Hospitals and Physicians should analyze the impact of Stark II Google

The Stark II Phase II regulations were published as an interim final rule on March 26, 2004 and will become effective on July 26, 2004. 

 

The (aka federal physician self-referral law) prohibits physicians from referring Medicare patients for certain designated health services (DHS) to an entity with which the physician or a member of the physician’s immediate family has a financial relationship–unless an exception applies. Stark was originally enacted under Section 1877 of the Social Security Act  in 1989 and only applied to physician referrals for clinical laboratory services. In 1993 and 1994, Congress expanded the prohibition to ten additional DHS and applied certain aspects of the law to the Medicaid program. The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA 2003) (Public Law 108-173) further altered section 1877 by establishing an 18-month moratorium on physician ownership of or investment in certain specialty hospitals. The moratorium is in effect from December 8, 2003 through June 7, 2005. The  is typically used in conjunction with the anti- laws to investigate for reimbursement related actions under . In addition, Stark is being used more and more as a basis for qui tam related whistleblower actions brought by individuals. 

 

The new regulations clarify a number of areas of that have been confusing and uncertain for years. Health lawyers have tried to provide the best advice possible to their clients when looking at Stark related issued — but because final regulations have been long in coming it has been very difficult to fully understand the complexity of some of the Stark related exceptions. Now that Stark II Phase I and Phase II have been issued many of the gray areas are now much clearer. What will this lead to? More enforcement? More qui tam whistleblower claims which contain Stark related allegations? Only time will tell. Hospital, physicians and other designated health service care providers should take a close look at the impact of the new regulations.

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Acne Free Clear Skin System Google

The purpose of Acne Free Clear Skin System is to clear the skin during an acne outbreak and help to prevent future outbreaks.

Pros: Those who suffer with acne are well aware of the fact that just because an acne breakup clears up (eventually) that doesn’t mean that the acne is really gone. Treatment for skin that is acne prone is an ongoing procedure.

Of course, the main objective when an acne outbreak does occur is to clear it up as quickly and as efficiently as possible. The Acne Free Clear Skin System is a three-step system that is designed to clear up an acne outbreak and then, with regular treatment, prevent future outbreaks.

The three steps in the Acne Free Clear Skin System are; (1) Cleaning and purifying the skin, (2) Applying a renewing toner and (3) applying a repair lotion. The treatment instructions say that this complete three-step program needs to be every day and twice a day to help clear acne outbreaks as well as prevent future outbreaks.

Cons: This product, while an excellent value, may not be suitable for severe cases of acne. Because it is designed to help prevent breakouts, people with scarring or severe acne should not expect miracles.

Guarantee: There is a very generous that reads in part: “All items purchased through CosmeticMall.com have a 30 Day Money Back Guarantee. If you are not satisfied for any reason you may return the product for a full refund (even if you have tried the product).”

Value for money: The Acne Free Clear Skin System is an excellent value.

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WVHCA Reconsiders HCR Manor Care CON Google

The State Journal provides background on the pending reconsideration hearing set for December 14, 2007 (9am), before the the West Virginia Health Care Authority regarding the Authority’s granting of a for the $6.3 billion buyout of HCR Manor Care by The Carlyle Group, a private global investment firm.

The Authority granted HCR Manor Care a certificate of need on October 19, 2007, however, on November 15 the Service Employees International Union Local 1199 filed a Request for Reconsideration with the Authority along with an Appeal to the Office of Judges.

On November 20, the Authority issued its Decision on Request for Reconsideration granting the reconsideration and ordering a stay of its October 19, 2007 decision pending resolution of the request for reconsideration.

UPDATE (12/10/07): Jeff Mehalic at the West Virginia Business Litigation blog picks up on my post and includes uploaded links of some of the CON pleadings in the matter, including the:

Thanks to Jeff for the link and for uploading some of the key public documents in this pending matter.

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State funeral for Bernie Banton Google

Bernie Banton, the public face of the campaign against asbestos company James Hardie, has died, but his efforts have been hailed as a decades-long legacy for asbestos disease sufferers.

Mr Banton, 61, died at his Sydney home about 1am (AEDT) on Tuesday with his family by his side.

His wife Karen, brother Bruce, sister Grace and five children have accepted the NSW government’s offer of a state funeral.

Mr Banton was diagnosed in August with , an abdominal cancer caused by his exposure to asbestos when he worked for a subsidiary of James Hardie from 1968 to 1974.

He had already been suffering for years from asbestosis, a lung disease also caused by exposure to asbestos.

Despite this, he led the campaign to force James Hardie to establish a fund that would provide adequate compensation for all its employees suffering from diseases caused by their exposure to asbestos at its factories.

