January 15, 2007  Legislation

New California Laws

Physician Payments

Peer Review

Healthcare

New California Laws

California has enacted the following health laws that went into effect January 1, 2007. 

AB 774 This is the major bill.  It prohibits hospitals from billing some uninsured rates above Medicaid, Medicare or Workers Compensation or any other government program with which it contracts.  The hospitals may no longer place liens or garnishee wages.  Patients have 150 days to notify the hospital that the new law pertains to them.  If they don't meet the 150 day deadline, the hospital may turn the patients over to collection.        Top

Physician Payments

In the recently signed law that took away the 5% physician decrease, there was provision that in 2008 the numbers would revert to the prior level.  This means that physicians would see a 10% decrease in payments from Medicare starting January, 2008.  It is never too early to lobby Congress to get rid of the old law completely.        Top

Peer Review

There is a new law that will go into effect soon.  Section 1921 of the National Practitioner Data Bank will modify multiple areas.  The first is who must report.  Added to the old list are Departments of a state besides the Board of Medical Examiners, peer review organizations and private accreditation entities such as JCAHO. The next is who queries.  Added to the organizations that can query are state health care entity licensure and certification entities, state agencies administering health programs, state Medicaid fraud units, US attorney generals, and QIOs.  The last change is what the new entities will get when they query.  They will now get all adverse licensure actions not only those related to competence or conduct, all negative actions or just findings by a state authority, a peer review organization or a private accreditation negative action against a health care practitioner or entity.        Top

Healthcare

Governor Terminator has proposed that all business with 10 or more employees will have to either offer insurance pay 4% of the payroll into a state fund.  There can be no exemptions for pre existing conditions.  All children will be covered.  Physicians will pay 2% of their annual revenue and hospitals will pay 4% of their revenue into the fund.  Those who care for Medicaid patients will get an increase. The state's physicians had better get started looking for other modes of income.  If the 10% Medicare decrease comes to pass along with this and the decrease or lack of increase in non-Medicare payments, they will be squeezed very tight.  Time to build their own GI and Surgery Centers as well as potential specialty hospitals.        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.