Readers may have been startled last week to learn that a pleading in a federal probe of Baptist Medical Center in Kansas City, Mo., included detailed records of procedures performed on named patients (Sept. 14, p. 3).
How that happened is a possible lesson for those concerned about the confidentiality of private medical records. "I don't fully understand why it's in the public domain and how you got hold of it," patient-privacy advocate Denise Nagel, M.D., told MODERN HEALTHCARE when confronted with patient-specific data we sent to her for comment. "Can you imagine if this was your stuff?"
Frankly, we'd rather not think about that.
Last week's article pointed out that federal prosecutors in Kansas had filed a 161-page legal motion that included nine pages of laboratory billing records with patient names.
The material came into MODERN HEALTHCARE's hands through a circuitous route that began at Baptist. According to the motion, a hospital employee faxed the billing statement to the hospital's outside counsel, Mark Thompson, at Thompson's request. The attorney was trying to sort out the facility's relationship with Blue Valley Medical Group. Thompson mailed the statements as enclosures in a letter to Bruce Houdek, attorney for Blue Valley, and several others. The records were obtained by the U.S. attorney's office in Kansas through discovery.
Later, that office began investigating Thompson. On July 15, a grand jury indicted Thompson and six others for conspiracy involving alleged kickbacks paid to the hospital for referrals to Blue Valley's nursing homes.
On Aug. 21 the prosecutor filed a lengthy motion and included Thompson's letters and enclosures-including the billing statements-in the court filing.
Patient-privacy experts said at least three safeguards were blown along the way:
The hospital shouldn't have sent the billing statement to Thompson without blotting out the names.
The lawyer or lawyers from whom these files were taken by subpoena should have asked the court to block out the patients' names or keep the document under seal.
The U.S. attorney's office should have concealed the names before photocopying the document and submitting it in the attachments to its motion.
Don't be so shy. It doesn't always pay to keep silent.
It seems that of all the high-profile healthcare and seniors' groups in Washington, only two did not submit comments to the National Bipartisan Commission on the Future of Medicare. The commission was created by last year's balanced-budget law. It will send its recommendations to Congress by March 1, 1999.
At a speech last week, powerful Rep. William Thomas (R-Calif.), who is both chairman of the House Ways and Means health subcommittee and administrative chairman of the Medicare commission, said he was upset with the American Hospital Association and the American Association of Retired Persons for keeping quiet on the issue.
Richard Wade, senior vice president for communications at the AHA, says the group decided not to submit a plan to the committee because it still hasn't figured out its position.
AHA officials will meet with the group's nine regional policy boards during the first week of October to develop a Medicare reform plan, Wade says.
"We didn't feel it was fair to submit official comments to the (Medicare) commission when we were only half done with the process with our members," he says.
Namesake. There's another AHA out there, and it wants us to brew our own beer.
The 17,000-member American Homebrewers Association. founded 20 years ago in Boulder, Colo., shares an acronym with the century-old American Hospital Association. The former lobbies states to recognize the federal legalization of home brewing, says Director Paul Gatza.
Gatza said home brewing is still illegal in eight states-Alabama, Idaho, Iowa, Kentucky, Mississippi, Ohio, Oklahoma and Utah.
Richard Wade, chief spokesman for the hospital AHA, says he hadn't heard of the other AHA. "We probably should look into some sort of strategic alliance," he says. In jest, of course.
Double trouble. A physician who is already serving jail time for tax fraud has been indicted on charges that he billed insurers for services he never rendered or that were medically unnecessary.
Nagesh Shetty, 53, is serving a 21-month sentence for filing false tax returns for the years 1987 through 1989. The indictment, handed up Sept. 10 by a federal grand jury in Orange County, Calif., charges Shetty with billing insurers for hepatitis and syphilis tests when patients were coming in only to refill prescriptions or get cholesterol tests.
The government alleges Shetty collected $45,000 in fraudulent payments. In some cases, the indictment charges, Shetty billed insurers for patient visits when the patients had come to his office just to complain about Shetty's billing practices.
Helping hand. The slogan at Wadley Regional Medical Center in Texarkana, Texas, is "Taking Wadley to the People." During a crisis this past spring, the people came to the hospital.
When more than 10 inches of rain caused a breach in a river levee May 28, the 62 residents of MeadowCreek Place Retirement Center, a residential community in Texarkana, were trapped by high waters, and some had to be rescued by boat.
When the water had settled, most residents had family members to turn to for shelter, but 18 people had nowhere to go, since their homes had been heavily damaged.
That's when 325-bed Wadley stepped in, offering the residents free room and board for two months in its vacant sixth floor while their homes were being restored.
The boarders' housing and meals cost the hospital about $32,000 for the two months. MeadowCreek residents were also cared for by the staff and had access to recreational areas.
"This kind act exemplifies the true character of the medical staff, administration and board of directors," says Hugh Hallgren, Wadley's president and chief executive officer.