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Judge Rules United Behavioral Health Guidelines Led to Denial of Claims Violations Print E-mail
Written by Vitale Health Law   
Tuesday, 12 March 2019 16:59
 
A California federal judge has issued a landmark ruling that could impact the way insurance companies cover mental health and substance use treatment. Chief Magistrate Judge Joseph Spero of the District Court for the Northern District of California ruled that United  Behavioral Health (UBH) used "flawed" internal guidelines resulting in the unlawful denial of mental health and substance use treatment for those it insured across the country, all in an effort to save money. UBH, which is owned by UnitedHealth, serves more than 60 million members. The case grew out of two consolidated class-action lawsuits (Wit, et. al. v. UnitedHealthcare et. al. and Alexander, et al. v. United Behavioral Health), filed in 2014 and heard by Judge Spero in 2017 during a 10-day bench trial.


Last Updated on Tuesday, 12 March 2019 17:03
 
‘Elbow grease’ may get the job done but could prove painful Print E-mail
Written by FHInews   
Monday, 11 March 2019 00:00
Hand and Upper Limb Orthopedic surgeon Dr. Alejandro Badia offers tips to reduce arm strain, avoid tennis elbow

Adding a little “elbow grease” helps get the job done but repetitively using too much “grease” can eventually lead to disabling elbow pain. So, says Florida-based orthopedic surgeon Alejandro Badia MD, who calls the medical condition “lateral epicondylitis” or “tennis elbow,” a persistent, debilitating injury that may develop in anyone who repeatedly overtaxes tendons and muscles in the forearm and elbow.  Forearm muscles control the extension and bending of the wrist; tendons connect muscles to bones. 

Tennis elbow primarily affects the extensor carpi radialis brevis (ECRB) muscle and tendon, resulting in often excruciating pain on the outside (lateral side) of the arm near the elbow.  Besides tennis players and other athletes, including Anglers (avid fishermen), factory workers and tradesmen, including carpenters, plumbers and painters, are prone to the injury. 

“Even do-it-yourselfers who decide to tackle a long-term project such as painting the house – a job that they are unaccustomed to doing -- may develop tennis elbow,” says Dr. Badia, noted expert in diseases and injuries of the upper limbs and founder and chief medical officer of the Badia Hand to Shoulder Center and OrthoNOW®.

“Repetitive bending and straightening of the elbow can stress, and eventually weaken and damage, the ERCB muscle, causing microscopic tears to develop in the tendon that connects the muscle to the elbow’s lateral epicondyle bone,” Dr. Badia explains. Dr. Badia adds that hard work doesn’t cause tennis elbow, but it does make it become more symptomatic in people who are predisposed due to minor tendon injury which reduce the blood flow to the tendons and joints.

An estimated 200,000 Americans are diagnosed each year as having the problem, which can significantly impact a person’s lifestyle, sometimes making it almost too painful to lift a mug of coffee with the affected arm or shake someone’s hand.

Scientists’ overall conclusion that a “wait-and-see” approach may be the best therapy for tennis elbow because the condition usually resolves on its own over time “is not an option for many patients,” Dr. Badia says. “It can take 12-18 months for tennis elbow to clear up without treatment. For athletes eager to get back into competition or workers whose jobs require constant use of arms, hands and wrists, time is of the essence.  They cannot afford to wait months,” says Dr. Badia.

In fact, Dr. Badia has successfully treated resistant tennis elbow in professional athletes, including former world’s top-10 tennis champion Marcelo Rios, whom he recently returned to competition within about a month after using an advanced therapy – ultrasonic percutaneous tenotomy with Tenex Health’s minimally invasive technology.
 
Developed by Tenex Health in collaboration with the Rochester, Minnesota-based Mayo Clinic, the minimally-invasive outpatient procedure is an option for patients whose tennis elbow has not responded to initial, nonsurgical therapies.

