LabCorp Settles with State of California Over Kickback Marketing Scheme–Lab Wars

Both Quest and LabCorp were doing this and this is funny in the information here from BNET that he had the actual PowerPoint slides.  Quest settled up for $241 million for their portion of gaining market share.  Quest Diagnostics Agrees to Settle California Medicaid Suit for $241 Million-Overcharging for Lab Tests Quest does not appear to be done yet though as now they have a whistle blower alleging even more fraud, maybe a billion and this case is a little more complex and has to do with billing during the time of the Uni-Lab purchase.  Lawsuit Filed Against Quest Diagnostics–Whistle Blower Case Alleging Medicare and Medicaid...

Another New Portable Device Slated to Make Fitness Fun - A Keychain to Reward for Exercise and Donate To Charities

How many more of these things are we going to see.  Folks I know that bough the Fitbit tried it for a while and got bored.  I don’t have one and this is just what others told me as they said it was something else they had to do and they had enough overload with all the other consumer IT stuff and gadgets to worry about.  I think from what I hear on these devices is just like the consumer, the attention span is short and again it something you have to do something with and most all have a smartphone today, so I guess we will see when it arrives on the market.  You know I just try and report on all of this and that in itself...

Non Profit HEALTHeLINK Partners with United Healthcare Subsidiary Optumsight to Remote Monitor Diabetics In Buffalo in Pilot Program

I try to keep track of mergers and acquisitions here and the partner Axolotl was purchased by Ingenix in August of 2010, about a year ago, so when you hear of insurers buying up technology companies here’s one and where bottom line revenues end up contributing to for profit insurers.  Ingenix Acquires Health Information Exchange Services/EHR Provider Axolotl-United Health Group Behemoth Continues to Grow–Subsidiary Watch Here’s another post from the past that gives a little more background on the HIE and business intelligence algorithms used by United subsidiaries.  Axolotl (A Subsidiary of Ingenix) Creates Reporting and Analytics...

Abbott Labs to Discontinue Distributing FreeStyle Navigator Glucose Monitor in the US

The FDA just approved the Freestyle easier to use monitor in June of 2010 and received the European CE Mark in May of 2011.  In December of 2009 there were strip recalls for the old version of the Freestyle, however other Abbott models had a lot more strips recalled in December of 2010.  Abbott Diabetes Care Recalls Tons of Glucose Test Strips–The US Has the FDA Recall Blues-Solution Has Been Touted Here for a Year-It’s Time for a Fix–Readers Have Voted Supply interruptions was the reason given for the discontinuing in the US; however in Europe they will continue to sell and market, so not enough money here in the US is the first...

Non Profit Social Interest Solutions Group and Microsoft Partner To Advance State and Government Health Exchange Initiatives

Back in February of 2011 Microsoft Government also announced their low cost State Insurance Exchange solutions.  Microsoft’s HIX solutions eliminate the need for states to evaluate numerous point solutions from various firms to find one that works well with government policies or existing IT infrastructures. Microsoft Announces New Low-Cost Turnkey State Health Insurance Exchange Technology Solutions From the Social Interest Solutions Website: “Wherever possible, Social Interest Solutions utilizes the standard HIPAA transaction sets to form the basis of our interfaces as we have found that many of the entities with whom we share data...

California Bill to Regulate Health Insurance Rates Dies Due to Lobbying By Insurers and Other Groups So No Serious Audit Algorithms for Now to Control Premium Hikes

Well here’s one more not for the consumer.  If you read through the article in the LA Times the bill died as lobbying efforts claimed here would not allow for a majority of votes to pass.  It will be tried again next year.   It’s funny that we go through great lengths and trouble to audit and certify medical records, but the payers in all of this run their business intelligence models and reconstruct and change them with their analytics and laws can’t keep up.  I said back in August of 2009 we need a Department of Algorithms but until we get lawmakers that understand how business models worth and how math moves money,...

United Healthcare To Buy Huge Chunk of Orange County, California Managed Care Business with the Purchase of Monarch Healthcare–Subsidiary Watch

This is in my back yard in the OC and for a few doctors I know this just might be the big push to start a Concierge Medical Office.  Newport Beach which is south of where I live has a ton of affluent residents and the Boutique practices there do well as money for many in the area is not a problem.  Monarch has been around for many years and they are at all the Hoag Hospital money raising events and is very active, so things might be changing in time.  What will be interesting though is to see if the reimbursement changes and of course that’s at the top of every MD’s mind, so I don’t see much excitement about this at all here. ...

Janet Tracey and Unilateral DNAR Policy in the UK

More information about the Janet Tracey case is available on the website of Leigh, Day & Co, the attorneys representing the Tracey family in its lawsuit against NHS Tru...

