Thursday, October 27, 2011

Remember the Kadlec Case?

Although Lakeview Medical Center was dropped from the case, the courts found the physician who wrote the glowing reference for Dr. Berry, guilty of engaging in negligent misrepresentation with a 8.2 million dollar penalty. Read the full story below.

Our thanks to the MSSP Yahoo Group for forwarding us this story!

Thursday, October 20, 2011

CMS Recognizes The Joint Commission's Critical Access Hospital Accreditation

Elizabeth Eaken Zhani October 19, 2011

The Department of Health and Human Services’ Centers for Medicare & Medicaid Services (CMS) has again granted The Joint Commission deeming authority for the accreditation of critical access hospitals.

The CMS designation means that critical access hospitals accredited by The Joint Commission may choose to be “deemed” as meeting Medicare and Medicaid certification requirements. CMS found that The Joint Commission’s standards for critical access hospitals meet or exceed those established by the Medicare and Medicaid program. CMS’ notice of approval, which was published September 23 in the Federal Register, becomes effective November 21, 2011 and runs through November 21, 2017.

“The Joint Commission is pleased to once again receive this recognition for its accreditation of critical access hospitals, which are vital to the health of Americans, especially residents of rural areas,” says Mark R. Chassin, M.D., FACP, M.P.P., M.P.H., president, The Joint Commission. “This public-private collaboration between CMS and The Joint Commission creates the necessary quality and safety oversight framework for these hospitals.”

Critical access hospitals have no more than 25 acute care beds and have an annual average length of stay per patient of 96 hours. These hospitals, which are typically located more than 35 miles from another hospital, receive cost-based reimbursement from Medicare.

Accreditation is voluntary and seeking deemed status through accreditation is an option, not a requirement. Organizations seeking Medicare approval may choose to be surveyed either by an accrediting body, such as The Joint Commission, or by state surveyors on behalf of CMS. All deemed status surveys are unannounced.

In addition to critical access hospitals, The Joint Commission has federal deeming authority for advanced diagnostic imaging, ambulatory surgery centers, clinical laboratories, durable medical equipment suppliers, home health, hospice, hospitals and psychiatric hospitals.

Wednesday, October 19, 2011

NPDB Posts New Data on Reporting Compliance Status of Government Agencies

This is National Healthcare Quality Week. Please join me in wishing our Healthcare Quality Professionals a Happy Week and Thank them for all they do!

Quality and patient safety professionals are an integral part of the success of today’s modern healthcare system. They impact every aspect of the healthcare process in facilities large and small, from major metropolitan health centers to local long-term care facilities.

A quality professional addresses many issues in the healthcare workplace:

• medication reconciliation
• mortality and incident rate reduction
• risk management
• core measures
• patient safety
• quality management
• quality improvement.

Healthcare quality professionals ensure their facility meets specific requirements set forth by accrediting bodies for healthcare organizations and programs, such as The Joint Commission and Centers for Medicare & Medicaid Services.

CMS releases proposed Hospital CoPs

Below are the proposed rules published by the Centers for Medicare and Medicaid Services’ (CMS’) in line with their commitment to the general principles of the President’s Executive Order 13563, released January 18, 2011, entitled “Improving Regulation and Regulatory Review.” In these proposed rule CMS seeks to reduce the regulatory burden placed on hospitals by identifying a number of existing hospital CoPs that they believe could be reformed, simplified, or eliminated in order to reduce unnecessary burden and costs placed on hospitals and critical access hospitals (CAHs) under existing regulations. These revisions are open for comment. Please see the first few pages of the document which lists authorized means to submit comment and the deadline to do so.

Some points of interest are:

Governing Body
Revise and clarify the governing body requirement to reflect current hospital organizational structure whereby multi-hospital systems have integrated their governing body functions to oversee care in a more efficient and effective manner. Specifically, CMS proposes to revise §482.12 to state that “There must be an effective governing body that is legally responsible for the conduct of the hospital.”

Medical Staff Organization
Proposing changes to the more direct responsibilities for the organization and accountability of the medical staff. Presently, the hospital may assign these management tasks to either an individual doctor of medicine or osteopathy or, when permitted by State law of the State in which the hospital is located, a doctor of dental surgery or dental medicine. CMS proposes to expand the list to include doctors of podiatric medicine (DPMs). This change would permit a podiatric physician to serve as the president, or its equivalent, of a
hospital’s medical staff in a significant number of states.

