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Malpractice Defense: ‘Profiteering Parents’; Surprise Billing Squeeze; COVID & ICE

Welcome to the latest edition of Investigative Roundup, highlighting some of the best investigative reporting on healthcare each week.

Malpractice Defense: “Profiteering Parents”

One tactic a hospital may use to get off the hook for obstetrical malpractice: accuse the mother of trying to profit off her child.

That was what St. Petersburg General tried to do to Ashley Lamendola, whose son Hunter was born with brain damage, according to the Miami Herald.

Florida is one of two states that protect doctors and hospitals against legal actions after births go wrong, through a program called the Birth-Related Neurological Injury Compensation Association (NICA), which provides $100,000 upfront and covers “medically necessary” care throughout the child’s life. By enrolling, parents give up their right to sue.

Lamendola filed a lawsuit against St. Petersburg General, which is owned by HCA Healthcare. The hospital argued that Lamendola was pursuing her own self-interest by refusing to participate in NICA — and that the court should appoint a guardian to make the decision instead.

Lamendola could take millions of the hospital’s money, and then walk away from her son when he got older, the hospital argued: “The child is vulnerable given the Mother’s limited duty to only support the Child until the age of majority,” it wrote in a court pleading, the Miami Herald reported.

Lucinda Finley, a University of Buffalo law professor, called the accusation “emotional abuse. … I can imagine the parent saying this hospital whose doctors are responsible for killing or seriously injuring my child now has the audacity to say I don’t care about my child.”

“These are not parents who are suddenly seeking to improve their lifestyle,” Finley told the Herald. “These are parents who are suddenly faced with the crushing financial needs of seriously disabled children.”

The tactic failed and St. Petersburg General ultimately settled with Lamendola for $9.5 million, but it’s not clear how many other cases are handled this way, according to the Herald.

Watered-Down Surprise Billing Law?

Healthcare lobby groups are hard at work protecting their interests as details about how the new “surprise billing” law will be put into practice are being hammered out, Politico reports.

Patient advocacy groups worry that efforts by these groups — representing hospital systems, health insurers, air ambulance companies, private equity-backed physician staffing firms, and others — will water down protections during the rule-making process.

For instance, advocates are watching to make sure that patients won’t be signing away their protections, that providers who violate the ban are monitored and punished, and that a process is established for settling disputes.

One consumer advocate who spoke anonymously to Politico said the agency is “going to have to be really hard-hitting, or it’s another squishy law that’s supposed to be preventive but is totally circumventable.”

The surprise billing ban is supposed to go into effect in January 2022.

ICE’s COVID Failures

A New York Times investigation found key trouble spots where U.S. Immigration and Customs Enforcement (ICE) mismanaged its COVID-19 response, leading to high infection rates at its detention centers.

As cases rose last June, ICE detention facilities had average infection rates that were five times higher than that of prisons, and 20 times higher than in the general population, the Times reported.

Key issues included violations of mask-wearing and social distancing protocols, and a lack of testing. For instance, at one detention center in Virginia, failure to contain the virus led to an outbreak of 250 cases among 300 detainees in one facility, with one death, the Times reported.

Not all facilities were hit equally as hard by the virus, with larger outbreaks in southern border states. One pattern that occurred at many facilities was that increased infection rates were usually followed by more infections in the outside community.

The agency does publicly report active cases among detainees but doesn’t report infections among staff members, which is key to understanding community spread, the Times reported.

Finally, the news outlet found that ICE doesn’t have plans to vaccinate people in custody; rather, it’s leaving that to state governments.

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    Kristina Fiore leads MedPage’s enterprise & investigative reporting team. She’s been a medical journalist for more than a decade and her work has been recognized by Barlett & Steele, AHCJ, SABEW, and others. Send story tips to [email protected] Follow