Archive for September 21st, 2010
The federal agency that administers Medicare and Medicaid contributed to gaps in a national database of disciplined health care providers when it failed to report disciplinary actions as required by law, a new investigation found.
Significant gaps in the decades-old database came to light earlier this year when ProPublica found that many states hadn’t been reporting disciplinary actions taken against doctors, nurses, therapists and other health practitioners as required.
But the Centers for Medicare & Medicaid Services, a federal agency that’s part of the Department of Health and Human Services, essentially undermined its own department’s efforts to manage and maintain the federal database.
The new investigation was conducted by the department’s inspector general. It found that CMS, which oversees health care programs serving about 45 million Medicare beneficiaries and 59 million Medicaid beneficiaries, took disciplinary action against numerous bad medical providers but did not report those actions to the Healthcare Integrity and Protection Data Bank.
The database is meant to help hospitals and other entities make informed hiring decisions, and to prevent incompetent, fraudulent, or abusive medical providers from crossing state lines to continue practicing and putting patients at risk. But as we’ve reported, the database is riddled with gaps, and many states have also failed to report.
Because the sanctions that went unreported by CMS often involved institutions such as nursing homes and laboratories, the repercussions of this missing data may be less serious compared to the data that went unreported by states. Unlike individual practitioners, they’re less able to move across state lines and set up shop elsewhere.
CMS is required by law to report the following types of disciplinary action to the database: revocations and suspensions of laboratory certifications; terminations of providers from participation in Medicare; civil monetary penalties against all types of providers, managed care plans, and prescription drug plans.
Some of the data that should’ve been reported includes 148 sanctions imposed against laboratories in 2007 and 30 sanctions taken against managed care and prescription drug plans between January 2006 and July 31, 2009. From 2004 to 2008, the agency banned 45 nursing homes from participating in Medicare, and those actions were not reported until fall 2009, long after the required reporting timeframe, the inspector general’s office said.
One CMS division —responsible for tracking and reporting actions against Medicare-certified providers—didn’t report a single action between 2001 and 2008.
Officials from the agency wrongly believed “that only adverse actions related to fraud and abuse should be reported to the HIPDB,”the inspector general’s office found.
CMS acknowledged the lapse in a written response to the inspector general’s office. The agency said it will work on reducing the extent of manual reporting and building the necessary infrastructure to meet reporting requirements in the future.
Via Open Culture by Dan Colman, who notes:
From the makers of Wallace and Gromit comes the smallest stop-motion animation ever. The lilliputian main character, aptly named Dot, stands a mere 0.35-inch-tall. According to Popular Science, the animators “used a 3D printer to make 50 different versions of Dot, because she is too small to manipulate or bend like they would other stop-motion animation characters.” Then each print-up was hand-painted by artists looking through a microscope. Once the set and characters were ready to go, the directors attached a CellScope (a cellphone camera with a 50x magnification microscope) to a Nokia N8 and let the cameras roll. You can watch the final cut above.
via Popular Science
I ordered a couple of different mixes from meandgoji.com, and today they came. I’ll have to pick up some milk, and tomorrow I’ll report on one of them.
Mass customization meets the breakfast market.
15 minutes on the Nordic Track ski machine, in accordance with TYD’s suggestion to hold off until the weekend for advances in duration.
In fact, I doubt that I would have got on save that this monitor goes back at noon, and I certainly wanted to subject my exercise to monitoring.
Obama is a mystery to me. How can such hard-right, repressive, authoritarian if not totalitarian attitudes co-exist with his more progressive side? Marci Wheeler discusses the latest outrage:
The government appealed its loss in the habeas petition of Mohamedou Ould Salahi Friday.
It’s worth reviewing what this appeal is about. At the District level, Judge James Robertson ruled that while Salahi had clearly been an al Qaeda sympathizer and, before al Qaeda declared war on the US had been a sworn member of al Qaeda, the government had presented no admissible evidence (the most damning evidence submitted was gotten by torturing Salahi) that he was working under the orders of al Qaeda when they detained him in 2001.
His ruling is important–and damaging for the government’s hopes to indefinitely detain those who it can’t charge–for two reasons. First, because he hewed very closely to the terms of the AUMF.
If the government has any authority to detain Salahi without charging him with a crime, its source is the Authorization for Use of Military Force, Pub. L. 107-04, 115 Stat. 224 (2001).
“The President is authorized to use all necessary and appropriate force against those nations, organizations, or persons he determines planned, authorized, committed, or aided the terrorist attacks that occurred on September 11, 2001, or harbored such organizations or persons, in order to prevent any future acts of international terrorism against the United States by such nations, organizations or persons.” Authorization for Use of Military Force, Pub. L. 107-04, 115 Stat. 224 (2001).
That purpose, the “prevent [ion of] any future acts of international terrorism,” has the Supreme Court’s seal of approval, see Boumediene, 128 S.Ct. at 2277 (“The law must accord the Executive substantial authority to apprehend and detain those who pose a real danger to our security.”) those who, as the government argued in Hamdi v. Rumsfeld, 124 S.Ct. 2633, 2639 (2004), were “part of or supporting forces hostile to the United States or coalition partners . . and who engaged in an armed conflict against the United States.” (internal quotations omitted) .
And based on the AUMF’s reference to those who attacked us on 9/11, Robertson ruled that a suspicion that Salahi might one day return to al Qaeda–even if he had not been part of al Qaeda in 2001 when it attacked the US and had not taken up hostilities against the US–was not enough to detain him indefinitely.
The government’s problem is that its proof that Salahi gave material support to terrorists is so attenuated, or so tainted by coercion and mistreatment, or so classified, that it cannot support a successful criminal prosecution. Nevertheless, the government wants to hold Salahi indefinitely, because of its concern that he might renew his oath to al-Qaida and become a terrorist upon his release. That concern may indeed be well-founded. Salahi fought with al-Qaida in Afghanistan (twenty years ago) , associated with at least a half-dozen known al-Qaida members and terrorists, and somehow found and lived among or with al-Qaida cell members in Montreal. But a habeas court may not permit a man to be held indefinitely upon suspicion, or because of the government’s prediction that he may do unlawful acts in the future -any more than a habeas court may rely upon its prediction that a man will not be dangerous in the future and order his release if he was lawfully detained in the first place. The question, upon which the government had the burden of proof, was whether, at the time of his capture, Salahi was a “part of” al-Qaida. On the record before me, I cannot find that he was. [emphasis original]
And of course, given that both sides admit much of the evidence is inadmissible because it was coerced, this raises questions of what happens to those we’re holding because they incriminated themselves under coercion.
And when are we going to prosecute those lamebrain f**kwits who totally destroyed our ability to prosecute malefactors—and in the process committed war crimes? Answer: Never, if Obama has his way.
Prairie Creations is a vendor is new to me, but some guys over at DamnFineShave.com think highly of the product. I like how you get to choose (tallow or tallow+lanolin; scented, essential oils, or unscented; soap, cream, or shave stick). Take a look. She also sells aftershave balm, lip balm, exfoliating scrubs, etc.