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November 2007 Archives

November 2, 2007

Press Ganey 2007 Hospital Check-up

Press Ganey has released the 2007 "Hospital Check-Up Report: Nurse and Employee Perspectives on American Health Care." The report includes a summary of the case study on Hudson Valley Hospital Center in Cortlandt Manor, New York. The full version of the case study is available here.

November 5, 2007

Personal E-mails Sent by Hospital Executive to Private Counsel Using Hospital E-mail System Not Privileged

Scott v Beth Israel Med. Ctr. Inc.
2007 NY Slip Op 27429 (October 17, 2007)
Supreme Court, New York County
Ramos, J.

Dr. Scott argues that the e-mails are privileged under both the attorney client privilege and work product doctrine. BI counters that the e-mails were never protected by the attorney client privilege because Dr. Scott could not have made the communication in confidence when using BI's e-mail system in violation of BI's e-mail policy. BI also argues that both privileges were waived by Dr. Scott's use of BI's e-mail system.

BI wins.

This raises some very interesting questions - - such as, whether the same result would obtain when the employer is not also the defendant in the lawsuit (as is the case here). Let's say, for example, that Dr. Scott had sued his former employer, Hospital Z, or vice versa. Could Hospital Z discover all of Dr. Scott's e-mails to his lawyer concerning the suit that had been sent on BI's system?

Insurance Department Proposes "Principles-Based" Regulation

According to the Insurance Department press release:

Insurance Superintendent Eric Dinallo today released a draft regulation that would make the New York Insurance Department the first in the nation to establish principles-based regulation. The draft includes 10 principles for industry and is accompanied by 10 principles for regulators. The draft regulation will be distributed for discussion by the industry and consumers and will be on the agenda of the New York State Commission to Modernize the Regulation of Financial Services, which Dinallo chairs.

Principles-based regulation aims to reduce unnecessary regulatory and administrative burdens, ensure that regulation and its enforcement are proportionate, accountable, consistent, transparent and targeted, and provide benefits for consumers from more efficient markets, more effective protection, and better responsiveness to consumers' needs.

The press release is here, and the proposed regulation (which does not incorporate the "regulat-or" principles, only the "regulat-ee" ones) is here.

November 6, 2007

NY Senate Health Chair Summarizes 2007 Health Laws

Senator Kemp Hannon, Chair of the NY Senate Health Committee, provides an annual summary of the health laws passed during the session on his website, "including," says the Senator, "matters of policy embedded in the adopted Budget (e.g. the 2006 Hospital Charity Care Statute)."

The current list is located here and is current through October 14, 2007. Similar summaries from previous years can be found on the Senator's "Programs Page."

(hat tip to Senator Hannon for the submission)

November 13, 2007

Medical Centers Catching Retail Clinic Wave

Here's a bit from the Minnneapolis Star-Tribune:

Far from its world-renowned Rochester campus, the Mayo Clinic is conducting an intriguing research project in a low-slung Albert Lea mall, right next to a nail salon.

The ALMC Express Care clinic in this southern Minnesota town is a Mayo-affiliated retail operation, where a lone nurse practitioner treats simple ailments without appointments.

The 262-square-foot kiosk marks a stunning turnaround in how the medical establishment is reacting to the proliferation of MinuteClinics and other such outlets.

From the outset I have wondered why hospitals in New York were not going in this direction. Using a hospital extension site license would seem to resolve the icky issue of Article 28 licensure that standalone clinics otherwise have to face. It would also provide instant brand power in the local community where "St. ______ Hospital" is widely known and trusted but "MinuteClinic" is not.

DOH to Analyze "Near Misses" at NY Hospitals

From the DOH press release:

The state Health Department and the New York chapter of the American College of Physicians have agreed to analyze "near-misses" in New York hospitals - - events that could have harmed a patient, but did not - - to help prevent medical errors.

In a three-year demonstration program, the Health Department's Patient Safety Center will work with doctors-in-training in internal medicine to confidentially collect and analyze "near-misses" to help hospitals build safer health care systems to protect patients. This new system will complement New York's mandatory adverse event reporting system, New York Patient Occurrence Reporting and Tracking System (NYPORTS), which already collects information on serious injuries and deaths in hospitals.

The full press release is available here.

November 14, 2007

AG, Aetna Agree Over Physician Rankings

On the Attorney General's website:

Attorney General Andrew M. Cuomo today [Nov. 13] announced an agreement for doctor ranking programs with Aetna, the third largest health insurer in the country with over 16 million members nationwide. Aetna is the second insurer to adopt the Attorney General's model and is the first to apply it nationwide.

The AG's press release is here. The agreement with Aetna is here. The October 30th Supraspinatus entry regarding CIGNA is here.

Update: "In rare praise for the health insurance industry, the American Medical Association is commending Aetna Inc. for the managed care giant's decision to change its doctor ranking programs nationally." See the Chicago Tribune article here.

November 19, 2007

Clinical Trial Patient Has Hospital-Patient Relationship

Sosnoff v Jackman
2007 NY Slip Op 08439
(November 7, 2007)
Appellate Division, Second Department

[T]he Supreme Court erred in determining that the Hospital established the absence of any hospital-patient relationship. There is evidence in the record that when the plaintiff agreed to participate in the research program, she was not merely a subject or control person (see Payette v Rockefeller Univ., 220 AD2d 69, 72). Rather, she expected to receive medical treatment and services, and she reasonably accepted services from the physicians to whom she was assigned "with the expectation that proper professional skill would be employed" and that she could rely upon them for a proper diagnosis of her condition if she developed a malignant condition during the time they were regularly examining her (Bradley v St. Charles Hosp., 140 AD2d 403, 404; see Raptis-Smith v St. Joseph's Med. Ctr., 302 AD2d at 247).

