A former marketing director for Caremark International may have made a million-dollar mistake when he made a plea bargain with the U.S. Justice Department last December.
Bruce Margulis, M.D., who formed a company in 1986 with Caremark called Physician Health Resources, agreed to pay restitution to Blue Cross and Blue Shield of Michigan related to $3.4 million in overbilling (Jan. 22, p. 8). According to a lawsuit filed in federal court in Chicago, Caremark contends it does not hold responsibility for costs associated with the settlement, which total $1.2 million.
The Northbrook, Ill.-based company filed the suit in January after Margulis requested that Caremark pay his fines in accordance with an indemnity agreement the parties signed in 1992. However, the agreement stated that Margulis would need to notify Caremark and get the company's written consent before entering a settlement. Because Margulis spent several months negotiating with the U.S. attorney in Detroit but did not notify Caremark until after he had signed a plea agreement, Caremark contends it is not obligated to indemnify Margulis and his company for any damages.
In its lawsuit Caremark also cited reasons the indemnity agreement didn't cover Margulis' claims. For example, Caremark contends the agreement only covered violations or alleged violations of laws that prohibit payment exchange for patient referrals, and the settlement only related to billing issues.
A digitized human cadaver has allowed a company specializing in 3D visualizations to hunt for and isolate an obscure muscle in the human skull based on an anatomical description by dental researchers at the University of Maryland at Baltimore.
The muscle, called the sphenomandibularis, extends from a bony process located behind the eye to the lower jaw and aids in chewing. It's now included, in all its 3D splendor, in a computerized anatomical atlas of the human body called The Dissectable Human.
Entrepreneurs have been champing at the bit to get at the commercial applications of the Visible Human Project, spearheaded by the National Library of Medicine (Aug. 14, 1995, p. 40). For Engineering Animation, the Ames, Iowa-based publisher of The Dissectable Human, the 1,870 scanned body sections-sliced thin-constituted a superior foundation for its interactive CD-ROM atlas compared with conventional medical illustrations.
For the researchers who discovered the new muscle, the digital process helped whisk the finding into medical education. "We have been studying the muscles of mastication for several years but found no description of this muscle in any textbook," said Gary D. Hack, an assistant professor at the UMAB Dental School who along with co-researcher Gwendolyn F. Dunn, an orthodontist, first described the muscle at a medical conference in February.
Recent descriptions of the growth in the nation's supply of physicians in 1994 have made the increase sound like a rocket blasting off, when a little digging by Outliers found it's more like a train slowing down before the station.
In February, the American Medical Association trumpeted in a press release that the population of U.S. physicians "approaches 700,000." The headline in AM News, the AMA's weekly newspaper, blared: "Women fuel growth in doctor supply." Even MODERN HEALTHCARE* picked up the mantra and declared the "ranks of physicians continue to swell" in a March 4 headline. The reports were based solely on figures the AMA released publicly in its annual physician characteristics report.
Being somewhat more skeptical of the AMA, Outliers found the number of physicians grew at a smaller rate in 1994 than in the previous five years.
The number of docs grew 2.1% to 684,414 in 1994, compared with a 2.6% increase in 1993, a 3% hike in 1992, a 3.1% increase in 1991, a 2.4% rise in 1990 and another 2.6% increase in 1989. Those figures were supplied by the AMA at Outliers' request.
Let's face it, the U.S. Environmental Protection Agency doesn't usually save hospitals money. But lately, that's just what it's been going all out to accomplish.
Through the Green Lights program, the EPA has helped more than 200 hospitals nationwide reduce costs by 50% since 1991 by increasing energy efficiency and cutting overhead costs.
According to the agency, 25% of hospitals' electricity use is for lighting. Furthermore, they use twice as much energy per square foot compared with a typical office complex. By surveying the entire facility and upgrading to an energy-efficient environment, the savings is estimated to be at least 20 cents per square foot.
According to some recent data, Pennsylvania Hospital in Philadelphia upgraded 450,000 square feet and had savings of just more than $100,000 when it switched to energy-efficient lighting.
Such savings is not the only reason to join Green Lights. Technical support is available by phone, providing a variety of information ranging from various lighting technologies to disposal methods for equipment that contains such hazardous materials as mercury and PCBs.
It appears the Dairy State has established a small dynasty at the Medical Group Management Association.
Not only is outgoing chief executive Frederick Wenzel from Wisconsin, his replacement, Thomas L. Adams, has lived there for the past 10 years as executive vice president of the State Medical Society of Wisconsin (April 15, p. 3).
In fact, the cheesehead connection dates back to the MGMA's founding 70 years ago, when a group of clinic managers met for the first time in Madison, Wis.
We don't know if the MGMA saw the letter Adams wrote to the Wisconsin State Journal in Madison last year, but the correspondence certainly shows he knows how to butter up his adversaries.
Adams, who is a North Carolina native, was "shocked and appalled" at a Journal editorial that referred to grits as "simultaneously tasteless and of a repellent nature."
"The trouble with grits is, you done 'em wrong," he wrote.
Adams explained that grits are delicious when seasoned with salt, pepper, red-eye gravy and, of course, butter.
"Pure Wisconsin butter on that Southern delicacy is best. Do not substitute margarine or a butter look-alike as the grits will not taste right, nor will a substitute provide the proper yellow pool on top."
He continued: "Mmmmm, mmmmm, Aunt Bea. Yes, indeedy, grits is good!"