March 1, 2016 Legislation




CMS and the insurers have agreed on how well physicians do their jobs.  They have come up with a set of arbitrary ratings to measure what they say is quality in seven medical areas.  These will be introduced in later years to determine payments or when the contracts come up for renewal.  They are also designed to be standard and therefore reduce the paperwork for physicians.  Right!  The AMA and several medical societies have praised the agreements.

CMS has proposed an increase in payments to Medicare Advantage insurers next year by 1.35%.  This is a win for the insurance industry who lobbied hard to not get a decrease next year.  Looks like Marilyn Tavenner was worth the money paid to her as the new lobbyist and past head of the government organization.   The employers did not fair as well.  The employer offered Medicare Advantage plans will get a cut in payments next year.  

The Senate has cleared away the Democratic obstruction to the FDA commissioner nomination.  Robert Cardiff was finally confirmed.

The administration has finally seen the light and has a new policy that requires people who want to enroll in the expensive healthcare insurance known as Obamacare in to show proof that they are eligible.  They will be required to show the documents to prove they have changed their status.  The people will be able to get insurance while the feds check the documents.  Knowing how slow the feds are that could take a year.  There is no mention as to what happens if the documents are not legit.  They will lose their coverage going forward but what about services rendered during the fed check?  

CMS has again extended the meaningful use hardship application.  The new deadline is July 1.

New York City is changing its insurance for its employees in mid year.  They are giving more free preventatives and charging more for other services.  They then say the typical Democratic lie, it is a budget saving.  It is not.  What they actually did is over budget in the past so the actual looks better.  There is no savings.    Top


California has accused an anesthesiologist and a PA for non supervision in the running of Pacific Liposuction in University City.  The PA Rodney Davis is up for a hearing this week.  The Board is accusing Davis of working with a supervisor in name only.  They are also accusing the anesthesiologist Dr. Jerrell Borup of not supervising his PA closely enough.  His hearing is set for the fall.  Borup had a weekend course in lipo and Davis had done lipo with a radiologist who eventually lost his license.  Borup never did any of the procedures and did not participate in the pre or post op care.  He also was not present when the procedures were being done.  

South Carolina is requiring physicians to check the state database before prescribing Medicaid patient any controlled substances including opioids for pain relief.  This is to prevent abuses in the Medicaid population.   

New York is banning written prescriptions.  Soon the only prescriptions allowed in pharmacies will be electronic.         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.