Trends in Hospital Lawsuits Filed Against Patients for Unpaid Bills Following Published Research About This Activity.

Importance: Suing patients and garnishing their wages for unpaid medical bills can be a predatory form of financial activity that may be inconsistent with the mission of a hospital. Many hospitals in the state of Virginia were discovered to be suing patients for unpaid medical bills, as first presented in a 2019 research article that launched 2.5 months of media attention on hospital billing practices and a grassroots public demand for hospitals to stop the practice. Objective: To evaluate the association of a research publication and subsequent media coverage with the number of hospital lawsuits filed against patients for unpaid medical bills. Design, Setting, and Participants: This cross-sectional study of Virginia hospitals that sued patients for unpaid medical bills used an interrupted time series analysis. Data on hospitals suing patients for unpaid medical bills were collected during a preintervention period (June 25, 2018, to June 24, 2019), an intervention period (June 25, 2019, to September 10, 2019), and a postintervention period (September 11, 2019, to September 10, 2020). Exposures: Publication of a research article and subsequent media coverage. Main Outcomes and Measures: The total number of warrant in debt and wage garnishment lawsuits filed by Virginia hospitals and the frequency of those lawsuits filed before, during, and after the intervention period on a weekly basis. Results: A total of 50 387 lawsuits, filed by 67 Virginia hospitals, were included; 33 204 (65.9%) were warrant in debt lawsuits, and 17 183 (34.1%) were wage garnishment lawsuits. From the preintervention period to the postintervention period, there was a 59% decrease in the number of lawsuits filed (from 30 760 lawsuits to 12 510 lawsuits), a 55% decrease in the number of warrant in debt cases filed (from 19 329 to 8651), a 66% decrease in the number of wage garnishments filed (from 11 431 to 3859), and a 64% decrease in the dollar amount pursued in court (from $38 700 209 to $13 960 300). During the study period, 11 hospitals banned the practice of suing patients for unpaid medical bills. The interrupted time series analysis showed a significant decrease of 5% (incidence rate ratio, 0.95; 95% CI, 0.94-0.96) in the total weekly number of lawsuits in the postintervention period. Conclusions and Relevance: The findings of this study suggest that research leading to public awareness can shift hospital billing practices.

[Open doors, closed ports: can medicine suggest something to society?] / Porte aperte, porti chiusi: la medicina può suggerire qualcosa alla società?

Western countries are today experiencing a profound mutation of their immigration policies. Integration and hospitality have been taken over by closure and rejections. The policy of "closed ports" gained ground as never before. Traditionally, hospitals have imposed rules and restrictions to patients and visitors, ruling and limiting the space and the time offered. In the last two decades, though, a radical change in perspectives of some medical centres allowed a profound transformation of hospitals from closed realms to open spaces where communication and interaction with visitors is desired and encouraged. The policy of "open doors" became widespread and showed benefits in a lot of ways. Noticeably, a profound asymmetry exists between the idea of "closed ports" and "open doors", both representing - albeit in different contexts - opposite solutions for similar issues. It is possible to make a comparison? Can medicine suggest something to society?

[Current legislation in the healthcare system 2015/2016]. / Aktuelle Gesetzgebung im Gesundheitswesen 2015/2016.

The energy of the legislator in the healthcare system was barely stoppable in 2015. Many new laws have been brought into force and legal initiatives have also been implemented. The Hospital Structure Act, the Treatment Enhancement Act, amendments of the official medical fee schedules for physicians, the Prevention Act, the E-Health Act, the Anti-corruption Act, the hospital admission guidelines and amendments of the model specialty training regulations are just some of the essential alterations that lie ahead of the medical community. This article gives a review of the most important new legislative regulations in the healthcare system and presents the fundamental consequences for the practice.

[Current legislation in the healthcare system 2015/2016]. / Aktuelle Gesetzgebung im Gesundheitswesen 2015/2016.

The energy of the legislator in the healthcare system was barely stoppable in 2015. Many new laws have been brought into force and legal initiatives have also been implemented. The Hospital Structure Act, the Treatment Enhancement Act, amendments of the official medical fee schedules for physicians, the Prevention Act, the E-Health Act, the Anti-corruption Act, the hospital admission guidelines and amendments of the model specialty training regulations are just some of the essential alterations that lie ahead of the medical community. This article gives a review of the most important new legislative regulations in the healthcare system and presents the fundamental consequences for the practice.

