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June 2008 Archives

June 4, 2008

St. Vincent's Delivers Expansion Ultimatum

Today's New York Times covers the latest development in St. Vincent's efforts to get an expansion project approved, and the hospital appears to have thrown down the gauntlet:

St. Vincent's Hospital Manhattan will have to shut its doors if it cannot build a medical tower in Greenwich Village, representatives of the hospital said Tuesday at a hearing of the New York City Landmarks Preservation Commission.

More here.

June 5, 2008

State Approves 40% Bump in Assisted Living Beds

From the DOH website, originally posted June 4:

New York State Health Commissioner Richard F. Daines, M.D., today announced approval of 1,584 new Assisted Living Program slots – an increase of nearly 40 percent over the current available beds statewide and the largest expansion of the program in more than a decade.

Read the press release, including a list of the bed allocations to each awarded facility, here.

June 6, 2008

Medicaid to Cease Paying for "Never Events"

New York's Medicaid program has announced that beginning in October 2008, it will deny reimbursement for 14 "never events." If a patient suffers one of these adverse events while admitted to the hospital, Medicaid will not pay the hospital to treat the patient's injuries or illness that result from the adverse event. The Medicaid list of "never events" is more extensive than Medicare's current list of 8 non-reimbursable hospital acquired conditions. CMS has proposed expanding its list to add an additional 9 categories of conditions. Some of the events on the list seem too broad. The announcement does not cite to a proposed regulation or include any information about how this new policy will be implemented. For example, the Medicaid list includes "medication errors." Will all medication errors impact the hospital's Medicaid reimbursement or only those that cause serious injury? Hopefully, DOH will clarify what it means before the new policy goes into effect.

June 9, 2008

CLE Opportunity: Health Information Technology as an Update in Long Term Care

The Long Term Care Committee is hosting another telephone seminar Luncheon CLE on June 13, 2008.

This CLE will focus on Health Information Technology as an Update in Long Term Care:
Friday, June 13, 2008, 12:00 p.m. – 1:50 p.m.

Topics will be covered by three presenters:

I.Challenges of the Hybrid Paper-Electronic Medical Record in Long Term Care
II.Legal Issues with the Use of Electronic Medical Records
III.Current Technologies

Registration is through the NYSBA website. There is limited seating for the fully live version of this CLE (which comes with lunch). Please contact Raul Tabora as soon as possible if you would like to attend in person. In order to obtain CLE credits, you would still need to register through the NYSBA Web site. The local moderator from the LTC Committee is Anna Colello, Esq.

Faculty:
Anna D. Colello, Esq., New York State Department of Health (Moderator)
Dr. Patricia Hale, New York State Department of Health
Jonathan Karmel, Esq., New York State Department of Health
Bridget Gallagher, Senior Vice President of Community Services Division, The Jewish Home Lifecare


June 10, 2008

Mass. Insurers Undaunted by Opposition to Physician Rankings

Insurers in Massachusetts are pressing on with physician ranking programs despite staunch opposition from the Mass. Medical Society---which includes a lawsuit filed in opposition to the Group Insurance Commission's ranking program. From boston.com today:

Health plans that rate doctors individually are spreading beyond the state's Group Insurance Commission, despite the Massachusetts Medical Society's opposition to the ranking systems.

Tufts Health Plan, the third-largest health insurer in Massachusetts, says it will expand its health plan that features doctor rankings, called Navigator. And Harvard Pilgrim Health Care, the second-largest insurer, says it is considering offering health plans with doctor rankings later this year to consumers who are not covered through the Group Insurance Commission, which negotiates health insurance for about 295,000 municipal and state employees and their families.

Read the rest here. For more posts about physician rankings, including physician ranking programs in New York and the Attorney General's opposition to such programs, click the "rankings" tag at the bottom of this post.

Kaiser Backs Microsoft PHRs, Begins Pilot Project

Today's New York Times online reports on a partnership between Kaiser Permanent and Microsoft to open data flows between Kaiser's electronic records and Microsoft's personal health record application.

Kaiser Permanente, the nation's largest nonprofit health maintenance organization, is endorsing the drive toward consumer-controlled personal health records in a partnership with Microsoft.

