Health Care Providers

Proper DoubtsEditor: If Rudolph Almaraz kept silent about having AIDS because he doubted the ability of the news media, Johns Hopkins and the public, including his own patients, to react without hysteria, he was certainly justified. The sensationalism with which this story has been approached only confirms the validity of that decision.The Sun acts irresponsibly by legitimizing reactions of panic, in view of the extreme unlikelihood of the doctor having transmitted the disease to his patients.

Maryland is slated to receive $1.8 million for its part in a national settlement with Illinois-based Abbott Laboratories over allegations of illegal drug marketing, Attorney General Douglas F. Gansler said Monday. Abbott will pay $100 million to 44 states and Washington, where officials had claimed the company marketed Depakote for uses other than those approved by the U.S. Food and Drug Administration. It's considered safe and effective for treating seizure disorders, mania associated with bipolar disorder and migraines.

Nonprofit mental health care providers warned yesterday that they're in danger of going out of business unless the state puts more money into the system and starts paying its bills more quickly. "If you don't do something, you won't have any clinics left," Craig Knoll, executive director of Threshold Services in Montgomery County, told lawmakers. "We're waiting until April 8," the last day of the General Assembly session, Knoll said. "If the right things happen, we'll keep the clinics open.

Rape is a notoriously difficult crime to prosecute. Of every 100 rapes nationwide, 46 are reported, 12 lead to arrests and three result in prison sentences. To improve those odds, advocates are encouraging more nurses to receive the training to give a forensic examination that can be key to securing a conviction. Prosecutions are difficult when a victim fails to get a prompt examination. And with TV crime dramas such as "CSI" raising expectations among juries, prosecutors and victims' advocates view the forensic exam as more essential than ever.

Maryland health care providers - particularly nursing homes, pharmacists and adult day care centers - told the House Health and Government Operations Committee yesterday that the latest round of state budget cuts hits them disproportionately, and could lead to reductions in quality and in patient access. Gov. Robert L. Ehrlich Jr. announced, and the Board of Public Works approved, $208.4 million in cuts to state spending for the fiscal year; of that, $88.3 million is from the health budget.

The state has assembled a work group of top health professionals to come up with ways to reduce health disparities among racial and ethnic groups, Lt. Gov. Anthony G. Brown announced Thursday. The seven-member panel, to be headed by Dr. E. Albert Reece, dean of the University of Maryland School of Medicine, will identify new legislation and financial incentives that can be used to bring equality to healthcare. While studies have shown the overall life expectancy in the United States has improved, there are still large differences between the health of minorities and that of whites.

Blue Cross and Blue Shield of Maryland yesterday won the right to set the rates it pays doctors and other health care providers.The state Senate unanimously passed a bill, already approved by the House of Delegates, that frees Blue Cross from oversight from the state insurance commissioner over provider rates.Some providers had opposed the legislation, but the insurance commissioner, Dwight K. Bartlett III, told legislators that reviews of fees by his office -- a regulatory mechanism dating from the 1930s -- are no longer needed in the current health marketplace.

United Payors & United Providers Inc., a Rockville company that provides health insurers a national network of health care providers, said yesterday that it will buy America's Health Plan Inc. for $14.75 million.Publicly held UP&UP said AHP, which operates a network of health care providers nationwide, should significantly improve its earnings in 1998.UP&UP, which employs about 400, posted a net profit of $10.6 million on $35.2 million in revenue in 1996.Ed Civera, president and chief operating officer of the fast-growing company, which expects to post revenue of about $60 million this year, said the deal is part of UP&UP's plan to selectively acquire preferred provider organizations and other health care outfits as part of a growth strategy.

Maryland is slated to receive $1.8 million for its part in a national settlement with Illinois-based Abbott Laboratories over allegations of illegal drug marketing, Attorney General Douglas F. Gansler said Monday. Abbott will pay $100 million to 44 states and Washington, where officials had claimed the company marketed Depakote for uses other than those approved by the U.S. Food and Drug Administration. It's considered safe and effective for treating seizure disorders, mania associated with bipolar disorder and migraines.

WASHINGTON -- Hospitals and other health care providers who responded to demands for more rural health clinics, hospices and health care in the home for Medicare patients say they are stymied in offering these services because they cannot get approval from federal regulators.Because of budget cuts, federal and state officials say, they have a huge, growing backlog of health care providers awaiting certification to participate in Medicare.Matters will only worsen, they say, as Republicans in Congress cut the budget for such regulatory activity, while encouraging doctors and hospitals to form new health plans to serve Medicare patients.

