Modern biotechnology now makes possible issues that were not contemplated by Congress in the adoption of the Social Security Act. One of those issues is whether a child conceived by artificial insemination a year after her father’s death is a “child” of her father entitled to survivor benefits under the Social Security Act. The 9th U.S. Circuit Court of appeals earlier ruled “yes.” In the recent ruling in Beeler v. Astrue, the 8th U.S. Circuit Court of Appeals ruled “no”, overturning a lower, trial court decisions and affirming the final decision of the Commissioner of Social Security.
The Utah Supreme Court last month held that a prescriber of drugs has a duty to third parties injured by the conduct of the patient following the consumption of the medication. In the case of B.R., a Minor Child and C.R., a Minor Child, through their Conservator, William M. Jeffs v. Trina West, Hugo Rodier and John Does I-X, (Utah, 2012), the Court overturned a lower court dismissal of a case for lack of duty. The Plaintiffs are the two surviving children of David Ragsdale, who killed their mother after taking the medication prescribed by Ms. West, a nurse practitioner. The drugs prescribed were Concerta, Valium, Doxepin, Paxil, pregnenelone and testosterone.
The Office of Civil Rights of the Department of Health and Human Services (“OCR”) announced a settlement with Blue Cross and Blue Shield of Tennessee this month a compliant alleging a security leak, in violation of HIPAA. The case is interesting factually and resulted in the payment by Blue Cross of a $1,500,000.00 penalty and the imposition of a Corrective Action Plan.
On February 16, 2012, the Secretary of Health and Human Services, Katherine Sebelius published a proposed new rule to implement Section 6402(a) of the Accountable Care Act that requires Medicare providers to report and repay government overpayments within the later of 60 days of being “identified” or of the date of submission of a required cost report. The term “identified” is not defined in the Act and is the critical trigger for commencing the running of the 60 day period and the exposure for False Claims and Civil Monetary Penalty liability.
It seems counterintuitive and contrary to the overwhelming majority of articles and studies, but the New York Times today reported on a study recently appearing in Health Affairs that suggested that the switch to electronic medical records resulted in a 40 percent increase in tests, most of the MRI and CAT scan variety. The study, based upon the analysis of a 2008 survey by the National Center for Health Statistics, performed for an entirely different purpose, and has questionable design. The study followed 28,888 patient visits and 1100 physicians and claims to have a more National perspective. The authors of the study suggest that most earlier studies are based upon statistical models of expected savings like those undertaken by the RAND Corporation and the study of flagship integrated systems like Kaiser, rather than on national utilization data.
Dr. Vincent L. Guinn, an African American Cardiologist, brought a sham peer review suit against Mount Carmel Health and a number of physicians in the U.S. District Court in the Southern District of Ohio. He alleged two principal federal claims: antitrust conspiracy and monopolization and a violation of his civil rights. Mt. Carmel summarily suspended Dr. Guinn’s privileges after a colleague alleged that he had placed an intracardial device in a patient “pocket” that had broken down and was infected. The defendants sought to have the two claims dismissed for lack of standing under a number of different theories. The Court in Guinn v. Mount Carmel Health, et al., S.D. Ohio, No. 2:09-cv-226, 2/27/12, dismissed the antitrust case on the pleadings, but chose to allow Dr. Guinn to move forward with his discrimination case.