The partnership, announced Monday, will begin with a pilot project open to Kaiser's 156,000 employees, which will run until November. If successful, the product linking Kaiser's patient information with Microsoft's Health Vault personal health record service will be offered to Kaiser's 8.7 million members in nine states and the District of Columbia.

. . .

Both Microsoft and Google have previously announced collaborative pilot projects with other health providers. For Microsoft, they include the Mayo Clinic and NewYork-Presbyterian Hospital. For Google, they include the Cleveland Clinic and Beth Israel Deaconess Medical Center.

But the Kaiser move, analysts say, is significant given the California-based health company's size and its reputation as an innovative user of information technology.

Read the rest here.

June 11, 2008

Physicians Using EHRs Will Get Medicare Bonus (Updated)

Yesterday's online edition of the Congressional Quarterly included an announcement that Medicare will spend some additional money on physicians deploying EHR technology:

The Bush administration announced on Tuesday a new program providing bonuses to doctors using electronic health records — part of a broader push that may yet include new legislation by year’s end.

Health and Human Services Secretary Michael O. Leavitt said that the new program will provide through Medicare about $150 million extra over five years to physicians in selected areas who replace paper medical records with electronic versions. The announcement marks the latest in a series of efforts by the government to encourage the adoption of what is known as health information technology, or health IT, since President Bush issued an executive order creating an office to supervise the issue in 2004. There has also been some recent progress on health IT bills in both the House and Senate.

Read more here.

Update (12:24p) According to a CMS press release, the icentive payments will apparently be limited to certain areas, of which New York is not one.

The communities selected to work with the Centers for Medicare & Medicaid Services (CMS) on the EHR demonstration project range from county- and state- level to multi-state collaborations. They include:

Alabama
Delaware
Jacksonville, FL (multi-county)
Georgia
Maine
Louisiana
Maryland/Washington, DC
Oklahoma
Pittsburgh, PA (multi-county)
South Dakota (multi-state)
Virginia
Madison, WI (multi-county)

The press release is here.

June 16, 2008

NYSTEM :Update on comments by interested parties

UPDATE!
Interested parties may submit comments on the draft for the Empire State Stem Cell Board's (ESSCB) Strategic Plan for consideration prior to the Board taking final action on the document at its June 27, 2008, meeting. The draft Strategic Plan may be accessed at the URL shown below, along with an electronic form for submitting comments up to June 20, 2008 or submitted by mail.The Board will consider submitted comments at its June 27, 2008 meeting.
Written comments may be sent to:
Judy Doesschate, J.D.
Director of Board Operations
Wadsworth Center
New York State Department of Health
Empire State Plaza, Box 509
Albany, NY 12208-0509.
NYS DOH's Wadsworth Center has been assigned responsibility under the direction of the Board for the administration of NYSTEM.

The Empire State Stem Cell Trust is a Special Revenue Fund created specifically to collect and distribute grants in support of stem cell research--to make grants to basic, applied, translational or other research and development activities that will advance scientific discoveries in fields related to stem cell biology. ESSCB's draft Strategic Plan was developed through an iterative, collaborative process that involved members from both Committees of the Board, as well as external experts and NYSTEM staff. The Board adopted the draft Strategic Plan at its May 13, 2008, meeting.
To maintain flexibility and allow the Board to respond quickly to new discoveries in stem cell research, the Board plans to reassess the Plan on an annual basis as a rolling five-year framework for how the state's $600 million commitment to stem cell research may best accelerate scientific discoveries into novel prevention and treatment strategies.
The Strategic Plan is the foundation for the Board's decisions on the allocation of the funds and future program direction. As part of its annual report, the Board will assess its progress in meeting the goals established in the Strategic Plan.
(1)http://stemcell.ny.gov/plan_comment_form.php
(2) http://wadsworth.lpmedia.net/about_nystem_esc_board_statute.html

Discerning public opinion: how financial incentives could improve organ donation,reduce donor-recipient gap

