SEIU has reached a deal in Oregon to not put on their November ballot a proposition that would go after hospital pricing, executive pay and transparency. In return the union got a promise to accelerate progress toward improving patient experience, health and reducing the per capita cost of care. This was mediated b the Oregon governor.
In California the union is going after a proposition that would prohibit hospitals from charging more than 25% over cost for items. Another proposition the union is attempting to get on the ballot is to limit not for profit hospital CEO pay to $450,000. The union would withdraw their potential ballot measures if they get more organizing efforts.
Truven has rescinded the top 100 designation of Desert Valley Hospital in California due to it being fined by the state for a problem. The hospital is and has been appealing the fine. Truven stated that if the penalty is reversed they will consider changing their rescission. Other hospitals that have similar or worse fines by the state have not had their Top 100 designations rescinded. These other hospitals are not owned by Prime. Top
In California, voters may decide the med mal economic damages cap. There is a potential proposition that would raise the limit from $250,000 to $1.1 million. The backers have to March 21 to get required signatures. This would pit the two well funded opponents against each other. The Trial Lawyers versus the Insurance Companies and Physicians. Top
The USA Today has a story about Medicaid and the taking of homes by states. There is a federal law passed under Clinton that allows states to be repaid for money expended by Medicaid for people 55 years of age and older. Not only are homes liened for the amount put out but there is also a capitation or administration fee of $454 per month for every month Medicaid paid out money. With Obamacare there will be more on Medicaid and therefore more homes repossessed.
The San Francisco Business times had an item that showed how much reforming heath care in California is costing. Sutter Heath is paying $8.15 million for a telemedicine company. California has received grant money under Obamacare totaling $45.8 million. The feds have so far put into Covered California $1.065 Billion to date.
The administration is cutting about 3.55% from Medicare Advantage payments in 2015. The insurers are planning a large media barrage against the cuts to help the administration forget about the cuts. It worked last year when they forgot about the 2.2% decrease and made a 3.3% increase instead.
When is an Obamacare regulation fixed? Never. Again, the administration has changed a regulation. This time it is the ability of people to get subsidies when buying private insurance outside of exchanges. In those states (Democratic) that did their own exchanges and ran into the same problems as Healthcare.gov can now get subsidies for private insurance if they ran into problems getting exchange insurance.
The mayor of Washington, DC, has stated that insurance companies must pay for gender dysphoria, including sex change operations. The insurers loved this. Wait for the new premiums to emerge. However, the mayor stated that additional premiums charged for such benefits should be eliminated. Five states now mandate insurance coverage for transgender individuals. They are California, Colorado, Oregon, Vermont and Connecticut.
Should the position of surgeon general go to a political hack? Dr. Murthy, the Obama nominee, just was pushed through committee on a political vote. He now comes to the full Senate for a vote. He will be confirmed since there can not be a filibuster on his nomination. He was the head of the Doctors for Obama organization.
CMS head Tavanner says that the dreaded ICD 10 will not be delayed. It will go into effect on October 1. This, according to the AMA, potentially could create a billion dollar backup of claims that would jeopardize physician practices. Physician practices are still waiting for vendors to deliver the new software. Top
UnitedHealth's Optum mental health arm was fined $20,000 by California's Managed Health Care Department over withholding payments to providers. I wish it were more. 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