Anesthesiologist Sentenced for Research Fraud

Dr. Scott Reuben, a Massachusetts anesthesiologist, was sentenced to six months in prison after pleading guilty to the fabrication of data in a research study.

Reuben admitted to providing false data for a pain management study he performed for Pfizer, Inc. It was later discovered that he had fabricated data in several studies, dating back to 1996. Baystate Medical Center in Springfield, MA stripped him of educational and research duties after this discovery.

Reuben's defense claimed that his undiagnosed bipolar disorder made him unable to prevent his wrongful behavior.

This example highlights the need to take some caution when relying on research studies, and for medical facilities to monitor the research conducted by members of their staff.


Source: BNA

Minnesota Nurses Announce Plans for New Strike

The Minnesota Nurses Association (MNA) has filed a 10-day notice for a strike to begin on July 6 and last indefinitely. 10,000 of the MNA's nurses already held a one-day strike on June 21. The strike notice was filed as the union continues to negotiate a new labor and pension agreement with Twin Cities Hospital system, which serves the Minneapolis/St. Paul area.

Some observers believe that the 10-day strike notice is a tactic by the MNA to pressure the hospital system into an agreement before the July 6 deadline.

Hospitals were able to maintain care during the June strike by bringing in over 2,000 temporary staff members for a single day. The threat of an open-ended strike is a bigger concern for potentially affected hospitals, which must figure out how to remain open and maintain continuity in patient care should its nursing staff go on strike.


Source: StarTribune.com
http://www.startribune.com/lifestyle/health/97166854.html?elr=KArks7PYDiaK7DUvckD_V_jEyhD:UiD3aPc:_Yyc:aUU

HHS Launches ESAR-VHP Website

The Department of Health and Human Services (HHS) has launched a new website with information on the Emergency System for Advance Registration of Volunteer Health Professionals (ESAR-VHP) program at www.phe.gov/esarvhp.

The ESAR-VHP program is intended to promote the efficient delivery of first response care in emergency and disaster situations through the creation of state plans and a registry of healthcare professionals. The new website provides reports and materials that communities can use in planning their own preparedness programs.

HHS has also established a YouTube channel at www.youtube.com/phegov where visitors can view testimonials and videos made by volunteers.


Source: HHS

21 Percent Physician Pay Cut Delayed

On June 25, President Obama signed The Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010.

The law cancels a 21 percent physician Medicare reimbursement cut that CMS began enforcing on June 18. The law also increases physician reimbursement by 2.2 percent through November.

The temporary increase is a sign that Congress still needs to take action to address the sustainable growth rate, which factors into the reimbursement rates. There have been estimates that the physician payment cut may reach as high as 30% by January if Congress does not find a long-term solution, or implement another "patch" when the reimbursement increase expires in November.

CMS will begin processing all claims at the new rate by July 1.


Source: BNA

Study Shows Limiting Surgical Training Hours May Hurt, Not Improve Care

A study conducted in a Swiss hospital shows that most residents and surgical supervisors believe that limiting surgical training hours has a negative effect on training and performance. In Switzerland, residents are limited to 50 hour workweeks. In the US, residents have been capped at 80 hours a week since 2003.

Limiting surgical residents' working hours has been a recent strategy used to increase safety. It is believed that limiting hours decreases the likelihood that medical errors will be made by a tired resident. Respondents in the Swiss study stated that while their quality of life increased with less work hours, they felt that they did not have the adequate time to learn necessary skills and build endurance for long surgeries.

The study did not take into account whether or not nurses and patients perceived a lower quality of care.


Sources: Health Care Advisory Board, Medpage Today
http://www.medpagetoday.com/PublicHealthPolicy/GeneralProfessionalIssues/20797

HHS to Invest $250 Million to Boost Primary Care Workforce

The Department of Health and Human Services (HHS) announced that it will invest $250 million to boost the primary care workforce in an effort to address a predicted shortage of physicians in the field. The funds will be derived from the Prevention and Public Health Fund, which has $500 million for fiscal year 2010.

HHS intends to spend the $250 million on the following main initiatives:

• $160 million for the creation of 500 new residency slots in primary care
• $32 million to train 600 physician assistants
• $30 million to fund the full-time education of 600 nursing students
• $15 million to support nurse-managed clinics
• $5 million to help states plan for the primary care shortage
• Training of 16,000 new primary care providers over the next five years

The Association of American Medical Colleges is predicting that the US will face a shortage of 21,000 primary care providers by 2015. The shortage is due to a combination of various factors including: fewer medical school graduates going into primary care, an aging population, and the expected patient increase resulting from expanded health coverage.

Source: BNA

Study Highlights Shortage of Primary Care Physicians

A George Washington University study shows that medical schools are continuing to produce more graduates going into research and specialty professions and not enough primary care doctors. The study also found that graduates of public medical schools were more likely to promote a "social mission," encouraging graduates to go into primary care, especially in underserved communities. More prestigious schools were

Many analysts believe that the continued shortage of graduates entering the primary care field is due to the low reimbursement rate. After graduating with massive debt, graduates are hesitant to select a field that pays an average of $124,000 a year, the lowest rate among physician specialties.

The new health reform law sets aside $1.5 billion in funding for primary care physicians who work in underserved areas. Some hospitals are also working to attract physicians into primary care, fearing that without first-line care, patients will flood their emergency rooms with minor and preventable conditions. This study and others that have been released, continue to serve as indicators that improvments to the delivery of care are needed to support an increased patient population.


