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HIPPA Omnibus Rule

Author:First Lastname/ Date:February 20.2017

Do Not Let Your Own Words Get You into Trouble

Aug 07 2018

Physicians in litigation have a hard enough time when faced with expert witnesses hired by an attorney to find fault with the care given to a patient. Those difficulties can multiply when the doctor's own words help to articulate a plaintiff's case.

Be Sure to Pay Attention to Your Own Words

  • Your recommendations for patient care need to be consistent, whether you're speaking to the patient or to the patient's primary care physician.
  • If your care plans are concrete enough for you to write them to another treating physician, it's important that you communicate that message to the patient.
  • If you do provide your treatment recommendation to the patient, make sure you document that you have done so.

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Here Is Where Procedure Errors Often Occur

Nov 02 2018

In the complicated maze of medical referrals and authorizations, a physician's reliance on a competent staff to work with benefit providers to complete any necessary paperwork is eminently reasonable. In the end, though, the patient will look to the physician as the one ultimately responsible for completing the task.

Proper Delegation Can Help Avoid Litigation

  • While practice staff are often involved in completing paperwork, patients look to the physician for answers when something goes wrong.
  • Even if you think paperwork has been completed, it's best to check to avoid errors in patient care.
  • Ensure that everyone in the practice understands their duties and responsibilities up front, and review procedures regularly to solidify understanding of all necessary tasks.

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When Normal Test Results Get You into Trouble

Dec 19 2018

Family practitioners know that good specialty backup is essential for the health of their patients. They also believe that because over-referring to specialists can sometimes harm patients, they should do their best to treat within their skills. The limits of those skills may be reached in the interpretation of complex diagnostics: Sometimes after a bad result, the only error committed by a family practitioner turns out to be trying to do too much without a specialist's assistance.

When in Doubt, Call in the Experts

  • Complex diagnostics should be interpreted by a specialist, even if a physician fears that over-referring could harm the patient.
  • Being an effective physician often means asking for help with patient care.
  • If a problem persists, it may be wise to call in a specialist, even when some test results are normal.

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When a Payers Denials Cause Trouble

Feb 15 2019

When a treating physician believes that a referral to another specialist is appropriate, a denied authorization does not mean that the physician should just quietly soldier on. Physicians frequently participate in appeals over denied authorizations by contacting the decision-maker directly or by otherwise assisting the patient and family in their pursuit of the authorization.

Don't Let Denials Derail Proper Patient Care

  • A denied authorization shouldn't always mean the end of the line for treatment.
  • You may want to phone the decision-maker or help the patient pursue authorization for treatment if you feel that care is in jeopardy.
  • Document your discussions with the patient and family on the rationale for getting the test or consultation.

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Does Malpractice Reform Affect Clinical Practice? One Study Says Yes

Jul 27 2018

Malpractice reform can have varied results for doctors, patients and specific clinical practices. There is evidence that caps may influence physicians’ treatment approach. It can also effect plaintiff award amounts. Medical Boards are tasked with implementing malpractice reform to address medical malpractice claims.

For example:

  • Medical liability reform—specifically, caps on noneconomic damages—appears to have an effect on at least one area of clinical practice: coronary artery disease (CAD) management.
    • Physicians in both new-cap and no-cap states performed a similar number of ischemic evaluations for possible CAD. After these evaluations, however, the former group did both fewer initial invasive angiographies (-24%) and revascularization procedures (-23%) than physicians in no-cap states, while also ordering more noninvasive stress tests (7.8%).
  • The Georgia Medical Board yanked the license of an Atlanta-area dermatologist who had been seen in now-deleted YouTube videos dancing and singing during cosmetic medical procedures, at least one of which allegedly resulted in brain damage.
    • Georgia regulators said that the doctor’s continued practice "poses a threat to public health, safety, and welfare." They point to a "pattern of conduct," citing seven patients who had received unsatisfactory treatment while under her care.
  • The Wisconsin Supreme Court last ruled that the state's cap on medical malpractice awards is constitutional.
    • That comes as terrible news to Ms. AM, who lost all four limbs to medical negligence in 2011. This decision reduced his original judgement award of $16.5 million to $750,000, the maximum allowable under Wisconsin’s state cap.

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