MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'HealthBlawg :: David Harlow's Health Care Law Blog' source. Mon, 17 Nov 2008 22:45:53 +0100 http://feeds.feedburner.com/~r/HealthBlawg/~3/453106626/health-wonk-review-is-up.html The post-election edition of Health Wonk Review is up at Colorado Health Insurance Insider.David HarlowThe Harlow Group LLCHealth Care Law and Consulting (Source: HealthBlawg :: David Harlow's Health Care Law Blog) HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=1960605 Fri, 14 Nov 2008 05:00:00 +0100 1960605 http://feeds.feedburner.com/~r/HealthBlawg/~3/449811653/grand-rounds-is-up-at-musings-of-a-distractible-mind.html . . . wherein Dr. Rob offers some llama-inflected job advice for an anonymous correspondent (rhymes with "no llama").David HarlowThe Harlow Group LLCHealth Care Law and Consulting (Source: HealthBlawg :: David Harlow's Health Care Law Blog) HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=1951818 Tue, 11 Nov 2008 05:00:00 +0100 1951818 http://feeds.feedburner.com/~r/HealthBlawg/~3/444588412/dnv-senior-execs-speak-with-david-harlow-about-new-hospital-accreditation-authority.html Yesterday I had the opportunity to chat with several members of the executive leadership team from DNV Healthcare, the "new kid on the block" for hospital accreditation.  DNV was recently granted deeming authority by CMS -- the first time the federales have taken such a step since recognizing the Joint Commission about 40 years ago.  (The AOA has deeming authority for osteopathic hospitals.)  I spoke with Darrel Scott, Senior Vice President, Patrick Horine, Executive Vice President - Accreditation, and Becky Wise, Chief Operating Officer, and learned more about DNV, ISO 9001, and the National Integrated Accreditation for Healthcare Organizations (NIAHO) standards.  DNV developed its NIAHO standards for hospital accreditation, building upon both the Medicare COPs and o... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=1939011 Thu, 06 Nov 2008 05:00:00 +0100 1939011 http://feeds.feedburner.com/~r/HealthBlawg/~3/442666113/early-returns-point-to-nurse-ratcheds-place.html . . . for a presidential-history-filled edition of Grand Rounds.  Read, learn and enjoy.David Harlow The Harlow Group LLCHealth Care Law and Consulting (Source: HealthBlawg :: David Harlow's Health Care Law Blog) HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=1933146 Tue, 04 Nov 2008 05:00:00 +0100 1933146 http://feeds.feedburner.com/~r/HealthBlawg/~3/441323172/new-massachusetts-identity-theft-regs-overlap-with-hipaa.html Massachusetts identity theft regs take effect January 1, 2009.  Any business that does no more than keep a copy of a personal check from a client or customer on file is subject to these new rules, which require implementation of a security program covering any "personal information" maintained in a business' files.  "Personal information" means any non-public linking of a person's name and Social Security Number, driver's license number, or financial account number (debit, credit or bank account number).  The enabling statue does not apply to state government agencies, but Gov. Patrick brought them into the big tent by executive order. Internal and external security audits and employee training will be required.  For those lucky enough (!) to be subject to HIPAA already, these require... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=1933147 Mon, 03 Nov 2008 05:00:00 +0100 1933147 http://feeds.feedburner.com/~r/HealthBlawg/~3/440520082/don-berwick-ceo-of-the-institute-of-healthcare-improvement-speaks-with-david-harlow-about-the-5-million-lives-campaign-and.html Don Berwick, CEO of the Institute for Healthcare Improvement, spoke with HealthBlawg last week, as IHI comes close to wrapping up its 5 Million Lives Campaign.The audio file of my interview with Don Berwick (about 20 minutes long) is available for download/podcast. A full transcript is at the end of this post (and in the linked transcript.IHI sponsors an impressive array of collaborative health care improvement programs, offering programmatic support and creating a network of like-minded institutions and leaders who provide feedback to each other on improvements to their local systems.  The 5 Million Lives Campaign is the latest in a long line of successful campaigns.I asked Berwick about the plethora of health care indicators used in P4P and pay-for-reporting plans, and he suggested that... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=1930196 Sun, 02 Nov 2008 04:00:00 +0100 1930196 http://feeds.feedburner.com/~r/HealthBlawg/~3/438167419/2009-mpfs-final-regulations-are-out.html The 2009 Medicare Physician Fee Schedule regulation was released in final form yesterday (on display), and will be published in the Federal Register on November 19.  It is chock full of payment and policy changes, detailed in three CMS fact sheets: (1) payment policies and rates; (2) MIPPA-related changes; and (3) e-prescribing incentives and PQRI updates. A few highlights: MIPPA's 1.1 % MPFS rate increase in lieu of the previously-scheduled SGR pay cut Deferral of the proposed incentive payment and shared savings (gainsharing) Stark exception, together with a call for further comment Revision of the anti-markup rule Imaging accreditation and appropriateness criteria under MIPPA (follow link to earlier HealthBlawg post on the subject) E-prescribing incentives -- available under MIPPA... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=1926399 Fri, 31 Oct 2008 04:00:00 +0100 1926399 http://feeds.feedburner.com/~r/HealthBlawg/~3/436649341/health-wonk-review-samhain-edition.html All Hallow's Eve (celebrated around these parts tomorrow night) incorporates traditions tied to the earlier Celtic holiday of Samhain, which marks the beginning of winter -- as the great (swing) state (or should I say Commonwealth) of Pennsylvania knows only too well.  As we enter the last lap of the interminable presidential campaign of 2008, with one eye on our 401(k)s and HSAs, keep these Samhain traditions in mind:  This is a time of renewal, lighting new fires, divination, and the day to go down to a "boundary stream," take three stones from the water with your eyes closed, put them under your pillow, "ask for a dream that will give you guidance or a solution to a problem, and the stones will bring it for you."  If you don't have a boundary stream handy, print out three copies of t... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=1924456 Thu, 30 Oct 2008 04:00:00 +0100 1924456 http://feeds.feedburner.com/~r/HealthBlawg/~3/434315142/ascension-health-buys-100m-in-caritas-christi-bonds-phase-i-of-an-acquisition.html A year or so ago, Ascension Health wanted nothing to do with Caritas Christi.  The national Catholic health care system considered buying the Boston-based Catholic health system after it put itself on the block, but backed away given the toxic condition of Caritas Christi's books at the time.  After getting its house in order somewhat, Caritas Christi is looking for some capital to continue doing what needs to be done, and Ascension Health has agreed to pony up in a $100m, below-market-rate bond deal.  (See more HealthBlawg posts on Caritas Christi).  Question of the moment for Caritas Christi CEO Ralph de la Torre:  What's the end game here?  Ascension Health, like most for-profit or not-for-profit systems, must allocate its capital where it can best serve the mission of the organiz... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=1914586 Tue, 28 Oct 2008 04:00:00 +0100 1914586 http://feeds.feedburner.com/~r/HealthBlawg/~3/434332781/health-20-coast-to-coast.html Last week saw the most recent Health 2.0 conference in San Francisco.  While I did not make it out to the left coast for the event, I got a tiny taste in advance, at the second Health 2.0 Northeast confab earlier this month in Cambridge (our fair city), MA.  (Like John Grohol of e-patients.net, I enjoyed networking before the formal program.)  I was struck by a number of differences in tone and content from the last Health 2.0 Northeast event.  For starters, many of the companies featured in the presentations and panel discussion are not what I would call Health 2.0 companies.  Second, moderator Wade Roush (of Xconomy) asked each panelist to explain their business model (!) -- the ever-elusive monetizaton of Health 2.0, and a concern that is more front-and-center these days.  Patient... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=1914585 Tue, 28 Oct 2008 04:00:00 +0100 1914585 http://feeds.feedburner.com/~r/HealthBlawg/~3/422621839/a-really-wonky-health-wonk-review.html Check out the latest election season edition of Health Wonk Review at Joe Paduda's Managed Care Matters.  The upcoming Halloween edition will be right here at HealthBlawg.David Harlow The Harlow Group LLCHealth Care Law and Consulting (Source: HealthBlawg :: David Harlow's Health Care Law Blog) HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=1883299 Thu, 16 Oct 2008 04:00:00 +0100 1883299 http://feeds.feedburner.com/~r/HealthBlawg/~3/416989227/david-harlow-quoted-in-radiology-today-on-hipaa-compliance-reviews.html I spoke last month with Radiology Today on the question of HIPAA compliance, in light of increased, or at least more public, enforcement.  HIPAA security compliance audits are underway, and providers need to be aware of what to expect.  The best defense is still a good offense, which in this case means conducting an audit and beefing up policies and procedures, as necessary.  For further information, see an earlier HealthBlawg post.  David Harlow The Harlow Group LLCHealth Care Law and Consulting (Source: HealthBlawg :: David Harlow's Health Care Law Blog) HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=1870646 Fri, 10 Oct 2008 04:00:00 +0100 1870646 http://feeds.feedburner.com/~r/HealthBlawg/~3/416390802/david-harlow-quoted-in-health-plan-insider-piece-on-physician-shortage-in-massachusetts.html The Massachusetts Medical Society released a report this week -- the Physician Workforce Study -- highlighting physician shortages including -- but also well beyond -- primary care.  This issue was picked up by Les Masterson in the current issue of HCPro's Health Plan Insider; I spoke with him about the myriad factors influencing physician shortages and perceptions of physicians and payors about them.  Much of the literature on this subject looks at physicians per 1,000 population.  By contrast, the MMS annual survey is based on the experience and perceptions of physicians and related professionals (i.e., folks hiring physicians).  While clearly the Massachusetts health insurance experiment has added pressure by adding many patients to the rolls of the insured looking for PCPs (see rec... