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| Nurse Accused of Fatal Surgical Office Fire Leaves Prison
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After spending nearly a month in prison, the nurse who admitted setting a fatal fire at a Houston office building is out of jail after her bond was reduced from $330,000 to $180,000. Misty Ann Weaver, LVN, the subject of our May cover story, was placed under home confinement at her parents' house and must wear an ankle monitor that electronically tracks her movements, say authorities. Ms. Weaver may leave the house only for church and events related to her legal defense.
Fire investigators say Ms. Weaver, 33, confessed to starting a small fire in a supply closet to cover up the fact that she was woefully behind on a project to get the plastic surgery office she worked in for the past eight years reaccredited. She had previously told her superiors that the accreditor was expected to visit the office the day following the one in which she started the fire. But prosecutors say no employees of Capriotti Cosmetic & Laser Surgery had contacted accreditors since September 2003.
In her confession, Ms. Weaver told investigators she thought that starting a small fire would buy her more time. But the fire quickly spread to four alarms, killing three people in the six-story office building. If convicted, Ms. Weaver, charged with three counts of felony murder and one count of arson, may face life in prison.
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| Feds Cracking Down on Medicare Payments, Fraud
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You might want to double check that all your tax and Medicare payment ducks are in a row. The federal government is taking steps to ensure it's getting the money due to it and that it's not paying more than it needs to. Two days after two U.S. senators announced that they'd introduce legislation to crack down on tax debtors among Medicare providers, CMS revealed that a strike force targeting fraudulent Medicare billing has netted dozens of indictments involving more than $142 million.
The legislation, set to be introduced to the Governmental Affairs Permanent Subcommittee on Investigations by Sens. Norm Coleman (R-Minn.) and Carl Levin (D-Mich.), would withhold Medicare reimbursements from physicians and other healthcare providers who owe the federal government taxes. This is a response to a report released in March by the Government Accountability Office. The report, requested by the subcommittee, found that more than 21,000 physicians and other health care providers who participated in Medicare owed the federal government $1.3 billion in income and payroll taxes for the first nine months of 2005. Under the bill, CMS would begin participating in the Federal Payment Levy Program, which withholds payments to federal contractors until they pay taxes owed. If it did participate in the program, CMS would be able to collect between $50 million and $140 million in taxes owed in the first three quarters of 2005, according to the GAO report.
The CMS strike force has been able to quickly identify potential payment fraud cases for investigation and prosecution through real-time analysis of billing data from Medicare Program Safeguard Contractors and claims data extracted from the Health Care Information System, according to a press release. In phase one operations in Miami, teams have targeted two primary schemes that defrauded the Medicare program: infusion therapy and durable medical equipment suppliers. Since the first phase of operations began on March 1, the strike force has obtained indictments of 38 individuals and organizations that have collectively billed the Medicare program for $142,061,059. Charges include conspiracy to defraud the Medicare program, criminal false claims and violations of anti-kickback statutes. If convicted, many of the defendants will face up to 20 years in prison.
"The Medicare Fraud Strike Force is just one weapon in our arsenal to protect Medicare beneficiaries and taxpayers from fraud," says Department of Health and Human Services Secretary Michael Leavitt. "We expect industry leaders will embrace the changes that will improve the quality of the durable medical equipment industry and others who serve our Medicare beneficiaries."
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| Study Suggests Gel Rubs Increase Hand Hygiene Compliance
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Adherence to hand hygiene protocol is higher when staff are provided immediate access to alcohol-based gel handrubs instead of liquid-based products, according to a study published in the online journal Critical Care. Researchers at the University of Geneva Hospitals in Geneva, Switzerland, observed the hand hygiene practices of seven physicians, 80 nurses and 15 nursing assistants during a two-phase study.
The first phase used alcohol-based liquid handrubs throughout the hospital; during the study's second phase the liquid products were replaced with gel formulations. Opportunities for following hand hygiene protocol were compared to actual performance of proper practices.
Staff were also questioned on the condition of their skin and product preference at the conclusion of each phase, rating the gel and liquid formulations on appearance, integrity, moisture, ease of use, drying time and sensation upon application.
The researchers discovered that overall hand hygiene compliance increased from 32.1 percent in the study's first phase to 41.2 percent in the second. At the end of the study's second phase 57 percent of those polled rated the gel as better than the liquid formulation, 16 percent rated the two equivalent and 27 percent preferred the liquid-based handrubs. The researchers also report that providing staff with pocket-sized bottles of handrub increased hand hygiene compliance from 35.3 percent to 50.6 percent.
"Gel was associated with better skin condition, superior acceptance, and a trend toward improved compliance as compared to the liquid formulation," the study's authors conclude, adding that, "immediate access to the handrub was the strongest predictor of compliance."
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| Anti-nausea Drug Maker Seeks FDA Approval
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The makers of Aloxi (palonosetron hydrochloride injection), a medication for patients who suffer chemotherapy-induced nausea and vomiting, have asked the FDA to approve the drug for the prevention of post-operative nausea and vomiting.
MGI Pharma announced last week that it has submitted a supplemental new drug application to the FDA. The supplemental NDA submission is based on results from two randomized, multi-center, phase three trials conducted to evaluate the safety and efficacy of three doses of Aloxi as compared to a placebo for the prevention of PONV, says the company.
In the two trials, 1,219 patients undergoing elective outpatient abdominal or gynecological laparoscopic surgery or elective inpatient gynecological or breast surgery were randomized to receive one of three single IV doses of Aloxi or placebo before administration of anesthesia. Both trials successfully met the primary efficacy endpoint of complete response, defined as no emesis or use of rescue medication for the zero- to 24-hour time period after surgery for the selected dose of 0.075mg. In addition, both trials achieved the secondary endpoints of complete response for the zero- to 48-hour and zero- to 72-hour time periods. The incidence, pattern and intensity of adverse events were similar among all treatment groups, including placebo, and the most frequently observed side effects were headache and constipation.
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| News and Notes
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The makers of Aloxi (palonosetron hydrochloride injection), a medication for patients who suffer chemotherapy-induced nausea and vomiting, have asked the FDA to approve the drug for the prevention of post-operative nausea and vomiting.
MGI Pharma announced last week that it has submitted a supplemental new drug application to the FDA. The supplemental NDA submission is based on results from two randomized, multi-center, phase three trials conducted to evaluate the safety and efficacy of three doses of Aloxi as compared to a placebo for the prevention of PONV, says the company.
In the two trials, 1,219 patients undergoing elective outpatient abdominal or gynecological laparoscopic surgery or elective inpatient gynecological or breast surgery were randomized to receive one of three single IV doses of Aloxi or placebo before administration of anesthesia. Both trials successfully met the primary efficacy endpoint of complete response, defined as no emesis or use of rescue medication for the zero- to 24-hour time period after surgery for the selected dose of 0.075mg. In addition, both trials achieved the secondary endpoints of complete response for the zero- to 48-hour and zero- to 72-hour time periods. The incidence, pattern and intensity of adverse events were similar among all treatment groups, including placebo, and the most frequently observed side effects were headache and constipation.
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