In Brief: DMHC Trial Verdict Expected Soon; Consumer Reports Rates Hospitals On Surgery
Verdict in DMHC Lawsuit Expected
A verdict in the lawsuit filed by the Department of Managed Health Care against a South Pasadena physician for balance billing patients is expected by mid-August.
Los Angeles County Superior Court Judge David Milton is expected to issue a judgment in the lawsuit the DMHC filed against plastic surgeon Jeannette Y. Martello, M.D., as soon as Aug. 13, according to a DMHC spokesperson.
The DMHC sued Martello after she violated a 2010 cease-and-desist order it had issued against her for balance billing insured patients she treated at hospital emergency rooms in Pasadena and Burbank. A Payers & Providers investigation conducted last year indicated she had sued dozens of her patients.
In May 2012, the DMHC was able to obtain a permanent injunction against Martello balance billing any patients whose insurance policies were regulated by the DMHC.
In the suit, the DMHC is seeking disgorgement of money Martello may have collected from patients she balance billed, as well as additional monetary penalties.
Both the lawsuit and the cease-and-desist orders are the first and only times the DMHC has taken such actions against an individual provider.
In addition to the civil suit against Martello, the Medical Board of California has sought to revoke her medical license. The unprofessional conduct of balance billing of patients was among the charges filed against Martello.
An administrative law hearing regarding the Medical Board charges took place last October. Cindy Lopez, the California Assistant Attorney General who prosecuted the matter, said a decision could be issued in the next few weeks.
Consumer Reports Rates Hospitals On Surgeries
Consumer Reports has issued a new survey assessing how well hospitals care for patients who undergo scheduled surgeries under their care.
Of the more than 2,400 hospitals evaluated by the magazine, 195 were in California. Twenty-two facilities received much better than average ratings, including Saint John's Hospital in Santa Monica, French Hospital Medical Center in San Luis Obispo and the UC San Diego Health System. Thirty-five more hospitals received above-average ratings, while 11 receive below-average ratings, including Santa Monica-UCLA Medical Center and Antelope Valley Hospital Medical Center.
Eight hospitals received ratings that were much worse than average, including Good Samaritan Hospital in San Jose, Northridge Hospital Medical Center and Sutter Delta Medical Center in Antioch.
Consumer Reports based its scores on Medicare claims data submitted by the hospitals between 2009 and 2011.
“We know the ratings aren’t a perfect measurement, but we think they’re an important first step in giving patients the information they need to make an informed choice,” said John Santa, M.D., medical director of Consumer Reports Health.
