform.) There may be no shockers for anyone in the medical community there, and it’s certainly not a new conclusion, but this is current and conclusive information to support the desperate need for Tort Reform as soon as possible.

Here are the statements which physicians were asked to respond to:

Will Smarter Lawyers End Frivolous Lawsuits?

August 15, 2024July 6, 2010 by Jeffrey Segal, MD, JD

An excellent post from the MD Whistleblower blog. How do you know if a lawyer is any good? Of course, they’ve all passed the bar, but now their profession is lowering it. While most of us strive for excellence, and raise our children to value this virtue, prominent legal educators are establishing a new quality … Read more

Senate Passes Yet Another Short-Term Extension for Medicare, BUT…

August 15, 2024June 21, 2010 by Jeffrey Segal, MD, JD

On June 18, 2010, the U.S. Senate passed yet another short-term funding of physician’s fees for Medicare. The earlier proposed bill, which would have lasted 6 months and included a 2.2% increase for doctors, was denied by a GOP filibuster. The Republicans complained that the bill’s benefits were not paid for, and refused to allow the national debt to be increased. This leaves health care providers yet again in a lurch.

Had the temporary measure not been passed, doctors would have suffered a 21% reduction in fees. This “Doc Fix” (as its come to be called,) is a stay of execution for both doctors and patients, but only a temporary one. As it is, the reduction in pay was already technically in place, but claims had been paid at the “full” rate in anticipation of a (another) reprieve from Senate.

ONH Issues Temporary Certification Program for EHR, Wait Far From Over

August 15, 2024June 18, 2010 by Jeffrey Segal, MD, JD

Though it won’t be officially published until the 24th, Medical Justice has gotten its first look at the new “temporary” requirements for certification of EHRs. This tome, over 200 pages long, is a mandatory step for software developers of Electronic Health Records software. The software must facilitate record keeping and information exchange in accordance with those standards.

Health care providers who want to be eligible for Medicare and Medicaid EHR incentives payments must be considered “Meaningful Users”; To be considered a “meaningful user,” one has to comply with all of that when applying for Certification. Theoretically, if a doctor’s office purchases Certified software, that should satisfy the requirements.

According to the Health Information Technology site, “Use of certified EHR technology is a core requirement for health care providers to become “meaningful users” and eligible for payment under Medicare and Medicaid EHR incentive programs,” and “The program provides a way for organizations to become authorized by the National Coordinator to test and certify electronic health record (EHR) technology.

Senate’s 6-Month Payment Solution includes 2.2% Increase

August 15, 2024June 17, 2010 by Jeffrey Segal, MD, JD

Physicians who accept Medicare for their services have been through a rough ride, a recurring nightmare of last-minute (and last-second) renewals of their pay budget in Congress. The roller coaster still isn’t over, but at least it seems to be a little bit better. How much? 2.2%, if the Senate’s bill passes. Don’t get too excited yet, though. That authorization is only good through November, and that’s only if it passes. The Congress still hasn’t approved anything enduring, and the Senate votes thus far aren’t promising.

Physicians aren’t the only ones caught on the roller coaster. Patients have also been left in the lurch. Patients turn to their doctors for information and consolation. They want to know that the ability to receive medical treatment from their trusted healer won’t lapse. Unfortunately, doctors are in the dark too. Much as they would like to be able to give comforting news to their patients, honesty requires that they say “I don’t know any more than you do.” Most won’t make their patients worry about their problems, but the fact is that some practices are hanging on by a thin thread, and the Medicare delays make matters worse.

Tort Reform and Frivolous Lawsuits: Show Me the Money

August 15, 2024May 27, 2010 by Jeffrey Segal, MD, JD

The following excerpt is from a great post by MD Whistleblower Years ago, as a younger and more idealistic gastroenterologist, I was kept dangling on a lawsuit for a few years. I endured the light hearted amusement of the discovery process, including expert witnesses outside of my specialty who claimed in their written reports that … Read more

Rasmussen: 63% of Voters Favor Repeal of Health Care Reform — But Is That So?

August 15, 2024May 25, 2010 by Jeffrey Segal, MD, JD

According to Rasmussen Reports, the percentage of people who favor repeal of the national health care plan is at its highest point ever, 63% in favor of repeal. The report states that the highest previous polling results were at 54-58 percent. Further, the report indicates that 46% “Strongly Favor” a repeal, while only 25% “Strongly Oppose” repealing it. But is that the full story?

The survey was performed by phoning 1000 “Likely Voters” last Saturday and Sunday. The calls were automated, and placed between 11 am – 6 pm on Saturday, and between 1 pm and 9 pm on Sunday. “For political surveys, census bureau data provides a starting point and a series of screening questions are used to determine likely voters. The questions involve voting history, interest in the current campaign, and likely voting intentions.” One could question if this survey is a truly representative sample of the population at large.

In the Trenches: A Practical Look at the New Health Care Reform Law

August 15, 2024May 19, 2010 by Jeffrey Segal, MD, JD

The Health Care Reform bill passed by Congress and signed by President Obama was represented as allowing people to keep their present health care providers if they wanted to. The bill itself will not force anyone to change health care providers, but that doesn’t mean you’ll still be able to go to the same doctor the same way. If that sounds like double-speak, you’re paying attention. While the law doesn’t force anyone to choose a different doctor, it is forcing some doctors into rather dramatic solutions, not the least of which is selling their practices to hospitals and becoming employees of that hospital. What’s behind this new business model for health care providers? Let’s take a look:

$220M for Pilot Communities’ EHR – Jackpot for Them, But No Practical Solutions In Sight

August 15, 2024May 5, 2010 by Jeffrey Segal, MD, JD

The Department of Health and Human Services is releasing $220 million dollars (made available by the American Recovery & Reinvestment Act) to fund 15 pilot communities with the necessary IT technology to incorporate Electronic Health Records (EHR). This amounts to a bit over 1/10th of the entire $2 Billion allotted to achieve meaningful use of new health information technologies. The goal is that every person in the US have an EHR by 2014. According to Kathleen Sebelius, HHS hopes that the pilot program will “Offer insight into how health IT can make a real difference in the delivery of health care.” In her written statement, she expressed hope that HHS will be able to “tap the best ideas across America and demonstrate the enormous benefit health IT will have to improving health and care within our communities.”

Now the reality check. That’s 14.66 million dollars per community to get patients, community providers and Federal programs all on the same page? The joint statement from Sebelius and Vice President Joe Biden suggests that the pilot programs will support tens of thousands of jobs in the health IT industry. One would hope so. It would also pay for 18,000 $800 laptops or 29,333 $500 desktop computers in each of those communities. In short, depending on populations, that much money should just about put a computer on every street corner and medical office, and still leave money to spare for the actual integration! But wait! That’s not all! Another $30 million is available for additional Beacon Community awards, so you, too, may end up with a laptop on every street corner and office! But what will any of this actually do?

The 81 Million Dollar Misdemeanor

August 15, 2024April 29, 2010 by Jeffrey Segal, MD, JD

Breaking news today: “Two pharmaceutical subsidiaries of Johnson & Johnson will pay more than $81 million and plead guilty to a misdemeanor charge in a U.S. Justice Department case about illegal promotion of the epilepsy drug Topamax, federal officials announced.”

Let’s reread that one, break it down and let it sink in. The U.S. Justice Department has one misdemeanor case against Ortho-McNeil Neurologics and Noramco. The complaint is illegal promotion of a drug most people haven’t ever heard of. The promoting of a drug which has already been released as generic should cost Johnson & Johnson (the manufacturer’s parent company) 81 MILLION dollars in fines?

This isn’t a drug that has caused deaths. It’s not even inherently responsible for injuries. The drug isn’t the issue. The means of promoting it is. And that earns the Feds 81 MILLION dollars?

+ More