FEDS IGNORE MALPRACTICE LAW

Negligence by government doctors obviously has to be shielded where possible

Federal health agencies routinely flout a requirement to report any cases in which they pay medical malpractice claims against the government, federal investigators said Tuesday. Such reports are meant to protect the public against incompetent doctors. Hospitals and health plans check such information before hiring doctors or granting them privileges. Under a 1986 law, insurance companies, hospitals and others who pay malpractice claims on behalf of doctors must report the information to a federal clearinghouse known as the National Practitioner Data Bank. Under a 1990 policy directive, federal health agencies are supposed to report the same type of information within 30 days after a court judgment is awarded or a case is settled.

But the new inspector general of the Department of Health and Human Services, Daniel R. Levinson, found that the department itself had repeatedly ignored this requirement. From 1997 to 2004, Mr. Levinson said, 474 cases "should have been reported to the National Practitioner Data Bank," but were not. This failure, he said, deprives state licensing boards of information they need when they decide to grant, restrict or revoke doctors' licenses. Moreover, he said, "underreporting of the department's own medical malpractice cases lessens the usefulness of the National Practitioner Data Bank and undermines departmental efforts to regulate private and public sector compliance" with the reporting requirements.

Senator Ron Wyden, Democrat of Oregon, author of the law that created the databank, said: "It is imperative that the federal government fully comply with the reporting requirements. The National Practitioner Data Bank is only as good as the information it contains."

Federal health officials told the inspector general that they did not want to be bound by certain requirements that applied to insurers and hospitals in the private sector. Specifically, they said, they did not want to report payments if they believed that the care provided by a doctor measured up to an appropriate standard of care. But Mr. Levinson said, "The private sector is required to report all medical malpractice settlements and judgments" to the databank, regardless of whether they believed that the doctors had been negligent.

State medical boards use information in the databank to evaluate the performance of doctors. In at least 19 states, consumers can obtain information about malpractice payments made by or on behalf of doctors.

Mr. Levinson said the National Institutes of Health and the Indian Health Service did not want to report malpractice payments when, in their judgment, government doctors had provided acceptable care. Payment of claims does not prove that a doctor is bad, but it may prompt consumers and hospitals to examine a doctor's record more closely. In some cases, government lawyers, like insurance companies, settle claims to avoid the costs of litigation. Doctors often have little say over whether the Justice Department or an insurer decides to settle.

Senator Wyden said that "a pattern of six or seven malpractice payments on behalf of a doctor should set off bells," even if the doctor has not been formally found to be negligent. In choosing a doctor, he said, many consumers would want to know such information.

Federal agencies told the inspector general that they had failed to report some malpractice payments because they could not find the case files. Thus, for example, one agency in the department, the Health Resources and Services Administration, said that "in many instances, relevant data or records were misplaced or lost." The health services agency operates the databank and finances community health centers around the country. The federal government serves as the primary insurer for such health centers and pays malpractice claims on their behalf, as if their employees were working directly for the government. Such payments are supposed to be reported to the databank.

Betty James Duke, administrator of the health services agency, said she would soon recommend changes to "ensure greater compliance" with the reporting requirements. But in discussions with the inspector general's staff, federal agencies did not make any firm commitments. "It was not clear whether they would fully comply," Mr. Levinson wrote

Source

***************************

For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.

***************************