CASH-ON-DEMAND EPIDURALS: Federal Investigators Join Expanded County Probe
Federal investigators joined state and Los Angeles County officials in their probe into possible Northridge Hospital violations of state or federal laws when it denied epidurals to poor women during childbirth unless they could pay upfront in cash. At the same time, county officials expanded their probe to other hospitals in the area that may have denied anesthesia to other Medi-Cal women in labor, the Los Angeles Times reports. Chris Peacock, spokesperson for the federal Health Care Financing Administration, the agency that oversees Medicaid -- and therefore Medi-Cal -- said federal investigators would work with state and county officials to see if federal laws were violated by Northridge's policy. The Times reports that requiring cash payments before treating a patient could violate rules governing Medicaid funds, which comprise about half of the state's Medi-Cal monies. Demanding cash before administering epidurals may also violate federal regulations prohibiting hospitals from refusing to treat poor patients, or "patient dumping," the Times reports.
At The Local Level
State officials will be scrutinizing Northridge's billing practices "to determine whether a state law prohibits doctors from charging Medi-Cal beneficiaries for procedures, like epidurals, that the agency covers." The county, "charged with overseeing hospital licensing for the state," will "examine records and interview staff" at Northridge this week to determine "whether the hospital violated state law that mandates that physicians accommodate 'reasonable requests' by patients for care."
Shocked And Appalled
"This is the worst aspect of medical care these days. The greed of the anesthesiologist to have done this is beyond me," said County Supervisor Zev Yaroslavsky. The California Medical Association has also joined the chorus of outcries against the "pay or pain" practice. Yesterday Jack Lewin, CEO of the CMA, called the practice "unethical." He said, "What I want to say to doctors is, 'Let's not solve it that way.' Let's provide the care and then stand together and solve the problems" (Bernstein, 6/17).