Surprise Bills from Texas Emergency Rooms Enough to Give Even the Insured a Heart Attack

Categories: Healthcare

Taber Andrew Bain
If you're in the back of an ambulance and have control of your hand, you should probably try to call the hospital and find out if the on-call ER staff are in your network.

What's that? Your arm just fell off? Naturally your first reaction might be something along the lines of, "Thank goodness I'm insured!" Your next reaction might be to scream in agony, but instead you might want to suck it up, save your breath and tell the ambulance driver not to take you to Baylor University Medical Center.

Don't misunderstand -- Baylor doctors will probably patch you up just fine. But according to a new report, even insured patients are more likely to be saddled with horrendous bills after visiting the emergency room at Baylor or dozens of other ERs across the state. On Monday, the Center for Public Policy Priorities outlined "balance billing" problems in Texas. That's the bill insured patients are saddled with after they unknowingly accept care from an out-of-network physician.

The report focused on emergency room care, and cited Baylor as one major in-network hospital that works with the three largest state providers -- Humana, BlueCross BlueShield and United Healthcare -- but does not have any in-network emergency room doctors.

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The Future of Women's Healthcare in Texas Looks Bleak. What's Next?

Stephen Young
One of two Dallas clinics that will remain open.
Listening to the oral arguments before the 5th U.S. Circuit Court of Appeals on Friday confirmed what advocates for reproductive rights feared upon seeing the three-judge panel selected to hear the Texas' appeal of a lower-court ruling striking down two sections of House Bill 2, the 2013 legislation enacted to restrict access to abortion. Two of the judges, Jerry E. Smith and Jennifer Elrod, seemed ready to rule in favor of the state, as they did in a previous challenge to HB2. They peppered Stephanie Toti, the attorney representing the clinics bringing the challenge, with questions about whether reducing the number of abortion providers in the state to eight would actually pose an "undue burden" to women in the state seeking abortions.

As defined in federal case law, a law fails to meet the undue burden standard if it is too restrictive of one's fundamental rights. The standard has also been applied when a law lacks what former Supreme Court Justice John Paul Stevens called a "legitimate, rational justification."

No major medical organization has ever agreed with the contention made by proponents of HB2 and similar laws that its major requirements -- that doctors who perform abortions have admitting privileges at a nearby hospital and that clinics providing abortions meet the standards for ambulatory surgical centers -- make women safer. In fact, as Dr. Hal Lawrence, the CEO of the American Congress of Obstetricians and Gynecologists has said, the full implementation of the law could lead to women seeking out illegal abortions or failing to get necessary prenatal care, endangering themselves in the process.

See also: How Texas' New Abortion Restrictions Have Actually Impacted Access to the Procedure

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Dallas Jury Awards Woman Largest Amount So Far in Vaginal Mesh Lawsuit

Categories: Healthcare

Hal Samples
Dallas County jurors last week spent about three hours deliberating before they awarded Martha Salazar $73 million, the largest amount of money any plaintiff has received so far in a vaginal mesh lawsuit. Most of the thousands of lawsuits that women have filed against Big Pharma over the devices are stuck in a federal court in West Virginia, but a few suits have escaped that slow system and have ended up in local civil courts, including Salazar's suit against Boston Scientific.

"I have not seen any device that I'm aware of that has a $70 million dollar verdict on a single case," says Tim Goss, one of Salazar's attorneys.

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Everything You Need to Know About Friday's Court Hearing on Texas' Abortion Law

Stephen Young
Planned Parenthood of Greater Texas' new Dallas Ambulatory Surgical Center
It's September 11, and the harshest restriction in Texas' new abortion law, its requirement that all abortions take place at an ambulatory surgical center, has yet to go into effect.

HB2 was supposed to become the law of Texas on September 1, and the ACS rule would have immediately shuttered all but seven of the state's 22 abortion providers, but on August 29 U.S. District Judge Lee Yeakel found the surgical center requirement unconstitutional, giving the clinics a reprieve. How long the reprieve lasts is up to three judges on the 5th U.S. Circuit Court of Appeals in New Orleans, and the immediate future for clinics is not promising.

See also: Planned Parenthood's New HB2-Proofed Clinic Opens in Southern Dallas

As its did in 2013 after Yeakel struck down HB2's requirement that any doctor performing an abortion have admitting privileges at a hospital within 30 miles of his or her clinic, the state immediately appealed his latest ruling to the 5th Circuit. Unlike in the first case, the appellate court did not grant an emergency stay allowing the law to go into effect. Instead, it scheduled a hearing Friday over whether to let the law go into effect while appeals wend their way through courts.

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Call to Remove Fluoride from Water Keeps Chugging on Dallas City Council

Categories: Healthcare

Future Dallas ISD school picture day. Say cheese!
In the U.S., common knowledge -- that's a polite term for bigoted slander -- says the English have the worst teeth in the world. That's an unkind thing to say, and maybe not even true, as anyone who has traveled parts of the South can attest. So to soothe hurt feelings among our British allies, we offer the following good news: Someday in the future Dallas might replace the U.K. as the capital city of scary smiles if a group of fluoridation opponents have their way and fluoride is removed for the city's drinking water.

If a trend on the City Council continues, they just might.

