Modern Healthcare - - Regional News -

TA­COMA, Wash—

Mul­tiCare Health Sys­tem has opened new emer­gency de­part­ments at Ta­coma Gen­eral Hos­pi­tal and Mary Bridge Chil­dren’s Hos­pi­tal. The emer­gency de­part­ments are both housed in the 132,000-square-foot Mil­gard Pavil­ion, a $172 mil­lion con­struc­tion project. The pavil­ion also is home to the Mul­tiCare Re­gional Can­cer Cen­ter, which opened on March 1. The Ta­coma Gen­eral emer­gency depart­ment has a to­tal of 42 rooms on two floors, three in­take/triage Diego; and Tri-City Med­i­cal, Ocean­side. The Alameda County Med­i­cal Cen­ter in Oak­land was fined $75,000 be­cause this was its sec­ond penalty. Scripps Green Hos­pi­tal in La Jolla re­ceived two penal­ties to­tal­ing $125,000. Scripps Green has amassed four penal­ties for pa­tient-care vi­o­la­tions. Hos­pi­tals must sub­mit a plan of correction and can ap­peal the penal­ties. A to­tal of 156 penal­ties amount­ing to $4.8 mil­lion have been is­sued to 108 hos­pi­tals since the law went into ef­fect. Nearly $3 mil­lion has been col­lected from hos­pi­tals. Health­care Ser­vices, a hos­pi­tal sys­tem, over billing pa­tients the bal­ance of the costs for emer­gency ser­vices. As part of the set­tle­ment, 12-hos­pi­tal Prime Health­care, On­tario, Calif., agreed to halt the prac­tice of billing plan mem­bers the bal­ance of ser­vices pro­vided; not pur­sue col­lec­tions; pro­vide re­funds with in­ter­est to pa­tients; and au­dit its records for the past six years to de­ter­mine whether en­rollees paid the bal­ance of the ser­vices billed for emer­gency care. The set­tle­ment also re­quires Prime Health­care to do­nate $1.2 mil­lion to com­mu­nity clin­ics in the state’s need­i­est ar­eas. The Cal­i­for­nia Man­aged Health Care Depart­ment, which over­sees HMOs, filed a law­suit against Prime Health­care in 2008, af­ter re­ceiv­ing com­plaints from pa­tients and providers over bills for emer­gency ser­vices. A 2006 ex­ec­u­tive or­der signed by Gov. Arnold Sch­warzeneg­ger pro­tected con­sumers from ow­ing the bal­ance of a hos­pi­tal bill for ser­vices ren­dered in an emer­gency. In 2009, the Cal­i­for­nia Supreme Court ruled that emer­gency room doc­tors could not di­rectly bill pa­tients for the bal­ance of charges that the in­surance com­pany did not pay. Prime Health­care said in a writ­ten state­ment that al­though it be­lieves it would have ul­ti­mately won the case at trial, it de­cided to set­tle to avoid fur­ther costs. Prime Health­care “looks for­ward to work­ing with the depart­ment to en­sure that HMOs live up to their le­gal obli­ga­tions,” ac­cord­ing to the state­ment.


The New Mex­ico Hu­man Ser­vices Depart­ment said it is no­ti­fy­ing about 9,600 mem­bers of its Med­i­caid feefor-ser­vice and Med­i­caid Salud health plans of a data breach in­volv­ing a lap­top com­puter car­ry­ing med­i­cal claims in­for­ma­tion, in­clud­ing mem­bers’ names and health plan iden­ti­fi­ca­tion num­bers, which in some cases were those mem­bers’ So­cial Se­cu­rity num­bers. The depart­ment “is en­cour­ag­ing all mem­bers to pro­tect them­selves by plac­ing a free fraud alert on their credit ac­counts,” ac­cord­ing to a news re­lease on the state agency’s web­site. The depart­ment was no­ti­fied of the breach on April 9 by Den­taQuest, Bos­ton, a den­tal health plan un­der con­tract as a provider of den­tal health ben­e­fits to the state’s Med­i­caid ben­e­fi­cia­ries. The breach stems from the theft of data on a lap­top com­puter re­port­edly in the trunk of a car stolen on March 20 in Chicago, ac­cord­ing to the state agency.

Mul­tiCare Health Sys­tem’s new $172 mil­lion, 132,000-square-foot Mil­gard Pavil­ion opened last month at Ta­coma Gen­eral Hos­pi­tal and Mary Bridge Chil­dren’s Hos­pi­tal.

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