"Health & Medical News"

Some California physicians say a recent settlement between a Ventura hospital and the Dept. of Justice underscores the importance of a self-governing medical staff.

Community Memorial Hospital in December 2007 agreed to pay $1.5 million to settle allegations that the facility gave improper gifts, loans and payments to some doctors in exchange for Medicare patient referrals. No doctors were named in the agreement, and the hospital did not admit any wrongdoing. Community Memorial administrators voluntarily disclosed the financial relationships, which took place under the hospital’s former leadership.

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Some California physicians say a recent settlement between a Ventura hospital and the Dept. of Justice underscores the importance of a self-governing medical staff.

Community Memorial Hospital in December 2007 agreed to pay $1.5 million to settle allegations that the facility gave improper gifts, loans and payments to some doctors in exchange for Medicare patient referrals. No doctors were named in the agreement, and the hospital did not admit any wrongdoing. Community Memorial administrators voluntarily disclosed the financial relationships, which took place under the hospital’s former leadership.

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Imagine being allowed to practice medicine but not being allowed to drive. That’s what some Michigan physicians are facing.

Under a new state law that took effect Jan. 22, doctors in Michigan on a visa cannot get a new driver’s license. That’s because a law intended to prevent illegal immigrants from obtaining a driver’s license also prevents legal residents on student or work visas, including physicians, from getting a license.

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A California appeals court dealt another blow to health plans over their policy cancellation tactics.

The 4th District Court of Appeal unanimously said insurers have a responsibility to make sure patients’ policy applications are complete and accurate before issuing coverage — not after expensive claims come in the door. Judges said plans cannot revoke patients’ policies unless they fully investigate pre-enrollment forms up front or insurers show patients intentionally misled them.

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A California appeals court ruling may bode well for physicians and patients in their fight against alleged illegal policy cancellations by health insurance companies.

A three-judge panel of the 2nd District Court of Appeal unanimously ruled that the practice of reviewing individuals’ applications after they have submitted claims and then pulling the coverage based on alleged errors “is flatly prohibited” under state insurance laws. The Dec. 4, 2007, decision gave the green light to a patient’s class-action lawsuit alleging that Blue Shield of California tried to dodge claims by looking for supposed misstatements or omissions on patients’ policy forms after approving treatment.

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Medical staff members in California are getting protection from retaliation for filing formal complaints against health facilities about subpar treatment or conditions. The medical and hospital communities disagree about whether this change to the state’s health care whistle-blower law will interfere with peer review.

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Landlords who rent to medical-marijuana dispensaries in California are being warned by the federal government that they could lose their property or be sent to prison, the Sacramento Bee reported Dec. 15.

The Drug Enforcement Administration’s (DEA) Sacramento and San Francisco offices recently sent warning letters to landlords, following in the footsteps of the agency’s Los Angeles office, which issued about 300 such warnings over the summer. Nathan Sands of the Sacramento-based Compassionate Coalition said the letters have “definitely caused a panic,” although he predicted that the tactic would cause a backlash against the DEA.

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Oklahoma will no longer offer a loan repayment program intended to encourage physicians to practice in the state’s rural communities. But health care advocates say it was a small sacrifice because state lawmakers agreed to continue funding three other — much larger — programs that help rural communities attract primary care physicians.

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Students fighting a 2003 tuition hike at the University of California are one step closer to getting refunds.

In November, the California Court of Appeals upheld a lower court decision that found the university had breached its contract with continuing professional students when it raised their fees. The appellate court found that the increase ran counter to the university’s promise, posted on its Web site and printed in its catalogs, that fees would not be raised for the duration of students’ enrollment.

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California insurance regulators ordered the state Blues to stop using “confidentiality agreements” they said deprive physicians and hospitals of their rights to fair representation during contract negotiations. But doctors worry the cease-and-desist order the state Dept. of Managed Health Care issued Nov. 1 does not go far enough.

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