South Florida Hospital News
Monday May 21, 2018
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January 2006 - Volume 2 - Issue 7

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Payments, Physician Issues and Liability Lawsuits

Will Continue to Confront Healthcare Industry

From a legal perspective, last year was extremely busy for Florida hospitals and the law firms that work with them. A number of issues became hot button topics, and as always, there was continued examination of others. Bill Bell, legal counsel for the Florida Hospital Association (FHA) believes that, for most hospitals, those legal challenges will continue well into 2006.

According to Bell, the issues fall into three distinct groups: payment, medical staff and liability issues. On recent years, getting reimbursed for services provided has been a thorny issue. Bell says it’s a constant struggle.

"We’re seeing a number of disputes, mainly between hospitals and HMOs, related to reimbursement. Because the laws are changing, we’re constantly trying to determine what reimbursements are due for non-contracted services. This is going to be a key issue well into the future."

For that matter, he added, the same problem exists with payments from Medicare, Medicaid, Workers’ Compensation and personal injury protection. "In 2006, we’ll also be seeing a continuation of lawsuits by hospitals related to charity care for the uninsured." He notes that many of the suits have been dismissed, but some are still pending.

Medical staff issues tend to also be ongoing, especially now that so many physicians have exclusive contracts with hospitals. One affected area, says Bell, is the emergency department. "We’ve been focusing on this for a number of years," he says. "There’s a growing shortage of emergency department on-call specialists, along with an increase in regulations, meaning greater liability for hospitals."

Last year, the Terry Schiavo situation at a Florida hospice called attention to end-of-life issues and the need for patients to address advanced directives. Hospitals deal with this regularly, although Bell says it’s become somewhat routine. "Here in South Florida, a substantial part of the population is aging. Usually, end-of-life planning is handled via living wills, and, most of the time, there are no problems."

Bell does expect antitrust lawsuits to continue. He points to an antitrust case that was filed by an insurance company against Hill-Rom, which provides medical beds. That case went to a Federal court, which dismissed the charges.

The most common lawsuits Bell sees on a regular basis are those involving liability issues, including personal injury, One hot button issue that has brought about several lawsuits is Constitutional Amendment 7. This amendment, which affects hospitals but not physician practices, has made adverse incident reports and other documents associated with peer review, risk management and quality assurance available for public scrutiny.

Malpractice insurance, too, is a widely debated topic that will continue to be discussed. Bill Bell can be reached at 850-222-9800 or at billb@fh.org.
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