The Only Book on What Managed Care May Look Like After the Affordable Care Act Becomes Fully Effective.

  Front Book Cover


Well, the Supreme Court finally came through on June 28, 2012 finding the Affordable Care Act constitutional. Click here if you wish to see the Table of Contents.

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       President Obama's originally proposed "public option," would have guaranteed needy patients fully accredited care just like here, at Rye Hospital Center, where such care was already almost 100 percent federal- and state-funded by Medicare and Medicaid. But because the American middle class is still denied proper healthcare by "managed care" (see below), while "Medicare Advantage" (to the big insurance companies) was turned over to  the private insurance industry by the Bush II administration, what is needed now is for the Affordable Care Act to stop the insurers from fixing prices and excluding the middle class from proper treatment by the use of "managed care." The discredited managed-care private insurance industry has become a "market failure," creating another insurance cartel like in the 1940s.  Read more

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At Rye Hospital:

The suburban setting on a small private estate in Westchester County provided a quiet, comfortable environment where — through close interaction with staff and other patients — patients were able to be helped, and helped  themselves, toward recovery.

Rye Hospital Center was the only fully accredited inpatient psychiatric hospital on the Long Island Sound Shore between Connecticut and New York City.

Enhancing the Patient's Experience:

The Rye Hospital Center's mission was to empower persons with disorders--physical and emotional--to function at an optimum level and to better adapt to the daily demands of society.

The Center's patient population consisted of males and females, from early adolescence through geriatrics, whose primary diagnosis was psychiatric, although "dual focus" treatment for co-morbid medical disorders was available.

Patients were treated for depression, anxiety and stress, which accompany chronic benign pain such as migraines or other headaches and persistent medical illnesses like coronary disease and eating disorders.

Issues addressed ranged from substance abuse and prescribed-medication overuse, to physical and mental handicaps.
The hospital had no intimidating locked doors. No one wore a uniform.

The program and its setting enhanced outdoor activities –– sports, gardening and recreational therapy. Patients had ready access to the City of Rye’s swimming pool, library and “Y.” This extended the therapeutic environment to the outside community, helped eradicate stigma, and enhanced the patient’s hospital experience.

Psychotherapeutic sessions were supplemented with occupational, recreational, art, writing workshop and physical activities.

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Rye's Population Changed With the Times.

Rye adapted its population to regularly reflect societal needs. Since its inception in 1971, the Hospital accepted patients of all ages, and integrated them into its Therapeutic Milieu until the time of its closing by the Office of Mental Health in October 2012.

Accepted over decades of surveys by state and federal regulators, Rye's philosophy of treatment led the way for the successful transition of patients back to their communities. (See "Transition-Age Youth Services" [opposite column].)

Associate Supreme Court Justice Breyer says:
"The opinion of a responsible treating physician in determining the appropriate conditions for treatment ought to be given the greatest of deference."(click here & see): OLMSTEAD V.  L. C.

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Metabolic Syndrome: Adults/Youth and "Second-Generation" anti-psychotic medications.

Serotonin Syndrome  
Also New Important Link: Drug Interactions and AIDS . . .      AIDS Prevention

Welcome to MedWatch, your Internet gateway for timely safety information on drugs and other medical products regulated by the U.S. Food and Drug Administration.                 

See the latest:
Rye Hospital Center's--FDA MedWatch

FDA Approves Risperdal for Two Psychiatric Conditions in Children and Adolescents. Latest FDA Warning on antidepressants.

Late News!
FDA focuses on "Off-Label" use of medication:
Revealed in the latest FDA/ Johnson and Johnson warning about dangerous cardiotoxic effects of the neuroleptic tranquilizer Haldol, is the acknowledgement of its use, "off-label," when injected intravenously.

This marks an important moment in psychoactive-drug protection of the public by the government, since "off-label" uses of medication have long been subtly promoted by pharmaceutical companies to medical professionals to stimulate sales, when not backed by properly conducted and approved safety research.

The FDA September 2007 warning stated: "Although injectable haloperidol is only approved by the FDA for intramuscular injection, there is considerable evidence that the intravenous administration of haloperidol is a relatively common off-label clinical practice."

      "Jonathan's Law"

(Chapter 24 of the Laws of 2007-NY) was signed into law on May 5, 2007. The new law makes changes in the way certain notifications are made and information is shared, regarding incidents involving the health and safety of patients, as well as allegations of abuse in mental hygiene facilities.
To see official pamphlet
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Most recent "unannounced survey" results by the federal Center for Medicare and Medicaid Services (CMS), 3/07/07:  They said:. . . it is not the medical record, the staff or the plant--it is the treatment of the patient that shows through. . .World-class
treatment!" ENTER

How does the federal Center for Medicare and Medicaid Services Survey Psychiatric Hospitals?


New York's Commission on Quality of Care & Office of Mental Health Evaluates Private Psychiatric Hospitals (from the most recent report of its kind)

. . . and from the Office of the Surgeon General (the first-ever and still only-) comprehensive report on mental health in the U.S. . .

Center for Disease Control/JCAHO Infection Control Link
(see "Infection Control Guidelines)

Enter the CDC

The Affordable Care Act upheld by the U.S. Supreme Court!

