Judge holds state Medicaid officials personally liable.
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Biomedical subjects
Publications and source records attributed to T Hudson.
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Wilder et al v. The Virginia Hospital Association is about to go to trial. Wilder is the case that resulted in the Supreme Court's June ruling affirming hospitals' right to sue state governments for inadequate Medicaid reimbursement. A federal court in Richmond must now decide whether Virginia's payment plan adequately reimburses the state's hospitals. And with momentum of their own, individual hospitals and state hospital associations are pressing hard for fair Medicaid reimbursements.
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Adult day care programs are expanding throughout the United States, but funding has not kept pace with organizational development. Hospitals explores the issues and looks at three successful programs in diverse settings.
HCFA is poring over 50,000 letters commenting on the proposed new clinical lab regulations. Health care providers say the regulations are unreasonably complex. As a result, "It's very likely the standards will be changed," says Thomas Morford, HCFA's health standards director.
The message being sent by local tax boards, state agencies, and the Internal Revenue Service is clear: Not-for-profit hospitals will have to justify their tax-exempt status. But complying with this demand can be a costly administrative burden. Just ask the executives who have been through the experience. CEO Richard Anderson, of St. Luke's Hospital, Bethlehem, PA, is luckier than some executives who have faced tax-exempt challenges. He won his hospital's case. But he still faces a yearly battle: The hospital must prove its compliance annually to the county board of assessors. Other executives report similar experiences. Our cover story takes an in-depth look at how administrators faced challenges to their hospital's tax status and what they learned about their relationship with their communities, as well as a complete state and federal legislative outlook for future developments.
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The role of the nonphysician health professional is expanding. Health care sources say several factors are fueling this trend, including the familiar needs to reduce health care costs and improve access to care. And some legislators are planning bills to support this trend. In addition, some health care executives are also finding new roles for allied health professionals in cooperation with medical staff members.
Health care risk managers have mixed feelings about the new regulations governing patient transfer and the National Practitioner Data Bank. Although cumbersome, the regulations give risk managers the teeth to enforce practices that may previously have been difficult to enact.
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Most CEOs expect outpatient utilization to increase, but are executives planning ahead for what some term a virtual "revolution" in health care delivery? This issue's cover story takes a look at some of the key strategies that outpatient executives are implementing in their markets. Examples range from a large university teaching hospital, to a suburban facility, to a 40-bed rural hospital in Minnesota. Business strategy is only part of the outpatient story, however. One of the key questions that health care executives must answer is where the outpatient management talent will come from. Outpatient executives report that many of the same skills are needed in this setting as are necessary in the traditional inpatient side; however, there are major differences in management expertise that could make or break a hospital's outpatient services. Moreover, some experts say that this emerging definition of what it takes to be a successful outpatient services executive may be shaping the mold for all future health care executives, both inpatient and outpatient.
Not-for-profit hospitals will continue to face legal challenges to their tax-exempt status as state and municipal budgets are squeezed by service demands, says Spencer Knapp, partner with Dinse, Erdmann & Clapp, Burlington, VT. Knapp warns that hospitals could endanger their not-for-profit status by portraying themselves as businesses. "You want to emphasize the hospital's mission, not the bottom line," says Knapp.