Maryland officials plan to announce this week whether the state will sever ties with the state's second-largest foster care provider, a decision that also could determine whether the company keeps its contract in the District of Columbia. Officials with the Maryland Department of Human Resources, the agency charged with protecting the state's 7,400 foster children, is expected to announce a decision on renewing the license for Contemporary Family Services. The Hyattsville company's contract in D.C. depends on it retaining its Maryland license, according to officials with the District of Columbia's Department of Youth Rehabilitation Services.

St. Agnes Hospital was one of 11 medical institutions recognized by the Emergency Medical Technology program in the School of Health Professions at the Community College of Baltimore County. In addition to the Baltimore hospital at Wilkens and Caton avenues, the other institutions that received plaques from the school were Franklin Square Hospital, Harford Memorial Hospital, Johns Hopkins Bayview Medical Center, Maryland Poison Center - University of Maryland School of Pharmacy, Mercy Medical Center, R Adams Cowley Shock Trauma Center, Sinai Hospital, St. Joseph Medical Center, University of Maryland Medical Center and Upper Chesapeake Medical Center "These sites provide valuable experiences to our students that could not be duplicated in the classroom," said Deanna Wiseman, CCBC EMT program clinical coordinator, in a release.

The state has assembled a work group of top health professionals to come up with ways to reduce health disparities among racial and ethnic groups, Lt. Gov. Anthony G. Brown announced Thursday. The seven-member panel, to be headed by Dr. E. Albert Reece, dean of the University of Maryland School of Medicine, will identify new legislation and financial incentives that can be used to bring equality to healthcare. While studies have shown the overall life expectancy in the United States has improved, there are still large differences between the health of minorities and that of whites.

Patients should feel confident that the drugs and medical devices prescribed by their doctor are what is best for their health, not something influenced, even subconsciously, by a nice meal or a free trip to a sunny resort that the doctor enjoyed. That, in essence, is what is behind legislation expected to be introduced in the General Assembly this week. A final version of the proposal is still in the works, but the idea is to restore public confidence by greatly regulating the financial interactions between drug companies and medical device makers and doctors, a necessary step in the wake of highly publicized gifts to Dr. Mark G. Midei, the Baltimore cardiologist facing accusations of implanting hundreds of unnecessary stents.

At least once a year, executives from Ciena Corp. spend a day at Johns Hopkins Hospital getting poked and prodded as they undergo tests for a barrage of potential ailments, from anemia to prostate cancer. They aren't necessarily feeling ill or showing any symptoms. In fact, the executives of Linthicum-based Ciena are often healthy — and their company wants to keep it that way. The $2,000-per-person prices for these full-body examinations are considered an essential corporate expense.

Monica Dillon wasn't happy with her eye care provider, so when she saw an online deal for an exam and glasses for $50, she clicked on it. The accountant, who lives in Columbia and works in Washington, doesn't ordinarily get medical care without a recommendation. But the offer was too good to resist — and, as she notes, there would be no surgery or undressing. "The timing was right so I jumped on it," she said about her purchase via Groupon, a deal-of-the-day e-mail sent to tens of thousands of people in the Baltimore region and millions nationwide.

United Payors & United Providers Inc., a Rockville-based financial services company supporting the health care industry, said yesterday that it acquired ProAmerica, an operating subsidiary of UnitedHealth Group, for an undisclosed sum.ProAmerica, an Arlington, Texas-based network of health care providers, is expected to record revenue of about $13 million in 1998.The combined operations of UP&UP and ProAmerica are expected to exceed $100 million in revenue in 1999, said Ed Civera, UP&UP president and chief operating officer.

WASHINGTON -- The White House is clashing with governors of both parties over a plan to cut Medicaid payments to hospitals and nursing homes that care for millions of low-income people. The White House says the changes are needed to ensure the "fiscal integrity" of Medicaid and to curb "excessive payments" to health care providers. But the plan faces growing opposition. The National Governors Association said it "would impose a huge financial burden on states," already struggling with explosive growth in health costs.

Some of Dr. Maria Brown's young patients won't be getting a prescription they can fill at a pharmacy. Instead, they'll be instructed to fill their lungs with fresh air, feel the sunlight on their skin and stretch their muscles in the great outdoors. They will be told to walk around the block, visit a nature center or take a bike ride with their parents. Brown is a nature champion, trained by the U.S. Fish and Wildlife Service to teach other health care providers at St. Agnes Hospital about the benefits of getting children outside to combat obesity and accompanying diseases such as diabetes and asthma.

The anguished mother pounded the floor at Johns Hopkins Hospital, screaming, "Why, why, why?" Dr. John Wogan had just told her as gently as he knew how that her teenage son was dead, the victim of a stray bullet fired on the streets of Baltimore. The next day the mother was dead herself, felled by a burst blood vessel in her brain that Wogan believes resulted from the terrible, sudden stress of learning her child was gone. Twenty years later the episode remains etched in the doctor's memory.