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HCR: The Discussion Continues Print E-mail
Written by Jeffrey Herschler   
Wednesday, 13 April 2011 15:16

On March 24th the Coalition Panel on Health presented a debate on healthcare with the provocative title:

FINDING THE BALANCE BETWEEN REFORM AND REPEAL.  Produced by EarQ, the event was held at Ana G Mendez University System in Miramar.  The purpose of the event was to address issues such as:

·         Defining the healthcare debate

·         What HCR means for America

·         Can we afford reform?

·         Can we afford repeal?

Moderated by Rochelle Latkanich, Regional Vice President, Take Care Health Systems, the participants possessed diverse backgrounds and viewpoints.  The panel consisted of Dr. Olveen Carrasquillo, UM School of Medicine, Chief of General Internal Medicine, Tom Gomez, Transformation at the Edge, Executive Director, Dr. Manuel Laureano, Ana G. Mendez University System, Professor of Healthcare Administration, Linda Quick, South Florida Health & Hospital Association, President, Allan Boshell, AvMed Health Plans,  Vice President and Brian Payne, Catholic Hospice, Executive Director. 

The starting point was a discussion of anticipated benefits of HCR.  Dr. Carrasquillo noted that young people will now have more career and education options now that they can ride their parents' plan until age 26.  Dr. Laureano stated "I think HCR will be good for everyone eventually."  He went on to point out that the current situation is clearly unsustainable, "I have an employee who is 60 years old. Her health premium is over $1000 a month and she only makes $2000 per month."   

The current system's shortcomings were expounded upon by Mr. Boshell who emphasized the need to transition to a new method of compensation.  "The old paradigm of do more (procedures), make more (money) is unsustainable," he stated.  And "Payment reform is essential to solving the primary care physician shortage," Dr. Carrasquillo added.  Bringing the conversation closer to home, Mr. Gomez stated "Miami leads the nation in avoidable hospital admissions for Medicare patients. The probing question for this community is:  How do we reduce the waste?"  

Next the conversation turned to one of HCR's core goals:  Moving toward Universal Care.  "I don't think we can go from 75% insured to 97% insured like they did in Massachusetts; maybe we can fulfill half of that," Dr. Carrasquillo said.  Ms. Quick pointed out that of 4.5 million uninsured in Florida, 1 million are undocumented aliens who are specifically excluded from HCR.

Mr. Payne bemoaned the area's unique challenges stating "The problem in South Florida is a lot of illegal citizens die here and that is the first time they are documented. This affects our CON" (adversely). 

Ms. Quick was passionate about the government's role in health policy and administration stating flatly "I don't object to paying more in taxes."  She emphasized the government's role in educating citizens to make healthy lifestyle choices, addressing the primary care shortage and providing safety net health services, among other things.  "Many of us believe this individually but apparently not collectively" she said.  

All panelists agreed that the Great Recession combined with an aging demographic creates fiscal challenges for governments as well as at the organizational level.  "There has to be a change in culture," Dr. Laureno noted.  "How can we provide care within our economic limitations?" he asked rhetorically.

Mr. Boshell challenged Ms. Quick's faith in the government's role in fixing our flawed health system stating "I don't think the government can solve healthcare.  We saw what happened in Massachusetts.  I believe the American entrepreneur will deliver the solution."  Mr. Gomez then added "And that entrepreneur will be a doctor!"

Mr. Herschler is the Editor & Publisher of FHIweekly &   

Last Updated on Tuesday, 24 May 2011 08:43
Expert Witness Certificates Print E-mail
Written by Michael J. Sacopulos, JD   
Wednesday, 06 April 2011 14:29

At the present time, expert witnesses do not need a certificate to testify in any medical malpractice action pending in the State of Florida. However, there is a bill pending before the Florida Senate that would require expert witnesses to receive a certificate prior to offering testimony in Florida medical malpractice cases. Senate Bill 1590, sponsored by Senator Hays (and co-sponsored by others) would require physicians, that are not licensed in the state of Florida, to receive a certificate from either the Florida Board of Medicine or the Florida Board of Osteopathic Medicine in order to testify regarding the prevailing professional standard of care in a medical malpractice case. First, we should note that this requirement has not been enacted into law yet.  Next, it is important to note that it would apply only to individuals not holding a valid license to practice medicine in the State of Florida.

