By SUSAN ADELMAN, MD
Physicians are used to seeking practical answers to definable problems. We do this in our clinical work and in our research. Perhaps this physician might suggest a useful approach in a time of worldwide demonstrations over racism. Normally in medicine, we try to break down a larger problem into its component parts, which need to be definable issues that can be addressed effectively to create real change.

Just as occurred in Detroit after the 1967 riots, we need civic leaders to join with leaders of affected neighborhoods, identify the issues that would be the most productive to work on, seek the people who need to come together for [Read More]

By EWA MATUSZEWSKI
Today I revisit a topic I have written about many times: The Patient-Centered Medical Home Neighborhood (PCMH-N). Yet now I address it with a fresh perspective in the context of the pandemic.

The PCMH-N, with its connectivity to the broader healthcare community, encompasses primary care, health systems, nursing homes and rehabilitation centers, pharmacies, human service agencies and other organizations that seek to promote health, wellness, and healing within a community. Never before have the benefits of the PCMH been as clear as they have become during the pandemic. Starting with the immediate and wide-scale need for personal protective equipment (PPE) for those caring for community members, to the gathering [Read More]

By KAITLIN A. NUCCI, ESQ.
Wachler & Associates, P.C

Regardless of the fact that the United States is still in the midst of a public health emergency battling the spread of COVID-19, the Center for Program Integrity encouraged the Centers for Medicare and Medicaid Services to resume both Recovery Audit Contractor (RAC) and Medicare Administrative Contractor (MAC) audits. For now, these audits will focus on claims submitted prior to March 1, 2020. CMS has not yet stated when they will be auditing claims submitted after March 1, 2020 and through the duration of the current public health crisis, but professionals in the field expect these audits to begin in the coming [Read More]

Ombudsman Defends Nursing Home Decisions During Pandemic
Michigan’s Long-Term Care Ombudsman, Salli Pung, says she believes the “best decisions” were made about the placement of COVID-19 patients in nursing homes given the information and resources that were available at the time.

“If we had the opportunity to create nursing homes that were isolated simply for residents with COVID-19, we would all pick that,” Pung told the House Joint Select Committee on the COVID-19 Pandemic Sept. 15. “We would want that for them because that would be the safest, but I don’t know that we had that opportunity to do that and staff it and meet residents’ needs because staffing is critical at [Read More]

By JESSICA BUSCH
Minimally invasive cosmetic medical services are on the rise and in high demand. With their recent popularity, many licensed cosmetologists and estheticians are looking to offer these cosmetic medical services to their existing customers. Midlevel medical providers, such as registered nurses, advanced practice nurses, or physician assistants often desire to leverage their medical experience to start cosmetic medical businesses of their own. These businesses can yield significant profits and present an enticing investment opportunity for licensed physicians.

However, there are numerous legal pitfalls associated with offering cosmetic medical services that must be considered and avoided. Most significantly, cosmetology and medical spa businesses (collectively referred to herein as “medical [Read More]

Michigan hospitals have lost a combined $1.1 billion during the recent pandemic, and that’s even after factoring in $2.1 billion in emergency federal aid, according to a Michigan Health and Hospital Association report released July 30.

The loss of patients, canceled and delayed medical procedures, staffing changes and the need to buy additional personal protective equipment has cost the hospitals a combined $2.7 billion, according to the report. The addition cost of treating COVID-19 patients has added $440 million in emergency expenses for a total of $3.2 billion in combined financial losses.

MHA noted that MidMichigan Health lost 24 percent of its impatient volume between March and June compared to the same [Read More]

By LIZ SZABO
With millions of lives on the line, researchers have been working at an unprecedented pace to develop a COVID-19 vaccine.

But that speed — and some widely touted breakthroughs — belie the enormous complexity and potential risks involved. Researchers have an incomplete understanding of the coronavirus and are using technology that’s largely unproven.

Among many worries: A handful of studies on COVID-19 survivors suggest that antibodies — key immune system proteins that fight infection — begin to disappear within months. That’s led scientists to worry that the protection provided by vaccines could fade quickly as well. Some even question whether vaccines will really end the pandemic. If vaccines produce limited [Read More]

By EWA MATUSZEWSKI
“I have often depended on the kindness of strangers.” Thus, wrote Tennessee Williams in his famous Streetcar Named Desire. We, too, looked to the kindness of strangers in the early days of the pandemic, particularly for personal protection equipment. It was an all-in, humanitarian effort to keep our colleagues and patients safe. Because there were more stringent demands for the wearing of PPE for longer durations, and for more frequent changing of PPE than in our halcyon pre-pandemic days, the need to quickly source PPE for immediate use was paramount.

I wrote in a previous column of the need for keeping a 30-day inventory of PPE. I want to [Read More]

By ROLF LOWE
In July of 2020 the Wisconsin Supreme Court issued an opinion addressing the scope of the Wisconsin Department of Health Services authority to recoup payments to Medicaid service providers. Plaintiffs Kathleen Papa and Professional Homecare Providers (PHP) challenged WDHS’s recordkeeping policies, which included identifying things such as paperwork mistakes, that resulted in significant overpayment obligations from the state’s independent private duty nurses. In seeking an overpayment WDHS didn’t challenge whether the nurses provided a Medicaid patient with a covered service or that the payment for the claim was inappropriate or inaccurate, but instead based its right to seek recoupment of Medicaid funds because of inadequate documentation. The policy [Read More]

By ROSE WILLIS
In the world of health information technology, “information blocking” generally refers to actions that discourage the interoperability of electronic health information except when necessary to comply with law (e.g. HIPAA). The concept applies to a range of problematic activities from charging patients unreasonable fees for copies of their electronic medical record to a software system’s inability to transfer records to a healthcare provider’s new electronic medical record system. Ultimately, information blocking hinders the desired full interoperability and exchange of electronic healthcare information (EHI).

The Federal Department of Health and Human Services, Office of the National Coordinator for Health Information Technology (ONC) released a Final Rule on May 1, 2020 [Read More]