Thursday, January 28, 2010

Whistleblower Case Provides Lessons on Attorney-Client Privilege Protections

Shannon K. DeBra of Bricker & Eckler LLP has provided a summary of what is considered privileged attorney-client information, and what is not in the context of a lawsuit involving Christ Hospital of Ohio, Ohio Heart Center, and the Health Alliance.

According to the Department of Justice, Dr. Harry Fry, a cardiologist for Christ Hospital and Ohio Heart acted as a whistleblower under the False Claims Act, reporting that the organizations were involved in a scheme providing cardiologists with "improper incentives in exchange for generating revenue for the hospital."

In this case, Christ Hospital refused to turn over documents to Dr. Fry, including handwritten notes and meeting minutes that the hospital claimed were protected under the attorney-client privilege.

DeBra's article breaks down the communication requested by Fry and discusses what information is privileged and what is not. DeBra provides the following summary:

"This most recent decision in The Christ Hospital whistleblower case makes clear it is essential that any written communications (including emails and notes taken during meetings) discussing legal advice or the intent to seek legal advice about an issue include enough information to establish that legal advice was discussed or that an intent to seek it existed. A mere assertion later that such intent existed or that legal advice was discussed, without more explicit evidence, may not be sufficient to protect the document from discovery under the attorney-client privilege."

To read the full article, click here:

Source: Bricker & Eckler LLP

NPDB Section 1921 Final Rule Published

The final rule implementing the section 1921 changes to the National Practitioner Data Bank (NPDB) was published in today's Federal Register.

The new rule expands the NPDB, allowing users to query sanctions against all licensed healthcare providers, including nurses, podiatrists, chiropractors, and psychologists.

The rule becomes effective March 1, 2010 and can be found here:

Source: Federal Register

Wednesday, January 27, 2010

2009 CMS Annual Report Shows Reduction in Disparity Rate

The 2009 Annual Financial Report from the Centers of Medicare and Medicaid Services (CMS) to Congress shows an 8 percent decrease in the disparity rate between CMS onsite surveys and surveys performed by The Joint Commission (TJC).

The disparity rate measures the variance between survey findings collected by the two organizations. The reduction, which is the first drop ever reported, is attributed to TJC's recent efforts to align their standards with CMS requirements and improvements to their survey process.

The full CMS Fiscal Year 2009 Financial Report can be found here:

Tuesday, January 26, 2010

NAMSS Letter to ABMS Regarding MOC Implementation

NAMSS has provided feedback to the American Board of Medical Specialties (ABMS) regarding the American Board of Pediatrics' recent implementation of the Maintenance of Certification (MOC) program.

While NAMSS supports the ongoing skill development required of physicians through the MOC, there has been little guidance on how this will change the credentialing process. For example, the American Board of Pediatrics has implemented a permanent certification, eliminating end dates, which are currently verified.

ABMS requested NAMSS' thoughts on the American Board of Pediatrics' changes to their certification policy. A letter was sent to the ABMS Executive Committee last week for consideration. NAMSS will keep the membership updated on this issue.

To read NAMSS' letter to ABMS, click here:

MS.01.01.01 Field Review Ends this Week

The Joint Commission's (TJC) field review of MS.01.01.01 (formerly MS.1.20) closes this Thursday, January 28.

While the standard may involve some bylaws revision work by some hospitals, NAMSS believes that the draft standard preserves the authority of the medical executive committee better than the 2007 revision of the standard and is also more flexible than the previous revision.

Modern Physician featured an article yesterday which includes some views of those who, along with NAMSS, participated on the task force that created this revision of MS.01.01.01.

TJC plans to have its Board of Commissioners vote on the standard at their March meeting.

To read the Modern Physician article, click here:

To participate in the MS.01.01.01 field review, click here:

Monday, January 25, 2010

Implementation of Section 1921

The Health Resources and Services Administration/Division of Practitioner Data Banks has has announced the implementation of Section 1921.

"Implementation of Section 1921 will expand the information contained in the National Practitioner Data Bank (NPDB) to include adverse licensure actions taken against all licensed healthcare practitioners and any negative actions or findings by State licensing agencies, peer review organizations, and private accreditation rganizations against all health care practitioners and entities.