June 16, 2008, the AMA adopted policy calling for the modification of current law to allow pilot studies on financial incentives for cadaveric organ donation. The current law, the National Organ Transplantation Act, prohibits financial incentives for organ donation, stating that any motivation for donation other than altruism is unethical. The AMA already supports study into financial incentives for cadaveric organ donation.
AMA Board Member Joseph Annis, MD stated:

Today there are nearly 100,000 patients waiting for organ transplants of all types, and that number continues to grow. Exploring all ethical ways to increase the number of organ donations may save lives that may otherwise be tragically lost. Voluntary organ donation remains important, but motivational incentives that could increase organ donations — including financial incentives — must be studied.(1)

With respect to New York on this point, New York State Law prohibits the sales and purchases of human organs as described in PHL section 4307. Another strategy employed for increasing organ donations is reflected in Article 43-A - REQUEST FOR CONSENT TO AN ANATOMICAL GIFT , 4351 - Duties of hospital administrators, organ procurement organizations, eye banks and tissue banks.(2)
A paper dated 4/18/2006 focuses on certain aspects of this subject area: see Brooklyn Law School Law Review paper by David I. Flamholz entitled: "A Penny for Your Organs: Revising New York's Policy on Offering Financial Incentives for Organ Donation." (3)
An Internet search using the words: "organ transplants buying and selling"- resulted in finding an article from www.medscape.com, entitled: "National Organ Transplant Act of 1984 (NOTA) Bans Buying and Selling" (4). Here is a brief excerpt pointing to one important part of the picture, among others--please read the article in full:
[The] surge in biotechnology fuels the debate. While society has not shunned the sale of hair, sperm, blood, and other replenishable body parts, the question of whether society should venture into the commercialization of human organs remains unsettled; not so much because of a growing desire of individuals to sell their organs for transplantation, but partially because of the explosion of the biotechnology industry. Yes, a growing number of patients are waiting for an organ transplant, and alternatives to increase the donor supply are in constant demand. However, simply stated, advances in biotechnology have generated uses and needs for bodily tissues that were unfathomable until recent years. And although federal and state laws ban the buying and selling of organs for transplantation, they have not exclusively banned their use in research, education, and commercial endeavors, all of which have increased their value....

(1)http://www.ama-assn.org/ama/pub/category/18674.html
(2)http://public.leginfo.state.ny.us/menugetf.cgi?COMMONQUERY=LAWS Public Health Law , Article 43, in part below
(3) http://www.brooklaw.edu/students/journals/bjlp/jlp14i_flamholz.pdf

http://www.brooklaw.edu/students/journals/jlp.php The Journal of Law and Policy is a scholarly journal of analysis and commentary whose mission is to promote the debate of law related issues and public policy through the publication of articles written by legal scholars, law students, and distinguished members of the legal and policymaking communities.
(4) http://www.medscape.com/viewarticle/465200_2 link here to view the entire article plus its cites, please note that a one time registration is needed, which is free of charge. see Medscape Terms and Conditions, Permissions
http://www.medscape.com/pages/public/about/about Medscape is a part of WebMD Health Professional Network that includes theHeart.org and eMedicine.com.

Continue reading "Discerning public opinion: how financial incentives could improve organ donation,reduce donor-recipient gap" »

June 18, 2008

Good summer reading:Global strategy and plan of action on public health, innovation and IP by WHA/CIPIH

June 6 2008, IP Watch reported (1) the publication on line of, "Global strategy on public health, innovation and intellectual property" (WHA61.21 May 24, 2008 61st World Health Assembly).(2)

The document has been called the most important document since the Doha Declaration on IP and public health...a breakthrough that will benefit many millions of people for many years to come. (World Health Organization Director General Margaret Chan) The report outlines practical measures for using the [IP] system to promote innovation to achieve public health goals, particularly on diseases which disproportionately affect developing country or underserved areas.
Excerpts from the Report:
The Context
Poverty benchmark: 4.8 billion people live in developing countries=80% of the world poplation...43% live on less than US$2 a day. Poverty, among other factors, directly affects the acquisition of health products (including vaccines, diagnostics and medicines and medical devices), especially in developing countries.
Member States, the pharmaceutical industry, charitable foundations and nongovernmental organizations have taken initiatives in recent years to develop new products against diseases affecting developing countries and to increase access to existing health products and medical devices, [however] these are not sufficient to surmount the challenges to meet the goal of ensuring access and innovating for needed health products and medical devices.