Presente y futuro de la psicología clínica y sanitaria en España: una visión alternativa / No disponible

En nuestro país existen actualmente dos tipos de psicólogos titulados con competencias para el ejercicio de la psicología en el ámbito sanitario: el Psicólogo Especialista en Psicología Clínica (PEPC) y el Psicólogo General Sanitario (PGS). Estas titulaciones están legalmente reguladas y la acreditación en las mismas se obtiene a través de dos tipos diferentes de programas de formación de posgrado: el Programa de Internado y Residencia (PIR) en el caso de los PEPC; y el Master de Psicología General Sanitaria (MPGS) en el caso del PGS. Estos programas tienen una duración temporal diferente (4 años el PIR y 2 años el MPGS) y a ellos se accede después de la realización de los correspondientes estudios de Grado (o de licenciatura) en Psicología. Sin embargo, tanto los objetivos y las competencias a alcanzar, como el contenido de sus programas de formación, son realmente muy similares, a pesar de las diferentes denominaciones lingüísticas utilizadas para describir los mismos. En base a esas diferencias temporales terminológicas existentes entre ambos programas,algunas asociaciones españolas (ANPIR, COP, AEPCP y AEN) defienden la postura de que entre ambas titulaciones se debería estable-cer además de una jerarquización, una delimitación clara respecto de las funciones que pueden realizar ambas (clínicas y especializa-das versus sanitarias y generales) y de los ámbitos o contextos en los que pueden ejercerlas (público versus privado). En nuestro artículorebatimos estas posturas y las razones en las que se basan y argumentamos extensamente en favor de una propuesta alternativa másacorde con la realidad de los hechos y más armónica con el contexto europeo en relación con la acreditación profesional en PsicologíaClínica, en el sentido de asumir la existencia de las dos titulaciones independientes de psicólogos clínicos (el PEPC y el PGS), con accesodirecto a ambas desde la titulación del Grado en Psicología, y con unas competencias y funciones profesionales equivalentes, aunquecon algunas limitaciones en el caso del PGS, principalmente respecto a la posibilidad del ejercicio profesional en el Sistema Nacional deSalud (reservado para los PEPC) y cuya actividad sería ejercida principalmente en el ámbito privado

In our country, there are currently two types of psychologist qualified to practise psychology in the health field: the Specialist Psychologist in Clinical Psychology (PEPC) and the General Health Psychologist (PGS). These qualifications are legally regulated and their accreditation is obtained through two different programs of postgraduate training: the Residential Internship Program (PIR) in the case of the PEPC; and the Master of General Health Psychology (MPGS) in the case of the PGS. These programs are of different lengths (4 years for the PIR and 2 years for the MPGS) and they are accessed after completion of the corresponding degree in Psychology. However, both the objectives and the skills to be attained, as well as the content of the training programs, are really very similar, in spite of the different linguistic denominations used to describe them. On the basis of the existing differences in the terminology and the duration of the programs, some Spanish associations (ANPIR, COP, AEPCP and AEN) defend the position that there should be established between the two qualifications, in addition to a hierarchical structure, a clear boundary with respect to the nctions that the two types of psychologist can perform (clinicaland specialized versus health and general functions) and of the sectors or contexts in which they can practise (public versus private). Inour article, we refute these positions and the reasons on which they are based and we argue extensively in favour of an alternative propo-sal more in tune with the reality of the facts and with the European context professional accreditation in clinical psychology, in the sense ofaccepting the existence of the two independent qualifications of clinical psychologists (the PEPC and the PGS), with direct access to bothfrom the degree in Psychology, and with equivalent competencies and professional functions, although with some limitations in the case ofthe PGS, mainly with respect to the possibility of professional practice in the Spanish National Health System (exclusive to the PEPC) andin their activity, which would be carried out mainly in the private sector

[Representatives of consumer associations and the "hôpital, patients, santé et territoires" law: an outline of the issues and twelve proposals]. / Représentants d'associations d'usagers et Loi << Hôpital, patients, santé et territoires >> : enjeux et douze propositions.

