May 1, 2015 Legislation




The USPSTF is at it again.  This time they revisited their controversial breast cancer recommendations.  They continue to go against the practice of recommending mammography on all women at age 40.  They reiterated their age 50 recommendation.  This goes against the other cancer specialist's recommendation to start at age 40.  Oh, that's right.  There are no oncologists on the panel.

The Obama administration is using thuggery against the states.  CMS has notified those states who have not expanded Medicaid under Obamacare that their funding for uncompensated care is at risk.  They have sent letters to Florida, Texas Kansas and Tennessee to either pass Medicaid expansion or risk the loss of the funds.  The states have responded by threatening to sue CMS again putting Obamacare at risk especially since the Supreme Court has already ruled the states have the right to expand Medicaid or not.

Under the SGR Medicare will no longer list Social Security numbers on the Medicare card.  They are the only insurer that continues to use those numbers to identify patients.  As a matter of fact, it is against the law for other insurers to use Social Security numbers.  They have four years to to start issuing cards held by current beneficiaries.  Why hasn't CMS done it earlier.  They state they have been busy trying to fix the website. 

The SGR also forbid the use of a physician's performance of federal quality measures in med mal procedures as a standard of care. This can not be the sole basis for a medical malpractice suit or to be used to prove negligence.  

House Democrats introduce a law to repeal Obamacare's Cadillac tax.  This is at the bidding of their union bosses.  The tax takes effect on 1/1/18.  Obama supports the tax as a way o fund Obamacare and the way to redistribute wealth.

Medicare Appeals is not working.  The Senate has found there is a delay of over 500 days to get a first or second level appeal.  The backlog has gone over 500,000.  They feel providers are filing frivolous appeals to game the system.  There is also a problem with the initial appeals not being looked at by providers so they are routinely kicked up by the provider to get a peer appeal.  

California's Insurance Commissioner is calling the Anthem Blue Cross raise of premiums on those policies grand fathered in since they were in existence prior to the Obamacare.  Anthem is raising premiums on average 9%.  He states a 1.2% raise is adequate.  He has no power to prevent the raise.  He says the rate hikes are extortion to force the enrollees into Obamacare policies with restricted choices.

California is going to propose a cap on what individuals with Obamacare policies can spend out of pocket per month on specialty meds.  Some want a $200 cap and others want a $500 per month cap.  In either case this will mean a large bump in premium for all Obamacare purchasers in the state.  Currently California Obamacare insureds have a total yearly cap of $6500.        Top


Missouri will try again.  They keep passing med mal bills and the courts keep shooting them down.  The legislature has now passed another bill and sent it to the governor.  This one caps med mal non economic damages at $400,000 unless the case is catastrophic as defined when the cap would be $700,000.  This bill also would raise the cap on wrongful death cases to $700,000 and put an escalator of 1.7% per year.        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.