More efforts should be made:
-to avoid the suffering,
-to reduce preventable mortality
-to meet health related Millennium Development Goals
-to implement States' obligations and commitments arising under applicable international human rights instruments with provisions relevant to health.

Proposals should be developed for health-needs driven research and development that include exploring a range of incentive mechanisms, including where appropriate
the de-linkage of the costs of research and development and the price of health products..

The Universal Declaration of Human Rights provides that 'everyone has the right freely to participate in the cultural life of the community, to enjoy the arts and to share in scientific advancement and its benefits…everyone has the right to the protections of the moral and material interests resulting from any scientific, literary or artistic production of which he is the author'...[T]he WHO Constitution states that 'the objective of WHO shall be the attainment by all peoples of the highest possible level of health'.
Thus WHO will play a strategic and central role in the relationship between public health and innovation and IP within its mandates, capacities and constitutional objectives.
The global strategy and plan of action should promote the development of health products/ medical devices needed by Member States that are:developed in an ethical manner,available in sufficient quantities,effective, safe and of good quality,affordable and accessible and used in a rational way.

(1)http://www.ip-watch.org/weblog/index.php?p=1083 The Intellectual Property Watch Monthly Reporter is a 16-page monthly selection of the most important, updated stories and features available only for monthly subscribers.
(2)http://www.who.int/gb/ebwha/pdf_files/A61/A61_R21-en.pdf
(3) http://www.who.int/intellectualproperty/en/ The Report of the Commission on Intellectual Property Rights, Innovation and Public Health (CIPIH) See also many first rate submission papers archived from the on line public discussion conducted by CIPIH.

Continue reading "Good summer reading:Global strategy and plan of action on public health, innovation and IP by WHA/CIPIH" »

June 19, 2008

NYSBA Historic Webcast

House of Delegates Meeting to be Broadcast Live on the Web

For the first time ever, the New York State Bar Association's House of Delegates meeting, which is being held in Cooperstown this Saturday, June 21, starting at 8:30 a.m., will be broadcast live on the Association's Web site at www.nysba.org/JuneHOD. Interested members of the Association will be able to access the Webcast and watch the meeting as new President Bernice K. Leber (Arent Fox LLP) is sworn in and the House debates a full schedule of items of interest including reports from the Committee on Civil Rights, the Committee on Senior Lawyers and the Committee on Professional Discipline, as well as the Commercial and Federal Litigation Section report on electronic discovery.

The web cast will remain on the association's site and be available for members to view at their convenience.

Medicaid Primary Care Standards

The New York State Department of Health has issued draft practice standards for primary care clinicians and programs. Medicaid will require compliance with the standards in January 2009. DOH is seeking input on the draft standards by August 8, 2008. Specifically, DOH wants to know if these are the right standards to apply and whether providers can currently meet the standards.

June 20, 2008

SCOTUS on Age Discrimination

Although not peculiar to health law, a recent Supreme Court decision concerning age discrimination is of interest in that it arises from a New York case. Here's the NY Times lead:

The Supreme Court ruled for older workers Thursday in a closely watched age discrimination case, placing on employers the burden of proving that a layoff or other action that hurts older workers more than others was based not on age but on some other "reasonable factor."

The 7-to-1 decision overturned a ruling by the federal appeals court in New York, which said employees had the burden of disproving an employer’s defense of reasonableness.

Read the New York Times coverage here. The decision (Meacham v. Knolls Atomic Power Laboratory, No.06-1505, June 19, 2008.) can be found on the Supreme Court's website here.

Legislators Strike Deal to End Mandatory Nurse OT

Legislators have struck a deal to end mandatory overtime for nurses in hospitals and nursing homes, but not in home care, says Newsday:

The leaders agreed to end mandatory overtime for nurses working in hospitals and nursing homes but not in home care, beginning next summer. The move is aimed at encouraging more people to become nurses, addressing a chronic shortage.

