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Attorney and Accountant Indicted in Largest Medical Insurance Fraud Case
Santa Ana, Calif. — The California Department of Insurance and the Orange County District Attorney’s Office (OCDA) announced the unsealing of criminal grand jury indictments in the largest medical fraud prosecution in the nation, charging the final two defendants for their role in the Unity Outpatient Surgery Center scheme, in which $154 million was fraudulently billed to medical insurance companies. ...(More)
6/30/2008 11:37:37 AM
Darwin Announces 1st Q '08
FARMINGTON, Conn. — Darwin Professional Underwriters, Inc. announced its financial results for the first quarter ended March 31. Highlights include:-- Gross premiums written for the first quarter are $80.0 million. First quarter gross premiums written are 7.8 percent ahead of our gross premiums for the same period a year ago. Net premiums written for the quarter of $58.0 million are ...(More)
4/28/2008 2:12:27 PM
Gaining & Maintaining Accreditation is Tough
Accreditation is a personal matter. Leaders of every ambulatory surgery center (ASC) have their reasons for or against it, and one accrediting body may work better for one facility than for the next. Timing is also important. Now might not work, but next year? The answer is up to the leaders of each business.Some people, however, swear by accreditation. The ...(More)
1/15/2008 2:06:00 PM
Physician Owners Sue Insurance Companies
Several leaders of physician-owned surgery centers and surgical hospitals think they’ve been mistreated by mainstream hospitals and managed care organizations (MCOs), and some have filed suit. Only one case, however, is scheduled for trial, and that suit may determine whether physician-owners pursue litigation in the future, says Patrick Stueve, a lawyer who is trying the case. The outcome may also influence ...(More)
1/15/2008 2:06:00 PM
RISK Management: Q & A with Peggy Martin
RISK Management: Q & A with Peggy MartinBy Jennifer SchraagQ: Can you explain why root cause analysis is so important to an effective risk management program?A: Root cause analysis (RCA) is important to an effective risk management program because it provides opportunities to design and implement risk reduction strategies based on lessons learned. An important aspect of risk management is ...(More)
8/1/2007 8:42:46 AM
TECHNOLOGY RISK
TECHNOLOGY RISKDo You Know Yours? WHILE TECHNOLOGY AND INFORMATION RISK are not new areas of exposure, they are no longer limited to technology providers. Healthcare organizations — including ambulatory surgery centers (ASCs) — are collecting and disseminating more personal and clinical patient information than ever before. As the amount of information that ASCs collect, centralize, and transmit increases, so too ...(More)
5/31/2007 3:32:01 PM
Risk Management and Patient Safety in the Ambulatory Environment
Risk Management and Patient Safety in the Ambulatory EnvironmentBy Jennifer SchraagThe movement toward transparency is a very real issue facing today’s healthcare organizations. As it eventually trickles through every facet of healthcare, the success of a healthy risk management program is going to play an ever-increasing role.Risk management is quickly shifting from the behind the desk, financially-focused position it has ...(More)
3/1/2007 7:41:54 AM
Risk Management for ASCs
Risk Management for ASCsAdvances in technology and anesthesia now allow invasive procedures once done only in hospitals to be performed in ambulatory surgery centers. This trend is evident in numerous specialties: otolaryngology, ophthalmology, gynecology, dermatology, general surgery, gastroenterology, oral surgery, and plastic surgery, among others.All operative or invasive procedures, particularly those which use sedation or anesthetic agents, carry inherent risk. ...(More)
2/1/2007 6:25:12 AM
Risk Management and Insurance: The New Imperatives for Outpatient Facilities
Risk Management and Insurance: The New Imperatives for Outpatient Facilities By Joe Watson and Kelly M. PyrekFor ambulatory surgery centers (ASCs) and surgical hospitals, the trilogy relating to insurance and risk management issues is protecting patients, protecting physicians and staff, and protecting the owner/operator of the practice. But unless owner/operators of ambulatory facilities, especially those who are new to the marketplace, ...(More)
1/2/2007 11:31:57 AM
SAFETY IN ASCS
SAFETY IN ASCSPutting Patients FirstBy Kathy DixFor years, patients have been kept particularly safe in ambulatory surgery centers (ASCs). The fact that most patients are relatively healthy, and there voluntarily rather than emergently, makes it easier to release them in the condition they arrived in. However, no system is absolutely perfect, and it is still possible to improve on an ...(More)
12/1/2006 9:18:54 AM
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