May 1, 2010 Legislation

Hospitals

Physicians

Healthcare

Abortion

Insurers

Hospitals

The VA has decided not to appeal the $227,500 fine from the US Nuclear Radiation Commission for treating prostate cancer in the veteran's prostate at the Philadelphia VA with improper doses of radiation.  Why should they appeal.  They have no money to lose.  We, the taxpayers, are paying. 

Several days after California fined Murieta's Southwest Healthcare System $100,000 for poor patient care, Medicare came in and has threatened to pull their accreditation.  This will not happen.  The hospital will miraculously come into compliance at the last moment.  The state is also after the license.

Howard Brown Health Center in Chicago is under a federal probe for the way that funds are being used in an AIDS study.

California has cited Alta Bates Medical Center in Bezerkly for failure to notify patients and the state regarding a bacterial meningitis patient i the hospital.  The fine was just over $100,000.  The Oakland police and fire department were also fined for not warning the hospital of the diagnosis when they were bringing the patient to the hospital.  A hospital technician and a police officer both became infected and required hospitalization for a week.

The Washington, DC hospital United Medical Center, formerly Southwest, is in trouble again.  They have such financial problems that the District has been asked to take them over.

Obama has issued an executive order allowing same sex partners to have visitation rights in all hospitals that accept Medicare or Medicaid.  These rules will not take effect until drafted.  The partners will have the same rights as families.       Top

Physicians

The House and Senate have both passed a bill delaying the onerous TriCare/Medicare 21% pay drop to June 1.  This they believe will give time to get rid of the SGR for good.  This will not happen in this time span. The Senate has already passed a bill delaying any pay cut until October 1.  The House may follow suit and will look for a way to offset the over $210 Billion.   

California is considering a law that requires physicians and other health care workers to tell patients what they are licensed to perform and their board certification status.  The Medical Board does keep records of board certification but have no way of showing it is correct.

The OCR will begin posting on line the names of all practices that have privacy breaches that are over 500 people.  They no longer will need consent to post the information.     Top

Healthcare

As Yogi said, "It ain't over til it's over".  Both sides of the aisle are against the Obama Medicare Panel.  Congress does not like to be second guessed and have its power diluted or removed.  Look for this to be one of the first things to be changed after the November elections.

By April 30th the states had to either accept having their own health insurance pools or notify Sebelius of their intention to have the feds administer the pools.  Fifteen states opted out and will have the feds take over the pools for their residents.  They are afraid of the potential cost to the state.  These pools are for the people that can not get insurance due to pre-existing conditions.  This program will begin on July 1.  No one who had health insurance in the prior six months is eligible.

A major problem for Democrats is the new government analysis of the Obamacare plan that will cost more in overall health care spending.  There will be a 1% increase in spending during the first decade of the new plan, not a decrease as Obama has stated.  The reporter is one that Democrats like.  He states the new law will delay by a decade the Medicare bankruptcy and will reduce co-pays and premiums by Medicare beneficiaries.  However, the savings assume the law is as written and that is unlikely.  He believes some nursing homes and hospitals may be driven out of business.  

Clarifying legislation is now in the hopper over EHR Meaningful Use.  The Congress had no idea what this was when they passed the health care legislation.  Obama has signed a law opening up the legislation to non hospital based physicians.  New bills will also open the incentives to psychiatric hospitals and technicians.  The only ones left out are the ED physicians.

All agree the new Obamacare bill will do nothing to reduce healthcare spending.  A new bill has been introduced into the US Senate to regulate insurer premiums.  The Secretary of Health would have the power to review all premium rates and block any raises found to be unreasonable.  This would be in states that do not have anything in place to oversee premium increases.

Acute care hospitals will get a 0.1% decrease in payments in fiscal 2011.  This is figured by giving the hospitals a 2.4% annual adjustment increase and then take back 2.9% of the payments for 2008 and 2009 for overpayments to the hospitals.  

The ACP, who has no authority, will advise physicians what they should or should not order and what is too costly.  They will start with diagnostics and then go to therapeutics.  The ACP states this will be educational to prevent rationing when money begins to run out.  The ACP also wants more email communication with patients and less office visits.          Top

Abortion

Oklahoma has passed over the Governor's veto a law that states women that want an abortion must have an ultrasound examination and listen to a detailed description of the fetus prior to the abortion.  There is no exceptions to this law.  The physician or technician who performs the ultrasound must allow the patient to watch and to describe the arms legs etch to the patient.  Also no physician who withholds information about birth defects while the fetus is in the womb can be sued for withholding that information.  Oklahoma also has passed bills stating that abortion due to the sex of the fetus is illegal and another bill that mandates a sign that a woman can not be forced to an abortion.  There are two other bills before the legislature.  The first is a requirement for a woman to fill out a lengthily questionnaire as to why they want an abortion.  The other bill restricts insurance for abortions.        Top

Insurers

Missouri has a new law which requires insurers to process claims and either pay them or reject them in 45 days.  If they do not pay them within the allotted time the penalty is 1% per day.  The claim form must be complete to fall into the above. 

Most think that the Medicare Advantage plans will do OK in the first rounds of financial cuts.  All depends on whether the Advantage plans are in areas where traditional Medicare is more or less expensive than the Advantage plans.  It is expected that there will be about a 17% reduction in seniors in these plans by 2019.       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.