The Other Escobar

On this blog, I focus on what most of my clients have in common – the need for serious medical care and the attendant expenses. I often blog about Quality Fraud and share news items about how the cost of healthcare is driven by misrepresentations made in the course of providing care. Unlike other markets, […]

Overdose (No. 3)

This is the third in our blog series on obtaining and using confidential peer review records in litigation. In Overdose (No. 1), I reviewed JCAHO Hospital Root Cause Analysis and Sentinel Event Reporting. In Overdose (No. 2), I reviewed Hospital adverse medical incident reports, including Code 15 reports on nursing negligence submitted in Florida to the […]

Overdose (No. 2)

In my last Weekly Blog, I reviewed an Accreditation Decision Report I secured from internal Hospital and JCAHO investigations of a fatal overdose. These reports are usually confidential and contain information not available in other sources. That kind of sensitive information is rarely available but can be critical to a successful outcome in medical malpractice […]

May 30, 2017

Medical Loss Ratios (MLR’s) are designed to lower healthcare costs. Here is how they work. In a recent Federal Court ruling, a Court found that physician settlement payments may be included in the MLR for the carrier. CMS Page on Medical Loss Rule (MLR)