Health Care Providers

The superintendent of Anne Arundel County schools has recommended extending a contract with one of its health care plans to allow time to resolve a grievance filed last month by the teachers union over a proposal to change the company administering the plan. "We just need more time to get the various issues resolved on this," said Superintendent Eric J. Smith. At their meeting tomorrow, school board members will consider whether to negotiate a one-year contract with CareFirst BlueCross BlueShield, the administrator of its "preferred provider" plan, which nearly half of the school system's more than 10,000 employees use. System officials did not know how much such an extension would cost.

Gov. Robert L. Ehrlich Jr. appointed a task force yesterday to look for solutions to rising malpractice costs, but his selections came in for criticism before the group could convene. Ehrlich gave his task force a November deadline to report, and said he hoped the panel would reach a consensus early, allowing a special session of the legislature to approve reforms. "Everybody needs to sit down and get it done now," Ehrlich said. The path to getting it done, however, hardly appears bump free.

Citing what they say may be a multimillion-dollar abuse, Maryland health officials are tightening controls over emergency medical care provided to residents of foreign countries under the Medicaid program. Health Secretary Nelson J. Sabatini says he suspects that up to $12 million a year in Medicaid funds is being spent improperly to provide health care to aliens who have come to the U.S. expressly for medical treatments that are sometimes expensive and "esoteric." In a series of recent interviews, Sabatini also said he suspects that the problem stems from hospitals that might be steering patients to Maryland for expensive treatments at public expense.

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.

Faulting lawyers won't improve malpractice mess The Sun's editorial on the recent rise in malpractice insurance rates wisely recognized that we must improve the way we compensate victims and deter medical malpractice ("Defensive medicine," Aug. 17). However, I disagree with its emphasis on the harm supposedly caused by plaintiff lawyers. For example, the editorial devoted three paragraphs to the plight of a single doctor who claims he will no longer deliver babies because his premiums are too high.

WASHINGTON - Millions of low-income Americans would face the loss of health insurance or sharp cuts in benefits, such as coverage for prescription drugs and dental care, under proposals moving through state legislatures across the country. State officials and health policy experts say the cuts will increase the number of uninsured, threaten recent progress in covering children, and impose severe strains on hospitals, doctors and nursing homes. But those officials, confronting a third straight year of fiscal crisis, say they have no choice but to control Medicaid, the fast-growing program that provides health insurance for 50 million people.

Imagine a doctor who takes time to ask you about your family or chat about a movie. Who guarantees that you won't have to wait long for an appointment and even makes house calls. A doctor, in short, who provides the same VIP service you'd receive flying first class. You'd have to pay first-class prices, of course. One of the latest signs of the continuing backlash against managed-care medicine is so-called boutique doctors who promise red-carpet service to patients for a fixed fee, usually from $1,000 to $4,000 a year.

WASHINGTON - The Bush administration formally rolled back yesterday some major protections for the privacy of medical records adopted by President Bill Clinton. But at the same time, it also set new standards for the use of personal data to market prescription drugs and other health care products. The rules, the first comprehensive federal standards for medical privacy, will affect virtually every doctor, patient, hospital, drugstore, health insurance company and medical researcher in the United States.

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.