More conservative treatments include rest, application of ice to the affected elbow area, arm-wrist stretch exercises to enhance blood supply to the ECRB tendon, anti-inflammatory medications, growth factors found in platelet rich plasma (PRP) injections   and even use of radiofrequency and corticosteroid injections, Dr. Badia says.

“But in cases when the elbow tendon fails to heal because of poor blood supply, we have to remove the necrotic tissue.  With the Tenex Health technology, we use ultrasonic energy ablation to literally melt away the dead material and aspirate it through a small puncture wound with an instrument approximately the size of a syringe,” Dr. Badia says.  “The procedure requires less than 30 minutes to perform with the patient lightly sedated and since there are no stitches there is no scarring. “Unlike traditional surgery, which often requires months of healing, recovery from the ultrasonic procedure is “almost immediate,” with the affected elbow returning to full mobility right away and back to playing tennis within a few weeks, he says.

Of course, the best treatment for tennis elbow is prevention.  That’s why Dr. Badia offers these tips to workers and recreational sports players alike:
  • Warm up and do arm, wrist and even finger stretch exercises, especially prior to activities like tennis that require repetitive movements.
  • Engage in exercise regiments designed to strengthen the upper limbs, including wrist and elbow.
  • Learn to rely more on shoulder and upper arms to take some of the work off the elbow.
  • Avoid repetitive hand and arm movements; rotate work tasks.  If this is not possible, take breaks and even consider wearing an elbow brace.
  • Use on-the-job tools and sports equipment that are right for your grip and help take strain off the forearm muscles.  For example, a lighter-weight tennis racquet with string tension of 55 pounds or less can reduce stress on both arm and elbow.  Gloves or padding can absorb some of the shock when using tools. Dr. Badia also advises patients about the Xtensor reverse grip hand exerciser as a tool for recovering strength.
Dr. Badia concludes that this very popular condition can’t be avoided but early recognition and treatment are key to the best outcome and opportunity to get back to playing tennis and other sports or work activities.

Bio: Alejandro Badia, MD, FACS, internationally renowned hand and upper-limb surgeon and founder of Badia Hand to Shoulder Center and OrthoNOW®, a walk-in orthopedic care clinic.  He is a member the American Society for Surgery of the Hand, American Association for Hand Surgery and the American Academy of Orthopedic Surgeons. He is a specialist in treating all problems related to the hand and upper extremity including trauma, sports injury, joint reconstruction, nerve injuries and arthroscopic surgeries. Dr. Badia is co-chairing the upcoming STMS Tennis Medicine Meeting in Miami: https://www.tennismedicine.org/page/MiamiConference). To learn more about Dr. Badia, visit: www.drbadia.com.

Last Updated on Wednesday, 13 March 2019 16:03
 
Florida House Experience Announces Rebrand to FHEHealth Print E-mail
Written by FHInews   
Friday, 08 March 2019 10:44

DEERFIELD BEACH, FLFlorida House Experience, a JCAHO/CARF accredited healthcare institution delivering high quality, medically integrated personalized treatment for those suffering with behavioral health and addiction disorders, announced that it is rebranding with the new name of FHEHealth. This new name better represents their services and the fact that they are at the forefront of rehabilitative care.

Along with the new name comes a new logo. Each element carries an important meaning. The heart symbolizes compassion, the waves of movement represents the company’s constant innovation, the fhehealth-1200circle is for community and the leaf is for the patients who are able to grow under FHEHealth’s care. The company’s new tag line is Where hope becomes healing.

“For many years we have felt like our name did not accurately represent all that we do here,” said Sherief Moustafa, CEO of FHEHealth.  “While our addiction treatment program is still among our highest priorities, we have grown to offer so much more. From depression to anxiety and even trauma, our goal is to get to the root of the problem, and we felt like ‘Health’ really needed to be a bigger part of our name and brand.”

