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Monday, May 10, 2004
The Ohio House of Representatives last week passed substitute legislation to reform medical malpractice in Ohio by a vote of 92-2. Substitute House Bill 215, originally designed to implement medical review screening panels, includes several provisions providing moderate reform. It authorizes the Ohio Department of Insurance to collect data on judgments and settlements. It also requires that expert witnesses providing testimony practice the same specialty as the defendant and have expertise on the subject of the trial. Sub HB 215 would prohibit either a physician or defendant’s prior statements of sympathy to be used as evidence.
The House removed a provision urging the Ohio Supreme Court to establish a medical claims court, which was added to the substitute bill in the House Insurance Committee. The original screening panel concept was scrapped in the insurance committee after numerous organizations determined the proposal could actually be more costly and lengthen the court process. Sub HB 215, sponsored by Rep. Jean Schmidt (R-Loveland), now heads to the Senate and is expected to move quickly through the legislature. OHA supports modifications to the bill. (Bridget Gargan, bridgetg@ohanet.org)
Tuesday, May 11, 2004
The American Hospital Association (AHA) last week released its report, The Economic Contribution of Hospitals, which shows the importance of hospitals in their communities goes well beyond the health care services they provide.
The state-by-state analysis found few people are aware of the economic and community benefits hospitals also offer. According to the report, hospitals nationwide:
Ohio hospitals play a critical role in the state’s economy with nearly 228,000 hospital jobs and almost 560,000 individuals employed by organizations working with hospitals. Hospital expenditures positively impact the state’s economy to the tune of $43 billion.
Hospitals nationwide also make significant community contributions. AHA’s report shows hospitals provided over $22 billion in uncompensated care to patients and communities across America in 2002 alone, in addition to their many community health programs and other outreach.
To see a full copy of this report, published in AHA’s TrendWatch, visit www.hospitalconnect.com/aha/press_room-info/specialstudies.html.
Bill Requires Set Staffing Ratios
Legislation introduced last week in the U.S. House of Representatives
would mandate specific nurse-to-patient ratios by 2007 and require
hospitals to develop staffing plans. Among the nurse-to-patient ratios
outlined in the bill are the required ratios of 1-4 in medical/surgical
units, 1-3 in emergency room and pediatrics units, 1-2 in critical care
units and 1-1 in operating room and trauma emergency units.
H.R. 4316, sponsored by Rep. Janice Schakowsky (D-IL), has been referred to the Committee on Energy and Commerce and the Committee on Ways and Means for further discussion. OHA will continue to monitor the bill and alert members of any movement. (Jonathan Archey, jonathana@ohanet.org)
Wednesday,
May 12, 2004
Governor Signs Podiatrist Admissions Bill
Gov. Bob Taft last week signed legislation allowing podiatrists to make
independent admissions to a hospital. House Bill 189, sponsored by Rep.
Chuck Blasdel (R-East Liverpool), takes effect the first week of August.
The new law allows podiatrists to independently admit patients solely for the purposes of receiving podiatric services. If the patient requires additional non-podiatric services, the podiatrist must coordinate with a member of the hospital’s medical staff, who will supervise non-podiatric treatment. Formerly under Ohio law, only a member of a hospital’s medical staff who is a doctor of medicine, osteopathic medicine or dentist may independently admit a patient to a hospital. OHA did not oppose the legislation because hospitals retain the authority to determine admitting criteria through the credentialing process. (Jeff Klingler, jeffk@ohanet.org)
Insurer Downgraded but Still Secure
A.M. Best Company this week downgraded medical liability insurance
carrier The Doctors Company, based in Napa, Calif., from an A-
(Excellent) to a B++ (Very Good). A.M. Best, which provides insurance
company information, considers carriers with a B++ as financially
secure, but this downgrade illustrates the continuing volatility of the
medical liability insurance market not only in Ohio but nationwide. With
the Doctors Company downgrade, four of the five medical liability
insurance carriers writing policies for most of Ohio’s physicians have
been downgraded in the past year.
