Legal concerns addressed regarding JCAHO review
The Oakbrook Terrace, IL-based Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has announced two options intended to mitigate legal concerns related to the periodic performance review component of its new accreditation process. An organization can opt to attest that it has performed the midcycle self-assessment, completed a plan of action to address areas of noncompliance and identified measures of success for validating resolution of the identified problem, JCAHO said.
In that case, the organization would provide its measures of success to JCAHO for assessment at the time of the complete on-site survey.
Alternatively, JCAHO said an organization need not conduct a midcycle self-assessment and develop a plan of action, but for a fee could undergo an on-site survey at the midpoint of its accreditation cycle. The organization would develop and submit a plan of action to address any areas of noncompliance found during the on-site survey, and provide its measures of success to JCAHO at the time of the complete on-site survey.
More information is available at www.jcaho.org. For a more complete discussion of the new JCAHO survey process, see the June 2003 issue of Hospital Access Management.
Medicaid spending slows, first time in seven years
Medicaid spending growth slowed in 2003 for the first time in seven years as all 50 states implemented Medicaid cost control strategies, according to the latest survey by the Kaiser Commission on Medicaid and the Uninsured. Average spending growth for Medicaid in 2003 was 9.3%, down from 12.8% in 2002, the survey indicates.
Over the past three years, all 50 states have taken action to control drug costs and reduce or freeze provider payments, while 35 states have reduced benefits, 34 have reduced or restricted eligibility, and 32 have increased Medicaid copayments, the survey found. Inpatient hospital rates were cut or frozen in 31 states in fiscal year 2003. Ten states planned to reduce hospital payment rates in fiscal year 2004, while 22 states planned to freeze rates.
While spending on Medicaid has slowed, enrollment in the Medicaid program increased 7.8% in FY 2003 and is projected to increase 5.3% in FY 2004, another report released by the commission indicates. The report largely attributes the recent surge in Medicaid enrollment to the economic downturn, which has resulted in declining incomes and lower rates of employer-sponsored insurance among low-income Americans. More on the reports is available at www.kff.org.
EMTALA sourcebook cuts through new regs
You and your facility waited more than a year for the final revisions to the Emergency Medical Treatment and Labor Act (EMTALA), but are they really good news? Emergency department (ED) managers and practitioners, hospital administrators, risk managers, and others must quickly digest this complex regulation and determine how the changes will affect patient care. The revised regulation takes effect Nov. 10.
EMTALA: The Essential Guide to Compliance from Thomson American Health Consultants, publisher of Emergency Medicine Reports, ED Management, ED Legal Letter, and Hospital Risk Management, explains how the changes to EMTALA will affect EDs and off-campus clinics. Key differences between the "old" EMTALA and the new changes are succinctly explained.
Here are some of the vital questions you must be able to answer to avoid violations and hefty fines:
- Do the revisions mean hospitals are less likely to be sued under EMTALA?
- How does EMTALA apply during a disaster?
- What are the new requirements for maintaining on-call lists?
- How does EMTALA apply to inpatients admitted through the ED?
- What are the rules concerning off-campus clinics?
Edited by James R. Hubler, MD, JD, FACEP, FAAEM, FCLM, attending physician and clinical assistant professor of surgery, department of emergency Medicine, OSF Saint Francis Hospital and University of Illinois College of Medicine, Peoria, EMTALA: The Essential Guide to Compliance draws on the knowledge and experience of physicians, nurses, ED managers, medicolegal experts, and risk managers to cover the EMTALA topics and questions that are most important to you, your staff, and your facility.
EMTALA: The Essential Guide to Compliance provides 18 AMA Category I CME credits and 18 nursing contact hours. To order your copy today for the special price of $249, call (800) 688-2421 or click here and receive this valuable guide to the new EMTALA.
Legal concerns addressed regarding JCAHO review; Medicaid spending slows, first time in seven years; EMTALA sourcebook cuts through new regs
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