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When medical malpractice defense counsel first heard of the new privacy regulations issued by the U.S. Department of Health and Human Services under the Health Insurance Portability and Accountability Act of 1996 (the HIPAA privacy regulations), most probably thought that these detailed and complicated laws would affect only their regulatory health care colleagues. How great an impact the HIPAA privacy regulations will have on medical malpractice litigation, in general, is yet to be seen, but it is clear that these regulations have immediately affected discovery of medical records in med-mal cases.
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In the last 2 months, the General Accounting Office (GAO) issued two reports detailing the findings of its studies into the medical malpractice insurance crisis and its effects on medical care. The studies were conducted at the request of Congress, which wanted to learn what the root causes of the rising medical malpractice insurance premiums were and what effects these rising costs were having on the public's access to health care. With this information, it intends to consider legislation similar to some states' tort reform laws.
Contrary to the <i>Mejia</i> court's analysis, patients do not generally choose an emergency room in reliance on any belief about the doctors' employment or agency relationship with the hospital. They may choose the hospital based on terms of their insurance plan, or the hospital's geographic location. But nobody can seriously suggest that if a patient were confronted with a neon sign in the hospital waiting room declaring the doctors to be independent contractors whose conduct is not attributable to the hospital, he or she would turn around and look elsewhere to find a hospital with employee doctors.
As the federal government and more and more states move toward capping non-economic damages in medical-malpractice actions, actual economic damages take on a new importance: Will economic damages by themselves, absent a large award for pain and suffering, justify taking a case that may cost $100,000 or more to present?
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Can fear of cancer be litigated? And if so, what is the potential impact on the med mal community? On March 10 the U.S. Supreme Court announced a decision in <i>Norfolk and Western Railway Co. v. Ayers</i>, 123 S.Ct. 1210 (2003), in which it ruled by a five to four vote that railway workers who suffer from asbestosis would be allowed to recover damages for fear of asbestos-related cancer. Rail-worker plaintiffs would still bear the burden of proof that their fear was 'genuine and serious,' but the Supreme Court did not specify how such evidence would be demonstrated or refuted. This article considers whether the <i>Ayers decision</i> could extend to medical malpractice litigation.
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In this era of heightened scrutiny of health care practices, every provider of health care services or products (<i>ie</i>, medical practices, clinical laboratories, billing companies, durable medical equipment suppliers, etc.) must implement compliance plans to educate their employees to avoid questionable billing practices before they become the subject of government criminal or civil investigations or lawsuits.
<b><i>Too Many Professionals Can Wreak Legal Havoc</i></b> Psychiatry is far from being the only mental health profession. A review of the statutes in just this author's state of Alaska reveals separate professional licensing boards for social workers, marital and family therapists, nurses, professional counselors, psychologists, psychological associates and, of course, physicians.