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Tuesday, September 30, 2014

American Heart Association: Pay More Attention to Radiation in Imaging Procedures

The American Heart Association is urging physicians to better understand the risks of radiation in cardiac imaging procedures. When ordering these procedures physicians should understand the appropriate use of each procedure, the radiation dose associated with the procedure, and the risks associated with that dose. Both the risks and benefits should be fully explained and discussed with patients prior to the imaging procedure.
The full importance of radiation from cardiac procedures is not always appreciated, write the authors of the newly published scientific statement, “Approaches to Enhancing Radiation Safety in Cardiovascular Imaging.” But, according to Reza Fazel, the chair of the writing committee, “heart imaging procedures account for almost 40 percent of the radiation exposure from medical imaging.” The role of radiation is particularly important when considering cardiovascular imaging in younger patients for whom the lifetime risk is likely higher, said Fazel.
The statement urges physicians to discuss several important questions with their patients, including how the procedure will be used to diagnose and treat the patient’s heart problem, whether there are other available techniques that don’t use radiation, how much radiation the patient will receive, and what is known about the risk of cancer associated with the radiation dose.
Fazel offered some overall reassurance: “In general, the radiation-related...
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Federal Appeals Court Rules State Apportionment Order Not A Bar to Medicare Recovery

A Medicare recipient brought an action against Medicare challenging a determination that she was required to reimburse The Centers for Medicare and Medicaid Services $10,121.51 for conditional medical payments alleging that such recovery was barred by a state court's apportionment order. \

The Court of Appeals, Hardiman, Circuit Judge, held that:

(1) recipient's liability settlement from third-party tortfeasor qualified as a “primary plan” within the meaning of the Medicare as a Secondary Payer Act;

(2) recipient's $90,000 settlement with tortfeasor included her medical expenses, and thus recipient had obligation to reimburse Medicare for $10,121.15 in medical

(3) the New Jersey Collateral Source Statute (NJCSS) did not prevent Medicare from recovering medical expenses as part of her damages in tort suit;

(4) state court's order apportioning settlement proceeds did not bar government from seeking reimbursement for medical expenses;

(5) District Court lacked jurisdiction to adjudicate recipient's unexhausted claim pursuant to “equity and good conscience” exception under Act; and

(6) District Court lacked federal question jurisdiction over due process claim.

"As the ALJ correctly found, the Superior Court's apportionment order was not “on the merits,” and need not be recognized by the agency. A court order is “on the merits” when it is “delivered after the court has heard and evaluated the evidence and the parties' substantive arguments.” Black's Law Dictionary 1199 (9th ed.2009); cf. Greene v. Palakovich, 606 F.3d 85, 98 (3d Cir.2010) (finding, in a criminal case, that “on the merits” means the state court “acted on the substance of [the] claim”), aff'd sub nom. Greene v. Fisher, ––– U.S. ––––, 132 S.Ct. 38, 181 L.Ed.2d 336 (2011); Thomas v. Horn, 570 F.3d 105, 115 (3d Cir.2009) (holding that state proceedings occur “on the merits” “when a state court has made a decision that 1) finally resolves the claim, and 2) resolves the claim on the basis of its substance”). Here, the state court did not adjudicate any substantive issue in the primary negligence suit. Indeed, in her motion for the order, Taransky clarified that she sought an apportionment not to resolve any outstanding issue in her suit, but “only to the extent necessary to obtain specified documentation relevant to anticipated administrative proceedings with the federal Centers for Medicare and Medicaid Services.” JA at 267. The state court, in effect, rubber stamped her request. Taransky's motion was uncontested, issued pursuant to a stipulation between Taransky and Larchmont, and prepared and submitted by Taransky's counsel for the judge's signature. This order is the antithesis of one made on the merits."

Taransky v Sec of US Dept of HHA, 760 F.3d 307 (3rd Cirt 2014)

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Monday, September 29, 2014

Private Military Companies And The Ever-Changing Army

What will be th impact of the change upon potential Defense Based Act claims? Only time will tell. Toaay's post is shared from http://iissonline.net/
Immigrants, mercenaries and the new military service
The rise of the private military - who is fighting our wars?
The rise of the private military - who is fighting our wars? © TwitterThe rise of the private military – who is fighting our wars?
Troops deployed by the thousands, adorned with camouflaged combat wear, tough boots ready to tread the ground of conflict territories and hands at one with a military-grade rifle – This is the image we often see when nations instigate , but do we ever really think about exactly who is fighting it?
It seems this vision has become more blurred in recent decades as reports have surfaced recently highlighting that immigrants, some illegal, are recruited to the service by mercenaries – what are now referred to as Private Military Companies or contractors (PMC). Fear of the companies have once again been affirmed by the newest installment of the Call of Duty franchise, Advanced Warfare, which follows mercenaries who have turned against the US Government.
But are these fears and events simply fabricated fictional narratives, or is there a dark reality lurking behind the plot?
The Military Times reports that the Department of Defence (DoD) have unveiled a new policy which will allow undocumented immigrants to join the military, and is deemed a new path for gaining citizenship in the US. Estimates have shown that between...
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Study: Cancer costs 'skyrocketed' despite drug cuts