Paterson estimated 30 percent of licensed nurses aren't working in the profession - many because of mandatory overtime, which leaves them exhausted and away from their families. "This is an issue of patient care as well as workers' rights," he said.

The nurse's union echoed the safety issue:

"We are extremely excited at the prospect that nurses will no longer be compelled to work beyond the point of safe functioning," said Pat Greenberg of the union's nurse alliance.

Read Newsday's coverage here.

HANYS ultimately supported the bill. From the HANYS press release:

Key provider concerns addressed in the agreement include:
  • The definition of an emergency could include an unanticipated staffing emergency.
  • The limitations of the legislation would not apply in a case of an ongoing medical or surgical procedure in which the nurse is actively engaged and whose continued presence through the completion of the procedure is needed to ensure the health and safety of the patient.
  • Pre-scheduled on-call time will not be considered mandatory overtime.
  • The time spent before or after regularly scheduled work hours to communicate shift reports will not be considered mandatory overtime.
  • The legislation will focus on regularly scheduled work hours, not on a prescribed number of hours per day or week.
  • The agreement will not prohibit voluntary overtime.

Read the HANYS press release here.

Section Leadership Revamps Committees

The Section's Executive Committee recently approved the creation of new articles voted to revamp their committees to more accurately reflect changes in health law and the way health care is provided and administered. The new committees are:


  • Committee on E-Health and Information Systems

  • Committee on Long Term Care Providers

  • Committee on Managed Care, Insurance and Consumer/Patient Rights

  • Medical Research and Biotechnology

  • Committee on Payment and Reimbursement Issues

  • Committee on Physicians and Licensed Health Care Professionals

  • Committee on Public Health/Policy

  • Committee on Publications and WebPages/Blogs

  • Special Committee on Medical-Legal Partnerships; and

  • Special Committee on Legislative Issues


June 23, 2008

Lawmakers Pass Cancer Mapping Legislation

Last Thursday, New York State lawmakers passed legislation designed to transform New York’s current cancer mapping program. The measure would require the New York State Department of Health to plot cancer cases by census bloc, the smallest geographic entity that the federal government uses to tabulate information for its decennial census. From The New York Times:

[R]esidents would be able to gain access to that information through the most detailed map yet available, and track all kinds of cancers and where they occur. The online map would also plot where industrial facilities like power plants and chemical factories are located.

Read the full New York Times Article here

The Governor’s Deputy Secretary for Health, Dennis Whalen, cautioned:

It is not a diagnostic tool. A cancer map can’t tell you what causes cancer, it can’t tell you in a certain area where you live or reside if you will get cancer, so it’s important to put into context whatever is produced so it is useful to the public.

Read his remarks in Newsday.

Current data tables and maps of cancer incidence in New York can be found on The New York State Department of Health’s Cancer Surveillance Improvement Initiative page (http://www.health.state.ny.us/diseases/cancer/csii/).

June 24, 2008

Do we want more cancer patients on clinical trials?

June 3, 2008 Andrew J.Vickers of MSKCC (1) shares his personal perspective from his experience working in a major cancer center in the USA (although other authors have drawn similar conclusions)

[It] is for the reader to judge the degree to which they are applicable to other countries or to non-academic settings.

He observes that the most commonly diagnosed cancer in men is prostate cancer and yet there have been no adequate trials comparing the 2 major treatment approaches-radiotherapy and surgery.
It is obvious to me that we should prefer a single 10,000 patient randomized trial comparing primary treatment for prostate cancer to having 20,000 patients join the sort of early phase trials that typically go nowhere. We need...more patients on the right sorts of trials.
According to one estimate, he notes that about 45% of US-sponsored trials are currently being conducted overseas.
He describes 2 important barriers to greater clinical participation-financial and regulatory.
His references include excerpts in Table 1 (from the Report of the National Cancer Clinical Trials Program Review Group 8/26/97) noting broadly: the practice issues of obtaining informed consent, disqualification of potential enrollees, the need for a common algorithm for protocal development (to minimize the time necessary to obtain and obtain a letter of intent or concept to NCI for consideration and review), reduce data collection (accrue only data pertinent to the study endpoints and patient safety) and the need for a more uniform streamlined process to enroll more patients in trials through info technology
(1) http://www.trialsjournal.com/content/9/1/31 Trials 2008, 9:31

AMA Says Patients Don't Use Physician Rating Sites

The American Medical Association has picked up the results of a survey showing that very few patients use online rating sites to choose their physicians.