The full George Washington study can be found here:
http://www.annals.org/content/152/12/804.full?aimhp


Source: The Baltimore Sun
http://www.baltimoresun.com/health/bs-hs-primary-care-study-20100615,0,6289224.story

12,000 Minnesota Nurses Go on Strike

12,000 nurses in Minnesota went on strike today in what has been reported as the largest nursing strike in US history. The Minnesota Nurses Association voted to approve the one-day strike last month after the union failed to reach a staffing agreement with Twin Cities Hospitals, a 14-hospital system located in the Minneapolis/St. Paul area.

The staffing plan proposed by Twin Cities Hospitals would allow hospitals to float nurses between departments to meet staffing needs. The MNA argued that this plan would lead to inconsistency in patient care and would burden an already stretched nursing staff. Twin Cities Hospitals argued that the staffing model proposed by the MNA was too costly in a time where hospitals are being asked to implement new technology while facing funding cuts.

Twin Cities hired temporary nurses to ensure that its facilities could remain open during the strike. The striking nurses are scheduled to return to work at 7 AM on June 11.

The Minnesota strike occurred as California nurses agreed to comply with a judge's temporary order stopping a strike against the University of California hospital system. The California strike was expected involve 12,000 nurses.

Source: ABC News
http://abcnews.go.com/Business/thousands-nurses-strike-minnesota/story?id=10875712

CMS Extends TJC's Telemedicine Hospital Standards

Hospitals and Critical Access Hospitals do not have to make changes to implement new telemedicine credentialing and privileging elements of performance by a July 15, 2010 deadline, says The Joint Commission (TJC). The deadline for implementing the new elements of performance has been pushed to March 2011.

TJC had issued new elements of performance which were in compliance with the Centers for Medicare & Medicaid Services' (CMS) requirements for telemedicine services. The CMS requirements currently disallow the "credentialing by proxy" system that is supported by The Joint Commission's current standards. The "credentialing by proxy" system is intended to support access to telemedicine services by allowing the hospital where the patient is located, to rely on the credentialing and privileging data of a hospital where the provider is currently privileged in making its own decisions on that provider.

CMS has issued a proposed rule that would make the CMS telemedicine requirements in accordance with TJC's "credentialing by proxy" system. For this reason, CMS allowed TJC to delay implementation of the new elements of performance that are aligned with the current CMS CoPs until March 2011.


Source: The Joint Commission
http://www.jointcommission.org/AccreditationPrograms/Hospitals/telemed_requirements_hap_cah_delayed.htm

CMS Anesthesia Guidelines Revised

The Centers for Medicare & Medicaid Services (CMS) have revised the interpretive guidelines for anesthesia delivered in hospitals. The changes focus on the differences between anesthesia and analgesia services, where the patient does not lose consciousness.

The memo released by CMS provides hospitals with information on what practitioners may provide anesthesia services, what hospital policies should include regarding who is allowed to administer these services, guidelines on the supervision of anesthesiology assistants, and a list of information that must be included in a patient's anesthesia record.

The American Society of Anesthesiologists has provided the following summary of the changes:
http://www.asahq.org/Washington/ASAInterpretiveGuidelinesWeb%20Posting12-22-09Final.pdf

To read the CMS memo, click here:
http://www.asahq.org/Washington/12-11-09%20RevisedANHospitalInterpretiveGuidelines.pdf



Source: Health Leaders Media
http://www.healthleadersmedia.com/page-1/LED-249481/New-CMS-Anesthesia-Guidelines-Completely-Rewrite-Former-Standards

ABMS Implements Continuous Reporting of MOC Pilot

The following announcement was made by the American Board of Medical Specialties on June 2:

The American Board of Medical Specialties (ABMS) announced that its data file now reflects continuous certification reporting information for diplomates certified by the American Board of Pediatrics (ABP). ABMS’ reporting pilot will begin with ABP, the first and only ABMS Member Board to eliminate specific certification “end dates” for its diplomates.

For all ABP diplomates who are initially certified in 2010 and beyond, as well as those whose certificate currently contains an expiration date, ongoing certification with the ABP is contingent upon meeting the requirements for Maintenance of Certification (MOC). To maintain ABP certification, diplomates must successfully complete numerous requirements throughout the ongoing MOC cycles; thus the ABP no longer provides a specific end date to certification.

ABMS recognizes that some credentialers may still require a certification end date to complete primary source verification. As ABP diplomate certification status only changes at the beginning of a calendar year, unless revoked for disciplinary reasons, conducting annual primary source verification on or after February 15 will ensure credentialers have accurate certification status for ABP diplomates. The practice of conducting annual primary source verification in mid-February of each calendar year will also serve as a reminder previously provided by an official end date.

Approximately 7,800 ABP diplomates whose certification expired December 31, 2009, are the first physicians to have this new designation.

“Although ABP’s policy does not affect other Member Boards, it aligns with the ABMS Maintenance of Certification® (ABMS MOC®) emphasis on continuous, life-long learning. For the credentialing community, the February 15 date will serve as an annual reminder to verify physicians’ credentials,” said Kevin B. Weiss, MD, president and CEO of ABMS. “We are pleased to be able to provide credentialers with this continuous MOC reporting data pilot program for ABP diplomates, and we look forward to hearing feedback from the credentialing community and further supporting their needs.”

For additional information visit the ABP website at http://www.abp.org/.