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Ban Due to Medicare Participation Prohibitions
Staff Reporters
A new report outlining violations of health and safety standards at some physician-owned specialty hospitals has some lawmakers renewing efforts to ban the facilities.
The American Medical News [AMN] recently reported that Department of Health and Human Services [HHS], Office of Inspector General [OIG], investigated 109 of the country’s orthopedic, cardiac and surgical hospitals and found that more than one-third of them may be in violation of Medicare’s conditions of participation.
The OIG concluded that the administration should work to require all hospitals – not just specialty facilities – to meet Medicare’s hospital staffing rules. These include having the capability for evaluation and initial treatment of emergency patients, and to include necessary information in their written policies regarding how to manage medical emergencies.
The Centers for Medicare and Medicaid Services [CMS] concurred with the findings, and for those who oppose them, the report is more evidence that legislation is required to address potential problems.
Conclusion: And so, what is your considered opinion of specialty hospitals?
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Filed under: Health Law & Policy | Tagged: Health Economics |
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Specialty Hospitals should be maintained since they provide access to specialties procedures which might not otherwise be available. They should however at least meet minimum standards for treating emergency patients who may present themselves at the facility.
The opponents to specialty hospital talk about single incidents as if they were an everyday happenstance. Studies have shown that infection rates and other complications are not as prevalent in specialty hospitals as they are in general acute care hospitals. There are several reasons for this but to claim that physicians’ “cherry pick” insured patients as one of them is ludicrous.
People and organizations that make outrageous claims need to be taken to task and required to prove their allegations. The OIG’s finding that ALL HOSPITALS need to meet Medicare’s hospital staffing rules, not just specialty hospitals. More regulation and legislation is NOT the answer to address this problem. Inspection for compliance with the current regulations is the answer.
It appears that the staff is too overburdened now to inspect for compliance with the current volume of laws, statutes, etc. let alone more regulations and laws which will exacerbate the issue. Why not scrutinize the advertisements of hospital about their capabilities?
When a Trauma Center says they are better equipped and prepared to take care of medical illness and medical emergencies like asthma or diabetes than there competition down the street, why doesn’t someone challenge their claim? Having staff to care for a trauma patient does not necessarily make you more prepared for a pediatric emergency patient with acute asthma. The Trauma Center may not have a pediatrician readily available. It may not have a pediatric emergency department which the competition may have.
That may be far afield form the issue of specialty hospitals, but aren’t Trauma Centers a form of specialty hospital? I administrated a Level II Trauma Center in Los Angeles and the capabilities of the hospital in the area of trauma did make it special.
The AHA and other like organizations don’t like specialty hospitals but they have never addressed the issues as to why they came about in the first place. Could it be that too many regulations force physicians to seek another venue in which to take care of their patients? Could it be that hospital administrations treated their medical staffs with such distain that the physicians had no other alternative but to “do their own thing?”
The most successful specialty hospitals, in the long run, will be cooperative efforts by local community hospitals and their medical staffs working together to improve all the services.
Stuart Katz
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