The full decision is here.

Minnesota Medical Association Turns the Tables, Ranks Insurers' P4P Programs

Turnabout is fair play, at least idiomatically speaking:

In their most confrontational move yet, the [Minnesota Medical A]ssociation turned the tables on insurers by ranking nine of the so-called pay-for-performance programs. The Centers for Medicare and Medicaid Services ranked at the top while Bridges to Excellence, a program used by large, self-insured employers, was at the bottom.

Link to the full article here. One wonders if the Minnesota Attorney General will launch an investigation into the process behind the MMA's rankings?

November 20, 2007

Giving: Foundation for the National Institute of Health is top rated charity by Charity Navigator

Charity Navigator (a 501 ( c ) (3) non-profit organization) works to guide intelligent giving by providing information on over 5,000 charities, evaluating the financial health of each one in order to advance a more efficient and responsive philanthropic marketplace. (1.)

Founded in 2001, Charity Navigator observes that it has become the nation's largest and most-utilized evaluator of charities-- professional analysts have examined tens of thousands of non-profit financial documents, using this knowledge to develop an unbiased, objective, numbers-based rating system to assess the financial health of over 5,000 of America's best-known charities. Charity Navigator notes that last year alone more than 4 million donors used the site that TIME Magazine called "One of America's 50 Coolest Websites for 2006."

Charity Navigator ranks the Foundation for the National Institute of Health with an overall top score of 69.72 (and four stars) in comparison to other highly ranked Charities Performing Similar Work. (2.)

The Foundation for NIH fosters public health through scientific discovery, translational research, and the dissemination of research results through specially-configured, high-impact public-private partnerships consistent with NIH priorities. (3.)

The Foundation helps to underwrite biomedical initiatives that might not be attractive for private funding alone, or for one reason or another are not appropriate for wholly public funding. The foundation may take on projects that are particularly risky in terms of the likelihood of success or where companies may be willing to forgo profits because of early stage nature of the program or in the case of some global health initiatives due to the charitable nature of the project. Foundation projects tend to be longer-term, operating on a time scale that can be unattractive for private investors. At the same time the foundation is capable of responding quickly and nimbly to funding needs that are immediate and pressing. (3.)

Public-Private Partnerships Lead the Way for Critical Biomedical Initiatives. (4.)
Major projects include: The Genetic Association Information Network, The Biomarkers Consortium (with its policies/procedures to comply with relevant requirements of antitrust and other federal law.), and Grand Challenges in Global Health.

See footnoted links and read more below

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November 26, 2007

AG and Legislative Leaders Announce "Doctor Ranking Model Code" Initiative

On the AG's website today:

Attorney General Andrew M. Cuomo, Senate Majority Leader Joseph L. Bruno and Assembly Speaker Sheldon Silver today announced that they have agreed to pass legislation in New York based on Cuomo's Doctor Ranking Model Code.

The announcement comes after six of the top health insurance companies in New York and the nation agreed to adopt the Doctor Ranking Model Code in agreements signed with the Attorney General's Office.

The full press release is here.

November 29, 2007

NYSTEM : Ethics Committee of ESSCB

Friday, November 30, 2007 - The Ethics Committee of the Empire State Stem Cell Board (ESSCB) meets for a Regular Business Meeting from 10:00 a.m. - 2:30 p.m. at the New York State Department of Health's office at 90 Church Street, New York, New York.
A webcast of the meeting will be archived and viewable (along with many other webcasts currently archived on the NYS DOH website).
The agenda for this meeting of the Ethics Committee includes discussions on strategic initiatives, potential interim guidelines for hESC research, IP issues: Committee Priorities among other topics.

NYSTEM works collaboratively with ESSCB in support of stem cell research in New York State. The NYSTEM website links to the NYS Stem Cell Statute, Funding and Ethics Committees Membership and references important related links. (1)

Sign up on the NYSTEM website for NYSTEM eAlerts. Visit the NYSTEM website and find out about events, NYSTEM publications, news, program updates among other great resources for information about NYSTEM. See the Research Support page (2) which links to the NYSDOH to find schedules of dates/forms for:
--NYSTEM Application for funds (3)
--NYSTEM Merit Peer Review RFP (4).

A Report (5) has been prepared and published. Through the use of surveys and structured personal interviews, investigators active in the field of stem cell research were queried for their opinions regarding the mechanisms of funding that might have the greatest impact and about the nature and scope of the research to be supported by NYSTEM. (6)

The agenda for the first Full Board ESSCB Meeting held October 22, 2007 included several presentations. (7) A presentation by Tia Powell MD. focused on the development of the ethics agenda topics. See her slides-for example, outlines of goals for ethics standards included support of NY’s value regarding research, reflecting best practices in research, specific to stem cell , time sensitive and sensible practical advice. Or also the regulatory context comprising the existing federal and state laws and regulations, HHS/OHRP human subject protection, tissue banking, regulations of IVF, HIPAA and NIH -approved stem cell research.
See below for links and brief excerpts of the Report on observations about "Funding Preferences".


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About November 2007

This page contains all entries posted to HEALTH LAW SECTION BLOG in November 2007. They are listed from oldest to newest.

October 2007 is the previous archive.

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