GAO report: deficits in state outpatient center regulation.
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Biomedical subjects
Publications and source records attributed to T Hudson.
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Tort reform is not just an esoteric debate for health care executives. On the local level, the medical malpractice liability crisis is having a very real effect on many hospitals. Although malpractice insurance premiums have moderated, access to care is being restricted in communities where obstetricians and family practitioners have decided to give up delivering babies. Nor does the future look any brighter. Experts predict that medical students will shun obstetrical and other high-risk specialties to avoid the high cost of malpractice insurance. On the national level, President Bush has expressed concern that the liability situation is adding to the high cost of health care. And a number of congressmen have responded with legislation.
Jackson Memorial Hospital, Miami, lost $5.6 million treating AIDS patients last year. Executives at the 1,246-bed public hospital project losses of more than $7 million in 1990. Jackson Memorial's experience is unfortunately all too typical of the effect that AIDS has had on public hospitals. But AIDS is not just a public hospital problem. The trend toward concentration of AIDS cases in public hospitals could have dire consequences for all hospitals in a community, say analysts. But the impact of AIDS on the health care community can be felt at a number of different levels. This executive report also takes an in-depth look at: How case management is being used--or misused--with AIDS patients. How much money state legislatures are allocating for AIDS and what the states are spending the funds on How executives are dealing with various liability issues.
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Hospitals now should be preparing for patient-transfer requirements, scheduled to take effect July 1. The new provisions are intended to make it simpler for government inspectors to identify inappropriate transfers and to penalize hospitals and physicians for violations. Those who have analyzed the requirements say that they may change emergency department procedures, increase recordkeeping, and cause feuds among the medical staff.
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As state Medicaid agencies struggle to cut costs for prescription drugs, their main tool has been the use of drug formularies--a state-approved list of thousands of drugs that the agencies will reimburse for the treatment of Medicaid patients. Now, states are trying to use a second method that could reap big savings: requiring drug companies to bid to be included in the formulary. However, both cost-containment strategies have attracted the pharmaceutical industry's attention--and their lobbyists.
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Attorneys disagree on how the yet-to-be-published fraud and abuse regulations will be enforced. Some interpret them as "guidelines," others as the "letter of the law." In addition, officials in the Office of the Inspector General say that they are not sure how the regulations will be enforced. Then there's the question of how the Secretary of Health and Human Services will use his official sanction. Is everything perfectly clear?
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During the insurance crisis of the 1970s, a handful of states established patient compensation funds to ensure providers access to insurance. Well, the funds are mature now. And for better or for worse, they have played key roles in how much the states' providers pay for medical malpractice premiums.
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