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Healthcare Risk Management – April 1, 2011

April 1, 2011

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  • Regulatory insurance: Worth the money, or not what it seems?

    With providers facing potentially costly RAC audits and crackdowns on violations of everything from HIPAA and Stark to EMTALA, the idea of an insurance policy that will cover your fines and other costs can be quite appealing. But experts tell Healthcare Risk Management that you must be skeptical and consider all the fine print before paying that premium.
  • Insurance is inexpensive, and it can be retroactive

    Regulatory insurance is becoming more popular with health care providers, says Chip Goen, vice president of sales with MAG Mutual Insurance Agency (MMIA) an insurance company in Atlanta. The company writes about 10 regulatory policies a month, up significantly over the past few years.
  • Shocker: First civil penalty for HIPAA violation

    The first civil monetary penalty handed down by the Department of Health and Human Services (HHS) has created a buzz throughout the health care industry, and not just because of the eye-popping amount of the fine: $4.3 million.
  • HHS: First they ignored patients, then ignored us

    The $4.3 million civil monetary penalty imposed on Cignet Health in Temple Hills, MD, could have been avoided by simply responding to the reasonable requests of patients for their own medical records, according to the case laid out by the Department of Health and Human Services (HHS).
  • Documents left on subway led to $1 million in fines

    A large hospital system in Massachusetts has agreed to pay $1 million in fines and improve its policies and procedures after an employee left patient information on a subway.
  • Patient safety and metrics: Obtain good data

    Risk managers are collecting data and using metrics in many ways lately, and patient safety should be a primary focus, says David G. Danielson, JD, CPA, senior vice president of clinical risk management at Sanford Health in Sioux Falls, SD.
  • Stop identify theft — Spend more on security?

    One-third of providers say their organization has had at least one known case of medical identity theft, and some of those cases might not have been reported, according to a recent survey by the Healthcare Information and Management Systems Society (HIMSS).
  • Most hospitals have full-time risk assessments

    These were some key results from the recent survey conducted by the Healthcare Information and Management Systems Society (HIMSS):
  • 1/3 of imaging costs defensive, study says

    Nearly 35% of all the imaging costs ordered for 2,068 orthopedic patient encounters in Pennsylvania were ordered for defensive purposes, according to study presented recently at the 2011 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS).
  • Woman involuntarily committed suffers mental anguish — $65,000 verdict awarded

    A woman suffering from personal problems and the subsequent unexpected death of her son was involuntarily committed to a behavioral health center by a psychologist allegedly following a telephone conference in which the woman expressed suicidal ideation. The physician failed to document the specifics of the conversation on the records required for an involuntary commitment.
  • Alleged: No treatment for ectopic pregnancy

    A pregnant woman experienced bleeding and cramps early on in her pregnancy. She visited her doctor, who confirmed that the woman was three weeks pregnant and diagnosed her with a probable spontaneous abortion. Prior to receiving an ultrasound to confirm the abortion, the woman experienced pain and presented to a local hospital. A pelvic ultrasound was ordered, and the reading radiologist noted "ectopic pregnancy is not ruled out. Please correlate clinically."