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Week in Review

by Kroger Burrus on February 27th, 2013

Kroger | Burrus Week in Review

CASES

University of Texas Southwestern Medical Center v. Gentilello
A professor of surgery filed suit under the Texas Whistleblower Act alleging he was retaliated against for submitting a complaint to a supervisor alleging lax supervision of trauma residents in violation of Medicare/Medicaid requirements.  The Texas Supreme Court held that the act was inapplicable. The Whistleblower Act applies when a violation of law is reported to an authority authorized to enforce, investigate, or prosecute violations of law against third parties outside of the entity itself. The supervisor who received the complaint was authorized to monitor internal compliance with Medicare/Medicaid requirements but not to enforce these requirements as required for the Whistleblower Act to apply.

NEWS

Federal Judge to Weigh Complaint Over Texas Medical Board
Closing arguments have been presented before a U.S. District Judge in a lawsuit charging the Texas Medical Board with abusing its power. The lawsuit claims that various Texas Medical Board members treated some doctors differently than others and retaliated against doctors who objected to the Board’s tactics. The Board maintains that the plaintiffs have not established any inappropriate practices.

Nurse Practitioners’ Role Expected to Expand
Change driven by the Affordable Care Act and an anticipated shortage of family practice doctors are expected to contribute to a broader role for nurse practitioners. The American Medical Association and other physician groups are expected to oppose efforts to expand the scope of practice for nurse practitioners, citing concerns about the ability of nurse practitioners to diagnose and manage complex illnesses such as diabetes.

‘Choosing Wisely’ Before Routine Tests Could Save Billions
Doctors in 17 medical specialties have identified 135 routine treatments and procedures that that are often unnecessary and potentially harmful. Foregoing the routine administration of  these procedures, compiled as part of a campaign called Choosing Wisely, could save billions of dollars a year in unnecessary spending.

Health Care Analytics Set to Save Money, Improve Care
As the health care analytics field evolves number-crunching is expected to improve patient outcomes and prevent further expensive health problems. Data analysis can be used to predict which patients are more likely to develop conditions such as diabetes or require future hospital admissions, allowing providers to adjust their care accordingly.

Feds Identify What Insurers Must Cover
The Obama administration has finalized the “essential health benefits” insurers must provide for individual and small group plans. These plans will be required to include coverage for 10 categories of services including prescription drugs, maternity care, mental health services, and physical rehabilitation.

Florida Reverses Medicaid Expansion Stance
Florida Gov. Rick Scott, a vocal critic of the Affordable Care Act, has announced that his state will proceed with Medicaid expansion, enabling it to receive federal funds for a limited period. Gov. Scott’s announcement leaves Texas as the last big-state holdout. Gov. Rick Perry has reiterated his opposition to Medicaid expansion, warning that extending coverage would “dump more taxpayer dollars into an unsustainable system.” The Texas House recently approved a supplemental spending bill to close a $4 billion budget deficit for Medicaid.

Lawmakers Consider Mandating Hospital Nurse-Patient Ratios
Lawmakers in Washington D.C. and Minnesota are considering legislation that would require hospitals to maintain minimum nurse-to-patient ratios in order to reduce workload and improve care. Opponents have expressed concern that these requirements would be cost prohibitive.

Cancer Trial Grant Recipient Shuts Down
A Texas cancer trials network that received a $25 million grant from the Cancer Prevention and Research Institute of Texas has shut down in the wake of auditors discovering more than $300,000 in expenses deemed inappropriate. The state’s cancer institute has already been under fire over allegations that it awarded $11 million to a private biotech firm in Dallas without first properly vetting the company’s proposal.

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