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Week in Review

by Kroger Burrus on April 15th, 2014

Kroger | Burrus Week in Review


Texas Department of State Health Services v. Balquinta
Health care entities affiliated with Planned Parenthood filed suit challenging a state law that excluded entities that perform or promote elective abortions from obtaining Medicaid funding. In response to the state’s assertion that the lawsuit was barred by sovereign immunity, the Travis County appellate court held that the trial court had subject-matter jurisdiction under the state’s Administrative Procedure Act to determine if a legal right or privilege had been impermissibly affected by the state’s exclusion of the Planned Parenthood-affiliated entities from the Medicaid program.


2% of Medicare Physicians Receive 25% of Payouts
About 2% of physicians receiving Medicare reimbursements receive 25% of payouts according to data recently released by the Centers for Medicare and Medicaid Services. Physicians have cautioned that this data can be misleading, noting that in some instances large payments that appear to be directed to a single physician are actually funneled through that practitioner to several other members of large group practices.

Current Medical Coding System Out of Date, Critics Argue
Critics of the coding system used to bill for medical services have argued that the antiquated system does not accurately capture the complexities of modern medicine, noting as an example that the current system does not include codes to differentiate between dozens of different kinds of implants used to open clogged arteries. The new system, ICD-10, which Congress voted last week to delay the implementation of for one year, will increase the number of codes for procedures from 4,000 to 72,000.

New Service Offers Digital Glimpse of Future Offspring
A new service that creates digital embryos by virtually mixing DNA will offer parents an opportunity to screen out genetic disorders prior to conception. The service, which will be introduced in two US fertility clinics later this month, uses algorithms to run simulations that will help predict the risk level for various genetic diseases.

Diabetes Drug Case Yields $9 Billion Jury Verdict
Jurors assessed $9 billion in punitive damages against the maker of a diabetes drug accused of failing to adequately inform people of cancer risks. Jurors assigned $6 billion of the verdict to the Japan-based company that makes the drug and $3 billion to the drug’s US distributor.

Scientists Engineer Complex Body Parts in Lab
Scientists in the US, Mexico, and Switzerland have successfully developed and implanted lab-grown reproductive organs and nasal cartilage. Experts say these developments, announced in two recent studies, represent a move forward in terms of the size and complexity of lab-grown organs.

Physician’s ‘People Skills’ Affect Patient Care
A physician’s bedside manner can have real effects on patients’ outcomes, according to a new study. A review of 13 clinical trials found that when doctors were trained to hone their people skills, their patients typically fared better in their efforts to lose weight, lower blood pressure, or manage pain.

Harris County Offers Phone-based Triage
In an effort to alleviate emergency department overcrowding, local health officials have established a 24-hour nurse call center that will allow residents throughout Harris County and eight surrounding counties to obtain an assessment by phone to determine the level of care needed and receive a referral to an appropriate facility in their area.

Physicians Weary of Red Tape Turn to Cash-based Model
Physicians frustrated with red tape are increasingly turning away from insurance-based practices in favor of cash-based models in which patients can pay a flat fee for a doctor’s appointments. Doctors who use a “direct primary care” model say they can keep costs competitive by avoiding high processing costs, such as additional staff, associated with accepting coverage.

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