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| Mass. Proposes Far-reaching Plan for Reporting Medical Mistakes
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Massachusetts, one of a handful of states that requires hospitals to report errors and unexpected patient injuries or deaths, might become the first state to require physicians offices and surgery centers to do likewise.
The Massachusetts Board of Registration in Medicine, the agency that disciplines doctors, has proposed that practices as small as two physicians would have to notify the board if a patient needed to be moved to a hospital after an invasive procedure was done in the office setting or if deep sedation or anesthesia resulted in an "unexpected occurrence." Larger physicians offices would have to report a much longer list of "unexpected occurrences" to the board. Physicians could be disciplined for 29 reasons, including operating on the wrong body part.
According to published reports, physicians, health plan officials and hospital representatives denounced the plan last week at an informal hearing of the board, saying it would give the board far too much authority. "Frankly, the entire physician community is in a dither about that right now. We're working with the medical society in the hopes of blunting the impact," says Ronna Wallace, the executive director of the Massachusetts Association of Ambulatory Surgery Centers. "We'd love the opportunity to put forth our low error rate, but we have some concerns as to how the data will be reported."
Charlene DeLoach, JD, director of the board's patient safety program, defends the board's proposal by pointing to the shift from hospital to alternate sites in the surgical marketplace.
"Everyone in healthcare is aware of the fact that more and more procedures and more and more care are being delivered outside of the traditional hospital setting," says Ms. DeLoach. "If you only have reports from hospitals, that's only 20 percent of what's going on. We want patients to be confident that wherever walk into, they're going to receive the standard of care."
The board has been working on the regulations for more than a year and delayed adoption last year because of the barrage of criticism. Officials plan to hold a final public hearing on the proposal in June.
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| Colorado ASCs Charge Insurers and Hospitals With Collusion
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The Colorado Ambulatory Surgery Center Association is calling for legislators to investigate charges of collusion between insurance companies and hospital systems to prevent competitors from effectively competing against hospitals. The CASCA says hospitals are trying to recoup lost revenue by discounting their inpatient rates for insurers who agree not to contract with hospitals' outpatient competitors. The hospitals have said that's not how they negotiate.
At a press conference on April 21, the association invited state Rep. Keith King (R-Colorado Springs) to speak on its behalf.
"I am today calling for state and federal investigations of the business practices of the insurance industry and hospital systems in the Colorado and the U.S.," says Mr. King. "I am in the process of formally communicating with the Department of Justice, Federal Trade Commission and Health and Human Services. I will also be reaching out to Colorado's Department of Insurance and our attorney general."
"Unfortunately, patients in many states across the country, including Colorado, are currently being denied access to the high-quality, patient-friendly and cost-effective services provided by ASC facilities," says Rebecca Craig, president of CASCA.
The hospitals have disputed the claims of the lawmaker and the ASC association in published reports.
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| Hospital Transfer Agreement Bill Stalls In Missouri
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A bill to make is easier for Missouri ASCs to make transfer agreements with local hospitals is likely dead for now, but the state legislator who drafted it says he'll reintroduce the legislation next year.
Rep. Rob Schaaf, MD, (R-St. Joseph) introduced HB 1080, which would have made it easier for ASCs to make the necessary agreements with hospitals to admit patients in the event of complications from surgery center procedures. Dr. Schaaf's bill would either have broadened the definition of "community" so ASCs could make transfer agreements with hospitals that were further away or, alternatively, would have required hospitals to grant ASC physicians privileges.
Dr. Schaaf said negotiations broke down over how much call an ASC physician would have to take at a hospital. "The hospital association has used its political muscle with the various representatives in the House to cloud the issue," says Dr. Schaaf.
The MHA did not return a call for comment. The issue was in the news recently with accounts on the disputes between some hospitals and ASCs. The Surgery Center of North Central Missouri in Moberly, Mo., sat nearly empty for months because the nearby Moberly Regional Medical Center wouldn't grant a transfer agreement, according to The Associated Press. The governor's office later stepped in and said that the ASC could send patients to a hospital in Columbia, 30 miles away. Of the approximately 95 ASCs in Missouri, about four have had problems with local hospitals, says Dr. Schaaf.
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| News and Notes
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A bill to make is easier for Missouri ASCs to make transfer agreements with local hospitals is likely dead for now, but the state legislator who drafted it says he'll reintroduce the legislation next year.
Rep. Rob Schaaf, MD, (R-St. Joseph) introduced HB 1080, which would have made it easier for ASCs to make the necessary agreements with hospitals to admit patients in the event of complications from surgery center procedures. Dr. Schaaf's bill would either have broadened the definition of "community" so ASCs could make transfer agreements with hospitals that were further away or, alternatively, would have required hospitals to grant ASC physicians privileges.
Dr. Schaaf said negotiations broke down over how much call an ASC physician would have to take at a hospital. "The hospital association has used its political muscle with the various representatives in the House to cloud the issue," says Dr. Schaaf.
The MHA did not return a call for comment. The issue was in the news recently with accounts on the disputes between some hospitals and ASCs. The Surgery Center of North Central Missouri in Moberly, Mo., sat nearly empty for months because the nearby Moberly Regional Medical Center wouldn't grant a transfer agreement, according to The Associated Press. The governor's office later stepped in and said that the ASC could send patients to a hospital in Columbia, 30 miles away. Of the approximately 95 ASCs in Missouri, about four have had problems with local hospitals, says Dr. Schaaf.
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