He was, NSW Premier Morris Iemma said, “a truly great Australian, a man who fought for others at a time when he should have been worrying about his own health”.

“In November 2006, on the day we signed the final agreement to secure compensation for Hardie victims (workers in James Hardie factories who contracted diseases caused by asbestos), Bernie knew he’d achieved something special.

“That deal was worth $1.5 billion over the next 40 years for those who suffered and continue to suffer this dreadful disease.

“It would not have been possible without Bernie Banton.”

Prime Minister-elect Kevin Rudd said he was “a fighter” who was “a symbol, a living symbol of what is right and decent and proper in the workplace relations of this country”.

“Australia is going to be poorer for Bernie’s passing – our whole nation will be poorer for Bernie’s passing,” Mr Rudd said.

Mr Banton was diagnosed in 1999 with asbestosis and ARPD (asbestos-related pleural disease), which reduced his lung capacity to 40 per cent.

He began to rely on an oxygen bottle, but he refused to let it slow him down, taking it with him everywhere he went as he campaigned for fair compensation from James Hardie for all its affected workers.

Estimates of future claims continued to rise, and the company was eventually forced in December 2004 to sign Australia’s largest ever compensation settlement, worth up to $4.5 billion over 40 years.

In a statement, James Hardie expressed its condolences to the family of Mr Banton, acknowledging his work in raising public awareness of asbestos-related disease.

“The company acknowledges the significant contribution Mr Banton made to raising the awareness of asbestos-related diseases in Australia, and his role in the eventual implementation of the final funding agreement to compensate Australians with asbestos-related personal injury claims,” the company said.

NSW parliament rose for a moment’s silence and both sides of politics delivered statements praising him.

“Bernie courageously pursued justice for sufferers of asbestos-related diseases and their families, we all owe him a debt of gratitude,” NSW Industrial Relations Minister John Della Bosca said.

Former ACTU secretary Greg Combet said Mr Banton had been a fighter for other people and a fighter for justice.

“I hope that people properly appreciate the importance of the settlement that was reached with James Hardie a few years back, because it was a very hard fight and Bernie contributed a lot,” Mr Combet said.

“That’s how he should be recognised.”

Last Thursday, Mr Banton won a confidential payout as compensation for his terminal mesothelioma, including exemplary damages for what his lawyers called James Hardie’s “contumelious” disregard for the health of its workers when they knew of the dangers of asbestos.

In 2000, he had been awarded $800,000 compensation for asbestosis.

And last month he succeeded in getting the palliative drug Alimta subsidised by the federal government for mesothelioma sufferers.

His brother Bruce said Mr Banton’s funeral would probably be held on Saturday but details were still being discussed.

“One thing we will be asking is for instead of flowers at the service is donations for asbestos research and treatments,” he said.

In a further tribute, the Asbestos Diseases Research Institute at Sydney’s Concord hospital will also be named the Bernie Banton Centre.

In Melbourne, he was honoured at a commemorative service, part of Asbestos Awareness Week, to remember people who have died from asbestos-related diseases.

Source

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How To Cut Back On Your Sodium Intake Google

How To Cut Back On Your Sodium Intake
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Have you recently been told by your doctor that you had to
go on a low-sodium diet? You are probably finding this to be
quite difficult as you discover that sodium seems to be
everywhere? Well you are certainly not alone as the typical
American eats way too much fast food when away from home and
at home they tend to gravitate towards those high sodium
comfort foods. Processed foods such as frozen, canned soups
and vegetables, boxed noodles, salsas and chips are all
loaded with sodium.

Those on a low-sodium diet are usually told to consume
somewhere between 2,000 to 3,000 milligrams (mg) of sodium
per day. That is the equivalent of about one teaspoon of
salt or approximately 2,300 mg of sodium.

So how can you cut back on your sodium intake? Here are
some tips to get you started on the correct path. As with
all major lifestyle changes the most important thing is to
just get started. As Confucius said A journey of a thousand
miles begins with a single step. By following these simple
rules you will learn to master your new low sodium lifestyle
in no time. Keep it simple, don’t stress and remember:

1. Don’t beat yourself up. The goal is not to
eliminate all the salt entering your system, it is to reduce
your sodium intake down to the level your doctor prescribed.

2. Stop adding salt to your food. Don’t add it when cooking and
remove the salt shaker from the kitchen table. While these
old habits are hard to break you also have to not feel like
you are depriving yourself of wonderful taste. So instead
learn to experiment. Fill the old salt shaker with some
salt-free herbs and spices ” basil, cayenne pepper, garlic,
lemon pepper, onion oregano and parsley are all great
options. Begin with small amounts until you find a
combination that you enjoy.