CMS is seeking comments on whether their language is clear on the single organized medical staff as it currently allows for a multihospital system to have the option of a single organized medical staff responsible for the quality of medical care provided to patients by all of the hospitals in the system, however does not state it in those words. However, CMS is not sure if this is clear to stakeholders and welcomes comment.

Allied Health Professionals:
Propose to revise language to clarify that a hospital may grant privileges to both physicians and non-physicians to practice within their State scope of practice, regardless of whether they are also appointed to the hospital’s medical staff. That is, technical membership in a hospital’s medical staff would not be a prerequisite for a hospital’s governing body to grant practice privileges to practitioners.

Changes and clarifications regarding medical staff and privileging would allow hospitals to substitute and rearrange actual delivery of care. In particular, use of Advanced Practice Nurse Practitioners (APRNs) and Physician Assistants (PAs) in lieu of higher-paid physicians could provide immediate savings to hospitals. CMS welcomes comments on their saving assumptions which are outlined in the full text.

Thursday, October 13, 2011

ABMS Now Publicly Reports Physicians' Status of Meeting Maintenance of Certification Program Requirements

Lori Boukas, October 11, 2011

The American Board of Medical Specialties (ABMS) announced today that it has begun reporting publicly whether physicians who are Board Certified by one or more of the 24 ABMS Member Boards are meeting the ABMS Maintenance of Certification® (ABMS MOC®) program requirements established by their certifying Board(s). The public reporting initiative is being rolled out during the next year beginning with seven Member Boards, including the American Board of Dermatology, American Board of Family Medicine, American Board of Nuclear Medicine, American Board of Otolaryngology, American Board of Physical Medicine and Rehabilitation, American Board of Plastic Surgery and American Board of Surgery. The remaining 17 Member Boards will make the MOC status of their Board Certified physicians available in August 2012 or sooner.

Some Member Boards have already been reporting the MOC status of their Board Certified physicians in alternate formats. For the first time, however, ABMS will serve as the central repository for the MOC status of physicians from all 24 ABMS Member Boards, which will be reported publicly in the same format. The MOC status of physicians Board Certified by an ABMS Member Board(s) will also be displayed by ABMS licensees, official display agents and on

“We’re honoring our pledge of increased transparency to the public by providing easy access to important information about individual physicians,” said Kevin B. Weiss, MD, ABMS President and CEO. “This is a significant milestone in ABMS history. The public can be confident that physicians who are meeting the requirements of the ABMS MOC program are committed to lifelong learning and ongoing self-evaluation.”

Board Certification is a voluntary process that assesses a physician’s competence in his or her specialty. To maintain their certification, physicians may participate in an ABMS MOC program, a rigorous process that continually assesses and enhances their medical knowledge, judgment, professionalism, clinical techniques and communications skills. For some ABMS Member Boards, physicians who were Board Certified before those Member Boards established their MOC programs are not required to participate in the ABMS MOC program created by their Member Board(s).

To obtain information regarding whether a specific physician is required to participate in the MOC program of his or her certifying Board(s), please contact that ABMS Member Board(s) directly.

“The ABMS MOC program is being incorporated into the credentialing process and is recognized as an important quality marker by insurers, hospitals, quality and credentialing organizations, the federal government and the public,” said Dr. Weiss. “We’re pleased to serve as the clearinghouse with the launch of the initial data from seven Member Boards, and look forward to full Member Board participation by this time next year.”

For those seven Member Boards participating in the initial rollout, the results of researching a physician’s status will show the name of the physician, the name of the ABMS Member Board(s) that certifies the physician and include a “yes” or “no” response to the question of whether the physician is meeting the MOC requirements of that Member Board(s). It will also include a link to the website of the physician’s certifying Board(s).

The types of tools and programs that physicians can use to meet the requirements of an MOC program vary by specialty. ABMS Member Boards tailor their MOC programs to the needs of their specific medical specialties.

