S U P R A S P I N A T U S

A nifty new website, "USAspending.gov," provides current information on federal spending. From the site itself:

Have you ever wanted to find more information on government spending? Have you ever wondered where Federal contracting dollars and grant awards go? Or perhaps you would just like to know, as a citizen, what the Government is really doing with your money.

If you answered "yes" to any of those questions the website can help you out. Link to it here or key www.usaspending.gov into your web browser. On my first visit I was interested to see the New York State Department of Health holding the current number 2 slot for federal assistance year-to-date. Here's the top five along with the associated numbers:

TOP 5 Assistance Recipients FY 2009 YTD

1 DEPARTMENT OF HEALTH CARE SERVICES $18,908,037,649
2 NEW YORK STATE DEPT OF HEALTH $18,335,672,042
3 TEXAS HEALTH & HUMAN SERVICES COMMISSION $13,514,862,175
4 PENNSYLVANIA DEPT OF PUBLIC WELFARE $11,168,181,944
5 LOUISIANA DEPT OF HEALTH & HOSPITALS $5,031,984,907

The top 5 contractors (versus assistance recipients) were all military contractors.

From the Attorney General's website yesterday:

Attorney General Andrew M. Cuomo today announced the indictment of 12 people and 9 corporations across New York City for their roles in a criminal enterprise that paid hospital employees for confidential patient information, lured patients into receiving unnecessary treatment, and then submitted over a million dollars in phony personal injury claims to insurance carriers. Attorney General Cuomo also announced separate criminal charges against two hospital employees for accepting bribes to provide confidential patient information to members of the criminal operation.

The hit list includes two physicians, two chiropractors, three acupuncturist, and an attorney. To see the names and the rest of the press release see the AG's press release here.

Here's a catchup post, the New York Insurance Department delivered it's 150th annual report to the legislature May 15, 2009. According to the report, the Insurance Department is believed to be the oldest state regulatory agency in the United States.

Link to the report here (Acrobat Reader required).

From today's New York Times online:

Hospitals in New York State are significantly worse than those elsewhere in the nation at limiting patients from having to return shortly after being treated for a major illness, according to federal data released on Thursday.

Read the rest here.

From today's TimesUnion online:

Three hospitals in the Capital Region have higher-than-average rates for three causes of death, according to an analysis of U.S. hospitals.

Read the rest of the article here.

For the biotech part of Supra, I'd hoped to develop a reference tool in part.
At Year #2 for biotech postings, continued here and in the following post are 2 dox for archive purposes.
Read below the fold for the--
BIOTECH ARCHIVE INDEX FOR POSTINGS JULY 13, 2008 TO JULY 14, 2009 (9 PAGES)
POSTING ENTRY TITLE, DATE AND FIRST SENTENCE.

Here is a second document for archives purposes which I also hope will be helpful.
This index shows the weblinks visited and referenced via the Supra weblink per posting for this last year of biotech posts.
BIOTECH ARCHIVE INDEX OF WEBLINKS PER POSTING JULY 13,2008 TO JULY 14,2009 (11 PAGES)
See below the fold.

From today's New York Times online:

A hospital in New York state is notifying about 2,800 patients of possible exposure to hepatitis C after learning that a former employee is suspected of exposing nearly 6,000 patients in Colorado to the disease.

Read the rest of the times article here. The hospital is Northern Westchester.

From HealthLeaders Media today:

A significant portion of surgical residents think the hours imposed on their work schedules inhibit their surgical education and puts patients' safety at risk, according to a study published in the July Journal of the American College of Surgeons.

"We were surprised to find that nearly half of surgical residents believe work-hour restrictions are actually an impediment to their training," said Jacob Moalem, MD, Department of Surgery, University of Rochester (NY) Medical Center, and lead author of the study.

Read on here.

From a US Department of Justice press release:

WASHINGTON - - The state of New York and New York City have agreed to pay $540 million to settle allegations that they knowingly submitted, or caused to be submitted, false claims for reimbursement for school-based health care services, primarily speech therapy and transportation, provided to Medicaid eligible children from 1990 to 2001, the Justice Department announced today. The settlement is a record federal recovery by the Justice Department for the Medicaid Program.

Read the rest here.

From a Justice Department press release July 20, 2009:

Jane W. Duke, United States Attorney for the Eastern District of Arkansas, along with Thomas J. Browne, Special-Agent-in-Charge of the Little Rock Division of the Federal Bureau of Investigation, announced today the guilty pleas of Dr. Jay Holland, age 56, of Little Rock, Arkansas; Sarah Elizabeth Miller, age 28, of England Arkansas; and Candida Griffin, age 34 of Little Rock, Arkansas. Each pled to a misdemeanor violation of the health information privacy provisions of the Health Insurance Portability and Accountability Act (HIPAA) based on their accessing a patient’s record without any legitimate purpose.

Duke has a history of prosecuting under HIPAA. Recall that in May 2008 she announced the guilty plea of Andrea Smith, 25, for disclosing PHI for personal gain. Supraspinatus coverage of that event is here.