3. If you dont already own a peppermill go out and buy one. The
flavor and aroma of freshly ground peppercorns is not only
amazing but there are also so many varieties to choose from.
The most recognized is a common black peppercorn which is
typically a variety like Lampong. A more upscale black
peppercorn is the gourmet quality Tellicherry. For those
that really want to embrace exotic taste sensations try
Pink, Green or Sichuan peppercorns. For a milder peppercorn
with a European twist go for a white peppercorn as these
tend to have less bite than the black peppercorns.

4. Learn how to analyze food labels. when you are comparing
products side-by-side you will soon see some amazing
differences between products that may at first glance seem
identical. A good rule of thumb is that all packaged food is
going to have higher levels of sodium than fresh foods. But
when you know what to look for you can still make healthier
choices!

5. Go fresh. Typically you don’t have to worry about high
sodium levels in fresh fruits and vegetables and as an added
bonus you can eat about as much as you would like and not
have to worry about packing on the pounds. Fresh lean meat,
fish and chicken tend to be low in sodium as well.

6. Learn how to fully experience herbs. Before adding herbs to
your dish crush them in your hand to bring out the full
taste. Also most herbs provide the most flavor when added
towards the end of the cooking process.

While it will be difficult to change your eating habits,
remember to start small. Begin with just one meal a day.
Once you always eat that one meal as low sodium as possible
then add a second meal. This approach will have you on the
right path before you know it. While it may take weeks
before you have a solid understanding of low-sodium foods,
you will learn to adjust. And eventually you will hardly
even miss the salt and your taste buds will come alive as
they are exposed to a world of mouthwatering new tastes and
flavors.

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Data Missing on 200,000 West Virginia PEIA Members Google

WSAZ News, the State Journal and Charleston Gazette are reporting that data on approximately 200,000 past and current members of West Virginia Public Employees Insurance Agency (PEIA) is missing. According to the articles, the data was contained on a computer tape being mailed to a data analyst in and was reported missing on October 18.

The data tape included names and maiden names, addresses, social security numbers, telephone numbers, and marital status of program participants and their covered dependents. The article indicates that the data tape did not contain medical or prescription claims information.

According to the article, letters will be mailed to impacted members and a hotline will be set up to answer questions about the lost data.

UPDATE: For more out the PEIA Data Loss Press Release and the Letter to Affected Policyholders about PEIA’s Recent Data Loss.

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Are You Having A Stroke? Watch For These Signs Google

Are You Having A Stroke? Watch For These Signs

signs of a stroke, heart disease, heart health, conditions and diseases, atrial fibrillation, heart ailments, cardiovascular disorders

By Barb Hicks

Stroke occurs when blood flow to the brain has been halted
due to a clot or bleeding into the brain. Therefore, blood
is unable to reach all destinations of the brain, resulting
in a stroke. The person experiencing a stroke will begin to
exhibit signs and symptoms. Some signs come and go usually
within 5 minutes and leave no lasting effects. However,
symptoms lasting longer may indicate a major stroke is
occurring. Even if symptoms are short lived, it is
imperative to get medical help immediately. If not treated
as soon as possible, major brain damage and lifelong
disabilities could result.

What are the signs?

- Tingling sensation in the face or extremities – Paralysis
or weakness on one side – Difficulty speaking – Inability to
understand speech – Blindness – Dizziness – Pain -
Nausea/vomiting – Sudden intense headache

If you believe someone around you is experiencing these
symptoms call 011 and seek the help of medical professionals
immediately.

Risk Factors for Stroke:

- Age: At age 55 the risk of stroke doubles every ten years
after – Race – Gender: Typically, women are less likely to
experience a stroke than men – Previous stroke – Fractures
resulting in a fat embolism – Family History – Atrial
Fibrillation

Reducing your risks:

Take all medications prescribed by your physician. Monitor
blood pressure. Lower cholesterol and triglyceride levels.
Quit Smoking. Eat a healthy diet. Get plenty of exercise.

Physicians use a CT, MRI or Angiogram to determine the
location of a stroke, the amount of damage it caused as well
as what type of stroke was experienced.

Treatment involves clot busters, such as tPA that must be
given within hours of the onset of symptoms. Surgical
intervention is an option for ischemic and hemorrhagic
strokes.

Care after stroke:

Recovery after a stroke may take a few days to over a year
to complete. In many cases, occupational, physical and
speech therapy may be required.

Types of Medications:

Thrombolytics – Clot busters that loosen or break up blood
clots. The debris is cleaned up by phagocytic cells.
Antiplatelet – Prevents platelet s from sticking together,
thus preventing clot formation. Anticoagulants – Stops
clots from forming, particularly those with A-fib who are
prone to blood clots due to the rapid contractions of the
atria of the heart.

If you have other diseases such as diabetes or high blood
pressure, it is very important to monitor and manage them
properly. Proper care will help ensure that the risk of a
stroke is lessened and a quality, productive life prevails.