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=1865446 Thu, 09 Oct 2008 04:00:00 +0100 1865446 http://feeds.feedburner.com/~r/HealthBlawg/~3/413882659/dnv-new-kid-on-the-deeming-block.html The organization formerly known as JCAHO finally has a little competition, after a 30-year-plus lock on the deeming business.  While the Joint Commission has changed with the times (looking more at process, not just at outcomes), its hospital survey process -- which is recognized by CMS so that passing a JC survey means that a hospital is "deemed" to be in compliance with Medicare Conditions of Participation (aka Medicare certified) and can forego a government survey -- has been the only game in town.  (Only about 5% of hospitals ever face a "validation" survey with government surveyors.)  The JC accreditation system has come under criticism on a number of fronts (I'm just framing the criticisms, not endorsing them): Surveys only take place every three years, resulting in a rush to com... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=1859471 Tue, 07 Oct 2008 04:00:00 +0100 1859471 http://feeds.feedburner.com/~r/HealthBlawg/~3/409299641/health-wonk-review-the-700-billion-edition.html Jason Shafrin, The Health Care Economist, hosts this week's edition of Health Wonk Review, and wonders who in the health care arena could use a $700b shot in the arm.David Harlow The Harlow Group LLCHealth Care Law and Consulting (Source: HealthBlawg :: David Harlow's Health Care Law Blog) HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=1850966 Thu, 02 Oct 2008 04:00:00 +0100 1850966 http://feeds.feedburner.com/~r/HealthBlawg/~3/408944672/swapping-arrangements-other-issues-addressed-in-oig-supplemental-compliance-program-guidance-for-nursing-facilities.html A recurring issue I see in my practice, regarding nursing facility contracts with suppliers and providers (e.g. clinical labs and ambulance services), has been addressed yet again by the OIG.  This time, it's in the OIG Supplemental Compliance Program Guidance for Nursing Facilities published on September 30 (supplementing prior guidance issued in 2000.  The issue is referred to as "swapping" -- swapping discounts on services paid for by a nursing facility (e.g., a service covered by consolidated billing requirements under Medicare Part A and therefore considered to be an "out of pocket" expense for the nursing facility) in exchange for referrals of services paid for by a governmental payor directly (e.g., a service paid directly by Medicare Part B).The OIG has addressed swapping directl... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=1844635 Thu, 02 Oct 2008 04:00:00 +0100 1844635 http://feeds.feedburner.com/~r/HealthBlawg/~3/408901980/doug-brown-umass-memorial-health-cares-general-counsel-speaks-with-david-harlow-about-transparency-and-systems-improvement.html I spoke with Douglas Brown, General Counsel of UMass Memorial Health Care in Worcester, Massachusetts earlier this week about his institution's experience with reinventing its cardiac surgery program.  The Medical Center voluntarily suspended operations of the program in 2005 after it became clear that its CABG mortality rate was twice the statewide average (though it was equivalent to national averages).  Doug wrote a Boston Globe op-ed piece on this issue that ran last week, and I wanted to hear more about the self-examination and reinvention of the program.  The team of experts brought in to review the situation came up with 70 recommendations, and the medical center has worked to implement them.  The system improvements in cardiac surgery have had a beneficial effect on other progr... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=1844636 Wed, 01 Oct 2008 04:00:00 +0100 1844636 http://feeds.feedburner.com/~r/HealthBlawg/~3/405947324/dra-advanced-imaging-cuts-examined-by-gao-mippa-accreditation-rules-welcomed-by-industry.html Advanced diagnostic imaging reimbursement (i.e., payment for MRI, CT and nuc med) has taken a beating under the DRA (Deficit Reduction Act of 2005), and last week's GAO report looking at the impact of the legislation on this slice of the health care economy -- specifically, technical fees for advanced diagnostic imaging in physician office settings -- confirmed that there have been deep cuts.  The cuts were a response to a couple of key factors.  First, the rapid increase in Medicare expenditures in this sector -- at an average annual inflation rate of 13% from 2000 to 2006 (i.e., doubling in that time), compared with a general Medicare physician-billed services inflation rate of 8% over the same time period.  Second, the geographic distribution of services rendered seemed, in the eyes ... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=1837128 Mon, 29 Sep 2008 04:00:00 +0100 1837128 http://feeds.feedburner.com/~r/HealthBlawg/~3/404159811/ehr-adoption-incentives-700-million-and-counting.html Well, it isn't $700 billion but, then again, it doesn't involve getting down on bended knee before Nancy Pelosi.CCHIT is taking an ongoing inventory of public and private incentives nationwide intended to promote adoption of CCHIT-certified EHRs.  Thus far, CCHIT has identified 90 public or private initiatives.  