July 1, 2002 Legislation

Clinical Trial Access

JCAHO

Malpractice

Managed Care

Clinical Trial Access

Michigan has joined New Jersey as the only states to ensure cancer patients access to trials without legislation.  This was done via an agreement between the insurers of the state, employers and cancer researchers.  Since 1997 eight states have some form of legislation to allow cancer patients access to clinical trials.  The Michigan agreement is only for Phase 2 and 3 trials whereas the New Jersey agreement adds Phase 1 trials.        Top

JCAHO

Hang on, there's a new sentinel event that all hospitals must comply with.  This has to do with delays in treatment, an easy thing to get your arms around.  The Joint recommends that the institutions implement process and procedures to improve timeliness and accuracy of staff to staff communication, do face to face interdisciplinary shift change reporting and decrease verbal orders.  When verbal orders are necessary there should be a process of verification of those orders.  The ED should also have strategies to maintain a high index of suspicion for meningitis.  It's easy for the Joint to decree, it's much harder to implement.  I continue to harp at using another vehicle for verifications of the Conditions of Participation.  The State Health Department will do it for free and the AOA will do it for much less money and hassle than the Joint.   

JCAHO has placed the Greater Southeast Community Hospital in Washington, DC on conditional accreditation.  They need to improve in many areas not connected with the Conditions of Participation.  All know that the hospital, which services the poor of the District, will not be given the heave-ho.  It would not be PC and The Joint needs the government.   

Speaking of the JCAHO, the June 17th Modern Healthcare talks about the stupidity of the AHA's president's idea to have their own surveyors survey themselves.  The wolf guarding the chicken coop idea.  Modern Healthcare is no fan of JCAHO and their non-helpful made-up rules, but even Modern Healthcare almost feels sorry for the Joint if this would go through.  

The same issue of Modern Healthcare details a story about the difficulty of reading and interpreting the JCAHO reports.  The maze of information is too much for most hospitals to consume but completely turns off the public. The Joint is redoing their hospital accreditation manual next year and then the new and improved data will go online in 2004.

The Medicare + Choice accreditation pot just got diluted some more.  Joining JCAHO and NCQA as accrediting organizations is the Accreditation Association for Ambulatory Heath Care. 

The JCAHO is now considering what to do about their inconsistent stance on the hospital bylaws.  The rule is the bylaws may not be unilaterally amended.  The stance is if there is something in the bylaws that states the hospital board can unilaterally amend the bylaws, it is all right.  The Joint will only come down if the Board actually does it.  This inconsistency gives tacit approval to Boards and hospital attorneys to place the language in the bylaws and then scare the medical staff into going along with the changes.   TYPICAL DIRTY POOL BY HOSPITAL PAID ATTORNEYS AND ONE OF THE MAIN REASONS THAT ALL MEDICAL STAFFS NEED THEIR OWN ATTORNEY FOR BYLAWS WORK.  DON'T LET IT HAPPEN TO YOU!!      Top

Malpractice

The Pennsylvania Governor has signed into law a bill to take away joint and several liability.  If a defendant is less than 60% liable, they would pay only their percentage of guilt toward the settlement or damages.  If a hospital is found 10% guilty and the physician 90%, the hospital would only have to pay 10% of the damages instead of all if the physician went bare.  This potentially could set the stage for later legislation allowing physicians to put up a bond and go bare versus having the full and expensive insurance.        Top

Managed Care

California legislation by the Department of Managed Care is underway to force HMOs to do what they were meant to do but don't, preventative care.  The first three preventions would be smoking cessation, colorectal cancer and screening for sexually transmitted diseases. The plan would need to give the Department a plan and then a follow-up in a year.  A spokesperson for Kaiser states that this is the right thing to do.

The California Assembly Health Committee voted 6-6 with 8 abstentions to kill a bill that would have allowed patients to bypass arbitration in certain circumstances. The committee did vote to reconsider the bill at a later time. The trial lawyers were not happy campers about this and will need to buy off (read lobby) more Assemblymen before the next vote.        Top

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DISCLAIMER: Although this article is updated periodically, it reflects the author's point of view at the time of publication. Nothing in this article constitutes legal advice. Readers should consult with their own legal counsel before acting on any of the information presented.