Federal Officials To Speed Up Dealing With Health Care Complaint Backlog

AP: Feds Promise To Trim Backlog Of Health Care Investigations 
Federal officials said Monday they’re working to cut down on a growing backlog of complaints lodged against health care providers, insurers or government agencies by patients who claim their civil rights or privacy have been violated. Americans filed more than 51,000 complaints against health agencies last year, a number that has grown tremendously — 69% — over the last five years, the federal Health and Human Services agency announced. Some complaints can take years to investigate. (Seitz, 2/27)

On surprise billing —

Roll Call: Surprise-Billing Lawsuits Slow Payments Processes
A year after the Biden administration implemented Congress' law to ban surprise medical bills, the policy particulars are still caught up in litigation, and lawsuits are preventing insurers and hospitals from settling out-of-network disputes. (Cohen, 2/27)

KHN: Surprise-Billing Law Loophole: When ‘Out Of Network’ Doesn’t Quite Mean Out Of Network
It was the first day of her family’s vacation in the San Juan Islands last June when Danielle Laskey, who was 26 weeks pregnant, thought she was leaking amniotic fluid. A registered nurse, Laskey called her OB-GYN back home in Seattle, who said to seek immediate care. Staff members at a nearby emergency department found no leakage. But her OB-GYN still wanted to see her as soon as possible. Laskey and her husband, Jacob, made the three-hour trip to the Swedish Maternal & Fetal Specialty Center-First Hill. Laskey had sought the clinic’s specialized care for this pregnancy, her second, after a dangerous complication with her first: The placenta had become embedded in the uterine muscles. (Meyer, 2/28)

In other health care industry news —

Reuters: Hospital, Top Surgeon To Pay $8.5 Mln In Whistleblower Suit Over Simultaneous Surgeries
The University of Pittsburgh Medical Center and the head of its cardiothoracic surgery department have agreed to pay $8.5 million to settle claims that they fraudulently billed Medicare and Medicaid for complex surgeries. The settlement resolves a 2019 whistleblower lawsuit by a former UPMC doctor, claiming that UPMC regularly allowed James Luketich to book as many as three complex surgeries at the same time, going back and forth between patients, not participating in key parts of the surgeries, and sometimes keeping patients under unnecessary anesthesia. (Pierson, 2/27)

Bloomberg: Elevance’s Deal For Louisiana Blue Plan To Cost $2.5 Billion
Elevance Health Inc. agreed to pay $2.5 billion for its previously announced purchase of Blue Cross and Blue Shield of Louisiana, documents reviewed by Bloomberg show, and additional conditions might raise the value of the transaction by $1 billion. (Tozzi, 2/27)

Columbus Dispatch: OhioHealth Spending $400 Million On Grant Medical Center Expansion
OhioHealth will spend hundreds of millions to expand and remodel parts of Grant Medical Center in downtown Columbus over the next five years. The expansion will bring with it a new seven story building along Town Street that will house a new trauma center, emergency department and critical care pavilion that will add 160 beds, according to OhioHealth. (Filby, 2/27)

AP: Georgia Senate Seeks To Allow Rural Hospitals Without Permit
Georgia senators want to allow new hospitals to be built in counties with fewer than 50,000 residents without state permission, a measure particularly aimed at allowing an undisclosed entity to build a new hospital in the home county of Lt. Gov. Burt Jones. Senators voted 42-13 to pass Senate Bill 99 on Monday, sending it to the House for more debate. The measure says governments or private nonprofit groups can build hospitals in less-populated counties without getting a certificate of need from the state Department of Community Health. (Amy, 2/27)