Health Law Pointers - Volume II, No. 5

MMIA Dissolution Date Extended

The Medical Malpractice Insurance Association ("MMIA") was originally required to dissolve no later than August 31, 2000. Governor Pataki, however, has signed legislation authorizing the MMIA to remain viable through June 30, 2001. Those physicians, dentists, podiatrists, certified nurse midwives, certified registered nurse anesthetists, or hospitals who are otherwise unable to obtain malpractice insurance coverage may apply for coverage through a private pool that will continue to be administered by the MMIA, at least temporarily. For more information on how to obtain coverage, please see http://www.ins.state.ny.us/mmianot1.htm.

New York Physician Profiles May Soon be Available on the Internet

This past year, both the New York State Senate and the Assembly have passed a bill that will require the Department of Health to post "physician profiles" on the Internet. The profiles will include:

bullet education, training and practice backgrounds;
bullet physician malpractice settlements and judgments over the last 10 years;
bullet professional misconduct and disciplinary actions;
bullet loss of hospital privileges; and
bullet details of criminal convictions.

The bill, called the Patient Health Information and Quality Improvement Act of 2000 (S.8127-D), awaits signature by Governor Pataki. You can track the status of this bill by clicking on http://leginfo.state.ny.us:82/nysleg/menugetf.cgi.

Texas HMO Medical Director Escapes Liability

A United States District Court judge has held that the medical director of United Healthcare is not liable for denying treatment to a boy whose treating physician said that the treatment was medically necessary. The facts of this case reveal that the boy’s parents had dual coverage and that the subordinate insurance plan paid for the treatment notwithstanding the denial by United Healthcare, the primary insurer.

Judge Barbara M.G. Lynn stated in her September 8, 2000 opinion that the medical director’s decision was one of coverage not treatment. Since federal law pre-empts coverage determinations, the state may not seek disciplinary action against the medical director for his decision.

Do you think that this decision would have turned out differently if the secondary insurer would not have paid for the treatment deemed to be medically necessary by the treating physician? Please forward your comments and responses to [email protected].

Congress Charged with Task of Providing Protection
Against Discrimination Based on Genetic Code

This summer, Dr. Francis Collins of the National Human Genome Research Institute and Dr. Craig Venter of Celera Genomics, Inc. challenged Congress to enact laws protecting the privacy of an individual’s genetic code and to prevent insurance companies and employers from discriminating against individuals that may be predisposed to develop certain diseases based on their genetic makeup.

The two entities have completed the basic mapping of the human genetic code. It is expected that these entities will soon be able to more accurately predict the likelihood that certain individuals will contract illnesses such as cancer and heart disease. This mapping of an individual’s genetic information is intended to assist health care providers in the diagnosis, treatment and prevention of highly susceptible cases of certain diseases and illnesses. In addition, genetic coding is expected to greatly enhance the research and development of drugs to treat and cure these diseases.

Congress has responded with the Senate attaching a rider to the Labor-Health and Human Services appropriations bill (H.R. 4577) in an effort to prevent health insurers from discriminating against individuals based on their genetic information. In addition, the Senate’s Patients’ Bill of Rights (S. 1344) includes provisions that would prohibit health insurance companies from discriminating against applicants enrolling for health insurance coverage. The bill would also prevent insurance issuers and plans from requiring predictive genetic information unless the plans or issuers were seeking this information for diagnosis, treatment, or payment.

Critics of the Senate bills believe that these protections are inadequate, noting that the proposed sanctions do not appear sufficient to stop the abuse of private information. Congress will also need to address the potential for discrimination in employment.

Legal Advisory: Medical Internet Sites

Many local practices are setting up sites on the information highway. Some are simply designed as practice advertisements, while others boast detailed medical literature and interactive physician/patient dialogue options. When designing your web site, remember that there is substantial room for the abuse of copyrighted information, lack of physician - patient confidentiality, and the misinterpretation of general medical information provided on the site. To avoid abuse of your intellectual property rights, potential liability for misconstrued information and breach of confidentiality, be sure to include an appropriate disclaimer.

For guidance in preparing a disclaimer that meets your specific web site needs, please contact Lawrence M. Ross at [email protected] or Anne M. Peterson at [email protected].

Employment Law Alerts!

Employee Rights Expanded

Following a recent National Labor Relations Board decision, employees, union and non-union alike, are entitled upon request to have a co-worker present at meetings with supervisors when the employee reasonably believes that the meeting could lead to disciplinary action. Employers are not required to notify employees of this right. Please see our Employment Law Pointers, Vol. 1, No. 4, dated August 22, 2000 at http://www.hurwitzfine.com/employment/08-22-001.htm for further details.

Assembly Passes Bill to Limit Number of Hours Nurses Work

This summer, the New York State Assembly voted to limit the number of hours nurses can be required to work. If enacted the law would limit the number of consecutive hours worked by nurses to 16 and would also limit the aggregate number of hours worked by nurses per seven-day workweek to 60 hours. The legislation, bill number A7405, is currently pending in the State Senate. To track its progress, please go to http://leginfo.state.ny.us:82/nysleg/menugetf.cgi.

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