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September 2011 Archives

September 9, 2011

NY health exchange lags despite $38.7 million in federal grants

From today's Albany TimesUnion:

The state has made little headway toward building a health exchange, but with $38.7 million in grants, New York still leads the nation in receiving money for one.

"In fact, New York state has probably received more money than any other state in terms of planning for health care reform," said Sen. Kemp Hannon, chairman of the Senate Health Committee.

Read the rest of the article on the TimesUnion website.

Appeals Court Tosses VA Challenges to Health Reform Law

Virginia Attorney General Ken Cuccinelli's lawsuit challenging the federal health reform law has suffered a setback on the issue of standing.

A federal appeals court on Thursday overturned a lower court and rejected Virginia's challenge to the federal healthcare reform law, ruling that the state lacked the standing to proceed with the suit.

The 4th Circuit Court of Appeals court tossed aside a ruling by U.S. District Judge Henry Hudson last December, who had sided with Virginia's Republican Attorney General Kenneth Cuccinelli and ruled that the individual mandate in the Affordable Care Act was unconstitutional. The appeals court sent the suit back to Hudson and told him to dismiss it.

Virginia passed a law--the Virginia Health Care Freedom Act--which by its language prohibits Virginians from the being forced to buy health insurance. Cuccinelli used the Virginia law as a basis for his lawsuit.

Read the rest of the article at HealthLeaders Media.

Update: Kaiser Health News keeps a "scoreboard" tracking the health law challenges which can be viewed here.

Hospital Monopolies: The Biggest Driver of Health Costs That Nobody Talks About - Forbes

Avik Roy at Forbes has up a post that nicely addresses the issue of hospital mergers and health care costs.

The debate about health-care reform, on both the Left and the Right, revolves almost entirely around changing the way we pay for health care. Progressives advocate government-run, single-payer monopsonies, whereas conservatives advocate consumer choice among private insurers.

I agree that changing the way we buy health care is important . . . but there's an entire other side to that equation that we completely ignore: changing the way we sell health care.

This is a particularly salient issue here in the Capital Region as we watch the merger of three major hospital systems.

Read the full article on the Forbes website.

New Deadline for Applications to Receive St. Vincent's Resident Cap Slots

CMS announced that the deadline for applications from hospitals seeking to take over FTE slots from St. Vincent's Medical Center's former residency training programs is now December 1, 2011. The prior deadline was September 28, 2011. Read the CMS notice in the Federal Register from September 9, 2011 here.

September 13, 2011

Hospital exec found guilty in NY corruption probe - chicagotribune.com

Further fallout from the Carl Kruger / William Boyland corruption matter, reported by the Chicago Tribune:

A former hospital executive was convicted on Monday of conspiracy and fraud for creating fake consulting contracts to funnel money to New York state
legislators in exchange for influence in Albany.

David Rosen, who was chairman of MediSys Health Network, a not-for-profit hospital and healthcare group, had been indicted in April along with former state assemblyman William Boyland, Jr., state senator Carl Kruger and others. But Rosen's case was severed from the other defendants.

Read the rest of the article at the Chicago Tribune website.

NY hospital readmissions cost state $3.7B a year - The Business Review

Richard D'Errico at the Business Review covers a NYSHF report on hospital readmissions in New York:

A report released today says the cost of patients returning to hospitals within 30 days of a stay--known as readmissions--is costing the state $3.7 billion each year.

The New York State Health Foundation's report, "Reducing Hospital Readmissions in New York State," said about 15 percent of all initial hospital stays resulted in a readmission. That's 274,000 additional hospital stays.

See the Business Review piece here, or link to the full report on the New York State Health Foundation website.

September 14, 2011

NY Nurses Stayed With Critical Care Patients During Hurricane Irene

There is a nice writeup at HealthLeaders Media on how Hurricane Irene played out at one of New York City's medical facilities:

Nurses at NYU Langone Medical Center didn't bat an eyelid when Hurricane Irene started barreling toward the northeast last month. The hospital, just steps away from New York's East River was ordered evacuated, along with four others in harm's way, by Mayor Michael Bloomberg.

But NYU-Langone refused to move six of its ICU patients, warning they were so desperately ill that moving them threatened their lives. The ICU's nurses instead opted to stay with their patients through whatever the storm threatened to bring.

Read the full article on the HealthLeaders Media website.

New CMS Rule on Patient Access to Lab Reports Would Preempt New York Rule, Give Patients Greater Access

A new rule published today by the U.S. Department of Health and Human Services ("HHS"), Centers for Medicare & Medicaid Services ("CMS") gives patients direct access to clinical lab results.

This proposed rule would amend the Clinical Laboratory Improvement Amendments of 1988 (CLIA) regulations to specify that, upon a patient's request, the laboratory may provide access to completed test reports that, using the laboratory's authentication process, can be identified as belonging to that patient. Subject to conforming amendments, the proposed rule would retain the existing provisions that provide for release of test reports to authorized persons and, if applicable, the individuals (or their personal representative) responsible for using the test reports and, in the case of reference laboratories, the laboratory that initially requested the test. In addition, this proposed rule would also amend the Health Insurance Portability and Accountability Act of 1996 (HIPAA)Privacy Rule to provide individuals the right to receive their test reports directly from laboratories by removing the exceptions for CLIA-certified laboratories and CLIA-exempt laboratories from the provision that provides individuals with the right of access to their protected health information.

An obscure New York regulation prohibits labs from releasing lab reports directly to patients without provider consent. See 10 NYCRR Section 58-1.8:

No person shall report the result of any test, examination or analysis of a specimen submitted for evidence of human disease or medical condition except to a physician, his agent, or other person authorized by law to employ the results thereof in the conduct of his practice or in the fulfillment of his official duties. Reports shall not be issued to the patients concerned except with the written consent of the physician or other authorized person, except that information concerning blood type and Rh factor may be provided in writing to the individual whose blood was tested without the consent of the individual's physician.

