The Business Roundtable, a group of very influential CEOs who know how to balance a budget, have called for an increase in both Social Security and Medicare to the age of 70. This would mean smaller annual increases for SS beneficiaries and decreased benefits for wealthy retirees. Medicare participants could either enroll in traditional Medicare or private plans. It is amazing that this group were Obama supporters since they now are obviously in tune with the Republican thinking of entitlement changes.
The New York Times has an article regarding the flood of suits that are being contested in both the district and appellate courts on the inability of religious orders to not cover birth control when it is against their tenets. This will lead to another case against Obamacare coming to the Supreme Court since there is divergence of opinions in the Appellate courts. Once it gets to the Court there is still a chance of overturning the law that was passed without anyone reading it per Pelosi. Top
The Winston Salem Journal has a story on how the nation's hospitals are getting tough on employees refusing the flu shots. This is true even if the flu shots do not cover the current outbreak necessitating a reformulation of the vaccine. Hospitals have never let common sense or facts get in the way of edicts. They continue to fire employees who do not get the vaccine for quasi religious or medical purposes. The hospitals do require that if one works with patients and is not vaccinated that they were a mask. These are standard masks and are only partially effective against viruses. One of the real reasons for the requirement is the JC requirement that all employees be offered the vaccine and that the hospital show increased compliance so that they can have over 90% of employees vaccinated. CMS is also requiring hospitals to report their vaccination rates.
Modern Healthcare has a story that my old hospital in northern California John Muir Health is purchasing a 49% stake in the for profit Tenet hospital in San Ramon. The money will be spent on clinics run by both with a new Board to oversee the clinics. There is no mention what John Muir will get out of this deal but knowing the paranoia of the CEO they will get the heart and high risk OB business.
The Boston Globe is now reporting on the immoral but legal facility fee charges that hospitals are charging on physician office visits. The only thing that changes when the hospital buys a medical practice is the huge fees that go to pay the physicians rent and employee costs. The hospital makes a huge profit from these fees and gets significant bad publicity, but money is more important. This immoral fee is costing the healthcare many billions of dollars being paid either by Medicare, private insurers or individuals. Medicare allows the fee if the patients are warned in advance. The article states that Lahey Clinic state on a sign in the office that the patient MAY be charged a facility fee. This is a way the hospital is compensated for purchasing physicians and paying their salaries. The insurers are putting a limit or prohibition on the fees in their new contracts.
The LA Times reports on tension between insurers and outpatient surgical centers that are out of network. They used an example of a Southern California surgical center giving a bill for knee surgery to Blue Shield for $84,000 and Blue Shield paying it. When queried for the article Blue Shield defended the payment but the surgical center said it was much too high and they had erred. Blue Shield blamed the school district that insured the patient since they were self insured and only used Blue Shield as an intermediary. The school district fell victim to the teacher's union and agreed to pay for out of network care at the prices charged. However, it is true that many outpatient surgical centers do charge way over the usual and customary price. Top
Here is a list of deadlines for physicians for 2013. February 28 is the last day to report the use of CPOE for your huge 1% Medicare bonus and to avoid the 1.5% penalty. The same day is the last day to report your meaningful use attestation for 2012, even though you know there is no meaningful use. 2012 and next year are the last two years for these payments. After that there are only penalties. Physicians will also start this year to report performance data via the PQRS as well as care quality (cost) and those with lower costs will get modifiers to increase their payments slightly and those with high costs will get a modifier to decrease their payments. This starts in 2015 but is based on what physicians do this year. It is imperative that physicians should at least make an attempt to report to avoid the stick. You must report at least one G code. Physicians should start this year making the decision as to whether or not to offer their employees health insurance or pay a $2000 per employee penalty on each employee over 50 in number not age. Physicians, as are all employers, required to tell their employees by March31 information not yet available about state of Federal exchanges operating in their state. Do you want Medicaid patients? This year is the start of a two year and only two year program where primary physicians will be paid Medicare fees to see these patients. After the two years payments will again drop to the unsustainable levels and you will have a moral and maybe a legal obligation to continue care for no pay. This is also the year that physicians should get started preparing for the dreaded ICD 10. Most importantly this is the year that you need to write to your legislators to get rid of the IPAB which, if it comes into existence, will decrease your pay even more.
To all physicians in Texas. You are very dangerous people. The TMB wants to have it's investigators carry side arms. The California Medical Board already has this and uses it to intimidate the physicians. The investigator makes sure you see his weapon when you enter the room to put you less at ease.
There is a report that over a 40 year career a physician will have an open med mal claim against him/her 11% of the time. This takes away from one's concentration on the patient at hand and forces the physician to spend more resources so that more cases and time is not wasted. The long time per case is due to the long time between the filing and the resolution.
Forbes is stating that 10% of the country's practice owner primary care physicians were going concierge due to the bundled payments and other onerous regulations of the new healthcare. This comes from a study by Merritt Hawkins. Currently 20% of physicians already restrict the numbers of Medicare patients they take. This new concierge practice will be only $50 or $60 per month, about the same as a gym membership. This payment give unlimited physician visits and 24 hour access to your physician via email. No insurance accepted. 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