All knew this would happen under universal care. The government either did a very poor job of estimating or they are more dishonest than even I believed. In either case, the People's Republic of Massachusetts lowballed the amount of money they would need to fund their healthcare fiasco. That money will come from the hides of the providers, hospitals and physicians. The providers will get a 3-5% decrease in pay to care for those in the subsidized plan. The more difficult decision to raise co-pays for those income is above poverty was tabled. Next comes the rationing.
The California Assembly and the Governor have agreed on a health plan for the state based on the People's Republic health plan above. The plan will be funded by a hike in the cigarette tax from $0.35 to $2.00 per pack as well as a 4% tax on hospital money. The California Hospital Association had agreed to be taxed when they thought the tax was to be 2%. Their response now should be interesting. The physicians were also to be taxed 2% but did not agree, so will not be taxed. The insurers will have to take all, even wit pre-existing conditions. They are not happy. Of course the public will have to vote even if the California Senate votes yes to it which probably won't happen. The Senate has called for a financial study prior to any vote. California has a significant budget shortfall even more than originally thought with a new report showing that the State has not set aside any funds for retiree health expenses. This is merely $48 BILLION.
The EEOC ha stated that employers can reduce or eliminate health benefits for retirees when they reach Medicare age. The new regs allow two classes of retirees, those not of and those of Medicare age. The Commission stated that under law employers are not obligated to provide retiree health benefits or negotiate those benefits. The AARP is not happy about this but they already sued over it and lost in the federal court of appeal. They are considering appealing to the US Supreme Court. The ruling stated that the employers may alter, reduce or eliminate retiree health benefits when the employee reaches Medicare age. The other option was for business to stop offering retiree health benefits to anyone.
Maine had passed a law stating the the prescriptions were private medical information and could not be sold. A judge just reversed that law stating that the law would violate the transfer of truthful commercial information. These will now be sold by collectors of the information to pharmaceutical companies, government agencies and researchers. This ruling was the same as the one in a US Court in New Hampshire and another one is pending in Vermont. Top
The OIG has given an advisory opinion on non surgeons investing in ASCs. This is not allowed. The OIG sees the ASC as an extension of the surgeon's office but those who do no work there and only refer patients to the surgeons are not allowed to be investors for fear of illegal kickbacks. The case at hand was the disallowance of optometrists to invest in an ophthalmologic surgi-center. Of course in the land of hospitals paying off (lobbying) public officials, surgeons are not allowed to own surgical centers either. Top
The Federation of State Medical Boards (FSMB) is considering a plan the recommends the state medical boards require self evaluation and practice assessment including an exam in their practice area, a certain amount of CME in their field and a home study course. This would be needed at least every ten years. The FSMB has acknowledged that recertification exams now done by the Boards would satisfy the requirement. Physicians believe that this means more paperwork and with no benefit as the specialty boards already do the recertification. Physicians would also need to show patient satisfaction or letters of recommendation from peers. The FSMB is taking public comments until Jan 7. Not a long time for a so potentially onerous decision.
Although not physicians, Chiropractors are still licensed by the state. In California, there has been an ongoing feud between the Chiropractic Board and the legislature. The Board has not been disciplining their members and has done unprofessional behavior in their meetings. The legislature has cut their funds in half in retaliation. Now the Board wants to start member discipline but the legislature will not give any money they require outside oversight over the rouge Board.
The US Senate has voted to delay any cut in physician Medicare payments for only six months. They also voted an 0.5% increase in payments. This was tied to a stripped down SCHIP that would pass muster with the President. The Senate was wise enough not to listen to the AARP and other lobbyists that wanted the raise tied to a decrease in payments to the Medicare HMOs. Although I personally favor that approach, it would never pass a Presidential veto. You take your wins where you can. Following the Democratic defeat in the Senate the House easily capitulated and voted 411-3 for the bill.
A New Haven 81 year old pediatrician, Dr. Charles Ray Jones was placed on two year probation and fined $10,000 for doing diagnosing Lyme Disease on two children based on a telephone conversation with the mother. He then started antibiotic therapy and would not change his diagnosis or therapy when tests came back negative for the disease. He has become a cause celeb for Lyme treatment, which makes him a target of the Medical Board. Top
In "it's about time" category, the IRS has issued new reporting rules for non profit hospitals. The new 990 forms that the hospitals have to fill out to keep their non profit status requires that starting in 2010 they will have to breakout how much they are giving back to their communities in many categories. They will also have to disclose all joint for profit ventures and top executive compensation. One Senator wants the hospitals to allocate a minimum of 5% of annual revenues or expenses to free care to people who can not afford to pay. Top
In a new law in New Jersey all pregnant women must have a HIV test early in the pregnancy and again in their last trimester unless they object. If they object and their status is unknown, the newborn must have a HIV test. This now becomes the latest state to have this requirement. New York, Illinois and Connecticut require testing on newborns and Michigan, Arkansas Texas and Tennessee have similar laws to New Jersey. The law goes into effect in July, 2008. 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