Tuesday, October 11, 2011 5 ways to manage your online reputation

Hello Members. Here is a good article from the AMA that affects all of us as well as your medical staffs:

5 ways to manage your online reputation
Pamela Lewis Dolan, Sept. 12, 2011

In the days of social media, negative online content could have far-reaching legs and a devastating impact on a physician unless it's managed efficiently.
By Pamela Lewis Dolan, amednews staff. Posted Sept. 12, 2011.

Even if some physicians themselves are not online, their names, comments on their style of practice, and complaints or compliments about them probably are.

All of the online content devoted to a particular physician could negatively impact his or her reputation, and subsequently his or her business, if steps aren't taken to manage that content and -- when necessary -- defend it. This is often referred to as online reputation management.

Online reputation management has become big business, as evidenced by the number of radio and online ads offering to help physicians. But physicians can manage their own reputations, help build positive ones, and prevent negative content from turning into a crisis that needs to be dealt with professionally.

As quickly as online content can spread, especially in the age of social media, experts say online reputation management should be a key component to any business plan.

"The best defense in these cases is good offense," said Scott Sobel, president of Media and Communications Strategy, a Washington-based public relations firm specializing in crisis management.

Christian Olsen, vice president of Levick Strategic Communication's digital and social media practice, said social media has changed the dynamics of reputation management, because in addition to physicians communicating with their patients, their patients are now communicating with one another on social media websites.

For most physicians, there are five simple steps they can take to manage and maintain a good reputation online. For others, managing their online reputations may require more time and expertise than they have available.

One: Google yourself
Olsen said many make the mistake of thinking that because they don't have a website or are not involved in social media they are not online. "It just means your voice is not being heard in a conversation about you," he said.

The first step in managing a reputation is knowing what there is to manage. Reputation management experts recommend that physicians conduct Google searches on themselves at least once a month, preferably more often. Things can spread quickly online, so seeing what content is there on a regular basis will help doctors stay ahead of a potential crisis. It's also a good way to see what positive things are being said about you, which you may be able to build on.

Steven Wyer, managing director of Reputation Advocate Inc. and author of the book Violated Online, said physicians should set up alerts on Google and Yahoo. These alerts work by registering keywords, such as a name, that the search engines will use to comb the Internet looking for any new mention of those keywords on blogs, websites, online forums and other sites. When it finds a new mention, it will send an email detailing where the keywords were mentioned, what was said and a link to the website.

The mistake many physicians make, however, is to not include all reasonable variations of their name in an alert, Wyer said. For example, John Smith, MD, could have several variations, including Dr. John Smith, Dr. John C. Smith, Dr. John Smith, MD, etc. Alerts for a handful of those variations should be set up.

Two: Correct mistakes and false information
The easiest places to start are websites that show up high in Google searches. Those sites are likely to be physician finder or rating sites or health plan physician finders. The sites often include wrong or outdated contact information and incomplete biographical and educational history.

Many of these sites give doctors the opportunity to edit their own profiles, which they should do by bolstering the information that is presented and highlighting positive aspects. Experts say physicians should complete their CVs by adding professional achievements such as awards and published articles. They also can use the forum to talk about their style of practice and what patients can expect from them.

The overwhelming majority of online physician reviews are positive. Dealing with false or inflammatory content can be trickier, Olsen said. How physicians handle false or misleading information on a site could make a situation worse, depending on how it's handled. They should do what they can to correct the information without being too aggressive, he said. One suggestion is to acknowledge the problem and then ask the author of the content to take things offline to find a resolution.

"Respond in public, but ... definitely don't play it out in the open," Olsen said.

Wyer said most websites have posted terms and conditions. If content on the site clearly violates those terms, a request can be made to the website's site administrator to have the information removed. The same request can be made of content that violates privacy laws or Health Insurance Portability and Accountability Act regulations. Insults are generally not violations, but Web posts that contain personal identifiable information would be considered violations.

Three: Create your own content
The best way physicians can steer conversations in the direction they want, or help hide the conversation they hope no one sees, is to start the conversation themselves. Experts say doctors can do this on many online venues: personal blogs, websites and personal social media pages, which all tend to rank high in search engine results.

