NYTimes.com Article: Medicare Shifts to End Doctors' Control of Disclosing Errors

[Guest guest]

This article from NYTimes.com

has been sent to you by ldarwent ldarwent@....

Chronic Pain

Here is an American medical story that some of the subscribers to the Chronic

Pain list might find interesting. It come from the Teusday New York Times

online.

Be Blessed

D.

Co-Moderator - Chronic Pain

ldarwent

ldarwent@...

/-------------------- advertisement -----------------------\

LOOKING FOR A TRULY HIGH-SPEED INTERNET EXPERIENCE? Then visit Alcatel.com and

see what makes us the world's leading supplier of DSL solutions. Alcatel, world

leader in DSL solutions. http://www.nytimes.com/ads/email/alcatel/index.html

\----------------------------------------------------------/

Medicare Shifts to End Doctors' Control of Disclosing Errors

http://www.nytimes.com/2001/01/02/national/02MEDI.html

January 2, 2001

By ROBERT PEAR

WASHINGTON, Jan. 1 Reversing a policy that has kept medical errors

secret for more than two decades, federal officials say they will

soon allow Medicare beneficiaries to obtain data about doctors who

botched their care.

Tens of thousands of Medicare patients file complaints each year

about the quality of care they receive from doctors and hospitals.

But in many cases, patients get no useful information because

doctors can block the release of assessments of their performance.

Under a new policy, officials said, doctors will no longer be able

to veto disclosure of the findings of investigations.

Federal law has for many years allowed for review of care received

by Medicare patients, and the law says a peer review organization

must inform the patient of the " final disposition of the complaint "

in each case.

But federal rules used to carry out the law say the peer review

organization may disclose information about a doctor only " with the

consent of that practitioner. " The federal manual for peer review

organizations includes similar language about disclosure.

Under the new plan, investigators will have to tell patients

whether their care met " professionally recognized standards of

health care " and inform them of any action against the doctor or

the hospital.

Patients could use such information in lawsuits and other actions

against doctors and hospitals that provided substandard care.

The new policy came in response to a lawsuit against the

government by the son of a Medicare patient who was admitted to a

hospital in ville, Fla., on Dec. 8, 1998, after an asthma

attack and after experiencing high blood pressure. The patient,

S. Levine, died of a stroke six days later, while still a

patient at the hospital.

The plaintiff, Alan S. Levine, had concerns about his mother's

care. He filed a complaint, which was investigated by a group of

medical quality experts known as a peer review organization.

Mr. Levine and his lawyer, Frost of the Public Citizen

Litigation Group, a nonprofit law firm, filed the lawsuit, in which

they argued that the old Medicare policy violated federal law.

" Getting the results of the investigation won't bring back my

mother, " Mr. Levine said in an interview. " But it will help me

understand her death and come to terms with it. "

Mr. Levine said his mother's death was a surprise.

" I was

curious to know whether the hospital or the doctors did anything

that contributed to her death, " he said. " A nurse told my sister

that our mother had received a very high dose of asthma

medication. "

The lawsuit is pending in Federal District Court here in

Washington.

The Florida peer review group had initially denied Mr. Levine's

request for information.

" Federal laws and regulations prohibit us from releasing

information about your mother's care without the consent of her

physician, " Dr. Ferdinand s III, medical director of the

Florida peer review group, wrote to Mr. Levine in August 1999. " Her

physician refused to give consent. Therefore, we are unable to

provide any specific information about the results of our review. "

Officials of the Department of Health and Human Services said they

recently told the Florida review organization to disclose its

findings to Mr. Levine. And the officials said they would change

Medicare policy so patients in similar circumstances could get such

information.

A senior official of the department, speaking on condition of

anonymity, said: " The revision of our policy is definitely an

outgrowth of this particular case. We want to fix the problem and

make sure no one has the same problem in the future. "

The peer review organizations are powerful watchdogs. They can

deny payment for services and can order corrective action,

including remedial education for doctors. In extreme cases, they

can recommend fining doctors or excluding them from Medicare and

Medicaid, the federal programs for people who are elderly, disabled

or poor.

Mr. Levine said he had recently received a report about the

investigation from the peer review organization, Florida Medical

Quality Assurance Inc., which has a contract with the government to

investigate complaints about Medicare service in Florida.

Dr. s wrote to Mr. Levine that the federal government had

instructed him to reveal the findings.

The services provided to Mrs. Levine " did not meet professionally

recognized standards of quality, " Dr. s wrote.

" Specifically, she received medications to which there was a

documented possible allergy. "

In a recent interview, Dr. s said government pressure led

him to disclose the review's findings to Mr. Levine.

" We were asked to re-evaluate Mr. Levine's case to see if we would

be able to disclose more information to him than was originally

disclosed, " Dr. s said.

Consumer advocates welcomed the change. But doctors and peer

review organizations said they feared that doctors would be less

willing to cooperate with investigations if they knew that the

findings might be disclosed to patients.

" If doctors know that anything they provide can potentially be

revealed, " Dr. s said, " they will be more worried about

lawsuits, penalties and a punitive reaction. They will be less apt

to come forward with information about mistakes and errors. That

will retard the effort to improve the quality of care. "

The New York Times on the Web

http://www.nytimes.com

/-----------------------------------------------------------------\

Visit NYTimes.com for complete access to the

most authoritative news coverage on the Web,

updated throughout the day.

Become a member today! It's free!

http://www.nytimes.com?eta

\-----------------------------------------------------------------/

HOW TO ADVERTISE

---------------------------------

For information on advertising in e-mail newsletters

or other creative advertising opportunities with The

New York Times on the Web, please contact Alyson

Racer at alyson@... or visit our online media

kit at http://www.nytimes.com/adinfo

For general information about NYTimes.com, write to

help@....

Copyright 2000 The New York Times Company