These include, for example, state and federal grant programs -- Massachusetts is kicking in $25m under legislation passed in August; the federales are kicking off an EHR Medicare demonstration that could be worth $100m in grants to physician groups -- and private initiatives that run the gamut from hospital funding of physician EHR adoption pursuant to an executive order and related Stark, antikickback and tax regulatory actions, to Bridges to Excellence bonuses to physicians.The... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=1833139 Fri, 26 Sep 2008 04:00:00 +0100 1833139 http://feeds.feedburner.com/~r/HealthBlawg/~3/401013188/ambulance-diversions-to-be-banned-in-ma.html As reported in the Boston Globe earlier this month, The state has ordered Massachusetts hospitals to stop turning away ambulances when their emergency rooms are overcrowded, a decades-old practice that can delay treatment and has upset patients denied care at their usual hospitals.As of January 1, 2009, no more so-called "diversions" of ambulances away from hospitals with backed-up emergency departments will be permitted in Massachusetts.  This policy shift, announced in a July 3 Department of Public Health circular letter regarding changes to hospital diversion policies, adopts the current thinking of a number of national health care organizations, but is apparently the first statewide policy of its kind in the nation.  (The only exception to the policy is a "Code Black," i.e., closed t... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=1825552 Tue, 23 Sep 2008 04:00:00 +0100 1825552 http://feeds.feedburner.com/~r/HealthBlawg/~3/399813008/from-todays-boston-globe-the-dearth-of-pcps-as-newly-insured-folks-in-ma-have-tried-to-find-them-has-been-frustrating-to-man.html From today's Boston Globe:  The dearth of PCPs as newly insured folks in MA have tried to find them has been frustrating to many. The new Massachusetts law alluded to in the Globe article takes some baby steps towards ameliorating this issue on the supply side. The problem, of course, is not limited to Massachusetts, as the tiny percentage of med school grads interested in pursuing a career in primary care demonstrates. But we have a looming crisis of medical homes with nobody home (remember when your G.P. was your medical home?), brought on by a persistent resistance to paying primary care physicians equitably (thanks to a reimbursement system controlled by proceduralists). Some would say that more would choose careers in primary care if their quality of life / quality of practice were i... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=1815271 Mon, 22 Sep 2008 04:00:00 +0100 1815271 http://feeds.feedburner.com/~r/HealthBlawg/~3/399836037/blawg-review-says-register-to-vote.html Well, not exactly, but stick with me here.  Aussie law prof Peter Black is hosting this week's Blawg Review at Freedom to Differ in honor of One Web Day.  This year's theme for One Web Day is online participation in democracy. So for starters, here's a link to online voter registration info for those in the US of A who may not have had the opportunity to do so yet: As they say, please forward/post as appropriate.David HarlowThe Harlow Group LLCHealth Care Law and Consulting (Source: HealthBlawg :: David Harlow's Health Care Law Blog) HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=1815270 Mon, 22 Sep 2008 04:00:00 +0100 1815270 http://feeds.feedburner.com/~r/HealthBlawg/~3/397358658/cvs-minute-clinics-first-massachusetts-sites-open-this-week.html Minute Clinic opened for business in Massachusetts this week.Check out the HealthBlawg archive on Minute Clinics.David HarlowThe Harlow Group LLCHealth Care Law and Consulting (Source: HealthBlawg :: David Harlow's Health Care Law Blog) HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=1809710 Fri, 19 Sep 2008 04:00:00 +0100 1809710 http://feeds.feedburner.com/~r/HealthBlawg/~3/397571371/david-harlow-quoted-in-article-on-medicare-and-telehealth.html CMS is slowly but surely adding some codes for payment of limited telehealth services -- this year, it's certain consultations to follow up on patients the remote physician has seen in person.  I spoke with the editor of Physician Compensation & Recruitment about the subject, noting that while it's the wave of the future, the benefits and burdens  of telehealth -- e.g., quality improvement and privacy concerns, respectively, go well beyond the individual encounter and raise a variety of systems ramifications.See the full article on p. 10 of the October 2008 issue of Physician Compensation & Recruitment, published by HCPro.David HarlowThe Harlow Group LLCHealth Care Law and Consulting (Source: HealthBlawg :: David Harlow's Health Care Law Blog) HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=1809709 Fri, 19 Sep 2008 04:00:00 +0100 1809709 http://feeds.feedburner.com/~r/HealthBlawg/~3/396189560/health-wonk-review-political-convention-style.html We recognize the gentleman from the great state . . . er, Commonwealth . . . of Pennsylvania.Check out Jaan Sidorov's political convention edition of Health Wonk Review, up at his Disease Management Care Blog.David Harlow The Harlow Group LLC Health Care Law and Consulting (Source: HealthBlawg :: David Harlow's Health Care Law Blog) HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=1809712 Thu, 18 Sep 2008 04:00:00 +0100 1809712 http://feeds.feedburner.com/~r/HealthBlawg/~3/396831013/where-does-hipaa-go-wherever-it-wants.html The GAO just issued another assessment of HHS's and ONCHIT's progress in identifying and addressing key HIPAA and other health IT related privacy issues, and developing an overall approach to HIT privacy.  