December 1, 2003 Legislation

JCAHO

National Provider Identifier (NPI)

Hospital Paid Malpractice 

California Rate Reductions

Increased Hospital Tax

JCAHO

The Joint has revised its standards regarding infection control.  The old standards were basically non-existent.  The new ones take place in 2005.  The new standards look to prevention and control by utilizing infection control into performance improvement.  This may be by doing epidemiological studies in the hospital.  I might wonder if this would look at infection rates of individual physicians during reappointment or prior if necessary.  

In another proclamation, the Joint will step out of the middle of a fight between the hospital and physician attorneys regarding the separation of the medical staff from the hospital.  They will leave for the present their schizoid rule that is OK to have the medical staff bylaws state that unilateral amendment of the medical staff bylaws by the Board is OK, but it is not OK if they actually do it.  Makes as much sense as many other things the Joint does.  The Joint will form a committee to look at the roles of the several components of the hospital.      Top

National Provider Identifier (NPI)

As I hope all know by now the NPI is on its way.  This identifier is one more for all to remember.  Now we have the EIN, SSN, DEA, UPIN, state license number, taxonomy and payer-specific identifiers.  This number, mandated by HIPAA, is to unique to each provider and must be used by all providers for all electronic transactions mandated by HIPAA.  It may replace one or more of the other numbers currently in use, but not the DEA number.  The new number will also be used for healthcare providers to identify themselves in HIPAA transactions or correspondence, to identify other healthcare providers, use of prescriptions, by health plans to identify providers, by health plans to coordinate benefits, by clearinghouses, by EMR to identify providers, by DHS for fraud and abuse, and for all other individual ID, especially related to Debt Collection Improvement Act and BBA.  This will be a good thing if it eliminates several of the numbers currently in existence.        Top

Hospital Paid Malpractice

The IRS has stated in a private letter ruling (only as related to the one entity that asked) PLR 200347017 dated August 29, 2003, that it was no threat to the hospital's 501 (c) (3) status if they formed a for-profit foundation for the purpose of helping their physicians obtain malpractice insurance.          Top

California Rate Reductions

California has a budget crisis due to the tax and spend policies of the legislature and allowed by the now ex-governor.  As part of the way to reduce the deficit, the legislature agreed to lower payments in Worker Compensation and in the MediCal (Medicaid) system.  Walgreen pharmacy has stated that since the new Worker Compensation rates are the lowest in the country and if the law reducing the MediCal spending is upheld, they will no longer fill Medicaid prescriptions at their 356 California pharmacies.  They have already done the same thing in Massachusetts and Washington.         Top

Increased Hospital Tax

Illinois has increased the tax on their hospitals.  The rationale is to put the increased money into the Medicaid program and in turn get more Federal matching fund money to the state.  The hospitals will get their money back by getting more money for each Medicaid patient.  They think it is a win-win situation for all but the Federal Government and the tax payers who have to pay for this charade with our taxes.        Top

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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.