Four Habits of High-Value Health Care Organizations

The New England Journal of Medicine recently published an article regarding four habits of effective hospitals. Although the article is geared towards, hospitals, the principles below are applicable to any health care organization. Specification and planning – Base choices, transitions, subgroups, and patient pathway on specific, meaningful criteria. Infrastructure design – Create microsystems to meet the needs [...]

Fall 2011 OIG Semiannual Report to Congress

The Office of the Inspector General (“OIG”) recently issued its semiannual report for the period ending September 30, 2011. The report provides an overview of the enforcement actions over the past year. Of particular interest is the report’s section of hospice care. Hospice care for nursing facility residents has grown nearly 70% since 2005. The [...]

Three Felonies A Day Redux

Some time ago, I wrote about Harvey Silverglate’s book Three Felonies A Day: How the Feds Target the Innocent. The book’s premise is that there is virtually no adult in this country who has not violated a federal criminal law because of the incredible number of laws and the vagueness and breadth of them. Moreover, [...]

Recent Reforms to the Texas Medical Board Disciplinary Process

Effective September 1, 2011, House Bill 680 moderately reforms the disciplinary process of the Texas Medical Board (“TMB”). The key points of the reform are listed below. Anonymous complaints: The TMB will no longer accept anonymous complaints. “Anonymous” is defined as a complaint that “lacks sufficient information to identify the source or the name of [...]

Electronic Medical Records

Are paper charts better?  Read this letter from a doctor to AAPS:   Why Paper Charts Are Better than EHRs. Though the U.S. government and insurers are determined to make us use electronic health records, paper is better in many ways: You will never recover the costs of the EHR, or even break even. EHRs [...]

Why Should You Have a Compliance Program?

The Patient Protection and Affordable Care Act (“PPACA”) mandates in Sections 6102 and 6401 that a broad range of providers, suppliers, and physicians adopt compliance and ethics programs. By March 23, 2013, skilled nursing facilities and other nursing facilities must have “in operation” a compliance and ethics program that meets the PPACA’s criteria. Although the [...]

Association of American Physicians and Surgeons Challenges PECOS

In August 2010, the Association of American Physicians and Surgeons (“AAPS”) filed an amended complaint asking the court to vacate HHS regulations requiring non-Medicare providers to enroll with Medicare, to appear in the Provider Enrollment, Chain and Ownership System (“PECOS”), or to obtain a National Provider Identifier (“NPI”). A copy of AAPS’ full amended complaint is available here. AAPS argues [...]

Fifth Circuit Rules Against Texas Medical Board in Due Process Case

On December 2, 1010, the U.S. Court of Appeals for the Fifth Circuit ruled against the Texas Medical Board (“TMB”),  remanding a suit brought by the Association of American Physicians and Surgeon (“AAPS”) and allowing the case to proceed. The AAPS complaint accused the TMB of the following: manipulation of anonymous complaints; conflicts of interest; violation of due process; [...]

Registration and Attestation for EHR Incentive Program begins on January 3, 2011

On January 3, 2011, eligible professionals and hospitals participating in Medicare and Medicaid programs may begin registering for electronic health record (“EHR”) incentive programs. CMS encourages providers to register for the Medicare and/or Medicaid EHR Incentive Program(s) as soon as possible. Providers may register prior to having a certified EHR or an enrollment record in PECOS. Providers may also register [...]

Institute of Medicine to Conduct Year-Long Study in HIT Safety

Under the HITECH Act of 2009, the Medicare and Medicaid electronic health record (“EHR”) incentive programs provide a financial reward for the meaningful use of qualified, certified EHRs to achieve health and efficiency goals. In July, CMS announced regulations outlining the initial requirements that eligible health care providers must meet to demonstrate meaningful use of certified EHR [...]

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