January 1, 2014 Legislation





Zients is out.  The new head of troubleshooting the healthcare.gov joke is a Microsoft techie and large Obama contributor DelBene.

Also appointed is Karen DeSalvo, MD, as the new head of the office of the National Coordinator for Health Information Technology.  She has been a major Dem in the employ of the New Orleans Mayor.  She likes tech.

On the last day of the year Michelle Snyder, the overseer of the notorious Healthcare.gov resigned.  No replacement announced.

The administration is attempting to smooth as many feathers as possible and in the process has dismantled Obamacare better than the GOP could.  They are pressuring the insurers to give retroactive coverage.  This means that if they pay by January 10 they will be covered from January 1.  The insurers are also encouraged to allow partial payments to count for full coverage.  They also state that insurers will (not may) insure people as of January 1 if payment is made by December 31.  This is later than the December 23 deadline previously announced.  The administration also will allow those people who are enrolled in the Pre-Existing Condition Insurance Plan (PCIP) to keep that plan until January 31, 2014, a full month after they would have had to go onto an exchange.  They are also encouraging insurers to allow people too keep their out of network physicians if they were in network at the time of the person's enrollment.  They are encouraging insurers to allow prescription refills in January.  Notice the use of the word encouraging.  The administration has said in the past to the insurers you will comply if you want 2015 business.  The above was announced on December 13 and was placed in the Federal Register on December 17.  Comment section was for a whole 5 days.

Sebelius after the above decided that the website was going to be too busy so the new deadline for signing up for Obamacare will by one day later.  They will do anything to up the numbers.  When asked about the change the CMS gave two different answers so they really did it for politics.  This may change again as it is possible to allow those who went to the website to sign up bet failed to because to the faulty site may appeal for special consideration and that will not be denied.  The insurers again protested the decision. 

Then the administration decided unilaterally that if people who had their insurance cancelled because it did not live up to the lofty goals of Obamacare, they could either skip insurance altogether and not pay a penalty (tax) or enroll in the catastrophic insurance PCIP. This came the same day that the ideal was written to Sebelius by a group of Democratic Senators.  It makes no sense to allow these people to get by and not allow the same exemption for the uninsured.  The insurers are not happy campers regarding this new "law".  This is to get around the insurers or state insurance commissioners of some states not allowing Obama's prior plea to allow the people who have been canceled to keep their policy.  Republicans have said before this new "law" that the number of cancellations would exceed the number of new private enrollees.  

The above changes are all done for one reason and one reason only, politics.  The Democrats know that they will lose control of the Senate and House in November.  They are trying to mitigate not the people's problems but their own.  The WSJ in an editorial states that with the new rules Obama has removed the teeth from Obamacare and dismantled it on his own.  The slight of hand may work.  As all know or should know the magical time to enroll in Obamacare in 2014 for 2015 is just after the November elections.  The new premiums will not be known at the time of the election.  I wonder how that happened?

Getting away from debacle, there is another agency of the feds that is almost as bad as Obamacare.  That is the US Preventative Services Task Force.  This is the group that says mammograms and PSA tests may be bad for you.  Now they say women should not get the BRACA test just because a relative has breast or ovarian cancer.  They should get genetic counseling first. The consult will be expensive and the feds just reduced the amount they will pay for this test.  The reduction is due to a court ruling that took away the exclusivity of the seller of the drug. This is to save money by the group that does not have an oncologist in its midst.        Top


Several Senators have written to CMS Tavenner to express their dismay that physicians who have convicted of crimes requiring their removal from payment lists for Medicare are still eligible to receive the payments.  The CMS response is as usual late and will probably be as prior. We will look into it.

The Senate has agreed with the House in passing a two-year budget which includes a three month delay in the stupid SGR.  Obama will sign.        Top


Rhode Island has approved Prime Health's acquisition of Landmark Medical Center but with conditions.  Prime had agreed to operate the hospital as a full-service institution for at least three years.  They will also put in $30 million of capital improvements and $15 million in maintenance or the facility.  They will also put in $4.5 million for physician recruitment.  The state says they will also pay back creditors $8.5 million.  Prime must also meet 11 quality benchmarks.          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.