It was Bishop Berkeley who asked rhetorically, “If a tree falls in the forest and no one hears it, does it make a sound?”
The judge in Pediatric Nephrology Assocs. v. Variety Children’s Hospital didn’t mention either the...more
Can any state rival Kentucky for keeping physicians in the headlines in recent days? Three big stories in a five-day span:
On October 30 the Franklin Circuit Court struck down as unconstitutional a new Kentucky statute...more
A case in a Louisiana federal court addressed an unusual question: what if circumstances at a hospital require that you, rather than hospital personnel, be the one to tell your mother she has only two weeks to live? Do you...more
Dr. Bob Halterman is something of a Midas-in-Reverse. His refusal to pay $38,000 he owed Johnson Regional Medical Center resulted in a $65,000 judgment in favor of the hospital.
When the hospital recruited Dr. Bob, the...more
A lot of people think they know something about hospital staffing levels: the proper ratio of nurses to patients. From time to time a legislator, patient advocate, or union spokesman will propose a required ratio—often a...more
EMTALA was enacted to prevent hospitals from turning away—or “dumping”—ER patients because they can’t pay. EMTALA requires a hospital to (1) provide a screening exam to determine if an emergency medical condition (EMC) exists...more
Was the Louisville hospital’s restriction of Dr. Ben Reid’s surgery privileges a professional review activity or a professional review action?
When Ben sued on various tort theories, the hospital claimed immunity under the...more
ER physician Ryan Kime believed his hospital lacked the resources, procedures, and capacity to meet the requirements of EMTALA, and he repeatedly said so. At an ER meeting he reported two cases as possible EMTALA violations...more
A recent First Circuit opinion demonstrates that sometimes how you say something is more important that what you say. In fact, that principle led the court to reverse the NLRB’s order that a Massachusetts hospital must...more
You can’t make this stuff up. When CMS conducted a study to identify hospitals that game the quality data reporting system, it used an approach that made the data reporting look better than it actually was. That bottom line...more
State limitations on medical malpractice recoveries seem to be under almost daily attack. The latest serious threat comes from Louisiana, where a federal district court has authorized an interlocutory appeal of his ruling...more
The recent decision in Dignity v. Burwell is interesting for three reasons. For one thing, it provides a reminder of the unfortunate fact that the acts (or inaction) of one party can adversely affect the fate of others—as...more
When Medicare beneficiaries are taken to the ER after an auto accident, they’re likely to have their Medicare cards with them, but not their auto policies. This creates a problem for Medicare because Medicare is supposed to...more
Since enactment of the Health Care Quality Improvement Act in 1986, physicians haven’t usually fared well when they go to court to stop or delay hospital peer review actions, provided the hospitals follow the procedural steps...more
Concerned about a surgeon’s skill, a hospital ordered him to “have five bowel surgery cases proctored,” specifying no time limit. After a month, when the surgeon hadn’t met the five-case requirement, the hospital filed an...more
At first glance it looks like a “Man Bites Dog” headline. The hospital insists that the patient was injured by professional negligence; the patient vehemently disagrees. The argument goes all the way to the state court of...more
Does the CMS star rating system reward hospitals for serving the affluent and punish those that serve the poor? The answer is a resounding yes, according to a recently published analysis by Bloomberg BNA. The analysis...more
You can tell by its name that you won’t like the Medicare “self-disallowance” rule. The federal district court for D.C. didn’t like it, either, and gave a group of Banner Health hospitals summary judgment that the rule was...more
The White House is reviewing proposed regulations to ease restrictions on certain financial arrangements between hospitals and physicians and on certain transactions between providers and patients. The proposed regulations,...more
If you bring a case in federal court alleging violation of federal law, you might assume that you needn’t be concerned with procedural requirements of state law. But you could be wrong. Just ask Cynthia...more
Why would a hospital and one of its physicians demand that a case against them be branded a malpractice case? Why would they sue the trial court to force it to call the action a malpractice case? A recent Nevada case...more
Hospitals are in the business of saving lives. So they don’t usually face liability for trying to do just that. But a July 5 Georgia Supreme Court decision is a reminder that it’s up to the patient—not the hospital or...more
On June 20, 2016, The Kaiser Family Foundation issued the first ever broad-based study of Medicare Advantage hospital networks. The study — "Medicare Advantage Hospital Networks: How Much Do They Vary?"— analyzed 409 plans in...more
If there’s one thing that unites the hospital industry—even the fiercest competitors—it’s hatred of audits by recovery audit contractors, or RACs. Why? For one thing, because RACs operate on a contingency fee basis. They...more
The Balanced Budget Bill Act of 2015 has a site-neutral billing provision relating to off-campus hospital outpatient departments (HOPDs). Those are facilities away from the hospital campus but certified as part of the...more