OHA - HEALTH e-NEWS

Monday, April 25, 2005
OHA Continues Work on False Claims Bill
OHA is continuing to work with Sen. David Goodman (R-Columbus) on concerns with his legislation, Senate Bill 39, which would expand the state’s False Claims Act. Goodman has indicated a willingness to address hospital concerns with State Attorney General Jim Petro, who supports the legislation.

As introduced, the bill would expand existing statutes allowing the state to bring suit against providers who falsely bill for a service to include whistleblower provisions, whereby an individual could file the suit against the provider and receive up to 30 percent of any awards or settlements. OHA is concerned that this provision would encourage frivolous and dangerous lawsuits, and it has resulted in a cottage industry at the federal level for plaintiffs’ law firms to solicit whistleblowers, often with misinformation.

SB 39 would also expand anti-kickback statutes to the state False Claims Act, which OHA opposes. The bill purports to be based on the federal anti-kickback laws that invoke a different intent standard and burden of proof.

The legislation also includes a lesser standard of fraud than other state and federal fraud statutes. OHA advocates that the bill does not adequately distinguish between mistakes and dishonesty, and should be modified so that the Attorney General’s office targets genuine fraud, and not be permitted to inappropriately apply the False Claim Act to billing mistakes or disputes.

OHA staff recently met with Goodman on these and other concerns with the bill, and forwarded to him a letter reiterating the association’s concerns, along with potential solutions. Find the letter online at www.ohanet.org/advocacy/state/issues/letters/041305sb39Letter.pdf. (Jeff Klingler, jeffk@ohanet.org)

Tuesday, April 26, 2005
Proposed Medicare Inpatient Payment Rule Would Cost Hospitals
The Centers for Medicare & Medicaid Services (CMS) this week released the proposed Medicare inpatient prospective payment system rule for fiscal year 2006, which begins Oct. 1, 2005. Under the proposed rule, acute care hospitals that submit data on 10 quality measures would receive a 3.2 percent increase in their payment rates and hospitals that do not submit the information would receive a 2.8 percent update. All eligible Ohio hospitals currently submit information on the 10 quality measures required for a full update.

CMS also proposed an extension of the post acute care transfer provision, from 29 diagnosis related groups (DRGs) to 223, which would cost hospitals nationwide an estimated $880 million in FY 2006. Disappointed with this proposal, the American Hospital Association and OHA will formally oppose the expansion in comments and provide continuing information to member hospitals. The proposed rule will appear in the May 5 Federal Register and comment on the proposal are due by June 24. (Charles Cataline, charlesc@ohanet.org)

Study: Physician Owners Add to Health Costs, Usage

Physician-owned limited-service hospitals drive up utilization and health care costs, according to two new studies released today, lending support to the OHA’s Board-adopted position that Congress should make permanent a federal moratorium on new physician-owned limited-service hospitals. An 18-month moratorium is set to expire June 8, 2005.

Jean M. Mitchell, Ph.D., an economist at Georgetown University, released studies of physician-owned limited-service spine and orthopedic hospitals in Oklahoma and cardiac hospitals in Arizona, which suggest the financial incentives linked to ownership caused physician owners to change their practice patterns, shift more profitable procedures to facilities they own, and cherry-pick low severity cases and patients with generous insurance coverage.

More information, including copies of the studies, is available from the Coalition of Full Service Community Hospitals’ Web site at www.fullservicehospitals.org/. An OHA news release is available at www.ohanet.org/media/news_release/2005/specialty_study042605.htm. (Jonathan Archey, jonathana@ohanet.org)

Wednesday, April 27, 2005
Med Mal Commission Finalizes Report
Citing some stability in Ohio’s medical liability market but the continued need for improvement, the Ohio Medical Malpractice Commission today approved its final report. The commission, headed by Ohio Department of Insurance (ODI) Director Ann Womer Benjamin, strongly recommends that Senate Bill 281—best known for its non-economic damage cap—remain in effect in Ohio. It also supports legislation and state funding to create a patient safety center, a public/private partnership similar to the Ohio Patient Safety Institute, an organization founded by OHA, the Ohio State Medical Association and the Ohio Osteopathic Association and dedicated to improving patient safety in the State of Ohio. The patient safety center could require medical error reporting and collect best practices.

Despite some early signs of relief in the market, the report notes that medical liability premium rates are still seeing double-digits increases this year, and have increased for the top five medical liability insurers in Ohio by 208.6 percent since 2000. The commission supports SB 281 as a long-term approach to addressing the rising rates.

Although the nine commission members had consensus on many recommendations, two members voted against the final report based on a handful of issues and will issue separate minority views. The full report is expected to be posted later today on ODI’s Web site at www.ohioinsurance.gov/. (Rick Sites, ricks@ohanet.org)

Hospital Compare Site to ‘Refresh’

Hospitals have the opportunity to update general information on the Hospital Compare Web site, a national repository of hospital quality information for consumers found at www.hospitalcompare.hhs.gov.

The Centers for Medicare & Medicaid Services plans to update or “refresh” general hospital data, including address and phone number, and facility characteristics, including emergency department and accreditation, on a monthly basis. The first update will occur mid-May.

