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Many U.S. Hospitals Fail To Report Physician Disciplinary Cases To National Databank
Many U.S. hospitals do not take sufficient disciplinary action against physicians for poor conduct or medical incompetence and fail to report such cases to the National Practitioner Data Bank, according to a report released Wednesday by Public Citizen, the Contra Costa Times reports. Congress established the databank in 1990 as a central repository for information about physicians whose hospital privileges had been withdrawn or limited for more than 30 days. The bank is closed to the public (Kleffman, Contra Costa Times, 5/27).For the report, Public Citizen"s Health Research Group analyzed studies by the HHS Office of Inspector General and the Citizen Advocacy Center, as well as medical journal articles and recommendations made during an October 1996 meeting on under-reporting by hospitals (Stark/Hallihan, ABCNews.com, 5/27). According to the report, nearly half of U.S. hospitals did not submit one physician"s name in 17 years to the databank. One purpose of the databank is to provide hospitals with background information about physicians they were considering hiring at their facilities. Under the initial expectations of the databank, federal officials estimated that at least 5,000 disciplinary cases would be reported annually. However, on average, about 650 reports have been made annually since the databank was created, the report found (Contra Costa Times, 5/27). The group on Wednesday sent a letter to HHS Secretary Kathleen Sebelius that included recommendations to improve the efficacy of the databank. The letter said that the reporting numbers are "unreasonably low, compared with what would be expected if hospitals pursued disciplinary actions aggressively and reported all such actions." The letter urged Sebelius to ensure that hospitals are conducting necessary peer reviews and oversight of physicians, taking proper disciplinary actions and reporting them to the databank so that physicians" track records are available to all hospital administrators. Penalties also should be established for hospitals that fail to comply with the reporting requirements, the group said.Al Levine, the author of the report, said some hospitals had found ways to avoid their physician reporting responsibilities, such as by limiting restrictions on hospital privileges to fewer than 30 days or giving physicians a "leave of absence" in place of suspending their privileges. Levine said, "Even in states with high levels of reporting," it "seems to be concentrated in a few facilities" (Contra Costa Times, 5/27).In a statement responding to the report, the American Hospital Association said, "The premise that the number of reports received by the National Practitioner Data Bank correlates to jeopardized patient care is inaccurate," adding, "Hospitals are actively involved in a wide variety of efforts to continuously improve care and talk publicly about the care we provide" (ABCNews.com, 5/27).
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CareFirst BCBS Covers ENO Measurement For Diagnosis, Asthma Treatment
Apieron, Inc. said that CareFirst BlueCross BlueShield has adopted a positive coverage policy for the measurement of exhaled nitric oxide (eNO). The Medical Directors of CareFirst determined that the published, peer-reviewed evidence is sufficient to support benefit coverage for the treatment of asthma. The policy, effective July 20, 2009, states the measurement of exhaled nitric oxide is considered medically necessary in the management of asthma patients. CareFirst is the largest health care insurer in the Mid-Atlantic region, serving nearly 3.4 million members in Maryland, District of Columbia and portions of Virginia.
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American Nurses Association Mourns The Passing Of John Garde
The American Nurses Association (ANA) joins with the entire nursing community in mourning the passing of American Association of Nurse Anesthetists (AANA) interim Executive Director John Garde, CRNA, MS, FAAN. John Garde passed away last week from complications related to pancreatic cancer.
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American Hospital Association Statement On Administration's New Proposals On Reform

Rich Umbdenstock President and CEO American Hospital Association America"s hospitals support systemic reform that lowers costs and improves care for patients; however, we are deeply disappointed and concerned to see the Administration propose cuts of more than $220 billion to hospitals, especially during these tough economic times when more patients are turning to their local hospital for care. Hospitals are already facing as much as $41 billion in cuts due to the Medicare payment system changes recently proposed by the Administration. Additional cuts of this magnitude could severely jeopardize hospitals" ability to care for their patients and communities. Hospitals have long supported expanding health care coverage to all Americans but feel this must happen while maintaining adequate financing for hospitals that serve large numbers of poor and uninsured patients. Cutting the Medicare and Medicaid Disproportionate Share Hospital (DSH) programs, as the Administration is proposing, overlooks the critical role these important programs play in supporting a broad range of services for uninsured children and adults as well as essential community services such as trauma and burn units, disaster readiness, neonatal care and emergency psychiatric services. These programs also help to mitigate the financial shortfalls hospitals experience from government program underpayments and treating undocumented immigrants. Even with today"s DSH payments, federal health programs pay hospitals more than $32 billion below the cost of caring for patients on average. These programs go beyond covering care for the uninsured and serve as a lifeline to hospitals struggling to meet the growing needs of patients and communities. Because of that, we urge lawmakers not to cut DSH programs before coverage expansions are universal and fully implemented as part of reform, and Medicare and Medicaid shortfalls are addressed. The Administration also is calling for a "productivity" adjustment for hospitals. Anyone who has been to a hospital knows how vital the nurses and other skilled caregivers are in their care. Other industries can replace people with machines but health care is about people taking care of people. That"s why the measure proposed to adjust for productivity, which was not intended for health care, does not make sense. Instead, our focus needs to be on ensuring that patients receive the right care at the right time in the right setting. In addition, the new proposals for long-term care and rehabilitation hospitals are problematic and could serve as a barrier to better coordination of care for patients. Hospitals have pledged to do our part to help reduce national health costs and we remain committed to doing so. Reform must improve care for patients without crippling hospitals" ability to care for patients and communities. We stand ready to help the Administration and the Congress make thoughtful reform a reality. American Hospital Association


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