Grand Rounds June


Blue Cross Plans Settle 900,000 Doctors' Lawsuit For $128 Million

A group of managed health care companies have reached a $128 million settlement in a class-action lawsuit filed by about 900,000 physicians over alleged unfair business practices that denied and delayed payments for medical care, both sides confirmed Friday.
Under the settlement, 23 Blue Cross and Blue Shield plans and the Blue Cross and Blue Shield Association will pay the money to a fund. The physicians can make a claim or select a charity to receive the money.

Blue Cross and Blue Shield of North Carolina will contribute more than $6 million toward the settlement.
Collectively, the plans also will pay legal fees determined by the courts up to $49 million, said Michael Pope, a spokesman for the companies.

Pope said that plans will pay a percentage based on their size.

In May 2003, the physicians filed a lawsuit in Miami against the companies. They contended they were systematically cheated by insurance companies that programmed computers to pay for less intensive services than were actually provided.
The settlement must be approved by U.S. District Judge Federico Moreno, both sides said.

Practice changes the plans have agreed to include implementing a definition of medical necessity that ensures patients are entitled to get medically necessary care as determined by the doctor and using clinical guidelines that are based on credible scientific evidence when making medical necessity determinations, according to a statement by Archie Lamb, an attorney for the physicians.


Florida Hospital Breaks Ground on New State-of-the-Art Laboratory

Florida Hospital Orlando is in the midst of a major expansion project — building a new 15-story patient tower. And to support the pathology needs for the expanding hospital and continuously growing community, Florida Hospital recently broke ground on the new Florida Hospital Center for Diagnostic Pathology. Located at 2855 North Orange Avenue, the 24,000-square-foot, two-story building will allow Florida Hospital to continue to expand anatomic pathology services, and open up additional space in the current laboratory on the second floor of Florida Hospital Orlando to grow clinical pathology services there as well. In addition, when the new lab is complete, patients will have easy access to a specimen drawing station with a convenient parking lot and entrance.

The new, stand-alone building is being built by Bovis Lend Lease, one of the world's leading project management and construction companies, and is scheduled to be complete in spring 2008. Staffed by more than 80 professionals from pathology, histology, cytology, and clinical teams, the new Florida Hospital Center for Diagnostic Pathology will process more than 80,000 specimens each year in a state-of-the-art facility with advanced venting and exhaust features. In order to meet the ever-growing needs of the Central Florida community, the new lab will be open around the clock every day. It will also allow Florida Hospital to increase research partnerships and contributions.


Drum Roll Please…Florida Hospital Unveils 2007 Cuties

The judges' scorecards have been tallied, the nearly 85,000 online votes have been counted, and Florida Hospital has found the seven cuties that will be featured in its upcoming advertising and special events. Nearly 800 cuties, from as far away as Jacksonville and Davenport, turned out for the first-ever Florida Hospital Cutie Casting Call on April 26 and April 27 at Florida Hospital at Winter Park and Florida Hospital at Altamonte.

Recently, the two highest scoring cuties in each age category (newborn to 12 months, 13 months to 3 years, and 4 to 6 years), along with the People's Choice Cutie, who received more than 12,000 online votes, were honored at a celebration party at Florida Children's Hospital at Florida Hospital Orlando. The little cuties received gold-plated Florida Hospital medals and posed for their very first pictures.

"Everyone always told me that my daughter was beautiful and that she had such a great temperament, so I thought why not take a chance? I'm so glad that I participated and that Sophia was chosen as one of the cuties," said Rachel Lombardi whose daughter Sophia was one of the highest scoring cuties in the newborn to 12 months category.

The inaugural Florida Hospital Cuties in each category are:
Newborn -12 months: Sophia Lombardi – 5 months old; Annaliese Trout – 7 months old 13 months – 3 years: Major Borack – 3 years old; Joseph Ortiz – 3 years old4-6 years: Brazyl Blake – 4 years old; Trinidy Parker – 4 years old;
People's Choice: Kylee Escoffery – 10 months old

"All of the cuties who came out for the first-ever Florida Hospital Cutie Casting Call are winners in our book. Instead of using models for our Florida Hospital and Florida Children's Hospital advertising, we wanted to find real kids who are representative of our great community. We are thrilled that the seven highest scoring cuties will be our little ambassadors. We never imagined that we would have such a huge turnout, but we are so glad to have met all of the families who participated," said Marla Silliman, administrator of Florida Children's Hospital at Florida Hospital.

The cuties were scored by a panel of local celebrity judges including Miss Florida, Miss Orlando, local mayors, slugger Ken Griffey Jr.'s mom Birdie Griffey, news personalities and general managers, community leaders, and other Central Florida notables. The People's Choice Award was given to the cutie with the highest number of online votes.

To see all of the cuties who participated, go to www.floridahospital.com and click on the cutie icon.


Anthony Giammanco Joins OMN

Anthony J. Giammanco recently joined Orlando Medical News as an account executive.

An Ocoee resident since 2003, Giammanco has more than two decades of expertise in sales and marketing management, with a focus on team development and strategic planning. He most recently worked in the New York metro area with clients such as Baker & Taylor, Public Service Electric & Gas, Ricoh Corporation and Sony Corporation.

For more than 20 years, he owned a successful contract furniture and installation business while concurrently serving as a consultant specializing in proposal development, labor relations, contract negotiations, and account management. He is also a licensed mortgage broker and communications consultant.


John Kelly Celebrates Milestone With OMN

John Kelly, a Florida resident since 1985, joined Orlando Medical News as associate publisher with the publication's first issue, and quickly advanced to market publisher of the Central Florida territory.

A graduate of the State University of New York at Cortland, he spent two decades in the communications industry before joining the Nashville, Tenn.-based publishing house.

"I love working for Medical News because it affords me the opportunity to provide high value solutions for our advertising partners, meet highly committed individuals every week, and leverage the opportunity to build the Orlando publication from the ground up," said Kelly, who has been married for 15 years to Karen, a pediatric nurse practitioner in Maitland.

The couple has one son and two daughters.


Obins & Morton Names Sturkie Senior Project Manager

The Orlando Division of construction firm Robins & Morton has announced the promotion of Johnny Sturkie to Senior Project Manager.
In this role Sturkie will provide daily coordination with owners and architects and assist the superintendent with planning, scheduling, and quality control.

Sturkie has worked in the construction industry since 1996. For Robins & Morton he has served on project management teams responsible for several healthcare projects, including the $112 million Winnie Palmer Hospital for Women & Babies.
He holds a Bachelor of Science in Business Administration from The Citadel.


Nemours Opens Larger Brevard Satellite Clinic In Viera

Nemours moved out of its Melbourne location recently and into a larger facility in Viera. The increased room will give physicians the ability to see more patients in an improved environment that also provides better access to major thoroughfares in Brevard County.

The new facility, located at 7000 Spyglass Court, Suite 120 in Viera, will continue to provide the same specialties of Nephrology, Urology, Gastroenterology and Pulmonology, however, plans are being considered to add Endocrinology by the end of the summer.

The previous location in Melbourne did not offer the room for growth that Nemours eventually wanted to add and was sometimes a challenge for patients to find.

The Viera clinic has a total of six exam rooms with additional clinical workspace that will allow nurses and medical assistants to be more efficient. The new facility, like the old one, will also have an electronic medical record (EMR) system that is integrated with all other Nemours locations for seamless care or consultation.


June 2007