Issues from Healthcare Law

November 22, 2011
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After many moons, I finally had another opportunity to attend the California Society for Healthcare Attorneys Fall Forum. It was an especially wonderful opportunity for me to present to an audience of healthcare attorneys on the subject of managing the risks of social media.  But, I also enjoyed the legal update from my fellow presenters.

Most of the really interesting bills are still in California’s legislative process.  A few interesting laws that did make it through this year include:

After many moons, I finally had another opportunity to attend the California Society for Healthcare Attorneys Fall Forum. It was an especially wonderful opportunity for me to present to an audience of healthcare attorneys on the subject of managing the risks of social media.  But, I also enjoyed the legal update from my fellow presenters.

Most of the really interesting bills are still in California’s legislative process.  A few interesting laws that did make it through this year include:

  • SB751 – Contracts between plans and hospitals prohibiting restrictions on providing plan enrollees information about cost range of procedures and quality. Quality information (ratings) must be risk adjusted and hospitals provided with the opportunity to review and respond.  This will protect hospitals from those plans who don’t do such a good job presenting information.  For example, the hospital that received poor NICU ratings from a plan when they don’t have a NICU!
  • AB1136 – Lift Teams – the staff do need to be trained and available, but they don’t have to be standing around waiting to lift patients.  Don’t any employee representatives tell you they do!
  • AB 655 – Mandatory sharing of peer review information It is limited to “peer review bodies” ie Medical Staffs, but ultimately the hospitals still have risks for liability. The medical staff coordinator and risk manager in me says this is confusing and a bit scary. Don’t really see how this will ultimately produce any real benefit. In the end, it really isn’t that mandatory!!  Wonder what the Medial Staff and Hospital Liability Carriers think about this?
  • AB 415 – Telehealth – The physician does still need to be licensed in CA. (I hope they talk more about this at future events.)

Other legal issues to be aware of include:

  • Physician-Owned Distributors (and also other physician-owned businesses such as laser rentals, neurodiagnostic monitoring)   Under Congressional Scrutiny mostly focused on orthopedic and cardiac devices today. Potential for kickback issues (a little concern about Stark).  Benefits of these arrangements is saving money, working with manufacturers to develop better quality products, promotes hospital-physician alignment on cost control.  Cons, could lead to use of more expensive devices, potential for medical decision-making will be influenced by financial gain.  Need to carefully analyze and plan for these relationships.

I also really enjoy the presentations on special issues related to ACOs under CA law and consent from the perspective of health reform and the Accountable Care Organizations.  We were also all reminded of the importance of completing our Advanced Directives.

The review of ED call coverage compliance dilemmas and projections of what we can expect with “Open” ED call panels as health reform takes hold.  Basically we will see these go away as the need for more skilled physicians/specialists are4 needed to care for the sicker ED patienst.  Selection of physicians will be tied to the level of care needed (expertise) by the patient.  Doctors who can’t perform will still need their due process as the transition occurs.  Think about the role of surgical intensivists in the new healthcare delivery system.

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