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The same two Senators that have groused about specialty hospitals, Grassley and Baucus, have asked the CMS to further delay, until October 8, of the ability of specialty hospitals to apply for CMS payments. They feel the survey that CMS sent out was not good enough and want more information. The current moratorium expired 8/8/06. The CMS decided not to go along with the Senators and will not extend the moratorium. The CMS report issued on 8/8 talks about getting community hospitals to work better with the physicians by a gainsharing project. CMS also stated that if any hospital does not have an ED they still must accept transfer patients under EMTALA. The specialty hospitals will need to respond to CMS surveys regarding physician investment and compensation or face a $10,000 per day fine. Specialty hospitals will also need to tell patients in advance of treatment about physician ownership and investments. The AHA after the announcement continued to spew its falsehoods regarding specialty hospitals in order to appease its constituents.
CMS has changed the PPS for hospital payments. In a three year phase-in, the new DRGs will be based on costs not charges. There will be breakdowns of various DRGs so that hospitals will get paid more for sicker patients and less for those not as sick. The estimates are that about 80% of the 5,000 hospitals will get an increase in payments of between 1% and 5%. About 2% of the hospitals will see a decrease in payments. Payments to cardiac specialty hospitals are expected to decrease by about 5%.
The physician fee will be reduced by 5.1% under the proposed rule. This will not occur since Congress is currently changing the rules. CMS will continue the 25% cut for the technical component of multiple imaging procedures.
CMS has announced that starting October 1, only those who use HIPAA compliant 835 version 004910A1 will get electronic remittances. If not, no payments. Top
The CMS issued on August 1 a new directive establishing an exception to the Stark law for EMRs. The donation of material and/or training for electronic prescribing and EMR by the hospital to the medical staff physician will now be OK. There are many hoops that the hospital and physician must jump through including having the physician pay 15% of the cost of the EMR hardware and software prior to receiving it. Top
Florida has decided that those physicians who do wrong side surgery will not get their license revoked until the third episode. The Board decided on pushing prevention of the mistake rather than the punishment. The third strike is an automatic revocation of the license. The Board may still revoke a license earlier, if they wish.
The Medical Board of New Hampshire has finally read the US Constitution. The Board states that Dr. Terry Bennett, the physician that called an obese patient obese and that she would only be attractive to Black men, was within his rights to say these stupid things. Dr. Bennett has now stated he will sue all those involved and will lose both the case and hopefully his money. Top
The Democrats still don't get it. Since Medicare Part D was put into place in January they have attempted to denigrate the plan by stating how bad the enrollment was. Indeed there was confusion in that initial process of attempting to enroll about 40 million people in a short time. Now, they are griping about the "doughnut hole" and want to close it. Either they don't read or too stupid to see that there are plans available that cover the doughnut hole. They are more expensive than those that make the patient pay for the prescriptions in that area. If there was no doughnut hole the plans would be very expensive for the populace and now over 80% of the populace are satisfied with the program. One Ohio Democratic hopeful for the US Senate stated that she has heard from her potential constituents that they didn't know about the hole. Those people who did not know about the hole are the ones smart enough to vote for this person as a Senator.
In a related matter the people of the People's Republic of Massachusetts are not going to be able to sign up for that state's new health plan on time. Here you are talking about several hundred thousand of people and not the 40 million for Medicare. The Republic may delay the start by three months at a minimum.
President Bush will enact a new law requiring all Medicare providers, hospitals and physicians, to adopt standardized care quality assessments and uniform specifications for health IT adoption. The providers would have to partner with HHS to devise appropriate outcomes, establish care standards and standardize IT for patient registration, reporting lab results, writing prescriptions and having secure communications. Top
San Francisco Mayor Newsom signed into law the nations first city mandated healthcare for the uninsured. This is the law that requires that business pay to the city an amount of money that is based on the hours worked by each employee. It needs to be working by next July.
San Francisco also put on the November ballot a vote as to the impeachment of President Bush and Vice President Chaney, have a parking tax of 35% on garage operators, provide for sick leave for all San Francisco workers, require landlords to pay relocation costs in some cases and other like resolutions. The sick leave item would give one hour of sick leave for every 30 hours worked. One wonders that there are any businesses left in the city at all. Top
The past 20 items that determine whether a person is an employee or an independent contractor are no more. A new set of eleven things grouped in three categories now rule. The first category is Behavioral Control. If a person is told when to work, what to bring, who will assist, where purchases should be made or what order or sequence of work to follow=employee. If trained=employee. The next category is financial control. This includes unreimbursed expenses, worker investment, if worker does not outside the business, how the worker is paid and the extent that a worker may make a profit or take a loss=employee. The last is the type of relationship. Is there a written description of the relationship in a contract? Does the worker get benefits, the permanence of the relationship and how integral the services are to the principal activity. This is now true for all industry, including healthcare. 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.