For all the concern and mistrust over physician rating sites, recent research shows that, for now, few patients are using them to decide where to get their care.

A Harris Interactive poll commissioned by the California HealthCare Foundation found that although more than 80% of the state's adults turn to the Internet for health-related information, less than one-quarter have looked at physician ratings sites. Only 2% of those surveyed made a change in physicians based on information posted on a rating site.

The low numbers aren't really surprising. Physician ranking sites - - where they even exist - - are new and do not have the history and reputational cachet of, say, Zagat, or Consumer Reports. And rating sites are useful primarily for those who are already looking to change physicians.

For my own part, I have a regular physician and I am happy with his services, and I don't have any pressing health issues and am not planning to move my residence or change my employment anytime soon. So even though I have an interest in online physician ranking sites, I have zero need to look at one.

In contrast, my kids are constantly coming home with sniffles, coughs, cuts, bruises, bites, rashes and you name what else. Going online to do some quick research before deciding whether to set in an appointment is second nature.

Besides that, one would hope at least that the majority of information put online about licensed, practicing physicians would confirm an inquiring patient's view that the physician is a competent and trustworthy practitioner. If the rest of the oversight system is operating as it should, physicians who are not worthy of a license for whatever reason should not be available to patients to begin with.

The online rating site should really serve to point out which characteristics of a physician or the physician's practice most closely align with the patient's personal values. For example, does a patient prefer a practitioner with a curt bedside manner or one who is more affable and chatty? Will patients endure longer wait times for physicians who will spend an unplanned half hour discussing a problem, or would they rather bypass the waiting room to get their ten minutes - - but only ten minutes - - quickly?

Although AMA downplays the survey results, I find them interesting for two reasons:

According to the survey of 1,007 Californians conducted by Harris Interactive between Nov. 5, 2007, and Dec. 17, 2007, the number of people who said they had looked at physician rating sites grew from 14% in 2004 to 22% in 2007.

First, a quarter of all patients is nothing to sneeze at. Second, the 2007 numbers are a 150% increase over the 2002 numbers. If the trend continues, by 2010 the number of online users will reach 1/3 of all patients. With the proliferation of rating sites by payors, consumer groups, advocacy groups and government agencies, my guess is that we will get to 1/3 long before 2010.

Read AMA's news article here.

Global Health and the portfolio approach to successful product development

There is a lot of literature about public private partnerships- both globally and from country to country. For the purposes of one blog-friendly reference and important perspective, I am linking here to David Brown's "The portfolio approach to successful product development in global health" (1) which I found published on the website of the Global Forum for Health Research.(2)
In 4 pages, he provides an overview which summarizes key factors in the construction of portfolios addressed to neglected diseases, building and learning from the pharmaceutical industry but also factoring in special circumstances--the focus is on small molecule drugs but key points may be equally applicable to development of vaccines and other products. From the section about the drug R&D process, to learning about the major reasons for project failure, to lessons for portfolio construction and management in public private partnerships targeted at neglected diseases, this is an article I would not miss reading.
The Health Partnerships Review section aims to contribute to the debate about the future role of PDPs.
A bit about the Global Health Forum excerpted from their website:

The ethical imperative of reducing health inequities, of closing the gap between the health of the poorest and those who are better off, demands the utmost collective effort.In the last few years, product development partnerships (PDPs), a form of public-private partnerships (PPPs), have gained growing popularity as mechanisms for increasing access to essential drugs. As a result, an expanded pipeline of candidate drugs and vaccines for clinical trials has been established.The scale of investments now needed to ensure that the best candidates go forward into clinical trials exceeds the funding capacity of any one donor in the public or philanthropic sectors and demands collective efforts. The Global Forum has commissioned experts and practitioners in the PDP field to provide pointers to key areas for urgent attention.