Having an exercise regimen at least three days a week can
lower blood pressure. Blood pressure is the number one
factor in bringing on a stroke or hemorrhagic strokes.

A healthy diet containing fresh fruits, whole grains and
nuts, vegetables and lean meats is another great way to help
lessen the risks for stroke.

Barb Hicks is a licensed registered nurse and featured
health writer on Clivir.com. You can find here her lessons
on
(http://www.clivir.com/lessons/show/what-causes-a-stroke-common-cause-of-stroke.html)
Stroke Causes and other information about
(http://www.clivir.com/lessons/show/early-warning-signs-and-symptoms-of-a-stroke.html)
Early Warning Signs of Stroke.

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Exploding Toilet Is A Real Sh#@#! Case to Defend in West Virginia Google

One of my favorite legal blawgers, Craig Williams at May It Please the Court reports on a recent lawsuit filed in Monongalia County Circuit Court involving an exploding porta-john. I saw a number of news items on this unique lawsuit and just hadn’t gotten around to posting on the lawsuit. I am sure this West Virginia case will make the rounds on Letterman, Leno and Conan.

It reminds me of a portable toilet company from my days of visiting my mother’s relatives in Bannock, Ohio and Flushing, Ohio. There was a local porta-john company named “John’s Johns”. The side of the modern day outhouses said “John’s Johns of Flushing, Ohio”. If that ain’t great advertising I don’t know what is.

Following is Mr. Williams post:

WLF May it Please the Court Law Weblog of legal news and observations, including a quote of the day and daily updates: “The Dangers Of Smoking
For some reason the headline ‘Man Sues Over Exploding Toilet’ sounds much too much like a Monty Python skit or a headline from the onion.com.

Not being a smoker, I am not sure if it is commonplace to sit down and light up or not. If it is, just imagine the additional warning labels that are going to have to be placed on packs of smokes. If words can’t get the message across, perhaps a picture (see photo) would do. This may be the best way to keep kids from every picking up the habit. ”

Brian Peterson’s West Virginia Legal Weblog also recently posted on this new lawsuit. Brian points out in a followup post that the case might not be as “unique” as first thought. See Supreme Court Tom Rodd’s comment citing West Virginia precedent for the case. Dowler v. Citizens’ Gas & Oil Co., 71 W.Va. 417, 76 S.E. 845 (1912).

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The Zone Weight Loss Diet from Zone Living.com Google

The purpose of The Zone Weight Loss Diet is to help lose weight according to their own specific requirements.

Pros: Dr. Sears designed all of the various Zone diets. He says about weight loss, “To achieve long term weight loss, you must reduce inflammation in your cells. To do this, you need not deprive yourself. On the all you have to do is eat the right combination if food, nourish your body with the Omega-3 fatty acids it needs and exercise moderately. The result? Burn fat faster, lose excess weight, boost your energy, keep hunger at bay and even help reduce the risk of chronic disorders.”

Many very famous people have had great success using The . Among them are Jennifer Aniston, Cindy Crawford, Madonna, Sandra Bullock, Jennifer Lopez, Demi Moore and Winona Ryder.

Diet products are recommended for various diet goals. These products can be ordered on the website at a reasonable cost and there is also a lot of support offered on the website that is helpful to .

Cons: The Zone Weight Loss Diet is either loved or hated. There has been some controversy surrounding it.

Guarantee: There is no guarantee of success offered on The Zone Weight Loss Diet website.

Value for money: The Zone Weight Loss Diet is a very good value.

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Colorful Spectrum of Blawg Review #47 Google

Eh Nonymous, an anonymous Philadelphia lawyer, covers a broad spectrum of colorful law related posts in this week’s Blawg Review #47 at Unused and Probably Unusable.

Didn’t mama always warned you about Philadelphia lawyers? Direct from the Philadelphia Bar Association:

It’s hard to talk about Philadelphia without talking about Philadelphia lawyers. And the Bar Association has forever been associated with the term “Philadelphia Lawyer.” The term actually predates the nation’s founding, having its origins in 1735 when Philadelphia lawyer Andrew Hamilton traveled to New York City to defend a poor printer, John Peter Zenger. Hamilton actually acted pro bono and accepted a case that no New York lawyer would take on. Defending Zenger against charges of sedition brought by the crown, Hamilton won the case and, in so doing, established the concept of freedom of the press more than 50 years before the First Amendment.

It was said that when the jury returned its verdict those in the galleries exclaimed: “Only a Philadelphia lawyer could have done it!” Ever since then the term “Philadelphia lawyer” has come to characterize a particularly adept lawyer: more clever; craftier; a lawyer who will find a way to prevail for his/her client.

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