Healthcare Risk Management
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Patient Selection, Standardization Can Reduce Surgical Liability
One-quarter of all malpractice claims in a recent closed claim study involved surgical allegations, second only to diagnosis-related allegations. The authors of the study said standardization and practice contribute to successful outcomes. Routine and rigor also are vitally important.
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Fall Prevention Always Is a Concern; Innovative Products Help
There has been progress in fall prevention, but there is much more room for improvement. Some organizations are finding success with innovative products that can help reduce falls.
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Medical Record Retention Requires Good Policies, Strict Compliance
Records retention is a critical issue for risk managers, as the loss of important patient records and other documents could compromise litigation defense and threaten ongoing care. Healthcare organizations must create clear records retention policies and follow them closely, experts say.
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HHS, CMS Easing Some Abuse Rules, Will Reduce Compliance Burden
The Department of Health and Human Services and the Centers for Medicare & Medicaid Services are trying to reduce regulatory burdens on healthcare organizations with rule changes that would protect some activities from anti-kickback allegations. The changes are intended to promote value-based care.
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Surgeon Sues Health System for ‘Forced Referrals’
A Florida health system is facing a whistleblower lawsuit from a surgeon alleging the system violated federal law by requiring him to perform surgery and refer patients within its own facilities. The surgeon claims the health system fired him for not complying with the policy. The mandatory self-referrals violate the Physician Self-Referral Law and other statutes, the lawsuit claims.
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Wrong Person Receives Bill, OCR Secures $2.175 Million Fine
Sentara Hospitals in Virginia and North Carolina agreed to take corrective actions and pay $2.175 million to settle potential HIPAA violations stemming from a complaint alleging the organization sent a bill to an individual containing another patient’s PHI. OCR determined Sentara mailed 577 patients’ PHI to wrong addresses.
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HIPAA Settlements Hold Lessons on Right of Access, Breach Reporting
The Office for Civil Rights (OCR) recently announced two HIPAA settlements that offer lessons for covered entities regarding right of access and failure to notify after a breach. In early 2019, OCR announced it would take steps to enforce the rights of patients to receive copies of their medical records timely and at a reasonable cost. This led to the introduction of the HIPAA Right of Access Initiative.
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Expect More High-Tech Breaches, Attorney General Audits This Year
The trend for HIPAA compliance is toward more breaches and complex breaches than seen in earlier years of efforts to follow the privacy rule, say some experts. A sharp increase in cyberattacks also may be coming this year.
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Appellate Court Reverses Summary Judgment Based on Expert’s Disqualification
This case demonstrates the importance of expert witnesses, which not only can determine a case at trial, but even potentially before trial. Although the outcome of this case remains uncertain, and the patient has not been awarded any monetary damages, the appellate court ruling certainly is a setback for the defendant care provider, and reopens a window of opportunity for the patient to continue the allegations of malpractice.
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Failure to Remove Sponge Results in $10.5 Million Verdict
The facts of the case left little doubt as to whether hospital staff had violated their duty of care. In addition to the ethical requirement to tell the patient about the retained sponge, there is a licensing and regulatory requirement as well.