Health Insurance

The Medical Society of New Jersey, the Alliance for Advancing Nonprofit Health Care, and QualCare, a New Jersey-based hospital and physician-owned nonprofit health plan, wrote a letter to the director of the New Jersey Dept. of Banking and Insurance and the state attorney general, calling for Horizon to withdraw its application or for the state to require a new one. The groups argued that the application should be amended to reflect the changes to the economy that have sent stocks plummeting and frozen the credit market.

"The political and economic world that Horizon knew [when it first applied] has changed substantially," said the letter. But it appears not to have interrupted the state's deliberations or convinced Horizon of the need to reconsider.

Paul Penna, spokesman for the state Dept. of Banking and Insurance, said the department had no authority to tell Horizon to resubmit its application. "It's Horizon's application, so it's not up to us to make a determination whether Horizon should or should not pull their application."

A new and extensive federal report released this week concludes that roughly one in four of our US Veterans of the 1990-1991 Gulf War suffer from Gulf War illness.  According to the 452 page report, “Scientific evidence leaves no question that Gulf War illness is a real condition with real causes and serious consequences for affected veterans.”  

Soldiers diagnosed with Gulf War syndrome have wide-ranging problems including headaches, dizziness and loss of balance, memory problems, chronic fatigue, loss of muscle control and shortness of breath.  It is believed that brain cancer deaths and Lou Gehrig’s disease are also potentially connected to service during the Gulf War.
 
Hopefully, this new study will lead to the necessary treatment that these wonderful veterans certainly deserve.
 

At least that's Gov. Arnold Schwarzenegger's hope; in September he signed into law two bills that put some teeth into patient privacy rules and give doctors good reason to comply.

Under the new laws taking effect Jan. 1, 2009, the state has significantly increased fines not only for the illegal use of medical records but also for unauthorized access of records. The laws also open the door for patients to sue doctors when their records are accessed, even if there is no damage.

Other states have privacy laws that require notification of a breach, but the California bills are thought by experts to be the first to place a strong focus on enforcement.

Experts predict California's actions will lead to more states following suit, as well as tougher enforcement of HIPAA privacy and security rules, which have gone largely unenforced since they took effect in 2003 and 2005, respectively.

For physicians, "the idea behind all this is don't wait until the 500-pound gorilla is pounding on your door," said attorney Peter MacKoul, president of Sugar Land, Texas-based HIPAA Solution, a consultancy that helps practices become HIPAA-compliant. "It's called preventative action."

About the same time the California governor signed the two patient privacy bills into law, a report published by the California Health Dept. found snooping incidents at the UCLA Medical Center were much worse than initially thought. The study found that since 2003, hospital workers inappropriately accessed the electronic medical records of 1,041 patients, including those of California first lady Maria Shriver. Some of those employees were feeding celebrity information to the media, the report said.

Research on sophisticated diagnostic tests were presented this weekend at the annual meeting of the society for neuroscience in Washington, D.C.  According to a report published in USA Today, researchers from the University of California-San Diego combined “two advanced brain scanning techniques-MEG (Magnetoencephalography) and DTI (Diffusion Tensor Imaging)- that permitted them to detect brain damage in patients with mild traumatic brain injury in which conventional MRI and CT scans had been normal.  Mingxiong Huang, the presenting researcher from this study, stated “More research is needed before the dual technology can be used clinically in patients with such injuries (MTBI).”

Also presenting at the annual meeting were researchers from the University of Miami (Andrew Maudsley) who “reported that they used a new all-brain method of magnetic resonance spectroscopic imaging (MRSI) to detect for the first time widespread brain damage that sometimes fails to show up in conventional brain scans of patients with mild to moderate TBI.

The researchers studied 17 patients admitted to a trauma unit with closed head injuries.  According to USA Today, “They looked at changes in three major brain chemicals and compared them with healthy brain images.  They found the MRSI images picked up diffuse chemical changes in the TBI patients, even in people who had been classified as having very mild injury.”

Clearly, the day is coming when patients with mild traumatic brain injury will have their injuries confirmed by objective diagnostic testing which obviously will have a significant impact on neurolitigation.