When Will MDs Prescribe Life Extending Drugs Such as Provenge–Reimbursement And Delivery Matters

Fierce Pharma in conjunction with Sermo, the doctor’s social network have compiled a survey of interest with regards to prescribing life extending drugs, Provenge is the big example that stands out.  It is not cheap. You can view the full results of the survey from the link below and can download the full survey report.  Over 68% voiced a concern with either reimbursement or drug delivery.  Sermo-medical-ethics-life-extending-drugs Survey Results Back in July Fierce Pharma and Sermo announced they would be working together to bring some of the information from Sermo, the private doctors' social network in order to bring forward...

Prognosis Health EHR System Buys Creative Healthcare Patient Accounting Company

Software companies continue to merge and acquire one another, the merging of the software algorithms.  In this case the EHR system will be adding more financial accounting modules, and this seems to be pretty common place today to add the financial and/or billing capabilities to medical record systems.  BD Houston-based Prognosis Health Information Systems Inc. is acquiring Creative Healthcare Systems Inc., based in Springfield, Mo. Creative Healthcare Systems developed MedGenix, a financial management and patient accounting system. Prognosis developed ChartAccess Comprehensive EHR, an electronic medical-records system. The acquisition...

Illinois Doctors and Hospitals Refusing to Participate in Pilot Medicaid Managed Care Program Run by Commercial Insurers

The program is being run by two insurance companies, Aetna and Centene-IlliniCare and I am guessing the reimbursement rates are at the heart of the issue, what else today?  Many patients will need to change doctors and care facilities.  As what happens today with changes with doctors and care facilities, everybody has to get their data together and it becomes a big mess for the patients and the doctors.  BD  CHICAGO — Many doctors and hospitals are refusing to participate in Illinois’ pilot Medicaid managed care program, forcing some patients to find new health care providers, according to a published report. Leading...

Elder Rights - The Next Civil Rights Movement

On October 22, Temple Law (in Philadelphia) is hosting an all-day conference titled "Elder Rights - The Next Civil Rights Movement."  The speakers include elder law heavyweights Frolik and Dayton, with a keynote by Nina Kohn.  Other speakers include my Widener colleague Alicia Kelly.  Of particular interest is a session titled "Healthcare, Self-Determination and Autonomy."  Speakers in that session include two scholars whom I have been fortunate to work with:  (1) Michele Mathes, "Health Care and the Aged: Arguing Equality in the Absence of a Right" and (2) Lois Shepherd, "The End of End of Life Law and Ethics."                     &nb...

Governor Vetoes New Jersey POLST Bill

On Thursday, New Jersey Governor Chris Christie conditionally vetoed S-2197, legislation providing for the use of Physician Orders for Life-Sustaining Treatment (“POLST”) forms in New Jersey. While noting the prospective benefits in guiding end of life patient care for New Jerseyans by utilizing POLST forms, Governor Christie cited concerns with the provisions of the bill that would effectively allow a patient’s wishes to be overridden by the patient’s physician or healthcare representative without the patient’s prior consent, and that would mandate an alternative dispute resolution as a prerequisite to a patient’s or his or her representative’s...

VRFF-VSED - Major Topic of Conference

Over the past decade, VSED-VRFF has not received very much attention either in the medical literature or at bioethics conferences.  But that is now changing.  Compassion & Choices has begun an educational initiative.  And a major conference this October, in Victoria, Australia, devotes two hours to the topic.Voluntary Refusal of Food and Fluids (VRFF) by Currently Competent Persons08:30 The reality: representative cases — Nan Maitland (7 min)08:37 The legality of medical and nursing assistance — Ian Freckelton (12 min)08:49 Overcoming challenges to VRFF — Dr Stanley Terman (5  min)08:54 The nursing ethics — Susan Sherson (8 min)09:02 Some ethical reflections on VRFF — Helga Kuhse (12 min)09:14 The requirements for a good outcome — Tijn Hagens (7 min)Voluntary Refusal...

World Federation Right-to-Die Societies 2012 Congress

The World Federation of Right-to-Die Societies 2012 Congress will be held in Zurich from June 13-18, 20...

New Case -- Tracey v. Addenbrooke's Hospital

David Tracey has filed a lawsuit against Cambridge University Hospitals NHS Trust and the Department of Health alleging that providers at Addenbrooke's Hospital wrote a DNR order for his wife without her consent and without any discussion with her.  (Guardian 1; Guardian 2)  Janet Tracey had been diagnosed with terminal lung cancer but died at the hospital 16 days after breaking her neck in a car accident.Apparently, since directly applicable health law permits unilateral DNR orders, Tracey is basing his claim on the 1998 Human Rights Act.&nb...

Paternalistic Catholic Opposition to POLST

This is not unexpected.  But this articulation of a Catholic opposition to POLST is so terribly flawed and unpersuasive.&nb...

Rasouli - Upcoming filings with the Supreme Court

As I mentioned, the healthcare provider defendants in the Rasouli case have applied for leave to appeal to the Supreme Court of Canada.  If I understand the rules correctly, the Rasouli-Salasel response/opposition to the Application will be filed on or about next Friday.  The CCB, as intervenor, may also file a response at that time.  The providers then have ten days to file their reply.  Then, the Application is submitted to the Cou...