(1)http://www.globalforumhealth.org/filesupld/hpr/articles/HPR_Brown_The_portfolio_approach.pdf
David Brown has over 30 years experience in the pharmaceutical/biotechnology industry and since 2005 he has been Senior Advisor and a member of the Executive Team at OneWorldHealth, San Francisco where his work is dedicated to bringing medicines to the poorest of the poor in the world.
(2)On 24 June 1998, the Global Forum for Health Research was established in Geneva. http://www.globalforumhealth.org/Site/001__Who%20we%20are/003__Organization/003__Partners.php Partnerships and collaboration from all sectors are integral to the Global Forum’s 'forum spirit' and to making most impact with limited resources.

June 25, 2008

990 Coalition for Tax Exempt Hospitals

From the "990 Hospital Coalition" website:

What is the 990 Coalition for Hospitals?

Participants: American Health Lawyers Association, Catholic Health Association, Healthcare Financial Management Association, and VHA, Inc.

The Mission of the 990 Coalition for Hospitals is to promote accurate and standardized reporting of community benefit and related information on the revised IRS Form 990 and Schedule H by not-for-profit hospitals. This site has been designed for not-for-profit hospitals and their advisors.

What is provided by the 990 Coalition for Hospitals?


  • A central source for current information on IRS's activity and instructions

  • Forum for hospitals and their advisors to share information on planning and implementation efforts for filing the IRS form 990 and Schedule H

  • Resources for hospitals and their advisors on filing the IRS 990 and Schedule H

  • Guidelines for completing the IRS Form 990 and Schedule H

  • Annotation of IRS 990 H with expert advise

  • Suggestions for getting ready to file the 990

  • Coalition sponsored audio conferences

  • Calendar of events of educational programs regarding the IRS 990


Link to the site here.

At the very least this page is a useful collection, in one place, of links to original IRS source documents as well as many other informative articles on the principles in play in 990 preparation and submission. Perhaps owing to the collaboration of the American Health Lawyers Association, the site claims to be designed for both hospitals "and their advisors" and at first pass that seems to hold true.

The site hosts a discussion forum where registered users (registration is free) can initiate discussion on issues concerning the new 990.

This site would also be of some use to those counseling not-for-profit health care providers other than hospitals.

June 26, 2008

Empire State Stem Cell Board Meeting, June 27, 2008 -NYSTEM Agenda highlights

ESSCB will hold a regular business meeting on June 27, 2008, from 10:00 a.m. to 4:30 p.m. at the DOH offices (4th Floor at 90 Church Street, New York, NY). (1)
View a webcast of the meeting at http://www.nyhealth.gov/events/webcasts/
Meeting Agenda highlights excerpted from NYSTEM's website:
The Ethics Committee meets from 10am-noon. Their agenda includes a presentation concerning "Oocyte Donation Risks" by Catherine Racowsky, Ph.D., HCLD, (High-complexity clinical lab director)(2) and a discussion of standards and next steps of the “Informed Consent for Gamete Donors New York State Tissue Banking Statute and Regulations Committee”
A Full Board Meeting is scheduled to start at 12:30. Their agenda includes a presentation about secondary school initiatives by Samuel Silverstein, M.D. At 1:30 they will discuss the Strategic Plan, public comments on it and possible adoption. At 2:30 a discussion (and possible approval) of the Annual Report will be conducted. And at 3:00 there will be an update on the 2009 NYSTEM Grantees Conference
The Funding Committee meets at 3:30. Among other items, their discussion will focus on:
--Proposal Development Discussion: Assessing the Economic and Other Benefits of the NYSTEM Initiative,
-Discussion: An Open Request for Applications and Other Funding Mechanisms.

My editorial comment: The NYSTEM meetings webcasts have been exciting to watch as the Board members and Wadsworth staff have dealt with complex issues of the day in their public discourse. There is no substitute for listening in order to understand. It is obvious that Judy L. Doesschate, Esq., the Director of Board Operations helped the Board achieve amazing benchmarks in the first 9 months. To me, the substance of the draft Strategic Plan itself shows the critical thinking needed to take action as contemplated under the Public Health Law which enabled ESSCB to administer the empire state stem cell trust fund. I really hope everyone is proud of this public endeavoring and that the submitted public comments show appreciation for the long road that has produced this considerable tangible advancement towards the goals of public health.
We will see then tomorrow.

