News in brief - Aug. 18, 2008

WellPoint settles with Calif. hospitals over rescission payments

WellPoint Inc. agreed to pay $11.8 million to California's hospitals to settle allegations that the company illegally canceled patients' health insurance policies after authorizing treatment and then failed to pay the hospital bills.

The case parallels a similar class-action lawsuit brought by the California Medical Assn. on behalf of state physicians. That case is pending.

Under the July settlement with the California Hospital Assn. and more than 400 of the state's hospitals, WellPoint-owned Anthem Blue Cross agreed to establish a compensation fund to reimburse hospitals for the services they provided to patients whose policies were rescinded. The insurer also will set up a patient compensation fund to reimburse patients for their out-of-pocket payments to hospitals.

The hospitals agreed not to pursue reimbursement from patients for claims not paid by Anthem. The agreement awaits final approval by a Los Angeles trial court.

WellPoint admitted no wrongdoing as part of the settlement. Leslie Margolin, president of Anthem Blue Cross, formerly Blue Cross of California, said the company continues to work with state insurance regulators on the rescission issue.

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Study: Nurses sometimes skirt barcode safety checks

Nurses override bar-code medication administration safety alerts for 4.2% of patients and for 10.3% of medications, according to a study in the July/August Journal of the American Medical Informatics Assn.

The study, done at five hospitals in the Midwest and on the East Coast, found that nurses perceive many of these work-arounds as more efficient and better for patient care and safety, even though they have the potential to result in unintended oversights.

The study found that bar-code systems did stop thousands of medication errors from occurring, but the authors concluded that technology alone is not a fail-safe solution. For example, nurses may scan medications but not patients' wristbands because they are damaged or inaccessible due to patients' sleeping positions.

"Bar-coding is still under development," said lead author Ross Koppel, PhD. "Administrators and vendors may expect it to be foolproof, but users know it's not. It's a very promising technology that still requires constant refining and careful observation of on-the-floor workflow to get it right."

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Group wants doctors to boast of refusing to see drug reps

First came the "no free lunch" pledge, now comes the "no drug reps" certificate. Washington, D.C.-based PharmedOut, funded by a $400,000 grant from the Warner-Lambert settlement over allegations of deceptive off-label marketing of Neurontin (gabapentin), is pushing the concept.

The certificate boasts that doctors in a "no drug reps" practice refuse pharmaceutical sales consultant visits because "we rely on scientific information, not marketing, to decide what is best for you."

The PharmedOut initiative joins other efforts aimed at turning refusal to interact with industry into a point of pride for physicians. For example, the 10,000-member National Physicians Alliance recently launched its "unbranded doctor" campaign, in which physicians are urged to throw out drugmaker gifts such as pens, wall clocks, note pads and the like. About one in five doctors refuses to see drug reps, according to a study of 180,000 doctors conducted last year by marketing firm SK&A Healthcare Information Solutions.

The Pharmaceutical Research and Manufacturers of America says detailer visits can keep busy doctors up to date with new and improved drug therapies. American Medical Association policy says doctors should accept only gifts intended to benefit patients and worth $100 or less, and that drug samples should be given only to patients, not friends or family.

The "no drug reps" certificate is available at the PharmedOut Web site (www.pharmedout.org).

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New name for infection control stresses prevention

The Assn. for Professionals in Infection Control and Epidemiology announced in July that it wants its nearly 12,000 members to now be known as "infection preventionists."

The new name is meant to raise awareness of what infection-control professionals do to "uniquely contribute to patient safety, improved outcomes and bottom-line savings to health care institutions," said APIC CEO Kathy Warye. The name change came from months of branding research, which also resulted in a new logo and tagline: "Spreading knowledge. Preventing infection."

The profile of infection-control professionals is higher than ever because of state mandates on hospital infection reporting and a growing trend of not paying for preventable hospital-acquired conditions such as infections.

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