March 1, 2010 Legislation

Electronic Medical Records

Physicians

Healthcare

Malpractice

Electronic Medical Records

The $750 million that the administration put aside last year for electronic records may be spent this year.  Regional extension centers will get $375 million to help doctors, hospitals and clinics update their systems.  The remainder will be for new exchanges.  I wonder how much will be eaten up in admin charges for the exchanges. 

A fed workgroup is recommending to Congress that payments for EHR start in 2011 and penalties do not start until 2015.The committee was also at odds among itself as to the laxness or strictness of the rules, including not making CPOE mandatory in the early years.  The head of IT stated that one can't fix every flaw in the health system through an electronic record.       Top

Physicians

The LA Board of Stupes, never known to be smart politically or in the usual sense, have now dropped how much they will pay physicians to see uninsured patients at private hospitals.  They have done this retroactively to July 2009 and no physician has received any payment on seeing these patients since then.  This means that either EDs will close or that hospitals will have to pay physicians more to see patients in the ED.  The ED physician is also included and he is the one stuck. 

The FDA has deemed that all physicians that give erythropoietin stimulating drugs to cancer patients will need to take a short test on line and that these patients will have to sign a special consent form.  The rational is the potential for these drugs to cause cancers to grow even as they raise the red blood cell population.  Amgen, the maker of the meds, will be responsible for monitoring the program.  Of course these are also the costliest of all drugs Medicare pay for but I am sure that has nothing to do with the FDA decision.

The Senate expects to pass on March 2 the extension of the SGR Bill.  This will give an extra month to the bill so the 21% decrease will not go into effect. Of course in the next month no one will do anything until the last minute.  CMS has decided to hold all claims for the first 10 days of the month to allow Congress to get rid of the decrease in payments.      Top

Healthcare

If one wants to know why medical costs increase one need look no further than the Missouri legislature.  They are mandating that private insurers cover all autism spectrum disorders.  The bill has a $36,000 cap for each child with the disease.  The original intent was to have the children covered under Medicaid but that would be making all taxpayers pay for the folly of the legislature.  This way only those with insurance will pay and the state will be off the hook. 

Another example is that of New York.  About 20 years ago the state mandated that insurers accept all applicants. This kept healthy people away since premiums were high.  That exacerbated the problem and New York has the highest health care premiums in the country. This is akin to Obama's plan to force all to buy insurance which will happen while they are on the way to the hospital.  Be careful what you wish for.  It may come true.

Another mandate that will hopefully raise quality but will cost providers money is the new advanced imaging accreditation requirement for MRI, CT and PET scans.  The requirement excludes ultrasounds, x-rays and mammography.  The three agencies that are deemed to accredit ate the American College of Radiology, Intersocietal Accreditation Commission and The JC.

The JC has also put out a new Standard regarding medical interpreters.  There will need to be certified interpreters which should increase the cost of care considerably for those who need to provide the interpreters.  However, it is a good step.

The dichotomy between states is interesting.  The People's Republic of Massachusetts always in need of more money to fund their ill thought out healthcare program is willing to tax soda and candy to raise money.  In Mississippi, where obesity is king, a proposed tax of soda is going down to defeat in the legislature. The Left Coast is not to be denied.  California has introduced into their Senate a bill to tax each teaspoon of sugar in sodas.  California is so cash strapped that they would tax anything that moved or didn't. 

Obama is finally stepping into the healthcare debate and has posted his desires.  They follow the Senate plan except he took out the pork and the ability to pay for the plan.  He did not put in any public healthcare plan.  The plan is significantly higher cost than the Senate's plan but with less money to fund it.  This is another boondoggle and will not pass unless the Congress uses the reconciliation process which would get many Democrats removed from office at the next election.  

The House has voted to strip the health insurance industry of their antitrust exemption.  It now goes to the Senate.    Top

Malpractice

As Illinois drops the cap on non economic damages, Utah is starting on the path to put them in place.  The senate committee passed a drop in caps from $480,000 to $250,000 on med mal suits.          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.