Here are 35 updates from the last month.
Kissing Camels Surgery Center antitrust lawsuit against Centura Health to go to trial
Kissing Camels Surgery Center, based in Colorado Springs, filed an antitrust lawsuit against Centura Health for allegedly reducing competition for ambulatory surgery services. The initial complaint was filed in November 2012 and the case will go to trial.
California ASCs to settle out-of-network class action with United Health
Hooper, Lundy and Bookman filed a motion for preliminary approval to settle a class action complaint that was filed more than six years ago. The complaint was filed on behalf of out-of-network California ASCs against United Healthcare Services and Optumlnsight. The complaint claims United and Optumlnsight incorrectly calculated the reasonable and customary amounts for out-of-network ASC, resulting in millions of dollars in underpayments.
Cleveland Clinic loses orthopedic surgeon over implant dispute
Cleveland Clinic standardized implants to only two investors — Stryker and Zimmer — for joint replacements. As a result, orthopedic surgeon Raymond L. Horwood moved his practice from Cleveland Clinic to John Medical Center to continue using DePuy implants for joint replacements.
Husband and wife physicians convicted of healthcare fraud
On Sept. 4, Paramjit Singh Ajrawat, MD, and his wife, Sukhveen Kaur Ajrawat, MD, were convicted of healthcare and wire fraud, obstruction of justice and aggravated identity theft. The claim allegedly defrauded the United States of $2.5 million.
Legislators compromise to privatize N.C.'s $15B Medicaid program.
Legislators from North Carolina agreed to privatize the state's $15 billion Medicaid program under a proposal that took the North Carolina House and Senate more than two years to agree on. Three health insurers will be given contracts under North Carolina House Bill 372 to offer statewide Medicaid managed care plans, and North Carolina will have contracts with up to 10 provider-led entities that will enroll patients in regional managed care networks.
Tenet joint ventures with Dignity Health & Ascension
Tenet Healthcare and Dignity Health and Ascension will own and operate Carondelet Health Network, based in Tucson, Ariz. Tenet will be the majority stakeholder in the joint venture and will manage the operations of Carondelet Health Network's two physician groups, three hospitals, ambulatory services, outpatients and other businesses based in Tucson and Nogales, Ariz.
Excellus BlueCross BlueShield hack may impact 10M
Excellus BlueCross BlueShield found a data breach in its system dating all the way back to 2013. The data breach has impacted more than 10 million people. Subscribers' names, birthdays, Social Security number, financial account information and claims information may have all been compromised.
Patient accused of stabbing 2 nurses charged with attempted murder
Gary Michael Smallwood, 40, was charged with two counts of attempted murder in the first degree after stabbing nurses at Physicians Regional Medical Center in Knoxville, Tenn. He attacked the nurses with scissors and a knife. The female nurse sustained a puncture wound in her upper chest region and the male suffered lacerations during a struggle to take the knife from the attacker. Both are expected to make a full recovery.
There are more female physicians, but not at the top levels of healthcare
Since 1975, the number of female physicians in the United States has grown sixfold with 321,000 physicians by 2012. Despite this growth, the number of female physicians has not had the same presence in leadership positions. Women account for less than 20 percent of division chiefs, medical school deans, department chairs and hospital CEOs.
Arkansas interim CEO resigns over physician controversy
Arkansas State Rep. Joe Farrer (R-Austin) resigned from his role as interim CEO of North Metro Medical Center, located in Jacksonville, Ark. Rep. Farrer resigned after the hospital's owners reinstated a physician whom Rep. Farrer had requested to resign because of the physician's alleged alcohol issues.
Feds maintain strict out-of-pocket healthcare spending limits
Federal regulators are sticking to their strict out-of-pocket healthcare spending limits, and will impose new limits on how much out-of-pocket expenses employers with high-deductible plans can mandate employees to pick up starting next year. The regulatory guidance was jointly issued by the U.S. Departments of Health and Humans Services and Labor and Treasury in May.
2 patients shot by off-duty police officers at hospitals in Ohio & Texas
Two patients were shot by off-duty police officers Thursday in two separate incidents — one at Garfield, Ohio-based Marymount Hospital, and another at St. Joseph's Medical Center in Houston. Both patients were described as being "combative."
Undocumented immigrant arrested at Texas clinic
A Mexican woman was detained after seeking care at a Houston clinic, which may prevent immigrants from seeking healthcare. The undocumented immigrant's attorney claims the clinic potentially violated HIPAA. The clinic countered it does not report undocumented patients to law enforcement, but reported the woman in this case because she presented false identification.
Google invests $32.5M in Oscar
Google's growth equity fund, Google Capital, invested $32.5 million is Oscar Health, a health insurance startup company in New York. Oscar is valued at $1.75 billion, up from a previous valuation of $1.5 billion when it last received funding in April.
NIH aims to enroll 1M in precision medicine initiative
NIH approved a framework for the Precision Medicine Initiative, a $130 million study of 1 million people that works to better understand the genetic factors and environmental exposures that contribute to disease development.
