News in brief - Jan. 17, 2005

Managed care lawsuit moves forward - Dr. Hurwitz convicted on 50 counts - Study shows AHRQ safety indicators could work for children's hospitals - Doctor-owned insurance company to operate in Ohio - Medical books event in Philadelphia

Managed care lawsuit moves forward

There's a new trial set for the class-action litigation in which doctors challenged the way managed care companies have reimbursed them over the past decade. U.S. District Judge Federico A. Moreno now is scheduled to begin hearing the case Sept. 6. Discovery in the case is set to continue through Feb. 7.

Individual physicians and organized medicine filed numerous lawsuits against the nation's largest health plans. The lawsuits accused companies of actions such as downcoding and bundling claims. The cases were consolidated before Moreno in the U.S. District Court for the Southern District of Florida in Miami.

Aetna and CIGNA settled their lawsuits with physicians, but cases still remain against Anthem Blue Cross and Blue Shield, Coventry Health Care, Humana, Prudential Insurance Co. of America, United Healthcare and WellPoint Health Networks.

Dr. Hurwitz convicted on 50 counts

A jury found noted pain specialist William E. Hurwitz, MD, of McLean, Va., guilty on 50 of the 62 counts against him at the U.S. District Court in Alexandria, Va., on Dec. 15, 2004.

The jury deliberated some 30 hours before convicting Dr. Hurwitz of conspiracy to traffic in controlled substances, drug trafficking resulting in death and other charges, some of which carry 20-year sentences.

Dr. Hurwitz was found not guilty of nine charges. including health care fraud.

A mistrial was declared on the other three counts against him.

Prosecutors said Dr. Hurwitz knowingly prescribed narcotics to patients who sold them on the streets, but his supporters said he treated patients in severe pain whom other physicians refused to treat.

An appeal is forthcoming. The New York City-based Pain Relief Network announced that it had a created a defense fund to help finance the effort and has a goal of raising $60,000.

Study shows AHRQ safety indicators could work for children's hospitals

A new study led by a University of Michigan faculty member and compiled by the National Assn. of Children's Hospitals and Related Institutions shows that some of the tools used to measure patient safety in adult hospitals can be applied to children's hospitals as well.

The study evaluated information from about 1.92 million children's hospital stays over four years and found that there is room for improvement in preventing hospital-acquired infections, clots in intravenous lines and bedsores. This is the first study to evaluate whether the use of adult patient safety indicators established by the federal Agency for Healthcare Research and Quality might work at children's hospitals.

In an effort to establish accurate tools for measuring patient safety in children's hospitals, NACHRI is working with AHRQ and Aileen Sedman, MD, lead author of the study, to determine appropriate patient safety indicators for children.

Doctor-owned insurance company to operate in Ohio

The Ohio Dept. of Insurance has granted a license to operate to a doctor-owned insurance company.

The Healthcare Underwriters Group Mutual of Ohio, a nonprofit mutual insurance company that solely writes medical liability insurance, was granted approval to begin writing insurance Dec. 14, 2004.

Modeled after other successful doctor-owned insurance companies, HU operates as a non-assessable mutual, meaning policyholders cannot be assessed to pay losses if HU loses more than anticipated. According to a statement released by HU, actuarial data will be reviewed by a physician board of directors,who will help establish annual premiums and be involved in the underwriting and claims-handling policy development.

Medical books event in Philadelphia

The College of Physicians of Philadelphia will sponsor the symposium "Buying, Selling, Collecting and Caring for Rare Medical Books" Feb. 23. Presenters will include Eugene Flamm, MD, a college fellow and collector who is chair of neurosurgery at the Albert Einstein College of Medicine in New York City; Michael Ryan, PhD, associate director for special collections at the University of Pennsylvania Libraries; and Bruce Raymer, who specializes in antique medical books. The symposium is free to the public. For information, call 215-563-3737, extension 265.