A New Jersey bill that would require hospitals to report serious medical errors passed the state Senate unanimously but is unlikely to pass the General Assembly before the legislative session ends Jan. 12, an aide to state Sen. Joseph Vitale, the bill's sponsor, said. Vitale, a Democrat, has prefiled the bill for the new session, which begins this week, and hopes to have a hearing on it by the end of this month, said Laurie Cancialos, his aide on healthcare legislation. The bill, called the Patient Safety Act, would require hospitals to report preventable medical errors that kill or seriously injure patients. It would also encourage hospitals to report near-misses and mistakes that don't harm patients and would provide immunity from lawsuits for those lesser errors. It would not provide immunity for errors causing death or serious injury.
Medicare stuck with ER bills
Some hospitals may be routinely overcharging or undercharging Medicare for emergency room services, a study by the American Hospital Directory concluded. Using hospital outpatient claims from 2002, the Louisville, Ky.-based data service found that eight hospitals classified 90% of their emergency patients as receiving the lowest level of evaluation and management. Nineteen hospitals, meanwhile, classified less than 2% of their patients at that level. Hospitals may in fact treat an abundance of lower or higher intensity cases, but "if patients are being erroneously classified to a higher range there could be a compliance problem," the directory said. Guidelines for assigning evaluation and management levels are ambiguous for hospitals, but the CMS has said it will publish more specific criteria early this year, the company said.
Cleveland Clinic settles case
The Cleveland Clinic will pay $2.3 million to resolve civil False Claims Act charges against the home health division of its Meridia Health System. The former Meridia Home Health and Meridia Institute allegedly claimed non-home-health costs on their 1995 and 1996 Medicare cost reports to obtain higher cost-based reimbursement. Their parent company, Meridia, was acquired by the Cleveland Clinic in 1997. Medicare switched to a prospective payment system for home health in October 2002. In a written statement, a clinic spokeswoman said the home health division "believes that it operated within all applicable regulatory requirements and admits no wrongdoing.
Insurance czar named
Maine Gov. John Baldacci, a Democrat, appointed Thomas Dunne executive director of the state's Dirigo Health Agency, which is charged with putting into effect a law to expand insurance coverage, improve quality and lower costs. Dunne, who currently works in Baldacci's Office of Health Policy and Finance, will be responsible for developing a business plan for Dirigo Health and marketing it to the residents of Maine. Officials in Maine plan to have the Dirigo Health plan operational by July and expect it during the first year to cover as many as 31,000 state residents who do not currently have insurance. Dunne, 47, was formerly a partner at Accenture, a management consulting firm, and has worked in healthcare and financial services for more than 20 years. Dirigo Health, which Baldacci signed into law last July, is a voluntary program that asks hospitals to hold their consolidated operating margins to 3% and annual cost increases to no more than 3.5% for fiscal 2004, which began July 1, 2003.
HealthSouth associates sued
Investors suing HealthSouth Corp., Birmingham, Ala., are spreading the blame for alleged securities fraud at the rehabilitation and surgery center company. In an amended complaint in U.S. District Court in Birmingham, shareholders and bondholders accused HealthSouth's former auditor Ernst & Young, two investment bankers who handled HealthSouth's account at Salomon Smith Barney (now owned by Citigroup) and later at UBS, and a former UBS stock analyst with helping the company fraudulently inflate profits by $2.8 billion since 1997. The defendants also include HealthSouth directors, company founder Richard Scrushy, who awaits a criminal fraud trial, and the 15 former executives who have pleaded guilty to criminal fraud charges in the case. The lawsuit contends that Ernst & Young knew HealthSouth's accounts were being manipulated as far back as 1993. The lawsuit also contends that the investment bankers, Benjamin Lorello and William McGahan, and the analyst, Howard Capek, helped HealthSouth finance a series of acquisitions that covered up its bad results. The funds came from 237 million shares that HealthSouth has sold since 1986, when its relationship with Lorello and McGahan began, the lawsuit states. UBS said it has no reason to believe any of its employees had any knowledge of the fraud and it plans to fight the lawsuit.
Fla. hospital plans to expand
All Children's Hospital, St. Petersburg, Fla., is planning to build a new hospital or renovate its existing 216-bed facility in a major expansion within the next year, hospital spokeswoman Ann Miller said. The project will increase the number of private rooms available and cost at least $50 million, but "final details are not nailed down yet," Miller said. The hospital is expected to announce further details Jan. 21. Most of All Children's rooms are shared. The project also will involve neighboring 412-bed Bayfront Medical Center, which plans to lease space from All Children's for maternity and nursery services.