The federales -- not known for nimbleness -- have made significant progress, but have not yet fully addressed all of the issues on this front tagged by GAO in its Febuary 2007 HIT report.  In GAO-speak:We recommended that this overall approach include (1) identifying milestones and the entity responsible for integrating the outcomes of its privacy-related initiatives, (2) ensuring that key privacy principles in HIPAA are fully addressed, and (3) addressing key challenges associated with the nationwide exchange of health information. In this regard, the department has fulfilled the firs... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=1809711 Thu, 18 Sep 2008 04:00:00 +0100 1809711 http://feeds.feedburner.com/~r/HealthBlawg/~3/395555930/grand-rounds-is-up-at-nurse-ratcheds-place.html This week's edition of Grand Rounds, at Nurse Ratched's Place, is a paean to the old patent medicines -- with nifty ingredients like cocaine -- and the ads that sold them.  Put that in your BPA water bottle and suck it down.David Harlow The Harlow Group LLC Health Care Law and Consulting (Source: HealthBlawg :: David Harlow's Health Care Law Blog) HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=1802659 Wed, 17 Sep 2008 04:00:00 +0100 1802659 http://feeds.feedburner.com/~r/HealthBlawg/~3/393366945/obama-mccain-proxies-duke-it-out-over-health-care-at-harvard-school-of-public-health.html David Cutler and Gail Wilensky spoke about health care reform on behalf of Obama and McCain, respectively, at a Harvard School of Public Health forum last week here in Boston.  Martha Bebinger at WBUR's Commonhealth summarizes the discussion of the two health reform plans.  Each candidate has, as they say, his own weltanschauung, which informs this portion of the debate as well as others.  Here's hoping the campaign coverage at large can return swiftly to focusing on the issues.David Harlow The Harlow Group LLC Health Care Law and Consulting (Source: HealthBlawg :: David Harlow's Health Care Law Blog) HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=1798082 Mon, 15 Sep 2008 04:00:00 +0100 1798082 http://feeds.feedburner.com/~r/HealthBlawg/~3/390873902/the-medical-home-primary-care-panacea-or-the-next-doughnut-hole.html The news on the medical home model this week is good:  A Commonwealth Fund-funded Geisinger study published in Health Affairs demonstrates the extent to which development and implementation of a medical home model can actually prevent those preventable hospitalizations we keep hearing about.  This is a very good thing, and the model described should be studied and replicated to the extent possible.  The current issue of Health Affairs, and companion pieces on the Health Affairs Blog include a range of articles on medical home successes ("medical home runs") and challenges. What's interesting about the collection of information put forward by Health Affairs is the fact that two studies may reach somewhat inconsistent conclusions: for example, one concludes that smaller practices don't ha... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=1788679 Fri, 12 Sep 2008 04:00:00 +0100 1788679 http://feeds.feedburner.com/~r/HealthBlawg/~3/388836471/a-flibbertigibbet-a-will-o-the-wisp-a-blog.html It's Sound of Music Grand Rounds at AppleQuack this week.  Reminds me of Sing Along Sound of Music -- great fun if it ever comes to a theater near you.-- David Harlow (Source: HealthBlawg :: David Harlow's Health Care Law Blog) HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=1782588 Wed, 10 Sep 2008 04:00:00 +0100 1782588 http://feeds.feedburner.com/~r/HealthBlawg/~3/388857252/two-day-seminar-on-health-law-basics-plus-in-boston-next-week.html Massachusetts Continuing Legal Education puts on its annual two-day extravaganza introduction to health law next week (September 17 and 18).  I'll be speaking on post-acute care, and there is a bang-up panel of speakers filling out the entire two days.  If you are -- as they used to say  -- within the sound of my voice and have an interest, please come on down.  Bring your friends and neighbors.  You can find more information on topics, speakers and and registration on the MCLE Health Law Basics Plus page.  Here's a sneak peek at links to some new developments in health law that I'll be touching on in my talk.-- David Harlow    (Source: HealthBlawg :: David Harlow's Health Care Law Blog) HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=1782587 Wed, 10 Sep 2008 04:00:00 +0100 1782587 http://feeds.feedburner.com/~r/HealthBlawg/~3/386676163/massachusetts-universal-health-insurance-law-changes-in-regs-could-prompt-erisa-pre-emption-challenge.html Massachusetts has famously gotten many of the state's uninsured covered thanks to the state mandate.  The "pay or play" approach taken has long seemed ripe for an ERISA pre-emption challenge (cf. the Wal-Mart case in Maryland).  The program now seems to be a victim of its own success, with enrollment in subsidized plans exceeding expectations, and the Commonwealth looking for additional revenues to fund the $130M shortfall.  One approach now proposed is to apply the "pay" part of the pay or play rule to a broader swath of employers -- including many that have been "playing" by the rules to date.As the Boston Globe reported last week,  The current law requires most employers with more than 10 full-time employees to offer health coverage or to pay an annual "fair share" penalty of $295 p... