Week in Review: 9 biggest healthcare stories this week

Stay in the know with Becker's Hospital Review's weekly roundup of the nation's biggest healthcare news. Here's what you need to know this week.

1. Montefiore employee found dead, locked in hospital bathroom
An employee of Montefiore Medical Center in Bronx, N.Y., was missing since Thursday and found dead in a facility bathroom on Monday, according to an NBC New York report. Anthony Iuso, 44, cleaned the operating rooms on the hospital's third floor. On Oct. 1, Mr. Iuso left work to get an injured finger treated in the emergency room. Afterwards, he returned to the third floor to use a bathroom, and no one saw him after that. After continuous attempts to contact him for four days, Mr. Iuso's family came to the hospital Monday morning, demanding to see hospital surveillance footage. That is what led hospital employees to discover Mr. Iuso's body in the bathroom. 

2. MU stage 3, modification rules finalized
CMS on Tuesday released the final rules for the Medicaid and Medicare EHR Incentive Programs and for the 2015 Edition Health IT Certification Criteria. The rules for the meaningful use program include a 60-day comment period, while the 2015 Edition rules are final. Much of the realigning and rulemaking is centered on recent changes to the Medicare Access and CHIP Reauthorization Act of 2015, which was enacted April 16. For a more detailed breakdown of MU stage 3 and the 2015 Edition Health IT Certification Criteria, click here.

3. 504 hospitals hit with whistle-blower lawsuit alleging false claims violations
Jacksonville, Fla.-based Healogics, which operates wound care centers across the U.S., and 504 hospitals across the country — including hospitals from systems such as Cleveland Clinic, St. Louis-based Ascension Health and Dallas-based Tenet Healthcare — have been accused of defrauding Medicare, Medicaid and Tricare, among others, according to a whistle-blower lawsuit filed by three former employees of Healogics in federal court. The whistleblowers allege patients were charged "superbills" for many procedures that were not actually done.

4. MedStar Washington patient dies after struggle with guards
A patient at MedStarWashingtonHospitalCenter is dead after a "tragic interaction" with the hospital's security guards, The Washington Post reported. The incident occurred Sept. 29 and the patient died Oct. 1. A male patient reportedly left the hospital without being discharged or signing discharge papers. When a nurse and security guard found him outside, they led him back to the building where the patient began to struggle against two security guards. One guard used "hand controls" to restrain the patient, and a nurse and rapid-response team had to resuscitate him. The patient was taken to intensive care before he died. The hospital did not release the patient's injury.

5. Novant Health to close North Carolina hospital
Winston-Salem, N.C.-based Novant Health will close Franklin Medical Center in Louisbug, N.C., Oct. 16, according to a Triad Business Journal report. Novant decided to close the hospital due to declining patient volumes over the last several years. The system attempted to find a buyer for FMC, but failed to do so.

6. ONC unveils Final Interoperability Roadmap
The ONC released its final guidance Tuesday on how it plans to make the American healthcare system fully interoperable within the next 10 years. The ONC's Final Interoperability Roadmap outlines goals from now to 2024:
2015-2017: Send, receive, find and use priority data domains to improve healthcare quality and outcomes.
2018-2020: Expand data sources and users in the interoperable health IT ecosystem to improve health and lower cost.
2021-2024: Achieve nationwide interoperability to enable a learning health system, with the person at the center of a system that can continuously improve care, public health, and science through real-time data access.

7. Nearly half of HealthCare.gov plans don't cover out-of-network costs
A study from Mountain View, Calif.-based HealthPocket shows 47 percent of Affordable Care Act plans on HealthCare.gov lack out-of-network coverage. The study utilized government data on individual and family plans in the 37 states that use HealthCare.gov. The percentage of HealthCare.gov plans offering out-of-network coverage varied. Zero percent of plans in South Dakota offered such coverage, while 100 percent of the plans in Alaska, Alabama, Louisiana, Tennessee and West Virginia offered out-of-network coverage. In the 37 states using HealthCare.gov, there were eight states in which less than 33 percent of plans covered out-of-network coverage.

8. CMS launches new ACO dialysis model
CMS is launching a new accountable care organization model to improve care coordination for patients with kidney failure and control costs for end-stage renal disease treatments. The model, called the Comprehensive ESRD Care Model, is based off CMS' experience with other programs, such as the Pioneer ACO and Medicare Shared Savings Program. Under the CEC Model, nephrologists and other providers team up with dialysis facilities to create ESRD Seamless Care Organizations, which function like ACOs. The model is meant to prompt providers to support patients both in and out of the dialysis facility. ESCOs are at risk for Medicare Part A and B spending, dialysis services and quality outcomes of their assigned beneficiaries.

9. FDA orders scope manufacturers to study how devices are used in healthcare settings
The U.S. Food and Drug Administration ordered three duodenoscope manufacturers — Olympus, Fujifilm and Hoya Corp. (Pentax Life Care Division) — to perform postmarket surveillance studies to increase their understanding of how the devices are reprocessed in real-world settings. The manufacturers will have 30 days to submit their postmarket surveillance plans to the FDA. The plans must include details on three concerns, including those regarding reprocessing instructions, rates of remaining contamination after reprocessing and subsequent required steps for decontamination.

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