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The large health insurers have seen their share price increase due to a major increase in payments by Medicare for HMO care. Originally the insurers were to get 95% of the FFS payments per month for providing the care. The HMOs are now getting 12% more than the FFS institutions. A new increase of 3.5% for 2008 on top of an increase of 3.9% for this year is gravy for the HMOs. Under 20% of Medicare recipients get care via Medicare Advantage plans.
In Colorado, the Governor signed a law protecting hospital personnel from retaliation for blowing the whistle on poor patient care.
The San Francisco Laguna Honda Hospital was fined $100,000 by the state Department of Health for the death of an 82 year old woman who was found outside the hospital and who may have fell from her room. The hospital will appeal and continue the charade. The family will sue the city and get a settlement.
Georgia is on the way to getting rid of the antiquated CON processes. The new law that is being considered will allow specialty hospitals as well as doctor owned surgical centers and imaging centers. Hospitals opposed all.
Blue Cross of California's cancellation of individuals coverage retroactively has been deemed illegal by the Department of Managed Care. This has led to the $1 million fine. The state found that the insurer systematically investigated and cancelled the policies f pregnant women and the chronically ill using a computer program to target these people. The insurer will appeal but eventually will pay. This is the second fine for the same general offense. Blue Cross was fined $200,000 for an individual case last year. There are also many individual law suits against the insurers for the rescissions of the insurance policies. The Department is starting an investigation into other HMOs starting with Kaiser.
CMS has blinked. The organization has backed down from its NPI deadline of May 23 date. It now states that entities that make a good faith effort to comply may have an additional year to obtain the NPI and will not pay penalties. This is absurd. All entities knew of this rule and had more than enough time to get NPIs which take about 3 minutes on line to obtain.
It's about time! Senator Grassley has asked the GAO to institute an investigation into non-profit hospitals and how much community benefits they are doing to justify their non profit status. This may make the non profits that do little community benefit become tax paying organizations or start doing what they are supposed to do.
Universal health coverage is again being talked about. The people of Switzerland have recently voted on a single payor system as proposed by the Left Coast Socialists. The Swiss voted 71% against the idea. This was only slightly smaller than the vote several years ago in Oregon where 79% voted against the idea.
The People's Republic of Massachusetts is still attempting to figure out the balance between the socialists who want no premiums or penalty for those making under $60,000 versus the original state help for those who at or just above the poverty level. The do-gooders keep wanting the state t pay more and more until there is a single payor system.
The Republic is also considering exempting about 20% of the uninsured from the requirement that all have health insurance. This is because it still would be unaffordable for this population and the state certainly isn't going to pay.
Next door in Connecticut the cost of the proposed Universal care is so high it is all but dead. The cost is now up to $18 Billion. This leaves nothing in the pot for anything else. The state has only about 6% uninsured. Top
The Kansas Supreme Court allowed a case against a physician for breaking the Consumer Protection Act of Kansas. The Legislature is attempting to remedy the decision but the Democrats spurred by their natural allies, the trial lawyers, are fighting to keep the bill from becoming law.
In Tennessee, the Senate has passed a med mal reform that will require attorneys to pre-certify the merits of their cases with independent medical experts. The legislature still refuses to place caps on the non economic damages as a condition of passage. The House still doesn't like the law and the Democrats are planning to let it die. Top
Tenet has agreed to pay another $10 million penalty to the SEC on charges it fraudulently billed Medicare. The SEC also charged several of the Tenet officers with fraud and they also paid settlements to the SEC. Top
The Chiropractic Board of California is still in trouble. The Board is made up of the Terminators friends in the industry. They have done illegal acts and have had to apologize for holding illegal closed sessions. The legislature is now looking into the Board and its activities. Never a good sign.
In Florida, the Medical Board has fined 6 physicians for various mistakes. A 7th physician turned in his license. The highest fine was to a urologist who gave the wrong dosage of medication for treatment of priapism. The physicians are also required to take classes and perform community service. Top
After a series of mishaps throughout the country in transplantations of organs, the feds have put new standards in place. If not followed, the institutions lose fed money. The regs will not be final for 90 days. If strict compliance is followed about 64 centers or 13% of the total will lose financing. The new standards are in the number of procedures needed to be done per year and the outcomes. The programs will be reviewed on a triennial basis and CMS believes that abut 2% will lose funding each inspection. Top
Minnesota is moving toward legalization of the medicine marijuana. Both the House and Senate committees have passed the law with some compromises to law enforcement. There will be no home grown weed, only in dispensaries. Users would be identified with ID cards. The Governor has threatens a veto due to the message it sends to young people, the government does not care about your future pain and suffering. 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.