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=1779185 Mon, 08 Sep 2008 04:00:00 +0100 1779185 http://feeds.feedburner.com/~r/HealthBlawg/~3/384501568/when-it-comes-to-antibiotics-less-is-more-no-pay-rules-for-hospital-acquired-infections-motivate-change-in-prescribing-beha.html About 15 years ago, someone I knew was active in an organization called the Society for the Prevention of Overuse of Antibiotics (or something like that).  While this has long been an issue of concern, back then it seemed a decidedly fringe issue.  Fast-forward to the MRSA superbug and no-pay rules for hospital-acquired infections, and reduction in the use of broad-spectrum antibiotics is a decidedly mainstream effort.  Premier is on the case; VHA has a "Bugs and Drugs" program for its member hospitals which, the Wall Street Journal reports this week in a piece on antimicrobial stewardship programs can yield concrete results in a relatively short timeframe:Some hospitals have measured tangible benefits. Hunterdon Medical Center in Flemington, N.J., a 178-bed community hospital affiliate... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=1768844 Fri, 05 Sep 2008 04:00:00 +0100 1768844 http://feeds.feedburner.com/~r/HealthBlawg/~3/383235035/health-wonk-review-is-up-at-insureblog.html As the kids head back into the school year, my wife and I find ourselves subconsciously humming a song they liked a couple of years ago, Wake Me Up When September Ends . . . .  Those of you looking for a cuppa joe or equivalent before then would be well-advised to check out Hank Stern's latest snappily-written edition of Health Wonk Review, up today at InsureBlog.  Thanks, Hank (I think), for recognizing my contribution this time around to be "truly wonkish (in a good way!)"          -- David Harlow  (Source: HealthBlawg :: David Harlow's Health Care Law Blog) HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=1768846 Thu, 04 Sep 2008 04:00:00 +0100 1768846 http://feeds.feedburner.com/~r/HealthBlawg/~3/383450167/5-blogs-5-blawgers.html Robert Ambrogi tagged me with the 5 blogs & 5 blawgers meme. The idea is to list five great non-law blogs and then tag five blawgers to do the same. Here are five terrific blogs I read regularly, which skew to health care (natch):Maggie Mahar's Health Beat David Williams' Health Business BlogBob Laszewski's Health Care Policy and Marketplace Review Paul Levy's Running a HospitalMatthew Holt and friends' The Health Care BlogI'm afraid I read more than five, but them's the meme's rules.  No offense meant to all the other terrific bloggers out there.And I'm skewing away from health care (at least a little) to tag five blawgers -- you're "it":Bob Coffield, Health Care Law BlogCarolyn Elefant, My ShingleRobin Fisk, Managed Care Contracting & Provider PaymentLee Gesmer, Mass Law BlogEri... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=1768845 Thu, 04 Sep 2008 04:00:00 +0100 1768845 http://feeds.feedburner.com/~r/HealthBlawg/~3/382890774/in-an-interview-earlier-this-week-leah-binder-previewed-some-of-the-concerns-likely-to-be-aired-at-next-weeks-chasing-zero-s.html In an interview earlier this week, Leah Binder previewed some of the concerns likely to be aired at next week's Chasing Zero Summit in DC.The audio file of my interview with Leah Binder (about 25 minutes long) is available for download/podcast. A full transcript is at the end of this post (and in the linked transcript file).The Leapfrog Group, an organization whose members include some of the largest employers -- and thus, purchasers of health care services -- in the country, works to "leverag[e] their purchasing power to try to influence improvement in quality in America’s hospitals."The Leapfrog effort begins with transparency -- using a small number of NQF measures, includes some early pay for performance efforts -- such as the Leapfrog Hospital Rewards Program, and also serves as a p... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=1759842 Wed, 03 Sep 2008 04:00:00 +0100 1759842 http://feeds.feedburner.com/~r/HealthBlawg/~3/380779639/blawg-review-is-up-well-staggering-along.html I drove home early to beat the rush this Labor Day, and was amused by Ed.'s -- that is, the anonymous Blawg Review editor's -- selection of Jamie Spencer, aka Austin DWI Lawyer, as the latest topical host.  I didn't even have to wear drunk goggles to read this week's edition.-- David Harlow (Source: HealthBlawg :: David Harlow's Health Care Law Blog) HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=1750069 Mon, 01 Sep 2008 04:00:00 +0100 1750069 http://feeds.feedburner.com/~r/HealthBlawg/~3/375812293/contractual-joint-ventures-the-oig-hangs-tough.html The OIG released an advisory opinion today finding that a proposed arrangement between two physician group practices -- one a practice providing cancer treatment services, including IMRT, the other a urology group -- whereby the urology group would bring the IMRT services in-house through a series of contracts, would be barred as an impermissible contractual joint venture, assuming the requisite intent (to exchange payment for referrals) were present.  There has been very little advisory opinion activity related to the contractual joint venture special advisory bulletin issued by the OIG in 2003.  