Update on Jordan Allen - TADA Case

Parents Fight for Son's Life: MyFoxHOUSTON....

VSED - in the NY Times

The voluntary dehydration to hasten death case of Armond and Dorothy Rudolph is further discussed in a NY Times piece today.  Compassion and Choices is raising the profile of this peaceful and legal means to hasten dea...

Hospitals Exclude Patients with "Incurable Diseases"

Boy have times changed.  In the Bulletin of the History of Medicine, Emily Abel describes "American Hospitals and Dying Patients before World War II."  Very interesting is her explanation of how hospitals excluded patients with "incurable diseases" both by not admitting them in the first place and by dumping them onto public hospitals (in a pre-EMTALA world).  For example, noting that some patients had died soon after admission, Pennsylvania Hospital urged "physicians to pay strict attention to rules that say no incurable patients can be admitte...

Negotiating Death: Does Culture Matter?

Twice a year, usually in March and September, the DeVos Foundation sponsors a Medical Ethics Colloquy.  In March 2011, the speakers were Timothy Quill and Barbara Koening.  While not the direct, primary target of the session, there was significant discussion of medical futility.  A complete transcript is here.Dr. Quill remarked that we "err on the side of utilizing medical technology if it has any chance of working at all."  But, he said, "we're going to have to set limits on certain kinds of things, mainly advanced technology.  We can't throw every drop of technology at every person because they want it."  "Just because something has a teeny bit of value and its costs a gazillion dollars, we're going to have to say 'no' to some of that stuff."  Dr. Quill...

Armond and Dorothy Rudolph - Successful VSED at Last

ABC News reported, today, on the deaths of Armond and Dorothy Rudolph.  In their 90s, their bodies were failing them.  “He suffered severe pain from spinal stenosis, a narrowing of the spinal column. She was almost entirely immobile. Both suffered from early dementia.”    They did not want to endure a lingering decline.  They did not want to lose their independence.  They wanted to dieThey voluntarily stopped eating and drinking (VSED).  But three days into their fast, the couple told their plan to staff at their assisted facility.  Administrators immediately called 911, citing an attempted suicide. ...

Reimbursement for Advance Care Planning: Why Should Intensivists Care?

Randy Curtis writes about “Reimbursement for Advance Care Planning:  Why Should Intensivists Care?” in the current issue of the American Journal of Respiratory and Critical Care Medicine (184 (2011): 387–400). “There are few professional groups that stand to lose more business by the systematic implementation of advance care planning than critical care clinicians.  Therefore, you would think this provision would be opposed by the four largest critical care societies: the American Association of Critical Care Nurses, American College of Chest Physicians, American Thoracic Society, and Society of Critical Care Medicine.  So why do these professional societies, representing more than 100,000 critical care clinicians through a collaborative...

Cuthbertson v. Rasouli - Supreme Court Arguments

I have posted, here, the Sunnybrook physicians' August 2011 Application for Leave to Appeal to the Supreme Court of Canada.  This 69-page filing includes a brief memorandum of argument, the affidavits of two physicians, and the affidavit of a bioethicist.  I have spent the past week revising a new piece for the Annals of Health Law titled "Physicians and Safe Harbor Legal Immunity."  But I will post comments on the appeal shortly. &nb...

Medical Futility Law 2009 to 2011

My next "Legal Briefing" column in The Journal of Clinical Ethics 22, no. 3 (Fall 2011), coming out next month, reviews worldwide legal developments concerning medical futility from the past two years.  I group these developments  into the following eleven categories:1.      Texas Advance Directives Act2.      Ontario Consent and Capacity Board3.      Surrogate Selection4.      Ex Post Cases for Damages5.      Ex Ante Cases for Injunctions6.      Coercion and Duress7.      Assent and Transparency8.      Brain Death Cases 9.      Criminal and Administrative Sanctions...

Resuscitation over Patient Objections

Two"reverse futility" cases were reported in the past few days.  These patients were resuscitated contrary to their documented treatment preferences.  In DeGeronimo v. Fuchs, the New York Supreme Court (Richmond County) held that the Jehovah Witness plaintiff failed to state a medical malpractice claim even though she was provided blood products.  Since the CPR saved her life, there were no legally cognizable damages.  The court suggested the plaintiff should have sued for battery.Consistent with the New York court, the Louisiana Court of Appeals held, in Jones v. Ruston Louisiana Hospital, that an action for unwanted resuscitation (an ignored DNR order) did not sound in medical malpractice.  Therefore, it did not have to go to a medical review pan...

Cuthbertson v. Rasouli - Going to the Supreme Court

In March 2011, the Ontario Court Justice held, in Rasouli v. Sunnybrook Health Sciences, that Ontario healthcare providers must use the CCB to resolve intractable medical futility disputes.  In June 2011, the Court of Appeal for Ontarion affirmed that ruling.  I discussed the Rasouli case here and here and elsewhere.  The providers who lost before both courts have now appealed to the Supreme Court of Cana...