Today's post is shared from thehill.com
The cost of treating cancer has "skyrocketed" despite a 2003 law that sought to control Medicare drug costs, including the cost of chemotherapy, according to a new study.
Research published Monday in the Journal of Clinical Oncology found that oncologists did not stop prescribing expensive cancer drugs even after Medicare cut the drugs' reimbursements in 2005.
In fact, the aggregate cost of cancer care rose by as much as 60 percent between the passage of the law in 2003 and 2013, the study noted.
"Economists expected a sharp decline in use of the most expensive drugs targeted by the [2003] law, because reimbursement to oncologists for these drugs was reduced, but that did not happen," said Mark C. Hornbrook of Kaiser Permanente Northwest, the study’s lead author.
Cutting drug reimbursements is one way federal health officials seek to influence doctors' prescribing habits.
Profit on Medicare reimbursements for chemotherapy drugs is one way cancer clinics generate profit, making the payments ripe for scrutiny by Medicare.
The study looked at 5,831 chemotherapy regimens for 3,613 patients and found the the law lowered prescriptions for affected cancer drugs "slightly" in fee-for-service cancer clinics.
The 2003 law — the Medicare Prescription Drug, Improvement and Modernization Act — is best known for creating Medicare Part D.
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Group Health Patients Win 61% of Medical Care Denial Appeals; WC Patients Lose 84% of Appeals

Today's post is shared from fbgslaw.com

Part Three in CAAA’s “What’s Wrong With This Picture?” Infographic on the contrast between the use of IMR decision in Workers’ Compensation vs. Group Health. Read the full article from CAAA below and let us know what you think in the comments section.

Insurers have Stacked the Deck Against Californians Hurt at Work

Sacramento, CA – The California Applicants’ Attorneys Association (CAAA), whose members represent Californians injured on the job, today continued its series comparing quality health care measures in workers’ compensation insurance to group health insurance. The third release compares the frequency of Independent Medical Review (IMR) upholding Utilization Review (UR) denials of doctors’ recommended medical care. Workers’ compensation IMR denied84% of patients’ appeals of denied medical treatments in one year, while group health IMR reviewers approved 61% of patients’ appeals. Group health patients win appeals of denied medical care nearly four times as often as California’s injured workers.

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American doctor exposed to Ebola hospitalized at NIH facility

Today's post is shared from cidrap.umn.edu

US health care workers remain at growing jeopardy over Ebola virus.

An American doctor who was exposed to the Ebola virus while working in Sierra Leone has been airlifted back to the United States and was admitted to the National Institutes of Health (NIH) Clinical Center in Bethesda, Md., for observation.

No details were available about the patient. The Associated Press (AP) today published a photograph of a person in head-to-toe white protective gear descending the stairs of a private jet at Frederick (Md.) Municipal Airport, led by an individual who wasn't wearing any protective gear.

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What We’re Learning About Drug Company Payments to Doctors

On Tuesday, the federal government is expected to release details of payments to doctors by every pharmaceutical and medical device manufacturer in the country.
The information is being made public under a provision of the 2010 Affordable Care Act. The law mandates disclosure of payments to doctors, dentists, chiropractors, podiatrists and optometrists for things like promotional speaking, consulting, meals, educational items and research.
It’s not quite clear what the data will show — in part because the first batch will be incomplete, covering spending for only a few months at the end of 2013 — but we at ProPublica have some good guesses. That’s because we have been detailing relationships between doctors and the pharmaceutical industry for the past four years as part of our Dollars for Docs project.
We’ve aggregated information from the websites of some large drug companies, which publish their payments as a condition of settling federal whistle-blower lawsuits alleging improper marketing or kickbacks. Today, in cooperation with the website Pharmashine, we’ve added data for 2013, which now covers 17 drug companies accounting for half of United States drug sales that year. (You can look up your doctor using our easy search tool.)
Here are some facts we’ve learned from the data:
Many, many health professionals have relationships with industry.
Dollars for Docs now includes 3.4 million payments since 2009, totaling more than $4 billion,...
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