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Insurers Underpaid 'Billions' In Health Claims
The Senate Commerce Committee has found that a flawed payment database produced by a UnitedHealth subsidiary and distributed to other major insurance companies has led insurers to underpay millions of out-of-network claims, forcing patients to make up the difference of health care providers" fees, the Wall Street Journal reports. Aetna, Cigna, WellPoint, and other large insurers used the data to calculate their "reasonable and customary" charges. They also provided UnitedHealth"s subsidiary, Ingenix, with historic data about their payments, which became the foundation of ongoing versions of the flawed payment models.
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Molecular Typesetting -- Proofreading Without A Proofreader
Researchers at the Universities of Leeds and Bristol (UK) have developed a model of how errors are corrected whilst proteins are being built.
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Antidepressant Ineffective Against Autism Spectrum Disorder Children's Obsessive Behavior
A new multi-center study, conducted at The Feinstein Institute for Medical Research in collaboration with five other centers throughout the country, tested the commonly prescribed antidepressant citalopram and found that it was no more effective than placebo in altering obsessive features of the condition - the spinning, rocking and repetitive behavior.
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Many U.S. Hospitals Fail To Report Physician Disciplinary Cases To National Databank

Many U.S. hospitals do not take sufficient disciplinary action against physicians for poor conduct or medical incompetence and fail to report such cases to the National Practitioner Data Bank, according to a report released Wednesday by Public Citizen, the Contra Costa Times reports. Congress established the databank in 1990 as a central repository for information about physicians whose hospital privileges had been withdrawn or limited for more than 30 days. The bank is closed to the public (Kleffman, Contra Costa Times, 5/27).For the report, Public Citizen"s Health Research Group analyzed studies by the HHS Office of Inspector General and the Citizen Advocacy Center, as well as medical journal articles and recommendations made during an October 1996 meeting on under-reporting by hospitals (Stark/Hallihan, ABCNews.com, 5/27). According to the report, nearly half of U.S. hospitals did not submit one physician"s name in 17 years to the databank. One purpose of the databank is to provide hospitals with background information about physicians they were considering hiring at their facilities. Under the initial expectations of the databank, federal officials estimated that at least 5,000 disciplinary cases would be reported annually. However, on average, about 650 reports have been made annually since the databank was created, the report found (Contra Costa Times, 5/27). The group on Wednesday sent a letter to HHS Secretary Kathleen Sebelius that included recommendations to improve the efficacy of the databank. The letter said that the reporting numbers are "unreasonably low, compared with what would be expected if hospitals pursued disciplinary actions aggressively and reported all such actions." The letter urged Sebelius to ensure that hospitals are conducting necessary peer reviews and oversight of physicians, taking proper disciplinary actions and reporting them to the databank so that physicians" track records are available to all hospital administrators. Penalties also should be established for hospitals that fail to comply with the reporting requirements, the group said.Al Levine, the author of the report, said some hospitals had found ways to avoid their physician reporting responsibilities, such as by limiting restrictions on hospital privileges to fewer than 30 days or giving physicians a "leave of absence" in place of suspending their privileges. Levine said, "Even in states with high levels of reporting," it "seems to be concentrated in a few facilities" (Contra Costa Times, 5/27).In a statement responding to the report, the American Hospital Association said, "The premise that the number of reports received by the National Practitioner Data Bank correlates to jeopardized patient care is inaccurate," adding, "Hospitals are actively involved in a wide variety of efforts to continuously improve care and talk publicly about the care we provide" (ABCNews.com, 5/27). The report is available online. Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation. © 2009 Advisory Board Company and Kaiser Family Foundation. All rights reserved.


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