Medicare has retained its original rule regarding amputees. It considered changing to curtail coverage for the high end artificial legs. Now it will work for guidelines to determine which are the best legs at the cheapest price.
CMS has also finalized the stupid two midnight rule. It now leave the judgment if one is an outpatient or inpatient to the physician. There must be documentation in the medical record supporting the decision to have the stay covered under Part A. All stays of at least two nights will be automatically judged as Part A. The reviews of the appropriateness of the stay will be done by QIOs not RACs. They will not be paid on a contingency fee basis.
The DOJ has put out a new set of compliance guidance. It includes the office of a full time compliance officer at the Department. This shows how serious they are about compliance. The DOJ wants to make sure corporations ensure the directors embrace compliance, the compliance people have status within an organization, the policies are clear and communicated to the employees with repeated training, the policies are updated periodically and enforced and that third parties are held accountable for the compliance policies. Top
The California Medical Board has gone with all the other Boards and not required physicians to tell their patients if they are on probation. the patient may look up the physician status on line if they wish. The proposed law would have gone too far and make all patient sign forms and have them sent to the state.
Oklahoma was investigating Dr. Steven Anagnost of Tulsa for license revocation when Governor Perry of Texas intervened via a hone call. suddenly the investigation was dropped. This may have been part of a large campaign contribution to the Perry campaign. Perry apparently called the Oklahoma Governor and soon after the surgeon had a deal of keeping his license, taking a few courses and paying a $10,000 fine. The surgeon has also filed suit against the Board and that is still in the courts.
The LA Board of Stupes still can not keep their noses out of healthcare. They have mandated that all female breast and pelvic exams have a chaperone present. This is due to a settlement of an alleged sexual act by a physician in an exam. Top
California has fined Anthem Blue Cross and Blue Shield for lying on the extent of their physician networks. The former was fined $250,000 and the latter $350,000. The higher fine was for being less cooperative. Both liars continue to say the consumers should trust them. Top
The feds have investigated and found problems with St. Luke's Hospital in Idaho. This came after an infant death from being given the wrong meds. They also found problems with retraining patients, medication safety and training of workers who are not permanent employees.
The feds have found serious problems with a psychiatric hospital in Lakewood Washington. They have three weeks to get it right. The problems seems to be with protecting patients from other patients. 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