(Washington, DC, June 28, 2012) In an historic decision, the High Court upheld the constitutionality of the Patient Protection and Affordable Care Act, President Obama's signature legislative achievement. Chief Justice John Glover Roberts delivered the majority 5-4 opinion, together with associate justices Breyer, Ginsburg, Sotomayor and Kagan.
     Although the government's "case-in-chief" defended the challenged "individual mandate" section of the law as supported by the Constitution's "Commerce" and "Necessary and Proper" Clauses, the High Court accepted the argument based on Congress's constitutional authority to "lay and collect taxes," one more politically acceptable as an alternative pleading.
     Now, the work by the states begins: State insurance Exchanges for the less well-off will have to be set up by January 2014, when most Americans must begin to be brought into the system of close-to-universal healthcare coverage or the federal government will do it for them. To the extent that the few "holdout" states refuse the virtually fully-funded Medicaid expansion generated by the law, the electorate of those states will probably see to it that their governments give them what the citizens of complying states have made available.   
   All in all, the President's victory must be considered a victory for the healthcare of the American people.
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May, 2012:  Rye Hospital Center has been re-certified for over another two years. The New York State Office of Mental Health completed its routine periodic review of Rye and affirms its operation; another in the long line of regular state approvals since the hospital's founding over forty years ago. This follows the federal government and The Joint Commission's findings of Rye's competence as a fully accredited mental-healthcare provider hospital.

Obama Aministration issues new mental health coverage rules:

The New York Times (1/30, A14, Pear) reported the Obama Administration "issued new rules...that promise to improve insurance coverage of mental healthcare for more than 140 million people insured through their jobs." Under the rules that go into effect July 1, "employers and group health plans cannot provide less coverage for mental healthcare than for the treatment of physical conditions like cancer and heart disease."

        The AP (1/30) reported that the new rules prohibit "separate annual deductibles for mental health treatment" and higher "copayments for visiting a psychiatrist or social worker." The measure "also prohibits health plans from setting limits on number of visits or hospital days for mental health problems that are different from any such limitations on treatment for medical problems."

        Modern Healthcare (1/29, Zigmond) reported, "The rule applies to group plans of 50 or more people and divides benefits into the following six categories: inpatient, in-network; inpatient, out-of-network; outpatient, in-network; outpatient, out-of-network; emergency care; and prescription drugs." CQ HealthBeat (1/30, Norman) also covered the story.


Rye Hospital Center defeats commercial, profit-based  Medicare Managed Care!
   In significant, administrative law court  decisions, which may help end waste and abuse of Medicare beneficiary funds, Rye Hospital Center won a victory over the Bush II  Administration's deferential giveaway to the big commercial insurance companies: the "managing" of healthcare for seniors (to save on "costs"), Rye won 100 percent of its appeals to federal Administrative Law Judges on its total sixteen cases denied by National Government Services (a wholly owned subsidiary of the mammoth, commercially owned WellPoint Insurance Company).

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A task force created by forty-nine out of 50 state attorneys general finds that Internet child predation "is not a significant problem" as popularly thought by some (including the NY State Office of Mental Health). Moreover, the Harvard-based report concludes that "bullying among children, both online and offline, poses a far more serious challenge than the sexual solicitation by adults." (N.Y. Times 1/14/09).

"Integrated Care" says U.S. Supreme Court. The federal government defines: Mentoring for Transition-Age Youth and Young Adults With Disabilities: "Youth or young adults with [physical or mental] disabilities means individuals with disabilities who are between the ages of 16 and 26.": 34 CFR § 373.4 [(Authority: 29 U.S.C. 711(c) and 723(a)). Thus, while for purposes of "abuse" a "child" must be under 18, for purposes of help, rehabilitation or medical assistance (Medicaid), a "child" is defined as under the age of 22. (42 USC § 1396a)].
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Rye did it again!
    A full, three-year accreditation through 11/09-12. 
"In preparation for the submission of its application to the Centers for Medicare & Medicaid Services (CMS) for continued hospital deeming authority, . . . Joint Commission accredited hospitals are already meeting the spirit of many of these revised requirements."
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    New Problems Linked to SSRIs
Prolongation of the QT interval (on the EKG) is a risk factor for sudden death. Selective serotonin-reuptake inhibitor antidepressants can prolong the QT interval and are widely used by pregnant women. The aim of this study was to determine the effect of maternal use of selective serotonin-reuptake inhibitor antidepressants during pregnancy on the QTc interval of the offspring.

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Westfield Day School is a community based therapeutic school "dedicated to helping students overcome personal obstacles and academic difficulties by designing individual programs for success."

Rye Hospital Center is proud to add to our inpatient programs the special skills of WDS, so that we can maintain a seamless transition for young patients that is focused on improving the academic and functional achievement of youth with disabilities and to facilitate  their movement from hospital back to community and school life.

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Rye Hospital Center received another recertification! . . . In May of 2012, the New York State Office of Mental Health affirmed for another 2 1/2 years, Rye Hospital Center's more-than 38th year of certification to admit patients in need. This followed the federal government and The Joint Commission's findings once more of Rye's competence as a fully accredited mental healthcare provider hospital.

With the latest bad news of "atypical-antipsychotic" drug use in children, see the chart of Cytochrome P 450 Drug Interactions:


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Moitri Datta,MD
 --Rye's Director of Transition-Age Youth Services (click)

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Public Health Advisory
- FDA - Combined Use of 5-Hydroxytryptamine Receptor Agonists (Triptans), Selective Serotonin Reuptake Inhibitors (SSRIs) or Selective Serotonin/Norepinephrine Reuptake Inhibitors (SNRIs) May Result in Life-threatening Serotonin Syndrome

SSRIs and Treatment Challenges of Depression in Pregnancy . . . SSRI-SNRI Side Effects(link)