For more information from A.M. Best Company, visit www.ambest.com/ and to learn more about the current medical malpractice environment in Ohio, visit www.ohanet.org/med-mal/. Find out more about OHA Insurance Solutions, Inc., a new company created by OHA to help stabilize Ohio's medical liability insurance market, at www.ohainsurance.com/. (Rick Sites, ricks@ohanet.org)
Thursday,
May 13, 2004
The Ohio House Health and Family Services Committee heard sponsor testimony this week on legislation increasing the payment cap on screening mammograms to $105, with an opportunity for an annual, medical inflation-based increase each year. The bill, House Bill 331, was introduced last month by Rep. Jean Schmidt (R-Loveland) at the request of OHA and a state radiologist group.
Since 1992, group health, public employee and employer-based health plans have been required by Ohio law to cover screening mammograms for women within specific age and risk groups. The statute established an $85 cap on the amount insurers have to pay for the diagnostic test, an amount that has not been increased in more than a decade.
The payment covers both the technical and professional components of the diagnostic test, and it is presumed the payment is designed to also cover any required digitization of the image. OHA will present proponent testimony in the Health Committee and seek a vote in the full House before the legislature adjourns for summer recess at the end of May. (Bridget Gargan, bridgetg@ohanet.org)
Hand-Rub Dispensers Permitted Pending Clarification
The National Fire Protection Association (NFPA) code amendment on
hand-rub dispensers became effective May 5, permitting hospitals and
other health care facilities to install alcohol-based hand-rub
dispensers in their corridors.
However, the Ohio Department of Health recommends facilities adhere to the previous ruling until it receives clarification from the Centers for Medicare and Medicaid Services on whether it will accept this recommendation. The Joint Commission on Accreditation of Healthcare Organizations also has not clarified how it will survey this new recommendation.
The new development stems from an October 2002 report from the Centers for Disease Control and Prevention recommending routine use of alcohol-based hand rubs in health care settings to combat hospital-acquired infections. Following the report, the American Hospital Association and the American Society for Healthcare Engineering worked with NFPA to change its fire codes based on a modeling study showing dispensers could be installed safely as long as they hold no more than 1.2 liters and are not installed too closely together or near electrical outlets. (Rosalie Weakland, rosaliew@ohanet.org)
OHA Center for Education
Don’t miss these upcoming OHA seminars and visit
www.ohanet.org/education/education_programs.asp for more information
on these and other educational opportunities offered by OHA.
Friday, May 14, 2004
Board Gives Campaign Thumbs Up
At its last meeting, the OHA Board of Trustees gave OHA staff the go-ahead on a statewide campaign to raise Ohioans’ awareness of and to move Ohioans to action regarding the medical professional liability crisis. After reviewing campaign messages, goals and initial ad concepts, the Board also directed staff to continue efforts to secure members’ financial support. The Board also reviewed an “ask your doctor” Web site being created to educate the public and hospital employees on the medical malpractice crisis and how the Ohio Supreme Court can help stabilize the liability insurance market. For more, visit www.ohanet.org/CareCampaign/.
The Board also heard an overview of key state legislative proposals on tort reform, tax-exempt bonds and mandatory overtime. Not expected to pass are legislation placing a one-year halt on increases in medical malpractice insurance premiums, Senate Bill 204, and legislation to prohibit hospitals from requiring registered nurses and licensed practical nurses to work overtime, House Bill 382. Expected to pass this year are House Bill 239, to allow the Ohio Department of Development, in addition to county commissioners, to issue tax-exempt bonds to hospitals, along with House Bill 215, which would provide moderate tort reform (see separate story).
Looking at improved patient safety, the Board was updated on efforts to implement computerized physician order entry (CPOE) across the state. Although CPOE is costly, it is an effective way to improve patient safety through electronic transmission of prescriptions and electronic drug record keeping. However, the Board also heard the roadblocks hospital face in implementing these systems with current Ohio State Board of Pharmacy regulations on such electronic systems. OHA will continue advocating against unnecessary mandates on hospitals working to implement CPOE.
The Board also heard updates on recent developments in federal health care advocacy and the role of the American Hospital Association political action committee, along with the pros and cons of federal legislation to exempt small employers from state regulation when offering health plans through association health plans. The Board also received an update on OHA Insurance Solutions and OHA’s audited financial statements. (Jim Castle, jimc@ohanet.org)