December 1, 2014 Legislation




HHS has issued a bulletin stating that HIPAA app;lies even in the face of an Ebola outbreak.  If the president declares an emergency and HHS declares a public health emergency (there was none issued to date) then penalties may be waived.

Obama's administration has said that large employer health care plans that do not include hospitalization will not be accepted under Obamacare.  If employees were signed up for these plans prior to November 1, 2014, they may keep them for a year or may buy a plan from the marketplace and receive subsidies.  I feel sorry for the companies that were going to offer these plans are are now blindsided by the order.

Obamacare states that the exchanges must bill separately for abortions except those that are for rape, incest or a threat to the life of the pregnant mother.  So far, 23 states have a law that bans elective abortions on all exchange plans.  It is almost impossible to tell which plans bill separately for abortions.  

Obamacare officials have proposed that starting in 2016 all those people who automatically reapply for coverage on an exchange would be given the lowest price plan.  This is due to the price increases and to not allow people to be surprised when they see their new premiums.   This year the most popular plans are increasing their premiums by 10%.

The Obama administration continues to have to attempt to put out fires caused by their own people.  Now the Business Roundtable, a supporter of Obamacare initially, is pissed at their members being sued by the EEOC for doing what is allowed under Obamacare, the rewarding of employees who do wellness and the penalization of employees who don't.  They are threatening to side with the Republicans in the repeal or change of Obamacare if the administration does not back off.  They will meet with Obama tomorrow.

The VA has adopted new rules.  If a vet lives more than 40 miles from a facility or can not be seen within 30 days of requesting an appointment he/she may receive care at a non-VA hospital.  The hospital may contract directly with the VA.

The VA has finally removed the head of the Phoenix VA.  This is after she had been on paid administrative leave for seven months.  Sharon Helman is finally gone.  Now for the rest of the incompetent and lying VA officials, you will be next.  The numbers may reach 1000.

Starting in 2015, those receiving SS benefits will get 1.7% more and those paying into the system will pay the same % but on a higher ceiling.  Medicare Part B will remain the same as is the deductible.  The hospital or Part A deductible will increase by just under $50.  Part D is expected to increase by about 4%.  401(k) maximum will increase by $500.  IRAs will stay the same.

California has determined that Blue Shield and Anthem have violated state law by lying to consumers about their provider panels.  This may lead to fines in the next year.

New Jersey's Governor's Chief of Staff Kevin O'Dowd is leaving politics for the cushy life as senior executive vice president and chief administrative officer at Cooper University Health Care.

As of now there are under ten states with the "Right to Try" laws on the books.  These would allow terminal patients to try any experimental drug that has passed a Phase 1 trial. Drug companies are not required to supply the drug to all who ask for it.  The anti crowd does not like the laws since patients may be inconvenienced by the need to travel and pay for the medication. 

India is a typical shoot from the hip country.  After patients died following state approved female sterilization procedures they immediately blamed without any evidence the physician who did the procedures.  Of course, it was not the physician but was contaminated medications provided by the state from the low bidder.  The state also forces the physician to do up to 80 procedures per day, well over the guidelines of 30 per day.          Top


The California Medical Board is planning to investigate whether or not drug companies are influencing physicians by the use of gifts etc. to over medicate children in foster care.  

Starting January 1, physicians will not need a face to face encounter with a patient to get paid.  CMS will begin to pay physicians for their work with taking care of all the behind the scene care for patients with two or more chronic conditions.  Physicians must prove they have EMR and provide 24/7 management services and must be able to create a structured clinical summary record with meds, diagnosis and allergies.  They will also have to get the patient to agree and only one physician per patient will get the huge sum of $42.60 per month.  This is not a preventative service and may require cost sharing.        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.