Only three advisory opinions before today's even mention the special advisory bulletin.  One of those, however, trod the same ground as today's advisory opinion.  The 2004 advisory opinion re... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=1733843 Tue, 26 Aug 2008 04:00:00 +0100 1733843 http://feeds.feedburner.com/~r/HealthBlawg/~3/371058246/beach-blanket-health-wonk-review.html Julie Ferguson's beach edition of HWR is up at Workers' Comp Insider.  My fellow health wonks may be blogging from the beach (I hope they are!) but I've either been inside to get out of the rain, or out biking (and I haven't yet mastered the art of blogging while biking -- nor am I sure I really want to try).-- David Harlow (Source: HealthBlawg :: David Harlow's Health Care Law Blog) HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=1723415 Thu, 21 Aug 2008 04:00:00 +0100 1723415 http://feeds.feedburner.com/~r/HealthBlawg/~3/369375757/the-s-word-single-payor-obama-and-the-wall-street-journal.html Even when denying that he plans to institute a single-payor model, Obama gets raked over the coals by most of the readers who commented on today's WSJ Health Blog post regarding his health plan.  Obama says that if we were starting with a clean sheet of paper, a single-payor system would make sense.  So far, so good: all industrialized democracies other than our own have taken the leap into this "monolithic" approach -- and their systems work better than ours, as recent reports have borne out. We in the US of A spend far more per capita for health care than other nations, and we fare more poorly on a number of key quality indicators.  Obama also says, wisely, that since we aren't starting with a clean sheet of paper, we shouldn't destroy the existing system.  Rather, we should work ... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=1717128 Tue, 19 Aug 2008 04:00:00 +0100 1717128 http://feeds.feedburner.com/~r/HealthBlawg/~3/368329645/a-phelpsian-blawg-review.html Dive into this week's Phelpsian edition of Blawg Review, up at David Donoghue's Chicago IP Litigation Blog.-- David Harlow (Source: HealthBlawg :: David Harlow's Health Care Law Blog) HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=1713902 Mon, 18 Aug 2008 04:00:00 +0100 1713902 http://feeds.feedburner.com/~r/HealthBlawg/~3/365249453/another-wonderful-ride-for-a-good-cause----2008-pan-mass-challenge-wrap-up.html About two weeks after the Pan Mass Challenge, I feel reintegrated into the rest of my life, and no longer part of a 10,000-person village on wheels.  (The PMC is the annual two-day bicycle fundraiser for Boston's Dana Farber Cancer Institute's Jimmy Fund.)  Monday morning after the ride, I was sitting in front of my computer, but my head was still out on the road.In my neck of the woods, if it's the first weekend in August, it must be the Pan Mass Challenge.  Two days, 5300 riders, 2500 volunteers, thousands of supporters, 192 miles.  Since I carried a rain jacket in my bike jersey pocket, we didn't get caught in any rain; the rain waited until after the biking was over each day.  Late Saturday afternoon, once we had arrived at the Mass Maritime Academy -- where later we had our massa... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=1709014 Thu, 14 Aug 2008 04:00:00 +0100 1709014 http://feeds.feedburner.com/~r/HealthBlawg/~3/363353675/grand-rounds-is-up-at-medical-humanities-blog.html Check out this week's edition of Grand Rounds, hosted by Daniel Goldberg at his very sharp looking Medical Humanities Blog, hitting all the high points of this week's offerings in the medblogosphere, from Oprah to the Olympics.-- David Harlow (Source: HealthBlawg :: David Harlow's Health Care Law Blog) HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=1700657 Tue, 12 Aug 2008 04:00:00 +0100 1700657 http://feeds.feedburner.com/~r/HealthBlawg/~3/362605212/the-latest-health-care-legislation-from-the-peoples-republic-of-massachusetts.html Once again, Massachusetts is out in front on a number of hot issues.  The legislation, championed by Senate President Therese Murray, was signed by Gov. Patrick earlier this week.  See the full text of AN ACT TO PROMOTE COST CONTAINMENT, TRANSPARENCY AND EFFICIENCY IN THE DELIVERY OF QUALITY HEALTH CARE and the Boston Globe story on the new health care law.  The Globe highlights parts of the act that:  Limit pharma industry gifts to providers Provide some funding to get physician offices on EHR systems Require UMass Medical School to graduate more PCPs Institute closer oversight of health insurance premiums Also of interest are:The mandate for hospitals and community health centers to all be on EHRs by 2015 The requirement that facility with EHRs and CPOE be made a condition of ... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=1696125 Tue, 12 Aug 2008 04:00:00 +0100 1696125 http://feeds.feedburner.com/~r/HealthBlawg/~3/361095626/does-the-dns-security-hole-worry-the-ehr-and-phr-worlds.html I read a disturbing article in the NY Times last Friday about Dan Kaminsky's talk at the Black Hat conference: he's been beating the drum for a while now, warning of what sounds like a serious security hole in Domain Name Server software offering an open door to hackers of websites containing confidential information and into email (which could allow phishing for usernames and passwords for otherwise protected sites).  