February 15, 2003 Legislation

Medicare Fee Formula

Malpractice

Physician Fees

Medicare Fee Formula

After Tenet was found to bill more than others for the outliers, Medicare has finally fixed the problem.  It was Medicare's problem all the time, not Tenet's.  The law was there and Tenet billed appropriately according to the law.  They were smarter than the others including the Government.  Ton Scully, the administrator of CMS, in trying to divert blame from himself accused Tenet of gaming the system.  This change will be an incentive to not take the very ill patients or to transfer them as soon as possible.  

California is getting into the act, albeit as usual, late and for publicity only.  The Assembly health committee is expected to hear how Tenet exploited legal loopholes, which are legal.  The committee will close the state loopholes but this does nothing for that already performed.  Tenet already has voluntarily agreed to change its billing practices.        Top

Malpractice

Pennsylvania's Congressional Representative Greenwood has proposed the Bush malpractice legislation in the House.  It is interesting that the State's two Republican Senators have conflicts of interest regarding the legislation.  Senator Specter has a son who is a plaintiffs attorney and has won a huge court verdict.  Senator Santorum has been a part of a malpractice suit by his wife where she asked for $500,000 and was awarded $175,000 against a Chiropractor.  Senator Santorum testified at the trial.

The Kentucky malpractice tort reform was killed in the State Senate when 21 Republicans but no Democrats voted for the measure.  This is a good time for the state physicians to target those Democrats who would not help them.

In Mississippi the House Insurance Committee approved a bill to help those physicians who are losing their malpractice coverage.  The House bill would force the public hospitals to join the pool unless they could show they could get insurance cheaper.  In Mississippi public hospitals are liable for up to $500,000 from any single act and may buy insurance to cover over that amount.   

South Carolina has effectively killed any tort reform legislation for this year.  They believe that since there is no crisis in the state, they would like to take more time to study the issue-or until it becomes a crisis.     Top  

Physician Fees

The Congress has heard the word.  Both houses have agreed to rescind the March 1, 2003 reduction in Medicare payments.  The government will also raise fees by 1.6% for fiscal year 2003.  

As one gets, so shall it be taken away.  The DEA has decided to double the fees for a license to dispense drugs.  For physicians, this means the new fee will be $120 per year.  The Feds state they need this money to hire more people to target the illegal drug online use.  They are not happy that the convictions have remained flat.  They want more each year.

As a follow-up to the above story, California Medical Board has fined six out of state physicians $48 million dollars for doing online prescriptions into California.  The Board states they have sent almost 2000 prescriptions into the state on patients they have not seen.  The prescribed fine is $25,999 per violation.  They don't say how they are going to collect nor if it is even legal as they have no power over physicians not licensed in the state.  They realize they may never collect but are doing this as a symbolic gesture of friendship and goodwill.         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.