Since 1996, consumers have been able to become involved in the development and implementation of national, regional and local healthcare policies, thereby demonstrating the possibility of establishing a model of democratic institution in healthcare at all levels of decision-making and policy implementation. Despite this 13-year political ambition, it is open to question whether the bill on the reform of the hospital will serve to extend the same dynamic for patients, healthcare institutions and local authorities. On 15 November 2008 and 18 April 2009, fifty-four consumer association representatives in the Franche-Comté region convened to conduct an audit of their commitments with a view to making proposals to adapt the bill aimed at reforming hospitals for the benefit of patients, healthcare and territories (HPST) before the bill is debated in Parliament (National Assembly and Senate). Despite significant investments since 1996 and some notable successes, for these representatives of consumer healthcare associations, the results are distinctly mixed. This is because they sometimes feel instrumentalized in healthcare facilities and believe that their opportunities for participation have declined since 2002. Their view is that this may diminish the power they wield at a time when the economy may be seen as becoming a substitute for public healthcare and participatory democracy. In a context of inequality in healthcare and at a time of economic crisis, this paradigm shift has tended to mobilize representatives of consumer associations. In their view, a strong counter-power is required to ensure fair and equal access to healthcare for all. They suggest twelve proposals concerning organization and professionalism at both territorial and national levels, articulated around the following principle : a representative of a consumers' association can become a regional reference in the management of the agency's regional healthcare system and may be given the means to coordinate the work of other representatives of consumer associations for each of the regional healthcare plans.

Policy Tech Trends 2010. Trend: privacy.

UNLABELLED: THE LANDSCAPE: Because HIPAA enforcement previously lacked teeth, many healthcare organizations haven't developed the policies and procedures required to prevent data breaches. The ARRA-HITECH Act is about to change all of that. THE FUTURE: HITECH's security provisions and heightened enforcement may force hospitals and their business associates to spend more on training and security features such as encryption and audit trail systems, and to hire consultants to conduct audits.

[Legal basis for the hygienic processing of medicinal products]. / Krankenhaushygiene - Gesetzliche Grundlagen der Aufbereitung von Medizinprodukten.

The major objectives of the German Medicinal Products Act (Medizinproduktegesetz, MPG) and the Medicinal Products Marketing Act (Medizinprodukte-etreiberverordnung, MPBetreibV) are to avoid the dangers (to health) arising from medicinal products (MP). This necessitates procedures for the professional maintenance of the, according to regulations low in germs or sterile, MP to be used. These procedures are associated with qualified personnel, appropriate resources, a reproducibly successful processing procedure and control of the technical-unctional safety of the MP.

[Amendment to the law governing the professional activities of physicians in "Medizinische Versorgungszentren"]. / Neuerungen für Medizinische Versorgungszentren nach dem Vertragsarztrechtsänderungsgesetz.

The amendment to the law governing the professional activities of physicians in general, free practice came into force on 1st January 2007 bringing important changes relevant to medical centres, which were first permitted by the government three years ago. Under the new regulations, for example, medical centres with the status of a private limited company now must provide a guarantee as a condition for the licence to operate. Some of the other most important new regulations include the abolishment of the restriction to practice in one place only and permission for physicians to hold positions in a hospital and a medical centre at the same time.

Healthcare providers constricted by financial, legislative, and regulatory issues.

The challenges facing the healthcare industry have created a chasm between the focus on quality of care and financial survival. More than 46.5 million Americans are uninsured, and another 16 million are underinsured with health insurance plans that leave patients unable to afford their portion of hospital charges. There are literally hundreds of solutions to assist hospitals in solving payor, self-pay, billing, and charity issues. Examples of solutions that are available include advanced analytics and modeling, automated decisioning and business rules engines, automated insurance eligibility verification, work flow tools, collection services, patient payment calculators, and many others. As the industry becomes more self-regulated and proactive, the pressure concerning business operations hopefully will diminish and hospitals can focus more on the delivery of care.

Externalización en los hospitales, ¿y el servicio de esterilización? / Outsourcing in hospitals, what about the sterilisation service?

El proceso de esterilización está cada vez más tecnificado y requiere un espacio adaptado, un equipo humano técnicamente cualificado, un sistema de control de calidad riguroso, unos equipos actualizados, el cumplimiento de la normativa vigente así como un nivel de inversiones que permita todo lo anterior. En este sentido, el presente artículo propone diversos motivos para externalizar el servicio de esterilización, entre ellos: reducción de costes, mejora de la calidad, mejora en gestión del personal, mejora en la capacidad de innovación, reducción de las inversiones, concentración en la atención al paciente y adecuación a la normativa vigente, teniendo en cuenta que el fin debe ser implantar el modelo que mejor responda a las necesidades del centro (AU)

The sterilization process is becoming increasingly more technified and requires a suitable, space, technically a level of investment which enables all this to be carried out. In this respect, this article presents different reasons in favour of outsourcing the sterilisation service, including,; cost reductions, improvement in quality, improvements in staff management, improvements in the capacity of innovation, reduction in investment, concentration on patient care and adaptation to the current regulations, taking into account that the aim should be to introduce the model which best suits the centre´s needs (AU)