In an article published on the web Bill Bysinger wrote the question "Is HIPAA really happening?" The author met with over 300 organizations of size and found that most were getting prepared for the new law. He also interviewed small physician practices and found the answer was they are doing nothing. As an aside, yesterday I was at my old hospital and saw a physician friend. We discussed HIPAA and he had no idea what it was or that he was a covered entity or had to be ready or file an extension by October this year. The bottom line is that the working physician has no idea what is coming. Since he/she has no idea they don't even know they need help. It is truly a shame that the hospitals are not more proactive in attempting to educate their medical staff on what they should be doing now and in the foreseeable future. Top
Florida still has not allowed nurse anesthetists give unsupervised anesthesia in hospitals but are allowing nurse anesthetist to give sedation for office procedures. The physician doing the procedures would have to know how to deal with office emergencies. This would enlarge the rule stating that nurse anesthetists could not give unsupervised office sedation. Top
The Joint has announced the new patient safety goals that all hospital will now have to adhere to. They are good rules and make sense but I'm not sure they should be part of accreditation. They include accuracy of patient identification, increase effectiveness of communication between caregivers, improve safety of the high alert meds, eliminate wrong site surgery, improve safety pumps and improve effectiveness of clinical alarms. The survey starts on 1/1/03. The new rules can be found on the web site www.jcaho.org. On the new site are also other new bigger and better ways you will be accredited for more money and less value.
The Joint has backed off its onerous accreditation decree that all of an organizations parts must be surveyed. They now give some alternatives for complex organizations. I still don't understand why organizations use this the Joint for their deeming authority. I guess they like to spend money unnecessarily and have to kow tow to unnecessary rules and regulations. Top
President Bush is proposing changes for malpractice in both state and federal malpractice cases. He recommends a $250,000 cap on pain and suffering and punitive damages to twice economic damages or $250,000, whichever is greater. There would be no cap on economic damages. The Democrats will counter this by stating it hurts the patient. Top
Florida has ordered American Medical Security, an insurance company out of Wisconsin, to stop selling any new health insurance products in the state. This is due to the company's policy of reunderwriting. This means they raise individual insurance rates when the individual becomes sick or files a claim as opposed to the other companies that raise rates for a class of individuals and not any one individual.
Sometimes legislators act and then think. A good example of that is the legislated 15% rebate drug manufacturers must give for seniors to purchase their medications. this is above the already reduced rate Medicare requires. Three of the largest generic drug manufacturers have refused to participate. They are TEVA, Mylan and Geneva. This is for the low income Medicare beneficiaries. This means that either the patients pay for the non-generic brands or switch meds. They should have expected that some companies would not participate and lose money. There are only 26,000 people in the program but it would be a bad precedent if the companies did it here and then not in other states.
Georgia has given Promina Health Systems the choice of dropping capitation payments or get an insurance license. The eight hospital not for profit system has decided to drop capitation as a payment model and return to fee for service. Top
I have just received my July issue of Action Report, the quarterly publication of the Medical Board of California. I wish to point out a problem in interpretation. The Report states the legislature is now considering a bill that tells the Medical Board to publish on line all misdemeanor convictions if substantially related to the practice of medicine, all civil judgments after entry of the judgment for malpractice along with the number and amounts of these settlements (meaning the settlements after judgments) and other things. The Medical Board erroneously glommed onto the word "settlement" and stated that all settlements need to be reported. This will wipe out settlements and widely open the door to the court. One of the main reasons for settlements is confidentiality. If this goes, so does the main reason for settlements in general. If the disclosure only relates to settlements post judgment, I have no objection. This is already public information. Top
I love the People's Republic of Massachusetts. They give me more fodder with their non-thinking legislature. As one might remember they are now considering the same as Washington as done, reducing the price the state will pay pharmacists to fill state prescriptions. In Washington many small pharmacies dropped out of the program. some of these were the only pharmacies in the town. In Massachusetts it would be different. The largest pharmacy chain in the state, CVS, would drop out. This would take care of 1/3 of the state paid prescriptions, causing untold hardship on its residents. The other pharmacies are considering their options and may follow suit. This is what happens when you try to be everything to everybody with a finite amount of money. They are not only trying to save money by paying less but actually raise money by charging a user fee for all non-Medicaid prescriptions filled. Top
As all physicians know the feds have reduced your payment another 4.4%, a total of 10% in two years. If that isn't enough the new deal under the CMS is to reduce the amount they pay on EKG reports by 8.2%; 99213 by 4.4%; chest x-ray 7.5% and eye exam and treatment 92014 by 5.6%. Is it any wonder why physicians are putting a cap on the amount of Medicare patients they will see? Top
DISCLAIMER: Although this article is updated periodically, it reflects the author's point of view at the time of publication. Nothing in this article constitutes legal advice. Readers should consult with their own legal counsel before acting on any of the information presented.