This column provides executive summaries of developments in legal and regulatory issues related to healthcare, lists a bibliography of pertinent healthcare law-related articles, and discusses interesting health law court decisions.
NEWS
The Flex Monitoring Team has released Briefing Paper No. 3: Critical Access Hospital Patient Safety Priorities and Initiatives: Results of the 2004 National CAH Survey. The full text of this paper is available at http://www.flexmonitoring.org.
The American Hospital Association has 2 new publications pertinent to legal and ethical issues. Ethical Governance in HealthCare deals with design of programs and allocation of resources to create legal, moral, and ethical governance environments in facilities. Partnering With Patients to Reduce Medical Errors is a book which aims to help providers better communicate with patients and their families to reduce litigation and improve patient compliance. Both texts are available at http://www.ahaonlinestore.com.
As of January 1, 2004, hospitals in Illinois were required to share nurse staffing information with consumers who request it. According to an article in the Chicago Sun Times published this summer, 1 of 8 of the hospitals contacted either refused to give an answer or ignored repeated requests, whereas others were only reluctantly cooperative. The article is available online at http://www.suntimes.com/output/news/cst-nws-hosp04.html.
CASES
Plaintiffs in Oregon and Washington have filed 2 additional class-action lawsuits accusing charitable hospitals of breaching their duty to provide charity care to uninsured patients by charging them prices that exceeded those charged to patients with insurance. Turner versus Legacy Health System, 12 No. 6, Andrews Health Law Litigation Reporter 2, October 20, 2004.
A federal court in Illinois will allow the mother of a suicidal minor to sue the hospital under Emergency Medical Treatment and Active Labor Act for failing to stabilize her son when he was suffering from a severe mental illness. Binkley versus Edward Hospital, 12 No. 6, Andrews Health Law Litigation Reporter 5, October 20, 2004.
VERDICTS/SETTLEMENTS
A New York University Hospital affiliate has settled a Medicaid billing fraud civil suit by paying US$2.1 million. United States versus NYU Downtown Hospital, 12 No. 6, Andrews Health Law Litigation Reporter 6, October 20, 2004.
A patient who suffered dehydration, malnutrition, bone fractures, poor hygiene, and infected pressure sores as a result of chronic understaffing at a nursing home was awarded US$9.7 million in compensatory and punitive damages. Groves versus Beverly Enterprises, 12 No. 6, Andrews Health Law Litigation Reporter 12, October 20, 2004.
In ongoing litigation in Oregon, a court upheld a US$16.2 million verdict against PeaceHealth awarded to McKenzie-Willamette Hospital. McKenzie-Willamette versus PeaceHealth, D Ore, No. 02-6032-HA, October 13, 2004.
REGULATIONS
The deadline to become compliant with the Health Insurance Portability and Accountability Act security provisions is April 20, 2005, for most facilities, and for small health plans, the deadline is April 20, 2006.
Centers for Medicare Services announced in November 2004 a new Medicare prospective payment system final rule for inpatient psychiatric facilities which replaces the current cost-based payment system for reporting periods beginning after January 1, 2005. The final rule can be viewed at http://www.cms.hhs.gov/providers/ipfpps/cms-1213-f.pdf.
Centers for Medicare Services announced in November 2004 a new final rule establishing payment rate and policy changes for hospital outpatient services. The rule, which was published on November 15, 2004, can be viewed at http://www.cms.hhs.gov/providers/hopps/2005fc/1427fc.asp.
BIBLIOGRAPHY