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The health insurers that remain in Ocare are threatening to pull out next year if there is not some firm assurances regarding the plans in the next several months. They want the continuation of subsidies and cost sharing reductions for at least one more year.
Medicare Advantage will get an increase in payments of 0.25% next year. This is the money the plans get from Medicare to care for people instead of paying fee for service providers.
Ocare is declining in enrollment. The number that signed up for Covered California as well as those in HealthCare.gov were well below the prior year. This was probably due to the uncertainty surrounding the law.
CMS thought they had a solution when they decreed several years ago that people who prescribe drugs to Medicare patients must be registered. The problem is they can not put the plan into action since dentists will not register and they prescribe drugs. This now will not go into effect, if at all, until January 2019.
After they lost the court case, Aetna and Humana have agreed to not pursue the merger. Aetna will pay Humana $1 Billion as agreed upon in the initial contract.
The California Department of managed Health has blasted the state's insurers for their inaccurate physician lists. They found that 36 out of 40 insurers had wrong names or other physician information and could be fined by the state. It appears that no one cares about the lists. This could be costly for the insurers as they must, under California law, reimburse patients who are charged out of network fees due to wrong provider lists. Top
In an interesting study by Vanderbilt University, it was shown that apology laws do not help in avoiding med mal suits as was the original idea. They found no statistical differences that show surgeons will be at greater or lesser risk. Other physicians will be at greater risk for suits with the apology laws in place. Apologies may alert patients to errors that they otherwise would not have known about.
Florida has aggressive plaintiff attorneys but this is ridiculous. The Rebublicans in the state House are attempting to push a law that would allow women who feel emotional distress up to ten years post abortion to file for medical malpractice. This would increase the now two year statute of limitations on this issue. Let us hope this dies quietly.
Utah has a deepening physician shortage. The reason is the large retirement of physicians in that state and the few Utah residency slots. Utah has a bad ratio of physicians to population ranking 44th in the country.
Prairie Cardiovascular Consultants, a 72 physician group, will leave Memorial Medical Center in Springfield, Illinois, and go wholly to the competitor St. John's. this may cost Memorial about $16 million in profits.
A physician imposter got into Brigham and Women's operating room saying she was a resident. She had been previously dismissed from a surgical residency in Mount Sinai in New York. They caught her later and escorted her off the grounds.
Partners HealthCare is bleeding money. They are making more revenue but their expenses are making them poor. They got hit for a $8 million assessment to fund the state's sinking Medicaid fund. They also have a poorly run insurance arm that is also bleeding money. In total they lost $17 million for the first quarter but they hope to make that up with volume.
Kenya has jailed the physicians who are the seven top officials of the physician union after they refused to call an end to the two month old strike. A judge said they were in contempt of court and sentenced them to one month in prison. The public health system has completely collapsed and the private health system is overloaded. The prison time will do nothing to the strike except make the physicians even stronger. The physicians want what was agreed to in June 2013 and the government has reneged on. No talks will be scheduled with the government until the physicians are out of prison. Top
The poorly run and deservedly maligned Broward Health an advisory form to assess the financial health and help guide the poorly run institution into the future.
When it rains it pours. Summa was hit by a vote of no confidence by their medical staff and soon thereafter their emergency medicine residency program was gone. They lost their accreditation. The loss is a direct relation to the loss of the old ED physicians who were abruptly replace in the beginning of January. 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.