August 2011

Aug 30, 2011 03:08 PM

Insurance companies hit hurricane victims again

As the clean up from Hurricane Irene continues, many homeowners are left picking up the pieces from the damage their homes sustained in this weekend’s storm.  Of the many headaches homeowners will endure, dealing with their insurance company is likely to rank high among them.  Today, Reuters warns of the problems millions of homeowners are likely to encounter in the coming days:

But attorneys and consumer representatives who have experience with disasters and insurance companies warn that homeowners could get soaked more than once.

"The real problem arises after a catastrophe because there is such a discrepancy between the hundreds of thousands of dollars at issue for the homeowner and the insurance company, which has millions or billions of dollars at issue," said Richard T. Phillips, a Batesville, Mississippi, attorney who represented homeowners who sued their insurers following Hurricane Katrina.
Aug 30, 2011 10:03 AM

Audits of TX Hospital Show Importance of Civil Justice System

In an article out this week, HealthLeaders Media looked at what can be learned from the audits of the inexcusable lapses in patient safety and basic hygiene at Parkland Health and Hospital System in Dallas, TX. An important point highlighted in the article is that the audit debunks claims that patients' ability to hold negligent providers accountable is driving up health care costs:

Aug 30, 2011 12:00 AM

FDA: Address Generic Drug Immunity

As you know we have been very outspoken on the Pliva v. Mensing Supreme Court decision issued in June.  The Court ruled that generic manufacturers are not responsible for updating their warning labels because they are required by law to follow the brand drug’s label.  This decision directly conflicts with the decision in Wyeth v. Levine where the majority found that FDA and FDCA regulations maintained “the manufacturer bears the responsibility for the contents of their warning label at all times.”

Aug 29, 2011 10:37 AM

Additional Article Highlights MSP Problems

Inside CMS, an influential trade publication for those involved in the world of all things CMS, wrote on the efforts of AAJ and other stakeholders to fix the MSP system and seek passage of the SMART Act. The full text of the article can be found here (sub. required).  Here are a few of the highlights:

Beneficiaries must pay back Medicare if they win suits that make third parties pay for Medical costs that Medicare covered. However, sources say CMS often takes months, sometimes years, to tell beneficiaries and their representatives how much money they are responsible for repaying, which delays settlements and creates headaches for lawyers, beneficiaries and insurers who are trying to determine settlement amounts.

The situation has become so untenable that the American Association of Justice (AAJ) tells Inside Health Policy that getting Congress to pass the SMART Act is one of their top priorities. The situation has also prompted the creation of a coalition -- the Medicare Advocacy Recovery Coalition (MARC) -- which is devoted to improving the Medicare Secondary Payer program.

The National Law Journal also wrote on this subject – you can read our previous post here.

Aug 26, 2011 10:42 AM

PolitiFact Debunks Myth About Texas Doc Numbers

Rick Perry says Texas added 21,000 doctors because of tort reform.

PolitiFact’s Truth-O-Meter Says:

FALSE

Aug 25, 2011 12:00 AM

Insurance Companies Prosper; Physicians and Injured Patients Pay the Price

Medical malpractice insurance companies enjoyed their most profitable year in 2010 and a new study published in the New England Journal of Medicine shows one of the ways they accomplished this feat: by not paying medical malpractice claims.

Researchers at Harvard University and the University of Southern California examined closed medical malpractice claims from a large medical malpractice insurer and found that most claims are closed without a payment to injured patients. However, the researchers did not attempt to evaluate the merits of the claims. Previous reviews of closed medical malpractice claims have shown that most claims are meritorious with 97 percent involving a medical injury.

Aug 23, 2011 04:34 PM

Hospital Infections cost lives and money

The Los Angeles Times reports hospital-related infections kill 99,000 Americans every year at a cost of $33 billion. These alarming numbers have brought together insurers and those in Washington to pressure hospitals to reduce infection rates. Medicare will no longer pay for costs associated with infections from catheters and intravenous lines, and large insurers are withholding payment increases for hospitals that don’t meet their infection standards. The LA Times goes on to say:

Nationally, 1 in 20 patients admitted to a U.S. hospital develops an infection. An estimated 1.7 million are infected each year, according to the most recent federal estimates, making hospital-borne infections one of the nation's top 10 causes of death.

California itself has 12,000 deaths a year from hospital infections, as estimated by the California Department of Public Health. A three-year program in 160 California hospitals has resulted in a cost savings of $11 million in the first 19 months. This serves as yet another reminder that safety should be the leading force for reducing health care costs, not taking away the legal rights of patients.

Aug 18, 2011 03:42 PM

New Study Underscores Need for Greater Patient Safety, Strong Civil Justice System

Yesterday the New England Journal of Medicine released a study on the rates and payments of medical malpractice claims submitted by patients to doctors’ insurance companies. The study found that most claims are dropped without payment. This study has reiterated two points we already know: insurance companies deny far more medical malpractice claims than they pay out and doctors’ perceptions of medical malpractice claims are not in line with actual risk.

The study found that the majority of the largest groups of doctors - internal medicine, family medicine and pathology - will never make a malpractice payment in their lifetime. In fact, for all low risk specialties, 81 percent of physicians never paid a malpractice claim. Additionally, 95 percent of low risk specialty and 67 percent of high risk specialty physicians would not make a payment during the first half of their medical career. Despite the low risk of having a patient file a malpractice claim, most physicians perceive their risk to be much greater than it actually is.

There are also two important points to make about what this study does not do. The researchers only analyzed data from closed claims from one major insurance company. This study did not look at the rate or frequency of medical malpractice lawsuits. This is an important distinction because there is a big difference between a claim and a lawsuit. A claim is filed by a patient with an insurance company, while a lawsuit is filed in a court. The researchers’ use of “lawsuit” and “claim” interchangeably creates confusion, but the two are completely different. Many patients file a claim with an insurance company without filing a lawsuit. In fact, patients who are injured in the course of medical care often have to file a claim just to see what went wrong. These claims do not always lead to lawsuits.

Aug 17, 2011 08:00 AM

Let's Talk About Texas Doc Numbers...

Are there more doctors in Texas since 2003? Yes.

Is this because of medical malpractice reform? No.

According to the American Medical Association’s (AMA) numbers, tort reform measures passed in Texas had no bearing on doc numbers in the state. The number of physicians practicing in Texas did increase following the enactment of the cap, but the rate of the increase is the same as the rate of increase prior to the cap. In fact, the number of practicing physicians in Texas has been steadily increasing for years.

Aug 16, 2011 01:00 PM

One woman’s stand against forced arbitration to protect her civil rights

Yesterday, The Las Vegas Review-Journal reported on Sandy Runkle’s fight to maintain her rights, even if that means finding a different doctor. Upon arrival at her doctor’s office, Ms. Runkle was asked to sign away her right to seek justice in the event that she was injured by medical negligence – all before she even received medical treatment. The form contained a mandatory binding arbitration clause, which in the event that she were injured by medical negligence, Ms. Runkle would be forced into a private arbitration system where the arbiter is typically picked and paid for by her doctor and whatever decision handed down would be final. She refused to sign saying:

"People just sign these things…They're not aware they're giving up their civil rights.

"It's my legal right. It's my constitutional right. It's one of our basic rights. I don't want it taken from me."

Arbitration is both a valid and effective process when both parties willingly and knowingly agree to it, but too often corporations use these claims as abusive weapons in employment contracts, nursing home agreements, credit card billing inserts, and health insurance plans to limit individual’s right to justice.