Stay tuned here on Supra for some musings on popularizing science in a nutshell pulled from the trunk in the old fashioned world of the philosophy of science. Some old ideas reveal just how value may be added by trained scientists as they build knowledge. Could scientific citations become the next customer list phenomenon? And where might HESC projects fit in the continuing development and growth of how organizational entities—whether they are for profit or not for profit, conduct their business--these posts will be sketches of context only--no advice will be given, no hypotheticals explored. But it might be interesting anyway.

(1)http://stemcell.ny.gov/events_funding_committee_meetings.html
(2)http://www.aab.org/hcld.htm see below for HCLD certification requirements

Continue reading "Empire State Stem Cell Board Meeting, June 27, 2008 -NYSTEM Agenda highlights" »

June 27, 2008

Erie County Lawsuit Over Hospital Closure Ends

From Wednesday's Buffalo Business First:

Erie County's attempt to force for the state to close either Buffalo General Hospital or Erie County Medical Center has been dismissed in state Supreme Court.

Judge John Curran ended the effort in a decision Wednesday afternoon, indicating the June 23 settlement between the health systems averted any action to shutter a facility.

Read the rest here.

WellPoint Incentivizes Good Care Management

From ChicagoTribune.com:

WellPoint Inc. employees earned a bump in their annual bonuses this year thanks to a new program that monitors care for the health insurer's patients.

WellPoint met or surpassed most goals for improvement in the first year of its Member Health Index program. That means employees saw their bonuses increase by about 10 percent, the company announced Wednesday.

WellPoint is the corporate parent of Empire BlueCross BlueShield, which with approximately five million members is the largest health insurer in New York.

Read the rest of the Tribune story here.

Court of Appeals Clarifies Charitable Property Tax Exemption Rulings

In two new cases, the New York Court of Appeals clarifies the rules on the exemption from property tax of properties used for charitable purposes.

The cases are Adult Home at Erie Station, Inc. v. Assessor of Middletown, and Regional Economic Community Action Program, Inc. v. Bernaski. Both are treated in a combined opinion reported at 10 N.Y.3d 205, 856 N.Y.S.2d 515 (March 13, 2008).

Adult Home at Erie Station (AHESI) concerned an adult home where about 30% of the occupants were poor but did not have government benefits as their sole source of income. These "contract residents" paid for their residence themselves, but paid at a below-market rate. The city proposed, in essence, that only SSI recipients are "poor enough to be objects of charity." The Court of Appeals disagreed, holding that "people whose expenses for housing and medical care leave them with no more than $2,000 in assets and $50 in disposable income" - - referring to the contract residents - - "are poor by any reasonable definition." Given prior precedent that providing housing to poor people at below market rates is "plainly a 'charitable' purpose," the court found that AHESI's property should be exempt.

Regional Economic Community Action Program (RECAP), in comparison, is a social work organization "devoted to combating homelessness, substance abuse and other social ills among low-income participants." RECAP operates a "community re-entry program" designed to transition participants back into productive community residency. RECAP received rents comparable to rents charged by private landlords. The City did not contest that RECAP's purpose of helping the homeless, alcoholics, and drug addicts was a charitable purpose. It did, however, claim that because the programs were not carried out on the exempt property itself (the properties at issue were merely residences, with the program activities undertaken elsewhere), the properties should not be exempt. The Court of Appeals relied on Matter of St. Luke's for the prospect that residential use of a property which is "reasonably incident" to the "major purpose" of the exempt organization will not disqualify the property from exemption. "Providing an acceptable place for people to live while they participate in social work programs advances the goal of keeping them in the programs and thus of helping them overcome their troubles."

The slip opinion is published at the Court of Appeals website here.

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This page contains all entries posted to HEALTH LAW SECTION BLOG in June 2008. They are listed from oldest to newest.

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