Freeman Health System opens acquired surgery center in Kansas
Freeman Health System acquired Century Surgical Associates in Pittsburg, Kan. The surgery center is 20,000 square feet and provides sports medicine and general orthopedic surgery services.
Magellan Health honored for online excellence
Health Information Resource Center's Digital Health Awards recognized Magellan Health, headquartered in Scottsdale, Ariz., for its superior online resources. Magellan Health provides healthcare organizations analytic and technology solutions to bolster health outcomes and optimize cost.
Kaiser Permanente hires hundreds of mental health professionals
Oakland, Calif.-based Kaiser Permanente has faced criticism from consumers and regulators for insufficient staffing at its mental health clinics. Kaiser has hired 497 mental health therapists since 2011 and plans to hire an additional 354 by the end of 2015 in response to the backlash.
CDC, FDA release medical device reprocessing advisory
The Centers for Disease Control and Prevention and U.S. FDA recently released an advisory notice on proper medical device management and disinfection for reusable medical devices. The notice advises healthcare facilities to review current reprocessing practices at their facility to make sure they are complying with the steps provided by device manufacturers and that they procedures are consistent with current guidelines.
Patient starts 2 fires in Houston hospital causing $1M in damage
David Williams started two fires at Houston-based Memorial Hermann Southeast Hospital after the hospital refused him for emergency room services. The fires resulted in approximately $1 million in damage.
Banner scraps UA's $115M Epic system for Cerner
Banner Health, based in Phoenix, announced plans to drop Epic's EHR system at its two Tucson hospitals. The company will replace the system with Cerner's platform.
Hospital-employed physician practices tend to favor their parent hospitals
Stanford researchers found physicians employed by hospitals were more likely to send their patients to their employer hospitals for treatment. The results are cause for concern for patients who may not be receiving the highest quality of care.
AMA voices concern over insurance mergers
The American Medical Association released a 12-page analysis explaining how the recent Anthem-Cigna and Aetna-Humana mergers will hurt patients. The AMA states the mergers will result in "unprecedented lack of competition" in the market.
Chipotle labeled as culprit in Minnesota salmonella outbreak
Minnesota has reported at least 45 cases of salmonella infection with investigator discovering that all of the infected individuals ate at various Chipotle's in Minnesota.
Epic, athenahealth only 2 vendors to not lose clients in 2014
Only three vendors posted a gain in market share and only two vendors lost zero clients. Epic, Cerner and athenahealth posted a gain in market share in 2014 with Epic reporting the largest net increase of new hospitals in that time.
Study refutes physician-owned hospitals avoid poorer patients
A recent study found there is no evidence proving that physician-owned hospitals systematically avoid poorer patients. The study contests past findings that indicated POHs choose less severe cases and wealthier patients.
Providers appeal to Congress about insurer mergers
Several medical groups plan to appear before Congress to voice concerns over the recent health insurance mergers, which providers claim will cost them financially and will leave patients with few choices. Insurers and providers alike are recruiting lobbyists for the debate.
Texas ASC Society founder establishes Hawaii ASC Association
Woodrow Moore, a healthcare consultant, played an integral part in establishing the Hawaii ASC Association. Mr. Moore is the founder of the Texas ASC Society and owns The Physician's Advocate, a consulting firm.
Cleveland Clinic Florida $302M expansion to include ASC
Cleveland Clinic Florida plans to expand its Weston location and build a new clinic and an ambulatory surgery center in Coral Springs. The expansion is expected to cost $302 million and will include 40 exam rooms and an ambulatory surgery center.
Kmart pays $1.4M in false claims settlement
Illinois-based Kmart paid $1.4 million to settle allegations that the company violated the False Claims Act by persuading Medicare beneficiaries to fill their prescriptions at Kmart pharmacies.
CMS selects Dr. William Rogers as ombudsman for ICD-10
The Centers for Medicare and Medicaid Services selected William Rogers, MD, to oversee the ICD-10 transition. He presently serves as an emergency room physician and director of CMS' Physicians Regulatory Issues Team.
IPSIS consults on how to operate patient safety investigations
The Independent Patient Safety Investigation Service and NHS organizations will look into how investigations are handled regarding patient safety incidents in 2016. An expert advisory group is deciding what IPSIS should investigate and which individuals and resources will prove to be important to the investigations.
SCA stock receives 'hold' rating
Nine analyst firms gave Surgical Care Affiliates stock a consensus "hold" rating. The stock has an average 12-month price target of $40.57 per share.
Tenet shares fall 0.7%
Tenet Healthcare shares dropped 0.74 percent during the week of Sept. 7 to Sept. 11. The company's shares dropped 10.2 percent in the last four weeks.
Physicians still content despite healthcare changes
Physicians report they are still happy despite the changes in healthcare, according to Physicians Practice's 2015 Great American Physician survey. The average rating of "happiness" on a scale from one to 10 was 7.3.