December 1, 2018 Legislation
The voters of Massachusetts are smarter than I gave them credit for. They voted down the nursing staffing ratios law that was before the state voters. The bill was endorsed by the Boston Mayor and Senator Warren, both union hacks. This continues to leave California as the only state with staffing limits.
CMS has released the final rule for the Physician Fee Schedule. There was a slight increase in the money per RVS code but they delayed until 2021 the controversial elements of getting rid of the EM codes an only paying for a single office visit. for codes level 2-4. The law also continues to reduce the payments to the hospitals for their ridiculous charges for off campus facilities. The law will permit payment for video check in with patients as well as the time to review a video or image sent in by a patient. It adds more clinicians to the MIPS program and is removing 26 "quality" measures. The law also cuts payments for new drugs covered under Medicare Part B. Starting in 2019 the rate of reimbursement will be cut from 6% over cost to 3%. The AHA will sue regarding the site neutral policies. Let us hope they spend a lot of money on this and lose.
President Trump's administration is trying to put pressure on the drug companies. The newest proposal is to to have some meds that now must be OK with Medicare insurers may lose that protection if their prices are raised over the consumer price index over a year. Obama had tried that in 2014 but bowed to pressure. The proposal would have insurers do step therapy, try a cheaper drug before the more expensive one or not to give protection to a drug that is merely a new formulation of an older drug such as a timed release formulations. The administration said they would support a law that would give these savings back to the consumer at the pharmacy counter.
The FDA is planning on updating its medical device approvals. They want to update the process that allows new products based on similarities to older products and not doing new testing on patients prior to approval. There has been no substantial updating of the approval process since 1976. Top
The California Department of Justice has approved the merger of Dignity Health and Catholic Healthcare Initiatives now named Commonspirit Health. This new entity will have 140 hospitals in 16 states. They will be required to maintain emergency services and women's healthcare services for 10 years and if they want to change these services in years 6-10 they must get approval from the state. They also must crate a Homeless Health Initiative in California to support the delivery of treatment and services to the homeless. This includes $20 million over six years to local communities to help the homeless with at least $10 million in the firt three fiscal years. The hospitals will also be required to give free there services to patients up to 250% of the federal poverty limit plus post financial assistance policy on its website and throughout the hospitals. The CEO of Dignity prior to the merger is Lloyd Dean. His salary was reported to be over $8 million. Great charity. Top
The Medical Board of California is now going after 11 more physicians based on death records. The physicians are accused of prescribing opiates and having the patients OD. This questionable practice looks at OD deaths from many years prior. 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