April 1, 2013 Legislation

Healthcare

Physicians

Hospitals

Malpractice

Healthcare

CMS found they had screwed up the calculations on the readmission penalties to hospitals.  They have corrected their math errors and changed how much hospitals owe them to the correct amount.  

Both houses of Congress have agreed on a Continuing  Resolution to keep the country afloat until the fall.  The bill keeps all the sequestration cuts including the 2% reduction in pay to Medicare providers.  It also did not include the Obama request for $1 Billion for Obamacare exchanges nor the $100 million for the dreaded IPAB.

In a vote that really did not count there was bipartisan support in the Senate to kill the medical device tax put in by Obamacare.  It shows that this may still be removed in the near future.

Obamacare is not even in operation yet and Sebilius is already stating that in 2015 the administration is going to start a new federal basic health plan based on the state of Washington model.  This is for people with too much money for Medicaid and not enough to get into the exchanges.  They state this will cost only about 1/4 of the exchanges.  Nobody has said where the money was coming from as it is not part of Obamacare.

In a glimpse at our future, Rueters reports that Britain's NICE will get more power over the value (cost) of drugs for the people.  Companies will be paid more for drugs that have more societal value.

The California Democrats who hold a 2/3 majority of both houses have never seen a tax they don't like.  They now want to tax things that they believe are harmful to society to pay for the very expensive exchange the state foolishly stated it would run. Fortunately governor Brown will not let any new taxes become law without a vote of the people.

Ah California, the state that continues to go into bankruptcy.  CalPERS, the state pension plan, has just given the okay to charge a 50% rate hike to employers.  This means a significant layoff of teachers and other employees.  This is in place of the more meaningful change in pension pay.  The Democrats that run the state have never found a payment they didn't love.        Top

Physicians

Starting May 1 all Medicare unenrolled physicians will get their Medicare claims denied.  This is true for those who are doing or have referred the service.  This is for the high risk for fraud aspects of lab, radiology or medical devices.  Both have to enrolled in order for the payment to be paid.  Chiropractors may not order any of the services for patients.  Only physicians can order Home Health.  Optometrists have more leeway to order.  

The OIG has just put out a special fraud alert to physician owned entities that get revenue from selling or arranging for the sale of implantable medical devices by their physician owners on their own patients at hospitals or outpatient facilities.         Top

Hospitals

California has reprimanded Kaiser for mismanaging its mental health services.  They rationed care by making patients wait long times for appointments and gave misinformation to dissuade patients from having long term care.  Kaiser states that it is improving its mental health services but the state in a rare move did an immediate referral to enforcement.         Top 

Malpractice

Oregon has made the break.  They have a new law that allows physicians and patients to enter into confidential mediation before going to suits.  The hope is that this reduces frivolous law suits and reduces some defensive medicine.  The next step is to work on caps.        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.