Traditionally, judges have had wide discretion in determining who may provide expert testimony. However, many boards of medicine across the country have declared that the offering of expert testimony in their state constitutes the practice of medicine. This would seem to mean that the state boards of medicine should have some involvement with out-of-state expert witnesses offering testimony in their state. Florida SB 1590 seems to be the first action by any state to address this matter head on. If enacted, this law could allow the state boards of medicine to prohibit certain individuals from testifying in state court medical malpractice actions.

As currently described by SB 1590, an out-of-state health care provider would need to have an active license to practice medicine in another state or a province of Canada and submit "to the board a complete registration application in the format prescribed by the board." In addition, the individual would need to pay an application fee not exceeding Fifty Dollars ($50.00). The Florida State Board of Medicine or the Florida Board of Osteopathic Medicine would then have five business days to approve or deny the application for an expert witness certificate. The certificate would be valid for two years.

It will be interesting to see if this bill is enacted into law in Florida. If so, the law would be the first of its kind and certain to receive national attention. 

Michael J. Sacopulos is a Partner with Sacopulos, Johnson & Sacopulos, in Terre Haute, Indiana. His core expertise is in medical malpractice defense and third party payment disputes. Sacopulos is also the general counsel for Medical Justice. He may be reached at

Last Updated on Sunday, 01 May 2011 12:55
Silver Lining for Jackson? Print E-mail
Written by Jeffrey Herschler   
Wednesday, 30 March 2011 15:39

University of Miami/Jackson Memorial Medical Center has been ranked No. 1 in Miami--Fort Lauderdale in U.S. News & World Report's first-ever Best Hospitals metro area rankings, posted online this week. Of the 69 hospitals in the Miami--Fort Lauderdale area, only 18 made the new ranking.  Outgoing CEO, Dr. Eneida Roldan stated “This is an incredible achievement for us, as we beat out all of our local competition in South Florida.  Despite our current fiscal challenges, this accolade is quite a testament to the unparalleled, quality medical care we provide here each and every day.”  To view the report, please click the link below:

Last Updated on Wednesday, 13 April 2011 15:21
New Administration Looking to Overhaul Florida's Workers' Comp Print E-mail
Written by Tom Murphy   
Wednesday, 30 March 2011 08:38

2011 Workers' Compensation Update

Even before he ever took office it was clear that Governor Rick Scott was serious about changing Florida's legislative and regulatory landscape. One of his campaign pledges included reducing workers' compensation costs by 35%. He recently renewed this pledge to the Florida Council of 100 shortly after taking office. This could be a formidable task given the fact that Florida rates have decreased by 64.7% since the major legislative reform in 2003.

Recently, Florida Insurance Commissioner Kevin McCarty approved a 7.8% rate increase that went into effect on 1/1/11. The reasons for the current rate increase are changes in claims experience and frequency. The dramatic decline in claims between 2003 and 2007 appears to have slowed, leading some experts to assert that the 2003 reforms have run their course.

Many industry leaders believe that the only possible way to cut workers' compensation costs further would be to change benefits or reforms associated with prescription drug benefits. One specific recommendation is legislation that would apply the pharmaceutical fee schedule to repackaged or relabeled drugs. Additionally, the legislature may find itself dealing with other issues, such as apportionment, that involve separating costs associated with pre-existing injuries.

One thing is clear. Nobody knows how the current legislature will respond to Governor Scott's ambitions to further reduce Florida's workers' compensations costs. Undoubtedly, he will push forward for these changes that will be welcomed by medical practices and all Florida businesses and vehemently opposed by injured workers and their attorneys

Tom Murphy is a medical malpractice and workers' compensation insurance specialist with Danna-Gracey, a boutique insurance agency specializing in medical malpractice and workers compensation for Florida's medical community. To contact him call (561) 276-3553 or (800) 966-2120, or e-mail

Last Updated on Wednesday, 06 April 2011 14:26
Miami Physician Featured in Medical Economics Print E-mail
Written by Jeff Herschler   
Saturday, 12 March 2011 16:18

Bernd Wollschlaeger, MD of North Miami Beach is featured in the current edition of Medical Economics.  I've known Bernd for almost a decade, feature his blog in FHIweekly and often run his op-ed pieces on  I am pleased to share this link:

Bucking Convention: Bernd Wollschlaeger, MD 

March 2011 - Medical Economics 

Last Updated on Wednesday, 30 March 2011 08:37
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