News in brief - March 10, 2003

Johns Hopkins pays $800,000 after Medicare audit - Med schools support Michigan's diversity policy - Calif. doctors donate day for child surgeries - No affidavit necessary in N.J. case - Temple to start 2nd year of probation

Johns Hopkins pays $800,000 after Medicare audit

Johns Hopkins University will pay the federal government $800,000 to settle overbilling issues raised during an audit of its Medicare billing practices.

The amount is small compared with what other schools have paid since the Dept. of Health and Human Services Office of the Inspector General started probing Medicare billing practices at teaching hospitals.

In May 2002, the Medical College of Wisconsin, Milwaukee, agreed to pay $8.9 million on allegations that its teaching physicians had billed Medicare improperly.

Others who have settled include the University of Pennsylvania School of Medicine, Philadelphia, which paid $30 million; the University of California's five schools of medicine, $22.5 million; the University of Pittsburgh, $17.3 million; the University of Florida College of Medicine, Gainesville, $8.6 million; and Medical University of South Carolina, Charleston, $5.2 million.

The controversial audits are meant to ensure that faculty physicians, not just residents, are seeing the patients that faculty are billing for and that faculty oversight of patient care is correctly documented.

Med schools support Michigan's diversity policy

As the University of Michigan goes before the Supreme Court in two affirmative action cases, at least 300 organizations, including the Assn. of American Medical Colleges, have joined to submit more than 60 briefs to the court on the university's behalf.

In Grutter v. Bolinger, the university's use of racial preferences in its law school's admissions policies is being challenged.

The AAMC argues that without race-conscious admissions policies, medical schools will be unable to increase the number of minority doctors needed to serve the growing U.S. minority population.

"A reasonable balance in the racial and ethnic composition of our nation's physician work force is essential if we are to care for an increasingly diverse population. No alternative to affirmative action in medical school admissions exists for meeting that need," said Jordan J. Cohen, MD, president of the AAMC. "In ruling on the affirmative action cases now before it, the Supreme Court must provide a clear means for allowing the medical and health professions to fulfill their solemn societal obligation."

At present, virtually all U.S. medical schools take race and ethnicity into consideration. The AAMC contends that if schools ignore race, students from underrepresented minority backgrounds will fall from the current level of 11% to no more than 3% of the medical student population -- at a time when African-Americans, Native Americans, Mexican-Americans and Puerto Ricans make up 23% of the population.

This would lead to a widening of existing health care disparities as minority populations grow. Minority physicians are more willing to practice in underserved areas, and minority patients' trust in the health care system increases when treated by members of their own racial or ethnic group. A decline in minority physicians would also lead to less diversity in medical research, the AAMC said.

The case is scheduled for oral arguments April 1.

Calif. doctors donate day for child surgeries

About 80 children underwent free surgeries recently through the Community ENT 2003 program, sponsored by the California Medical Assn.

Ear, nose and throat specialists from Orange County went to Redding, Calif., to perform surgeries on the children at Redding Medical Center and Mercy Medical Center. For the day of surgeries, both facilities provided free use of operating rooms and the aid of hospital anesthesiologists and other hospital staff.

The association said the project was needed because Shasta County in California has too few otolaryngologists and other specialists to provide children with timely specialty care. Since the project started in 2000, more than 250 children have been treated for a variety of ear, nose and throat disorders.

"The excellent work and tireless dedication of these physicians in both Redding and Orange County have allowed children to live normal lives thanks to these simple but life-altering procedures," said CMA Chief Executive Officer Jack Lewin, MD.

No affidavit necessary in N.J. case

A New Jersey man suing a prison and the physicians employed there for failing to provide insulin on a timely basis doesn't have to file an affidavit from an expert stating that there are grounds to bring the case, the 3rd U.S. Circuit Court of Appeals ruled in February. The court said a lay person could determine that there was a good chance that the minimum standard of care wasn't met.

Police arrested Daniel Natale in 1997. During a medical screening, he told prison officials that he was an insulin-dependent diabetic, according to court records. He got his first dose of insulin 21 hours after he was admitted to the prison, and two days later he had a stroke. He and his wife filed the lawsuit against the Camden County Correctional Facility and others, claiming the stoke occurred because Natale went so long without insulin.

Temple to start 2nd year of probation

Temple University School of Medicine faces another year on probation after losing an appeal with the Liaison Committee for Medical Education. The LCME put the school on probation in June 2002 for not offering enough student financial aid and for failing to update aging buildings.

Temple last year remodeled teaching areas and completed new research laboratories. It did not detail how it planned to increase financial aid.

In January the school's board gave permission to issue $75 million in bonds for construction of a new building, expected to cost $160 million, for Temple's School of Medicine. Groundbreaking is scheduled for 2004.

In general, a school may remain on probation for up to four years. If a school fails to get off probation in this time, its accreditation is revoked and it may no longer offer students federal financial aid.

Temple is the only mainland U.S. medical school to be put on probation in 15 years. However, two Puerto Rican schools have gone through probation then regained accreditation status, the Central University of the Caribbean from 1994 to 2000 and the Ponce School of Medicine from 1995 to 1999.

Temple is required to notify all current medical students and applicants about its probationary status.