The anti-fluorites have become a regular appearance at City Hall over the past several months, but at last week's City Council briefing, two council members jumped on board. Sheffie Kadane and Scott Griggs agreed that fluoridation does not do enough good for Dallas teeth to balance the cost.

CLARIFICATION: Griggs contacted us Tuesday morning and said he did not say at the meeting he agreed with Kadane on the benefits and costs of fluoridation -- although that's what Kadane told us. Griggs has said in the past that he's open to studying the issue though, according to reports in The Dallas Morning News.

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Feds Say Parkland Is No Longer Placing Patients in Jeopardy, Still Needs to Fix Discharge Policy

Categories: Healthcare

Parkland has until November to fix its discharge policy and governing board, or the hospital will lose its Medicare funding, the Texas Department of State Health Services announced today. On the plus side, Parkland isn't placing patients who dare visit the hospital in jeopardy anymore, according to the feds.

"We have determined that while the immediate jeopardy to patient health and safety has been removed," the Texas Department of State Health Services wrote to the hospital today, "Parkland Health and Hospital System remains out of compliance with the following," which are vaguely described as "governing body" and "discharge planning."

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The Financial Cost of Repairing North Texas VA Hospital's Reputation

Categories: Healthcare

Ildar Sagdejev
The VA Hospital system has a reputation to repair after the scandal this spring. So how much is that going to cost the North Texas VA hospital?

The VA Hospital system has taken a beating in the last several months. Between the Arizona scandal unearthed this spring about veterans dying while waiting for care and continued reports of absurdly long wait times -- this summer, the average veteran in Texas waited 60 days for an appointment, compared to 5 days for citizens -- the VA system is struggling to clean up its reputation.

See also: The Texas Medical Association Wants to Pair Vets with Private Docs in Wake of VA Scandal

Which is likely why the North Texas VA Hospital is increasingly contracting with private physicians to cut down on wait times. But the effort comes at a high cost: Froylan Garza, a spokesman for the North Texas VA Hospital, says the hospital expects it will spend upward of $70 million this fiscal year in contracting with private care physicians.

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Homeless, Suicidal Patient Parkland Tried to Discharge to a Shelter Is Now In Jail

Categories: Healthcare

Amy Silverstein
Todd Arko relapsed to using cocaine when he was still on probation for possessing the drug, then decided he would rather die than go back to jail. At the age of 53, he tried to hang himself. The rope broke, crushing his heels as he collapsed to the ground.

Arko is identified in federal documents only as Patient No. 5, the homeless, suicidal man the feds say was placed in immediate jeopardy by Parkland Hospital. In a report, the Center for Medicaid Services describes how Parkland discharged Arko too soon, to a homeless shelter unable to care for someone recovering from a recent suicide attempt, crushed heels, a fractured right arm and a fractured spine. Despite his obvious mental health problems, the hospital never gave him a psychiatric evaluation. And when he told the hospital that he didn't feel safe leaving, they called the cops, as we reported last week.

See also: Federal Funding for Parkland Threatened after Staff Calls Cops on Homeless Patient

Parkland wasn't the first facility that Arko's family says seemed more interested in pushing him away than treating him. A letter that the Center for Medicaid services sent yesterday to the Green Oaks hospital chain, obtained by the Observer, tells the hospital that they too placed a patient in "immediate jeopardy" and may lose Medicaid funding as a result. Arko received psychiatric treatment there before his stay at Parkland.

Yet somehow, Arko has survived the ordeal. While he was bouncing around between facilities and eventually a hotel room that a friend put him up in, he stopped reporting to his probation officer like he was supposed to do, so a judge issued a warrant for his arrest. Now he's back in the Dallas County jail, the very place he tried to kill himself to avoid.

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Planned Parenthood's New HB2-Proofed Clinic Opens in Southern Dallas

Categories: Healthcare

Stephen Young
Planned Parenthood's new clinic.
It's a nice clinic, it really is. With more space and amenities, it's a credit to the private donors who payed for it and continue to fuel Planned Parenthood's response to the Texas Legislature's crackdown on abortion. It's just unnecessary.

The large janitor's closet, the backup generator, the locker rooms, the extra wide hallways and the special air circulation system that qualify the building as an ambulatory surgical center (ACS) do nothing to promote women's safety. The American Congress of Obstetricians and Gynecologists says that Texas' requirement that all abortions be performed at ASCs, as well as that all abortion providers have admitting privileges at a hospital within 30 miles of the clinic from which they operate, actually increase danger to women. Those with an unwanted pregnancy, the organization's CEO Dr. Hal Lawrence says, are more likely to seek out an alternative means of termination or forego appropriate prenatal care when access to abortion is restricted.

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What Exactly Is Going On at Parkland's Troubled Psych Wing?

Categories: Healthcare

The public mental health system has long been plagued by outlier difficulties and controversy.
Parkland's psychiatric services division has been getting a hell of a lot of bad press lately, and it continues today, with reports that an elderly woman in Parkland's psych wing ended up with broken bones after she claims she was forced out of her wheelchair. Earlier this week, the Center for Medicare and Medicaid Services threatened to cut funding to the hospital after it was found that a homeless patient who had attempted suicide was prematurely discharged. And after an incident this past March, several employees were fired after a patient was found to have been gagged with a roll of toilet paper.

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