Ill. bill to limit charging of uninsured moves ahead

From Modern Healthcare (requires free subscription)

The Illinois General Assembly is poised to pass a bill that would limit what hospitals could charge and collect from eligible uninsured patients. A bill carrying an amendment dubbed the Hospital Uninsured Patient Discount Act was passed unanimously by the House and is expected to clear the Senate.

Specifically, hospitals could charge no more than 135% of costs for medically necessary care. To be eligible, the patient would have to be an Illinois resident and make no more than six times the federal poverty level, or half that amount in rural and critical-access areas. The hospital would be barred from collecting more than 25% of a patient’s income each year unless the patient has assets that exceed the income levels described in the eligibility guidelines, not counting a primary residence or retirement funds.

New Proposed EMTALA Regulations Issued By CMS

From Medlaw.com

New proposals for EMTALA rules issued April 30.

Just days after new site review guidelines went into effect in April, CMS issued proposed new regulations that would implement some recommendations of the EMTALA Technical Advisory Group (TAG) that were issued before the committee went out of existence last year. 

Among the proposals:

  1. Move the on-call requirements of the regulations from the regulations section pertaining to emergency responsibilities of hospitals to the section pertaining to terms of the Medicare Provider Agreement.  Contrary to the procedural intent of the industry advocates supporting the move, CMS’s proposed regulation would retain on-call violations as an EMTALA violation.  The industry goal had been to move on-call violations into the general conditions of participation process and out of the EMTALA enforcement process.
  2. Clarify that even though a patient has been admitted, hospitals with higher levels of care are required to accept the transfer of a patient with an emergency medical condition that remains unstabilized, even though the admission ends the sending hospital responsibilities under EMTALA.  CMS is also asking for comments on whether the rule should also apply to any in-patient, such as one that suffers a deterioration in condition while in the hospital for an elective procedure.
  3. Allow hospitals to meet their on-call obligation by participating in a formal community-wide on-call system, but a patient presenting to the “wrong” hospital would still be subject to EMTALA requirements and could not be moved to the “on-call hospital” without full EMTALA compliance.

Intolerances

From Edwin Leap:

Our emergency department electronic charting system is now going to start listing as separate categories allergies and intolerances.  It makes sense, really.  How many times are we told ‘he’s allergic to Lortab…it makes him act all crazy!’  (Never mind that he might have been a wee bit crazy to begin with.)  ‘She can’t take Motrin, it makes her stomach hurt.’  ‘I can’t take steroids…I’m allergic to them and get swollen, hungry and irritable.’

Nocturnists

From the Wall Street Journal Health Blog:

They call the overnight doctors “nocturnists,” though as far as we can tell they’re basically hospitalists who work at night. As of last year, about 1,200 hospitals had either a nocturnist or hospitalist sharing night coverage, compared with 700 hospitals in 2003, according to the Society of Hospital Medicine.

After Taser Shot, Fugitive’s Irregular Heartbeat Becomes Normal

From the Wall Street Journal Health Blog:

A 28-year-old man with a history of mental problems fled from the cops and spent 40 minutes hiding in a lake before they collared him and hauled him to the ER.

His body temperature had fallen to a chilly 89 degrees. Docs found speed and cocaine in his blood, and an ECG showed an irregular heartbeat.

Then things turned ugly. The guy got agitated, ripped off his electrodes and tried to pull out his IV. A cop stepped in and gave him a jolt to the chest with a Taser, and the suspect’s heart soon went back into a normal rhythm.