This final rule increases the amount of information accessible to hospitals and other organizations through the NPDB. Under the final regulation, private sector (non-Federal) hospitals will now have access to adverse licensure actions taken against all licensed healthcare professionals such as nurses, podiatrists, chiropractors, and psychologists—not just physicians and dentists. At this time, only Federal hospitals have access to this information."

NAMSS will post the language of the Section 1921 regulation when it is published in the Federal Register this week.

Information on Section 1921 can be found here:

Wednesday, January 20, 2010

Survey Shows Increase in Medical Errors Affected by Recession

A survey by the Institute for Safe Medication Practices shows that cutbacks due to the recession may be a contributing factor to medical errors.

The survey results show that many healthcare professionals are feeling short-staffed, and as a result, they are unable to participate in educational activities and feel too rushed to perform safety-focused activities such as double-checks on medication orders.

The increase in errors is also attributed to cutbacks in medication safety officer positions, where remaining staff cannot cover multiple units or facilities.

The full findings of the survey can be found here:

Source: Institute for Safe Medication Practices

Tuesday, January 12, 2010

Question of the Week: Healthcare Job Outlook

Modern Healthcare reports that despite a national loss of 85,000 jobs in December 2009, employment in the healthcare sector grew.

The Bureau of Labor Statistics (BLS) reported an addition of 21,500 jobs in healthcare in December 2009. Unlike many other fields, healthcare achieved a net gain in jobs each month in 2009. The highest number of new jobs opened up in physicians' offices, while hospitals saw the slowest growth in the healthcare field. Although December posted the second-lowest job addition number for hospitals in 2009, hospital employment was still able to add 1,400 jobs to the workforce.

The BLS results indicate that while the nation's unemployment rate hangs at 10%, healthcare is one of the few fields to have experienced growth.

The question of the week is, have you been experiencing this job growth in healthcare? Vote in the poll on the NAMSS Blog website. Use the comment field to let us know what kind of setting you work in and if you have noticed job growth in any of the positions at your workplace.

Source: Modern Healthcare

Monday, January 11, 2010

OIG Report Evaluates State Adverse Event Reporting

A January 6 report by the Department of Health and Human Services Office of the Inspector General (OIG) reviewed 17 state adverse event reporting systems. In the report, the OIG found that seven states provided no public disclosures, three provided limited disclosures, and seven provided extensive public disclosures.

"Adverse events" are described as a situation where a patient is harmed in the course of receiving medical care, such as surgical site infections. The systems with "extensive reporting" disclosed the event and also provided the medical community with information and strategies on how to prevent future adverse events.

The report recommends that other systems follow the lead of the seven states with extensive reporting.

The following is a breakdown of the systems in the report:
  • No Disclosures: Utah, Florida, Nevada, New York, South Carolina, South Dakota, Vermont
  • Limited Disclosures: Colorado, Maine, Rhode Island
  • Extensive Disclosures: Maryland, Massachusetts Board of Registration in Medicine, Massachusetts Department of Public Health, Minnesota, New Jersey, Oregon, Pennsylvania

The full report can be found here:

Tuesday, January 5, 2010

Question of the Week: Using the Internet in Credentialing

Attorney Mark Kadzieleski recently gave a presentation in which he recommended that MSPs "Google" applicants and practitioners in the reappointment process.

While Google might not provide the same in-depth information as a primary source, it and other Internet search engines are definitely a resource worth considering. For example, HR professionals are increasingly using Google and conducting searches of applicants' social networking pages like Facebook and MySpace to gain more information about candidates. An Internet search of a practitioner's name may help MSPs discover not only information about a candidate's character, but also information such as additional practice locations that the practitioner may not have disclosed on his or her application.

It is important to remember that while it may be useful, an Internet search is not a verified source of information on an applicant. When performing an Internet search, make sure that the "John Doe" that comes up in your search results is the same "John Doe" that has applied for privileges at your facility.

The question of the week is, do you use Internet search engines to obtain information about applicants and those going through the reappointment process? If you are performing Internet searches of your applicants, let us know what type of information you have been obtaining in the comment field.