Florida House, now known as FHEHealth, started in 2003 as a men’s halfway house and has grown to be a leader in cutting edge therapy for addiction and mental health. The facility offers a number of innovative treatments to provide patients with a full interpretation of their condition. They are on the forefront of neuro-rehabilitative research. FHEHealth is leading the way in research and development of the effective use of neurotherapies to treat behavioral health disorders.

For more information about FHEHealth and the variety of services they provide call 888-408-0210.
 

###
About the Florida House Experience: The Florida House Experience is a healthcare institution that delivers quality, medically integrated personalized treatment for those suffering with behavioral health disorders. The organization specializes in addictive disorders and other behavioral health diagnoses such as mood disorders, depression, anxiety, and traumatic disorders. FHE is a facility licensed by the both the Department of Children and Families (DCF) and the Agency for Healthcare Administration (AHCA). They are accredited by both the JOINT Commission and the Commission of Accreditation of Rehabilitation Facilities (CARF) and are members of the National Association of Addiction Treatment Providers (NAATP).

Last Updated on Friday, 08 March 2019 11:08
 
Medicare Trims Payments to 800 Hospitals, Citing Patient Safety Incidents Print E-mail
Written by FHI's Week in Review   
Monday, 04 March 2019 18:30
 
Jordan Rau reports for Kaiser Health News on 3/1/19:

Eight hundred hospitals will be paid less by Medicare this year because of high rates of infections and patient injuries, federal records show. The penalties pit hospitals against one another in a race to prevent the most infections, blood clots, cases of sepsis, bedsores, hip fractures and other complications. Each year, the quarter of general hospitals with the highest rates are punished, even if their records have improved from the previous year. The number is the highest since the federal government five years ago launched the Hospital Acquired Conditions (HAC) Reduction Program, created by the Affordable Care Act.
 
Read more in the current issue of Week in Review>> https://conta.cc/2EvlUpa
 
Last Updated on Monday, 04 March 2019 18:32
 
Polsinelli Opens Miami Office; Expands Presence in Southeast Region Print E-mail
Written by FHInews   
Tuesday, 26 February 2019 00:00

Polsinelli grows with group of six new attorneys and 22nd office nationwide 

MIAMI (Feb. 26, 2019) Am Law 100 firm Polsinelli has expanded its footprint in the southeastern region of the country with the opening of its 22nd office in Miami. The new office and its associated attorneys strengthen Polsinelli’s market position both in the geographic area and in key industry verticals, with a particular emphasis on health care.  

Polsinelli’s Miami office includes five new shareholders and one associate: James D. Barnett,  Michael P. Gennett, Marisa Rodriguez Wilson, Milton A. Vescovacci, J. Everett Wilson and Brian Seidenberg. The group brings deep experience in a range of practice areas, including middle market corporate, mergers and acquisitions, private equity, health care, real estate and financial services. 

Polsinelli’s Miami office has a particular focus in health care services, including navigating complex Medicare and Medicaid issues provider operations and compliance, managed care, and the regulatory and business issues particular to the industry and health care mergers and acquisitions. Polsinelli’s Miami health care attorneys represent health systems, providers, clinics, home health agencies, pharmacies, managed care entities MSO’s, and provider networks.   

“We’re pleased to announce our expansion in Miami,” said Polsinelli Chairman and CEO Chase Simmons. “We’ve been doing business there for years and our firm’s focus on health care, financial services, real estate and midmarket corporate work has been well received in the Miami market. The time to commit to Miami and the State of Florida is right, and we look forward to adding these talented lawyers to our client service offering.”   

The Polsinelli Miami office is located downtown in the Miami Center high-rise, 201 S. Biscayne Boulevard, just blocks from the Biscayne Bay waterfront. The new Miami group includes: 

• James D. Barnett, Shareholder, Real Estate Practice Group. Barnett represents buyers, sellers, developers, landlords, tenants, lenders and borrowers in transactions throughout the United States. He brings extensive experience with complex real estate transactions, including office, retail, hotel, marina and industrial properties. He also serves as counsel to major financial institutions in connection with complex commercial loan workouts, foreclosures, and deeds in lieu.