In the current case, both hospital employees who peeked at the records were fired. The physician who peeked at the records had his privileges suspended for two weeks and was given remedial HIPAA training.

In the New York Times online today:

A grand jury indicted a surgery technician infected with hepatitis C on several charges Thursday, alleging she stole syringes with painkillers and replaced them with needles she had used. Prosecutors allege that at least 19 people contracted the disease as a result.

The allegations by prosecutors, also made Thursday, are the first direct link of hepatitis C cases to 26-year-old Kristen Diane Parker, who has tested positive for the ailment.

Read the rest here. Parker was also formerly an employee at New York's Northern Westchester hospital.

Section Member Frank Serbaroli, with the New York office of Greenberg Traurig, writes a regular "Expert Analysis" column for the New York Law Journal. The latest article, "Health Plans: Getting Ready To Comply With 'Michelle's Law,'" appears in the July 29, 2009 edition:

Michelle’s Law amends the Employee Retirement Income Security Act of 1974 (ERISA),2 the Public Health Service Act, and the Internal Revenue Code. It prohibits a group health plan from terminating coverage of a dependent child for up to one year, when that child takes a medically necessary leave of absence from (or changes enrollment at) a postsecondary educational institution, and the leave would otherwise result in ineligibility for health coverage.

Link to the reprint posted on the Greenberg Traurig website.

New York's "Partnership for Coverage" released its final report, nearly two years in the making, on several initiatives to reduce the number of uninsured New Yorkers and the attendant costs of each.

The report itself, found here, is 17 pages long and essentially summarizes what has been done to date to expand coverage and what could be done under various expansion options. The latter are grouped into four rough categories which are: "Public Health Insurance for All," "New York Health Plus," "Public-Private Partnership," and "The Freedom Plan." The cost and coverage effects of each category are discussed in summary.

The report is accompanied by a much longer document containing the detailed analysis of the Urban Institute which underpins the discussion contained in the report. The longer document, which runs to 125 pages, is here.

Both reports as well as other documents and the transcripts of all of the public hearings leading up to the report can be found on the Partnership's website at partnership4coverage.ny.gov.

Prior Supraspinatus coverage of the Partnership's activities includes:

• First "Partnership for Coverage" Public Hearing


• "Partnership for Coverage" Adds Hearing Dates


• Viewpoint: transformation of New York's health care system is dynamic


• DOH Seeks Input on Universal Coverage Proposals

On July 29 Governor Paterson announced that he signed Assembly 9038/Senate 6030 into law, which extends the coverage option for unmarried dependent children of policyholders from the current 19 years of age (or 21 for full-time students) to 29 years of age. The law will apply to commercially insured products issued or renewed after September 1, 2009. The law will not apply to self-insured employer plans or government plans.

The bill was part of a small package of health reform laws, summarized in the Governor's press release as follows:

The first extends the period of time for COBRA coverage from 18 to 36 months; the second permits families to cover their young adult dependents through age 29 under their job-based insurance; and the third enacts a series of managed care reforms to make health insurance work better for consumers and permit timely access to necessary health services.

Read the governor's press release here.

The managed care reform bill is described in the press release as:

• Prohibiting insurers from treating an in-network provider as out-of-network simply because the referring provider was out-of-network;


• Extending current protections for consumers in HMOs to consumers in “HMO look-alike” plans – health plans that operate the same as HMOs but are not licensed as HMOs, such as “exclusive provider organizations” or EPOs;


• Reducing the prompt-pay timeframe from 45 days to 30 days for electronically submitted claims so doctors and hospitals are paid more quickly;


• Reducing the time insurers have to review requests for post-hospital home health care;


• Extending providers a right to request an external appeal of a concurrent denial;


• Extending protections to doctors and hospitals when health insurers seek to recover alleged overpayments. The protections include basic notice and an opportunity to challenge the insurers’ overpayment recovery efforts.


• Limiting health insurers’ and HMOs’ ability to deny or delay payment of claims by sending a coordination of benefits questionnaire;


• Permitting participating health care providers to request reconsideration of a claim that is denied as untimely and limiting penalties for untimely claims;


• Requiring insurers and HMOs to give participating providers notice of adverse reimbursement changes to provider contracts and giving providers an opportunity to cancel the contract;


• Requiring insurers and HMOs who fail to meet a loss-ratio requirement to make efforts to locate and pay dividends or credits to former policy holders;


• Permitting newly licensed providers and providers moving to New York to be provisionally credentialed until the final determination is made; and


• Establishing a new external appeal standard for rare disease treatments.

Today's Washington Times reports that a New York nurse is suing Mount Sinai Hospital for forcing her to participate in a late term abortion:

Catherina Lorena Cenzon-DeCarlo, 35, a Filipina nurse who is a permanent U.S. resident and married to an American, says that Mount Sinai Hospital in Manhattan "blatantly" violated a 35-year-old federal law that protects health care workers with religious objections from having to assist in performing abortions.

Read more here.