The Bush administration sent Congress a legislative package that pins his health reform agenda on a three-pronged approach of value-based purchasing, medical liability reform and higher Medicare prescription drug premiums for some seniors. Provisions in the 29-page bill would require HHS to make personal health records available to Medicare beneficiaries, and would give the department the authority to publicly release physician-specific quality and efficiency data. Components of the bill would restrict medical liability claims and the amount an injured person could recoup under punitive damages. The legislative blueprint comes in response to the so-called 45% trigger, which required the White House to act if, for two consecutive years, general revenue made up more than 45% of total Medicare spending. That happened last year. The American Hospital Association criticized the package. The administration relies largely on its ill-conceived budget to meet the requirements of the so-called 45% trigger, said Richard Pollack, AHAs executive vice president, in a written statement. This arbitrary policy will strike a devastating blow to Medicare and the patients who benefit from this program.
The nations credit woes are driving up not-for-profit hospitals cost of borrowing. A collapse in the market for auction rate securities is pushing interest rates up to two to three times higher for tax-exempt hospitals holding such debt, according to state municipal bond officials. The troubled debt, which is common in healthcare, typically can be sold in weekly or monthly auctions. However, when such sales fail, the debt typically jumps to its maximum interest rate. Nervous investors have fled the auction rate market amid the subprime mortgage meltdown, resulting in hospitals facing sharply rising interest rates, the bond officials said. The Massachusetts Health and Educational Facilities Authority voted last week to relax some oversight rules to allow borrowers to quickly exit the troubled market. We did not want to be whats keeping them back, said Liam Sullivan, an authority spokesman. In most cases people are simply trying to get out of the market, said Dennis Reilly, associate executive director of the Wisconsin Health and Educational Facilities Authority. Credit analysts say its unclear how long the turmoil will last or how significantly the crunch will affect tax-exempt hospitals. Higher interest rates could, over time, place a stress on operating performance or margin, said Lisa Goldstein, a senior vice president for Moodys Investors Service.
Florida Gov. Charlie Crist appointed former state representative Holly Benson, to succeed Andrew Agwunobi as head of Floridas Agency for Health Care Administration, which oversees the states Medicaid program. Her start date is Feb. 25. Agwunobi, 42, is expected to step down Feb. 22 after roughly one year as the agencys secretary to become chief executive officer of Providence Health Care, a four-hospital subsidiary of Providence Health & Services, Seattle. Benson, 36, is Floridas secretary of the Department of Business and Professional Regulation. She also is expected to step down Feb. 22.
A federal grand jury indicted former New Jersey state Sen. Joseph Coniglio on nine counts of mail fraud and extortion in connection with an influence-peddling scheme that allegedly resulted in millions of public dollars for 685-bed Hackensack (N.J.) University Medical Center. Coniglio, 65, a plumber by trade, allegedly received $66,000 yearly in a consulting arrangement with Hackensack, according to U.S. Attorney Christopher Christie. The arrangement was purportedly set up to perform hospital relations, an area in which he had no prior experience, but was actually a way for him to receive $5,000 monthly in exchange for his support of funding requests for so-called Christmas tree budget items from the state Legislature and funding from other state agencies, Christie said. The investigation by the FBI and U.S. attorneys office is continuing. Coniglio turned himself in to the FBI and made a court appearance. Bail was set at $250,000. At deadline, officials at Hackensack had no immediate comment.
Beginning in 2012, Blue Cross and Blue Shield of Massachusetts will require all physicians and hospitals participating in its quality-incentive program to implement and use computerized physician order-entry, or CPOE, systems instead of paper patient charts when requesting tests, drugs and other forms of treatment. The requirement aims to improve patient safety and care, streamline workflow and reduce costs by eliminating hospital-based medication and treatment errors and slow receipt of necessary patient records, according to a news release. Insurers also are pushing greater use of electronic prescribing (See story p. 6).
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