The technorati seem to agree that he's identified a serious problem, and it seems that not all affected parts of the internet infrastructure have applied patches or upgraded their software.Yet another reason to be wary of assurances that if the internet is safe for banking then it's safe for health care information.  Even the latest compact on privacy doesn't count for muc... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=1696126 Sun, 10 Aug 2008 04:00:00 +0100 1696126 http://feeds.feedburner.com/~r/HealthBlawg/~3/359526540/2009-ipps-rule-released-by-cms.html CMS put the 2009 IPPS rule (that's the acute hospital inpatient prospective payment system rule) on display last week, and it will be published in the Federal Register later this month (August 19, if you must know), to be effective October 1.  It was released in draft form in May (see HealthBlawg post on the draft 2009 IPPS rule).  The final version is described in a series of CMS 2009 IPPS fact sheets on Medicare hospital payment policy changes, more never events, pay for reporting and Stark and hospital ownership disclosure.  Gainsharing thoughts in the draft version found another home inthe draft 2009 MPFS regulation. -- David Harlow (Source: HealthBlawg :: David Harlow's Health Care Law Blog) HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=1692133 Fri, 08 Aug 2008 04:00:00 +0100 1692133 http://feeds.feedburner.com/~r/HealthBlawg/~3/348551870/pan-mass-challenge-coming-up-this-weekend-1.html This summer has been busy, busy, busy, so my apologies to all of you out there in HealthBlawg land for spotty posting lately.  My clients didn't get the memo about a nice long vacation this month or next, and I've been training for the Pan Mass Challenge, a 2-day, 200-mile bicycle fundraiser for Boston's Dana Farber Cancer Institute, which is coming up this weekend.  Think of me biking this weekend, and hope for nice weather.  If you are so inclined, please consider joining me in supporting the Dana Farber's Jimmy Fund by sponsoring my PMC ride via the link above.  I hope to be back soon to post about Massachusetts' revised DON regulations (that's CON regulations for everyone else) and green health care facility construction guidelines, a recent OIG advisory on a physic... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=1660707 Mon, 28 Jul 2008 04:00:00 +0100 1660707 http://feeds.feedburner.com/~r/HealthBlawg/~3/336735743/yes-virginia-gao-points-finger-at-diagnostic-imaging-providers.html "Round up the usual suspects!"  Once again, diagnostic imaging providers are singled out by the federales. This time the GAO says controls on diagnostic imaging utilization are needed -- including (yikes!) prior authorization requirements -- because diagnostic imaging costs have doubled between 2000 and 2006.  Sounds serious. Well, guess what?  While some advanced imaging costs have increased at a faster rate, the cost of employment-based health insurance has also doubled in the same time frame.  (In addition, this rampant growth story is half of an unintended consequences story -- service settings have changed: less hospital, more physician office.  Also, imaging, while expensive, is cheaper -- and easier on the patient -- than exploratory surgery . . . . ) My inb... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=1642624 Wed, 16 Jul 2008 04:00:00 +0100 1642624 http://feeds.feedburner.com/~r/HealthBlawg/~3/336735743/yes-virginia-gao-points-finger-at-diagnostic-imaging-providers.html "Round up the usual suspects!"  Once again, diagnostic imaging providers are singled out by the federales. This time the GAO says controls on diagnostic imaging utilization are needed -- including (yikes!) prior authorization requirements -- because diagnostic imaging costs have doubled between 2000 and 2006.  Sounds serious. Well, guess what?  While some advanced imaging costs have increased at a faster rate, the cost of employment-based health insurance has also doubled in the same time frame.  (In addition, this rampant growth story is half of an unintended consequences story -- service settings have changed: less hospital, more physician office.  Also, imaging, while expensive, is cheaper -- and easier on the patient -- than exploratory surgery . . . . ) My inb... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=1625563 Wed, 16 Jul 2008 04:00:00 +0100 1625563 http://feeds.feedburner.com/~r/HealthBlawg/~3/330432604/medicare-physician-fee-schedule-2009-mpfs-yes-theres-a-57-cut-but-its-packed-with-goodies-like-telehealth-and-gainsh.html Congress couldn't be bothered to stop grandstanding before July 4th long enough to undo the latest SGR-driven physician pay cut (over 10%).  This week, CMS rolled out its 2009 MPFS with an SGR-mandated 5.7% cut in place, while at the same time advising physicians not to submit bills until Congress comes to its senses and undoes this year's 10% cut.  If the proposed rule contained only this doom and gloom, there wouldn't be much to say about it.  However, CMS loves to stuff all sorts of goodies into these fee schedule rules, and the current proposed rule is no exception.  There are more measures to be added to the PQRI, but several other pieces are of greater interest:First, physician practices will now be subject to IDTF rules.  The idea is to bring some standards ... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=1596350 Tue, 08 Jul 2008 04:00:00 +0100 1596350