Healthcare Risk Management – December 1, 2019
December 1, 2019
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Hospital Creates Harm Collaborative to Improve Communication With Executives
Some patient safety issues are so important that risk managers and other safety leaders need direct access to the C-suite so that concerns can be addressed quickly. Helen DeVos Children’s Hospital in Grand Rapids, MI, devised a harm collaborative that makes that possible. The collaborative meets weekly so that risk managers and other safety or quality professionals can address the executive team about individual patient cases or trends that are concerning.
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Stark Anti-Kickback Law Refined for Clarity
The Department of Health and Human Services recently revised federal anti-kickback laws, changes that are seen as primarily good news for risk managers. The revisions clarify issues that were unclear and easing some restrictions that created compliance risks.
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Part-Time Documentation Eased Among Many Favorable Rule Changes
Proposed rule changes regarding anti-kickback restrictions offer compliance relief to physicians and hospitals. The revisions propose three levels of protected value-based arrangements.
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Avoid the Top Mistakes in Handling Medical Malpractice Claims
A medical malpractice claim is never a walk in the park, but there are ways to make the experience worse and ways to make it better. Becoming aware of some of the most common missteps can help risk managers make the best of a difficult situation.
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Uptick in Investigations Expected for 2020; Data Volume Growing
Healthcare risk managers can expect a greater focus on internal investigations and audits in 2020, with much of it aimed at heading off government inquiries with potentially large consequences.
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Larger Claims Increasing, Leading to Higher Premiums
The medical malpractice insurance market is hardening in response to an increase in claims with large payouts. Hospitals and health systems may feel the effects even if their own claims are stable.
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Government Moving to More Risk Arrangements Based on Quality
The Center for Medicare & Medicaid Innovation wants 100% of providers in upside/downside by 2025 and is using the Bundled Payments for Care Improvement Advanced model, primary care models, and (increasingly) more mandatory models to get there.
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California Law Could Cost Hospitals Millions
Healthcare organizations across the country should be keeping an eye on the California Consumer Privacy Act, which will go into effect Jan. 1, 2020. Failure to comply with this new rule can result in significant penalties, and it is a mistake to think HIPAA compliance will protect organizations.
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Incorrect Diagnosis Leads to Patient Refusing Cesarean Section, Infant’s Permanent Injuries
This case reveals how a patient’s circumstances can dramatically affect the size of a verdict, regardless of the underlying type of malpractice. Failures to diagnose or incorrect diagnoses are common types of malpractice when a reasonable physician in the same or similar circumstance would have accurately diagnosed the patient.
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Court of Appeals Holds That Failure to Diagnose Defects in Fetus Did Not Cause Mother’s Death
In this case, the alleged wrongdoing focused on the initial ultrasound, with the patient’s husband claiming that the defendant physician failed to timely diagnose the patient.
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Avoid Most Common HIPAA Violations With Best Practices, Education
HIPAA breaches can happen even to the best prepared healthcare organizations, but knowing the most common failings can improve your chances of staying in the good graces of the Office for Civil Rights.
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Enforcement Action Follows Predictable Path, Starts With a Letter
A healthcare organization’s involvement with OCR may begin with a simple letter acknowledging a complaint and providing guidance documentation related to it. For a more serious concern, OCR will assign a case number and ask for substantial information, such as policies and staff education records.