Hospitals should submit changes or corrections as soon as possible to the State Survey Agency OSCAR/ASPEN Coordinator. Ohio’s coordinator can be reached at pmiller@gw.odh.ohio.gov or 614.644.8118. (Rosalie Weakland, rosaliew@ohanet.org)

OHA Annual Meeting Makes a Move

OHA’s Annual Meeting will hail from a new location this year—the Hilton Columbus at Easton in Columbus’ Easton Town Center. Though the location will be different, this year’s meeting, June 20-21, will offer the same high-caliber educational sessions, plenary speakers and meal functions. Under the theme, Paving the Way: Hospitals’ Roadmap to Innovative Health Care Solutions, OHA’s Annual Meeting will offer hospital employees the opportunity to network with peers, learn more about current hot issues and visit with OHA Corporate Partners about the latest technology and cost-cutting measures. OHA’s annual Recognition Dinner, honoring Ohio health care leaders and the Albert E. Dyckes Health Care Worker of the Year, will also be held as part of the Annual Meeting.

Those interested in attending the 2005 Annual Meeting may now register online or print a registration form to submit via fax or mail at www.ohanet.org/annualmeeting/. This site also includes information on the sessions offered as part of this year’s meeting, meal functions and continuing education opportunities. Official programs with print registration materials will be sent to hospitals next week. (Joe Ruggles, joer@ohanet.org)

Thursday, April 28, 2005
Legality of Advance Directives Ed Still Under Investigation
The Ohio Supreme Court’s Office of Disciplinary Counsel continues gathering information regarding a Fairfield Medical Center nurse accused of practicing law without a license by providing community education on advance directives as required by federal and state law. The Disciplinary Counsel requested additional information on the matter from the hospital’s legal counsel, Richard Lovering at Bricker & Eckler, LLP, but stated, “it is not the intent of this office to place the hospital in a position where it violates federal or state statutes or regulations.” OHA and the Ohio Hospice & Palliative Care Organization also sent letters in support of the nurse and hospital. The Disciplinary Counsel will decide whether to dismiss the complaint or conduct a hearing before the Board on the Unauthorized Practice of Law sometime after May 5.

To learn more, or to download advance directives materials and forms for help in making end-of-life decisions, visit www.ohanet.org/advocacy/state/issues/advance_directives.htm. The Centers for Medicare & Medicaid Services also requires that hospitals make the publication You Have the Right or a similar summary of Ohio advance directive law available to patients upon admission. The most recent version can be ordered at http://jfs.ohio.gov/manuals/odjfspubs.htm or downloaded at www.odjfs.state.oh.us/forms/pdf/08095.pdf. (Rick Sites, ricks@ohanet.org)

Friday, April 29, 2005
OHA Voices Concerns on BWC Reforms
OHA this week met with representatives of the Ohio Bureau of Workers Compensation (BWC) to advocate for changes to pending legislation that would enact reforms to the state’s workers compensation laws. Senate Bill 7, sponsored by Sen. Gary Cates (R-Westchester), and House Bill 72, sponsored by Rep. Steve Buehrer (R-Delta), are supported by business and employer groups but have met strong resistance from labor groups.

OHA’s concerns with the bills include a provision that could result in providers being found liable for fraudulently billing the bureau, costing them millions of dollars in penalties for an honest billing mistake. OHA has requested the bills’ definition of “deception” be tightened so the bureau will target genuine fraud, and not be permitted to inappropriately apply the proposed law to billing mistakes or disputes. OHA also objects to including anti-kickback provisions in the legislation. OHA is advocating that federal anti-kickback statutes apply to all government claims, including BWC claims, and do not belong in state BWC reform legislation.

BWC indicated it is amenable to addressing OHA’s concerns, and both bills are receiving high levels of attention in their respective chambers (Jeff Klingler, jeffk@ohanet.org)

Hospitals Lead the Way
Ohio hospitals continue to receive recognition for honors ranging from facility-wide actions to individual achievements of hospital employees.

Columbus Children’s Hospital received Magnet Recognition by the American Nurses Credentialing Center of the American Nurses Association—a designation of excellence in nursing. The American Society of Health System Pharmacists Research and Education Foundation awarded its first annual Award for Excellence in Medication-Use Safety to OhioHealth, Columbus. Cincinnati Children’s Hospital Medical Center was honored as one of 10 “Growth Companies” by the Cincinnati USA Partnership. Toledo Children’s Hospital’s Way to Go Kids! program to stop weight gain while maintaining normal growth and development received a $5,000 grant from CVS Pharmacy.

OHA was honored as a Hospitals for a Healthy Environment Champion for Change Award (H2E) winner this month—the only state hospital association to receive an award this year. Fisher-Titus Medical Center, Norwalk; St. Charles Mercy Hospital, Oregon; and St. Luke’s Hospital, Maumee, received Making Medicine Mercury Free Awards, and Fisher-Titus Medical Center, St. Charles Mercy Hospital and Fairfield Medical Center, Lancaster, also received H2E Partners for Change Awards.

Hospital employees are also being highlighted for their excellence. Brian K. Felici, president/CEO of the Ohio Valley Medical Center and East Ohio Regional Hospital, was honored at the Grand Illusions Saute for his efforts in battling cancer. Lynn Reynolds, Mary Rutan Hospital, was awarded the Internal Meritorious Service Award at the Mary Rutan Health Association’s annual meeting for her service to the hospital since starting there in 1970. Carol Santalucia, ombudsman with the Cleveland Clinic Foundation, received the 2005 Ruth Ravich Founders’ Award, the highest honor of the Society for Healthcare Consumer Advocacy.

The Cleveland Clinic instituted color-coded uniforms that quickly identify their patient care roles and help patients and families determine which caregiver is best to assist them. MedCentral Health System, Mansfield, put its disaster preparedness equipment to work, effectively responding to a broken container of hazardous material. The spill was properly cleaned, the area ventilated and during the clean-up, several protected lab workers continued processing vital orders and supplies. (Mary Sterenberg, marys@ohanet.org)