To the extent that the new CMS rule provides greater access to the patient, it would be preempted. And this is indeed CMS's interpretation:

A number of States have laws that prohibit a laboratory from releasing a test report directly to the patient or that prohibit the release without the ordering provider's consent. If adopted, the proposed changes to ยง 164.524 would preempt any contrary State laws that prohibit the HIPAA-covered laboratory from directly providing access to the individual.

See 76 Fed. Reg. 56715.

September 20, 2011

DOH Posts List of Hopeful Health Homes

The Department of Health has posted the names of organizations submitting a letter of intent to become Medicaid "health homes" by November 1, 2011. The list is accessible from the DOH website page on Medicaid health homes. Several hundred organizations submitted applications; the DOH list is broken out by region and identifies the lead entity and partnering entities and agencies for each proposed health home.

From the DOH FAQ on health homes:

The health home model of service delivery expands on the traditional medical home model to build linkages to other community and social supports, and to enhance coordination of medical and behavioral health care, with the main focus on the needs of persons with multiple chronic illnesses.

More information is available at the FAQ page.

September 21, 2011

Ouch! Industry Reacts to Obama Budget Proposal

Yesterday's New York Times covered President Obama's proposed health care spending reductions in fair detail:

President Obama's budget director said Monday that the president's new deficit-reduction plan would impose "a lot of pain," and that is clearly true of White House proposals to cut $320 billion from projected spending on Medicare and Medicaid in the coming decade.

Continue reading "Ouch! Industry Reacts to Obama Budget Proposal" »

September 23, 2011

HHS Releases Final Medicaid Recovery Audit Program Rules

The US Department of Health and Human Services released a final rule under the Affordable Care Act implementing the Medicaid Recovery Audit Program. The following is from the rule summary in the unpublished release of the rule:

This final rule implements section 6411 of the Patient Protection and Affordable Care Act (the Affordable Care Act), and provides guidance to States related to Federal/State funding of State start-up, operation and maintenance costs of Medicaid Recovery Audit Contractors (Medicaid RACs) and the payment methodology for State payments to Medicaid RACs. This rule also directs States to assure that adequate appeal processes are in place for providers to dispute adverse determinations made by Medicaid RACs. Lastly, the rule directs States to coordinate with other contractors and entities auditing Medicaid providers and with State and Federal law enforcement agencies.

Read the complete version of the release here.

September 25, 2011

Recent Chapters and Vetos

On Friday, Governor Cuomo announced action on a series of bills, many of which are of interest to the health law community. The full press release can be found here.

Actions of interest include:


A.6446 Brennan -- Increase the amount of bonds and notes for the New York state medical care facilities finance agency

Same as S.4200 HANNON

A.6902-A Hevesi -- Authorizes records of bodies of deceased persons to be kept by an electronic Log

Same as S.4622-A MARCELLINO

A.7368-A Dinowitz -- Relates to continuing care retirement communities

Same as S.4738-A GOLDEN

A.8179 Gottfried -- Relates to restricting duties which may be assigned to specialist's assistants in radiology

Same as S.5395 HANNON

A.8188-A Gibson (MS) -- Authorizes the dormitory authority to provide financing to the Primary Care Development Corporation for the construction of primary care facilities

Same as S.5645 HANNON

S.1303 DUANE -- Requires the state office for the aging to report on the delivery of services to and needs of traditionally underserved populations in their annual report to the governor and legislature

Same as A.880 Kellner

S.3111-B LARKIN -- Relates to establishing a certificate of still birth

Same as A.8178-A Galef

S.3988-B LANZA -- Requires coverage of orally administered chemotherapy treatments

Same as A.6233-B Lopez V

A.3304-A Gottfried (MS) -- Relates to health-related legal services programs

Same as S.5556 HANNON

A.4899-A Rosenthal (MS) -- Requires the provision of a model health care proxy form to individuals applying for medical assistance

Same as S.4830-A GALLIVAN

A.8322 Schroeder (MS) -- Relates to designating the ombudsman as an employee of the commissioner on quality of care and advocacy for persons with disabilities

Same as S.5792 MCDONALD


A.8248 Gottfried -- Provides for the payment of capitated rates for services provided by assisted living programs, whether freestanding or not

Same as S.4918-A HANNON

S.4563-A SAVINO -- Relates to the practice of surgical technology and surgical technologists

Same as A.6539-B Cahill

S.4991-B HANNON -- Establishes the clinical information resource access program to provide information to medical institutions and facilities

Same as A.8202 Bing

S.3184-A LITTLE -- Relates to procedures, practices, and standards for actions by the office of medicaid inspector general and social services districts

Same as A.5686-A Gottfried

September 27, 2011

Surgical infections an issue for area hospitals - Business First

Last week Buffalo Business First covered a recent report from the New York State Department of Health on hospital infection rates.

Western New York area hospitals continue to experience higher levels of surgical site infections than at other hospitals across the state, according to a new report released this week by the state Department of Health.

On a statewide level, however, the total number of infections acquired by patients while in New York hospitals continues to decline. The fourth annual report includes details on hospital-acquired infection (HAI) in 2010 at 177 acute care hospitals in the state. The report includes data on more than a dozen different procedures resulting in an HAI, an infection acquired as a result of treatment in a hospital.

Read the rest of the article at Buffalo Business First.

Read the DOH press release here, or access the full report here.

About September 2011

This page contains all entries posted to HEALTH LAW SECTION BLOG in September 2011. They are listed from oldest to newest.

August 2011 is the previous archive.

October 2011 is the next archive.

Many more can be found on the main index page or by looking through the archives.