Like fighter jocks responding to radar, Massachusetts hospital guardians are scrambling to analyze and counter the surveillance of a Wall Street Journal reporter targeting hospital-acquired infections and complications in the state.
The Massachusetts Hospital Association last week alerted its membership that the newspaper had asked the Massachusetts Health Data Consortium, an independent health statistics agency, for a report using billing codes to identify each hospital's incidence. The consortium has asked hospitals for written comments as part of a "users guide" attached to the reports.
In a memo to hospitals, the MHA said it calculated rates from the report to peg institutions likely to be highlighted in a story. It also is consulting with experts in coding and performance measurement, and staffers have mobilized to survey and distribute hospital tactics on comment letters.
In the meantime, the MHA memo advised hospitals to "consider delaying sending written comments to MHDC until receiving further guidance," adding that the data agency will not deliver reports to the Journal until Aug. 31.
No denying it. Northridge (Calif.) Hospital Medical Center has agreed to reimburse Medicaid patients who claim they were denied epidurals during labor until they paid for them in cash.
So far, the hospital has mailed out letters to 663 Medicaid patients who may have been denied epidurals, a treatment for relieving labor pains. More than 50 checks have been cut to date, a hospital spokesman says.
The California Department of Health Services ordered Northridge, owned by Burbank, Calif.-based UniHealth, to repay the patients whose epidurals were covered under Medi-Cal, California's Medicaid program.
Hospital officials stopped the denial of epidurals, but the state and HCFA are continuing their investigations into the incidents.
"(Northridge) is committed to providing access to medical services for Medi-Cal beneficiaries in the communities it serves," a hospital statement says. "NHMC provides the same level of healthcare services to patients regardless of ability to pay, sex, race, color or creed."
The repayments may total as much as $120,000. The hospital will then seek reimbursements from the physicians who withheld the pain-relieving treatments.
Request denied. When MODERN HEALTHCARE learned the American Hospital Association was talking about a merger with the Healthcare Forum (Aug. 17, p. 2), we asked for a copy of the Forum's annual filing with the IRS. But the San Francisco-based Forum-unlike some other not-for-profit groups we've asked-declined to give us a copy of the filing, called a Form 990. Saying it was "following the letter of the law," the Forum only permitted one of our reporters to inspect the document at its headquarters.
In 1996, President Clinton signed into law the Taxpayer Bill of Rights, which requires tax-exempt organizations to make copies of their Form 990s available to people who ask for them (Aug. 5, 1996, p. 3). However, the law also instructed the IRS to write regulations implementing the new law, and those aren't final yet. Some tax attorneys say the final regulations should be out soon. When they are, the Forum can expect another call.
Reality-based policy. A new and improved HCFA stance on transmitting data over the Internet, now in its final stages, is expected to be released in the fall, Outliers has learned. The policy, anxiously awaited by information technology vendors, would supersede an Internet ban considered way behind the technology curve (June 8, p. 12).
The Center for Healthcare Information Management, an Ann Arbor, Mich.-based trade group for vendors and consultants, is expected to get the final draft for comment in the first half of September, says Bradley Casemore, CHIM's deputy director. While details are closely held, a July 9 letter from HCFA to U.S. Rep. Elton Gallegly (R-Calif.) says the policy "will address current technology and allow healthcare data to be transmitted over the Internet with certain safeguards in place."
The letter, from Stewart Streimer, HCFA's director of security and standards, says the agency was working for a July or August policy completion date, but that deadline has slipped, Casemore says.
Sandwiched. George Eways was surprised to discover earlier this summer that one of his Oakland, Calif., sandwich shop's best customers, the California Advantage health plan, had filed for bankruptcy protection.
Eways had been making sandwiches, salads, cookie platters and the like for the California Medical Association's managed-care plan for months, sometimes as many as 100 sandwiches a week.
No one told him that the ill-fated health plan had fewer enrollees than physician investors, and was about to go belly up. When it did, in late June, the reign of silence continued. The woman who usually ordered sandwiches for the Oakland-based plan wouldn't tell him anything, Eways says, and California Advantage employees wouldn't even let him in the door when he marched across the street to find out what was happening.
That left him holding an unpaid invoice for roughly $300, a big chunk of money for the 25-year-old sandwich maker.
Eways checked with an attorney but found he'd have to take time out of his jam-packed day, which lasts from 4 in the morning to 4 in the afternoon, to file with the bankruptcy court as one of California Advantage's creditors. Not an appetizing prospect for the hard-pressed small-business owner.
It wasn't until Eways wrote a short essay in a local healthcare magazine that he got some action. Right after the essay appeared he got two phone calls in short order, one from a local physician offering to pay the entire bill out of his own pocket, the second from Hobart Swan, the CMA's media relations manager, who not surprisingly wanted to make the whole mess go away.
Unfortunately, Swan says, the CMA can't pay the sandwich guy's bill, or every other California Advantage creditor would come swarming its way looking for restitution. But it looks like the kind-hearted doctor may yet save the day.
"They're working to get the bill paid," Eways says. "If I get paid, that'll be nice."