If you already have done a search on yourself, you would know which sites are ranked high and need to stay high, and which sites you may want to push down in the results. Posting information on sites that generally rank high in Google searches, such as physician finder sites and LinkedIn profiles, will help push other content down in the search results. The farther down the better, as 90% of people won't go past the first page of search results and 99% won't go past page 2, said Noah Lang, director of business development for

Wyer said it's important for physicians to own their own name online, starting with claiming their profiles on finder and review sites. On most physician profile sites, a link asks if you are the doctor being profiled. If you are, you can register with the site to take ownership of that listing and edit it as you see fit.

Owning your name could include buying website domains under the physician or practice name, creating social media pages and creating blogs in your name.

A misconception, Wyer said, is that all of these sites must be managed daily. If a physician wants to establish him or herself as a blogger, the goals and strategies are different. But simply populating the sites with basic information such as the doctor's bio, contact information and a link to a website, combined with the appropriate keywords and elements to ensure good placement in Google searches, doesn't require daily or even weekly maintenance.

Four: Embrace constructive criticism
Studies have found that an overwhelming majority of online reviews of physicians are positive. But even if a doctor does not achieve unanimous positive reviews, that's all right, experts said.

Sobel says having only simple and positive reviews will raise red flags. "You want to look for good but balanced comments. There will always be someone unhappy," he said. But it's important for patients to use reputable sites that rate doctors fairly.

Physicians should find a handful of rating sites they trust and direct patients to them. They can do so by having staff verbally tell patients about the sites, hang signs in the waiting room that list the Web addresses, and hand out fliers at the check-out desk.

Five: Address actionable items
Sobel said many of the things patients complain about online are things physicians can work to change immediately and publicize online.

Knowing what the "hot button issues" are among patients -- long waits, lack of response or slow responses, and leaving a message for the doctor and having someone else call them back -- and addressing those things in practice and online will go a long way toward improving your reputation. Part of managing your online reputation is managing how you come across online addressing those issues.

Lang said physicians should broadcast online when changes have been made due to complaints.

Sobel said a physician's website not only can be a source of the positive information they want patients to find but also can serve as a way to respond to negativity in a positive way.

When a physician's reputation has taken a beating, Sobel said, ignoring it and hoping it goes away is not a sound option. Besides their knowledge of medicine, physicians' reputations are their highest commodity, he said.

Think twice before taking legal action for something online
Things read online might be blatantly false and even harmful to a physician's reputation. But in most cases, taking legal action may make the situation worse.

When opinions and reviews include false information that would constitute libel or defamation, legal action might be warranted, said Craig Newman, a New York-based attorney. But he warns clients to think long and hard before filing a lawsuit or drafting a cease-and-desist letter.

Because of the many exceptions, libel and defamation are very hard to prove in a court of law. Therefore, physicians take a risk when filing a suit, bringing more attention to the matter, and not being able to prove their case.

Noah Lang, senior director of business development at, said it's generally better just to let things live and die. A physician could send a cease-and-desist letter, but then a blogger could post that online, only exacerbating the issue.

However, experts said legal action might be warranted -- including a call to law enforcement -- if a physician sees something threatening to family or staff members as well as the physician.

Here's what to look for in a reputation management firm
Not all reputation management firms are created equal. If a reputation management company doesn't handle things correctly, a bad situation could be made worse.

First, experts say, a good reputation management firm will have a good understanding of the physician's business. If it specializes in services for physicians specifically, the better.

Scott Sobel, president of Washington-based Media & Communications Strategies, said a good firm will have a relationship with a reputable lawyer or law firm and have some knowledge of public relations. The firm also should be familiar with First Amendment and copyright laws.

While a good firm should never talk about specifics of a prior case, it should be able to talk in general terms about the techniques it will use, such as search engine optimization, Sobel said. A firm that talks about committing some of the same actions it should be protecting clients from, such as verbal attacks, libel or defamation, also should be avoided.

Monday, October 3, 2011

HRSA: HIPDB to Merge with NPDB

The Division of Practitioner Data Banks (DPDB) is anticipating the merge of the Healthcare Integrity and Protection Data Bank (HIPDB) into the National Practitioner Data Bank (NPDB). The merger is planned for 2012.

Please see the following links for more information: