News In Healthcare

Rep­re­sen­ta­tive Jerry Weller (Il.) spon­sored an amend­ment to the 2008 Labor, Health, and Human Ser­vices, and Edu­ca­tion Appro­pri­a­tions Bill (H.R. 3403) which, with the approval of almost 270 mem­bers of Con­gress, pro­hibits CMS from reduc­ing Medicare pay­ments to hospitals.   The cuts were CMS’ way of recoup­ing funds it believes it will over­pay to hos­pi­tals in the future.  In his blog, Rep­re­sen­ta­tive Weller thanked his col­leagues for vot­ing for the amendment.

In a recent blog post, Sen­a­tor Mike Enzi spoke out about Sen­ate Bill 625, oth­er­wise known as the Fam­ily Pre­ven­tion and Tobacco Con­trol Act.  In a nut­shell, he is not a sup­porter of a bill that gives the pub­lic the per­cep­tion that tobacco prod­ucts have been reviewed and approved by the FDA.   Although cer­tain changes have been made to the lan­guage of the leg­is­la­tion, remov­ing the FDA approval process and replac­ing it with merely an approval to be mar­keted, the bill still does not have the goal of get­ting peo­ple to stop smok­ing.  Sen­a­tor Enzi got it right when he said, “Tobacco is one of the biggest con­trib­u­tors to our nation’s grow­ing health care cri­sis.  We need to address this issue head on, not sign a peace treaty with the com­pa­nies who per­pet­u­ate and profit from the cri­sis.”  The bill is cur­rently pend­ing before the Sen­ate Com­mit­tee on Health, Edu­ca­tion, Labor and Pen­sions (HELP).

The Min­neapo­lis Star Tri­bune recently reported that more physi­cians are going to start turn­ing away new patients cov­ered by Medicare.  Why?  The physi­cians say they can’t afford to treat Medicare patients espe­cially with the expected reim­burse­ment cuts in 2008.  Accord­ing to the Amer­i­can Med­ical Asso­ci­a­tion, the reim­burse­ment prob­lem is tied to the for­mula used to cal­cu­late pay­ments.  It is tied to the gross national prod­uct so when the econ­omy slumps, so does the reim­burse­ment to the physi­cians.  The prob­lem is that the cost of health care doesn’t fol­low suit.

The fed­eral lit­i­ga­tion attack on not-for-profit hos­pi­tals might have ended in case dis­missals but that didn’t mean that the IRS didn’t pick up on the tax-exempt sta­tus issue.  In a recent news release,  the IRS sum­ma­rized its find­ings from a sur­vey con­ducted in 2006 of almost 500 tax-exempt hos­pi­tals.  In a nut­shell, the IRS found that there is no con­sis­tent def­i­n­i­tion of “uncom­pen­sated care” across all hos­pi­tals and there is no con­sis­tency of how the uncom­pen­sated care is reported.  One rec­om­men­da­tion that came out of the report is that a form 990 spe­cific to hos­pi­tals should be drafted.

 You may remem­ber that last sum­mer Sen­a­tor Chuck Grass­ley released find­ings from his own sur­vey of 10 tax-exempt hos­pi­tal sys­tems and found sim­i­lar results as the IRS.  See the Novem­ber 2006 blog entry which details his posi­tion that hos­pi­tals should adopt the Catholic Health­care Association’s stan­dard of report­ing com­mu­nity ben­e­fit to develop some consistency. 

Do you remem­ber 2 years or so ago hear­ing all about the illicit prac­tices of not-for-profit hos­pi­tals and health sys­tems for charg­ing unin­sured patients full price for their health care?  One attor­ney, Richard Scruggs, led the charge in fed­eral court on behalf of the class of unin­sured vic­tims to get the tax-exempt sta­tus of these not-for-profits revoked.  Well, that really didn’t go any­where but there was one hos­pi­tal sys­tem that fell vic­tim at the hands of a local author­ity who took mat­ters into their own hands.  Four years ago, Provena Covenant Med­ical Cen­ter in Illi­nois had their tax-exempt sta­tus revoked by the Cham­paign County Board of Review.  After years of fight­ing the revo­ca­tion, and pay­ing over $6 mil­lion in taxes, the hos­pi­tal has finally won.  Mod­ern Health­care recently reported that a cir­cuit court judge sided with the hos­pi­tal to rein­state its prop­erty tax exemp­tion.  The county has not yet decided to appeal. 

Well at least that is Pres­i­dent Bush’s way of deal­ing with the “frus­tra­tions” of the health care cri­sis.  In a round­table dis­cus­sion with small busi­ness own­ers ear­lier this week, Pres­i­dent Bush con­tin­ued to try to sell peo­ple on the idea that through tax incen­tives, peo­ple will be able to get afford­able health care cov­er­age.  He fur­ther stated that small busi­ness own­ers should be able to cross state lines to pool risk with other employ­ers in other states in order to afford bet­ter insur­ance.  Noth­ing really new or excit­ing came out of his dis­cus­sion.  We are still wait­ing on a solution.

And that is exactly what a board mem­ber of Grady Hos­pi­tal in Geor­gia did recently.  Fed up with unpaid expenses for treat­ing poor and unin­sured res­i­dents of a nearby county, Bill Loughrey took a $4 mil­lion dol­lar bill to the Cobb County Board of Com­mis­sion­ers for pay­ment.  The Atlanta Jour­nal Con­sti­tu­tion reports that Loughrey’s actions did not sit will with the Com­mis­sioner of Ful­ton County, the per­son who appointed him to the board, and Loughrey was replaced.  

Can you believe that another insurer has received cita­tions by the Cal­i­for­nia Depart­ment of Insur­ance for wrong­fully can­celling mem­bers health insur­ance poli­cies?  The L.A. Times reports that BC Life & Health, owned by Well­point, can­celled 1,880 indi­vid­ual poli­cies in 2004 and 2005.  After a review of 83 sam­ple cases, the CDI issued 49 cita­tions against the insurer which could lead to fines of up to $10,000 a piece.  Blue Cross of Cal­i­for­nia has already been fined for improp­erly can­celling poli­cies.  Blue Shield of Cal­i­for­nia, Aetna, Health­net, and Cigna are cur­rently being inves­ti­gated by the CDI for improper can­cel­la­tion of policies.

Cell phones were always taboo in the med­ical indus­try: no cell phones in hos­pi­tals or in physi­cians offices.  How­ever, times are a chang­ing.    Researchers now see the ben­e­fits of wire­less tech­nol­ogy as a means of mon­i­tor­ing chronic dis­eases such as dia­betes, obe­sity, hyper­ten­sion and asthma.  Pic­ture home-glucose meters hooked up to cell phones so daily read­ings can be sent imme­di­ately to the physi­cians’ offices.  Results can be sent as a text mes­sage.   This form of com­mu­ni­ca­tion is not far off in the dis­tance.  Clin­i­cal tri­als of cell-phone mon­i­tor­ing tech­nol­ogy are already undeway.

Well maybe health­care facil­i­ties aren’t quite tak­ing the Domino’s approach but it is close.  MSNBC recently reported on tac­tics health sys­tems are tak­ing to ease the pain of long waits in hos­pi­tal emer­gency rooms.  One hos­pi­tal issued movie tick­ets to patients wait­ing over 30 min­utes to see a doc­tor while another hos­pi­tal gave away tick­ets to the local base­ball game.  One hos­pi­tal in Illi­nois is promis­ing no wait­ing at all.  It seems that patients can skip the wait­ing room and go right up to a pri­vate room and be seen by a physi­cian or a nurse.