• Michael P. Gennett, Shareholder, Health Care Operations Practice Group. Gennett’s practice focuses on healthcare licensing, as well as Medicare and Medicaid compliance issues. He represents health care practitioners and providers, including medical practices, medical equipment companies, home health agencies, pharmacies and surgical centers. Gennett defends False Claims Act whistleblower cases and data breaches.  

• Marisa Rodriguez Wilson, Shareholder, Health Care Operations Practice Group. Wilson provides counsel for regulatory issues at the state and federal levels, assisting health care providers with operational and compliance issues, complex regulatory matters, mergers and acquisitions, licensing, Medicare and Medicaid. Her clients include health care clinics, home health agencies, managed care providers, diagnostic centers, and pharmacies.     

• Milton A. Vescovacci, Shareholder, Corporate & Transactional Practice Group. Bringing experience in a wide array of industries, Vescovacci represents buyers and sellers in the sale or acquisition of business operations and interests. He serves as general outside counsel to several medium and small-sized companies, and provides counsel to members of board of directors and controlling shareholders on corporate governance matters. He represents health care providers, PBMs, third-party administrators, pharmacies, wholesale pharmaceutical distributors and medical technology companies. Vescovacci is a co-founder of the new Miami office.

• J. Everett Wilson, Shareholder, Health Care Alignment & Organizations Practice Group. A leading health care attorney, Wilson was earlier this month elected chairman of the Board of Directors for the Health Foundation of South Florida and is currently the Chair-Elect of the Health Law section of the Florida Bar. He focuses his practice on the representation of health care providers and entities in the health care insurance sector. He assists clients in nearly every area of health care law, with a particular focus on issues relating to Medicare and Medicaid, provider operations, managed care and the regulatory and business issues in health care mergers and acquisitions. Wilson is a co-founder of the new Miami office.

• Brian Seidenberg, Associate, Real Estate Practice Group. Admitted in Florida, New York and New Jersey, Seidenberg’s real estate practice focuses on complex real estate acquisitions, dispositions, leasing, financing and ongoing real estate development issues.

  While Polsinelli’s physical presence is new in Miami, the firm’s current business in the area has become increasingly important. Demand continues to rise, creating the need for a physical presence and opportunity for further growth. Additionally, the firm’s focus areas align with those of the new group of attorneys, particularly in health care, real estate, finance and corporate and transactional services. 

  “We feel that Polsinelli’s national platform and deep health care bench with over 100 health care lawyers will benefit our health care clients in Miami and around the country,” said J. Everett Wilson. “Our clients will be able to tap deep cross disciplinary teams to execute on their strategic plans as health care continues to change at a staggering pace.” 

Polsinelli’s Health Care Department represents one of the largest concentrations of health care attorneys and professionals in the country. The firm was recognized as a leader in health care law in 2018 as “Law Firm of the Year” in Health Care by U.S. News & World Report. The practice is currently ranked by the American Health Lawyers Association as the largest health care practice in the nation, and was nationally ranked by Chambers USA in 2018. 

The firm’s newest location increases the firm’s momentum in coast-to-coast expansion. In May, the firm expanded its West Coast presence with eight attorneys and a Seattle office location to better serve regional clients in health care, technology and government investigations services.   

In his first year as CEO and Chairman, this marks the first office expansion for Simmons, who assumed the new role on Jan. 1. 

 About Polsinelli   Polsinelli is an Am Law 100 firm with more than 850 attorneys in 22 offices. Ranked #30 for Client Service Excellence1 and #10 for best client relationships2 among 650 U.S. law firms, Polsinelli was also named among the top 30 best-known firms in the nation3. The firm’s attorneys provide value through practical legal counsel infused with business insight, and focus on health care, financial services, real estate, intellectual property, mid-market corporate, labor and employment, and business litigation.

Last Updated on Friday, 15 March 2019 06:19
 
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