CMS has announced that Medicare spending rose 10% which will necessitate a decrease in fees to keep the program within budget. The CMS states there will be $500 million more spent in fiscal 2002 on physician services. This is in contrast to the rule that physician payments are tied to the economy. The rates on many procedures are to be cut about 5%. Last year physicians received a 4.5 % increase. Top
Chicago's Edgewater Hospital has been removed from the Medicare rolls. This death knell was due to their owing millions in overpayments to the Federal Government. Edgewater and it's sister hospital Grant have been sold to independent investors without any guarantee of repayment to the government. The federal money accounts for 90% of its income. The prior management paid physicians and patients to use the hospital. The new purchasing group may only buy Grant Hospital at present since it is not involved in any investigation of penalty. Top
Attorney General Ashcroft has stated that if any physician
helps a patient die with the use of federally controlled purposes will lose
their DEA license. This is aimed at the Oregon Death With Dignity
Regulation that allows physicians to help terminally ill patients commit
suicide. There are no criminal penalties, only the loss of the DEA
number. This reverses Janet Reno's policy of leaving Oregon physicians
alone. Reno stated she found nothing in the Act to allow the Feds to
interfere with the practice of medicine in the individual states. The
State will file a law suit to head off the Attorney General's order.
Ashcroft states that this comes from the unanimous Supreme Court decision
stating marijuana is illegal for any purpose. Ashcroft is wrong. The
Court did not say anything about assisted suicide. It has spoken on
suicide in the past in due process and equal rights terms when addressing New
York and Washington laws allowing patient suicide. To date about 70 people
have opted for physician assisted suicide in the past four years. The real
problem is if physicians prescribe pain killers and the patient dies, they may
have their license lifted. This may lead physicians to prescribe a lesser
amount of medicine to those in need.
The Maryland Medical Board is under fire by the legislature for not disciplining enough physicians. There have been more complaints, therefore there should be more discipline. This is called faulty logic. The article focused as an example of a bad system on an OB/GYN who had 18 suits in 20 years and paid $2 million in nine of them. This means he had nine potentially legitimate suits in 20 years or one every two years. In OB/GYN, this is more than the norm but not by much. The physician has never been disciplined. Maybe it was not necessary. In a legitimate beef, the report stated that the two years now for an investigation is too long and is creating a backlog of cases. In one of the major problems with the Maryland system is the referral to the state Medical Society of all cases for peer review. Two physicians look at the case and discipline only if both agree there was substandard care. It would be much faster and better if the Board hired physicians to review cases. The State Society doesn't like it's power decreased and so is fighting. This ego trip will get it slapped by the legislature. Look at the takeover of the California Bar by the legislature for several years due to it's egocentric approach. Top
Kaiser Fined $500,000
The LA Times has reported that California has fined Kaiser $500,000 for "egregious errors" in the care and treatment of a patient. The 19 year-old Stockton boy died after a request for a transfer to a specialist had been refused. The Kaiser physician agreed to transfer the boy to a specialist but the paperwork never arrived and he died six days later. As someone who has worked in the Stockton facility, I can understand the mix-up and lack of paper work. Top
CMS has now formally given the states the power to rule whether or not a nurse anesthetist needs supervision. The state governor has the power to exempt the state from the federal rule requiring supervision.
CMS has placed limits as to which organizations may bill Medicare for the services of physician assistants. The new rules state that companies without their own provider numbers may not bill for the PA services. This deletes the ability of staffing companies to bill. This may impact small hospitals that do not have the resources to have their own staffing agency. As a part of this new rule Medicare will no longer pay for any services of medical groups if they are even partly owned by physician assistants. This is an extension of the rule that PAs are not allowed to form their own group practice and have a Medicare provider number. This may lead staffing companies away from PAs and more toward nurse practitioners. Top
The LA Times has reported that Covenant Care, a nursing home company, will pay the feds $3.2 million. They are accused of billing Medicare for non Medicare patients and for unverified hours of service. This is from a whistle-blower who may receive up to 25% of the settlement. 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.