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TRICARE contracts can bring affirmative action requirements

In this economy, every health care provider wants to say yes to a managed care contract that promises more revenue. A recent court ruling, however, shows that the money may come with strings attached.

Affirmative action includes impact analyses

If your hospital is now subject to affirmative action requirements because of a TRICARE contract or any other federal contract, what does that involve?

Surprise! You might be a federal contractor

Prior to the ruling in OFCCP v. Florida Hospital of Orlando, DOL OALJ, No. 2009-OFC-00002, most hospitals did not worry about being a federal contractor and all the obligations that can trigger unless they were engaged in specific business with the federal government. Now, you might be a federal contractor and not even realize it.

Court ruling: TRICARE not like Medicare

The defendant hospital in OFCCP v. Florida Hospital of Orlando, DOL OALJ, No. 2009-OFC-00002, argued that rather than being a contract with the federal government, TRICARE was merely another form of "federal financial assistance," just like Medicare.

Volunteers a great asset until they cost you

Volunteers are a key component to the success of many health care organizations, but how often do you consider the risks they bring? No one wants to turn away people offering their time for free, but at the same time, risk managers must consider the potential downside.

Compliance officer hat could take you far

If you are a risk manager who also serves as the compliance officer, that second title could be your ticket to advancement within the organization, says Roy Snell, CHC, CCEP, CEO of the Health Care Compliance Association (HCCA) in Minneapolis and a former Mayo Clinic administrator, consultant, and compliance officer.

Mediation effective, but many skeptical

Mediation can not only reduce the costs of malpractice litigation, but also has the potential to offer closure to plaintiffs and ensure that procedures are changed in hospitals to prevent recurrences of the error that sparked the lawsuit, according to a recent study. However, too often that potential goes unrealized, because doctors and hospitals are often reluctant to participate.

More than $9 billion recovered from fraud

Since January of 2009, the Justice Department's Civil Division and the U.S. Attorneys around the nation have recovered more than $9 billion in cases alleging false claims, fraud against the government, and violations of the Food, Drug and Cosmetic Act.

Hospital CEO guilty of six felony counts

In a case that should frighten every hospital administrator who thinks he or she won't be held personally responsible for criminal fraud, the former CEO and president of Archbold Medical Center and Archbold Memorial Hospital in Thomasville, GA, is facing a potential 105 years in prison after being convicted of six felony offenses related to Medicaid fraud and obstruction of justice.

Tort reform doesn't alleviate doctors' fear

Physicians' fears of being sued for malpractice are out of proportion to their actual risk of being sued, according to a recent study by a University of Iowa researcher and colleagues.

Legal Review & Commentary: Alleged Failure to Perform Adequate Follow-Up Care and Investigate Cause of Pain Leads to $500,000 Settlement

At the age of 69, a woman underwent rectal prolapse surgery. After conducting a preoperative history and physical exam on the woman, her internist released her for surgery.

Legal Review & Commentary: Nursing Home Resident Dies After Fall; $900K Verdict

An 83-year-old man was admitted to a nursing facility after suffering a broken hip and a stroke. The hospital, prior to discharge, determined that the man required 24-hour stand-by assistance for all movement. The admitting nurse at the nursing facility, however, assessed the man and determined that he was independent in ambulation and needed no assistance for daily routine activities.

HIPAA Regulatory Alert: Importance of security risk assessments rise with advent of electronic health records

A landmark study conducted by the Poneman Institute Reference shows that 70% of hospitals say that protecting patient data is not a top priority and 67% have less than two staff members dedicated to protection management.

HRA: Patient data protection not a top priority

Data breaches cost health care organizations more than $6 billion annually, and 71% of the respondents to a study released by the Ponemon Institute say they do not have enough resources to prevent or to quickly detect a loss of patient data.

Pay attention to content of phone messages

Calling to remind patients of their appointments, instructions on how to prepare the night before a procedure, or to see if patients have questions prior to surgery are important ways to keep your outpatient surgery or diagnostic testing departments' schedules on track.

HRA: Meaningful use incentive program dates

Healthcare Risk Management – February 1, 2011

February 1, 2011