 | |
| |
| |
|
In jolly olde England, PM Brown has allowed Labour's MP will be allowed to vote separately on three portions of the legislation on embryo research. The three are fertility research, inter-species hybrid embryos and creation of savior siblings to help a sick brother or sister. The scientists are for the bill and the Catholic members of the Parliament are against it.
California's governor has proposed a reg to prohibit balance billing by ED physicians and hospitals for money above what is paid by the cheap HMOs. The way the regulation is now worded, it is potentially possible for the hospital and physicians to bill the patient only and then let the patient hassle with the HMO for payment reimbursement. The rule will go into effect May 12. Sheila Kuehl, the chair of the Senate Health Committee, is misinformed when she stated that the contract for payment was between the insurer and the provider. The whole problem is when the provider has no contract with the insurance company. If there was a contract between the insurer and the provider this problem would not exist. Some of the HMOs such as Health Net pay the non contracted providers less than the low fees they pay their own providers. Health Net was fined $250,000 for this in about 65,000 claims. This new reg allows the provider to sue the plan for non payment but not sue the patient.
The corrupt California Chiropractic Board is getting some of its finances back. They will get back half of what was taken away for their old boys ways. When they get the money they can start doing their job and prosecute the 20 chiropractors who were pending when the money was withdrawn. The Board has agreed to the conditions suggested by a recent audit.
A report by Indiana University of 2193 physicians from across the country showed that 59% supported a national insurance plan. It sounds like the study did not define what it meant by national health insurance. Was it by the feds or by private insurance companies that allow individuals to purchase insurance over state lines? Is this a guarantee of insurance for all on a mandated or a voluntary basis? We don't know.
Ohio has mandated clarity in contracts between physicians and insurers. This includes the silent PPO and disclosure of exactly what the insurer will and will not pay for as well as a moratorium of most favored nation status. There also must be a uniform credentialing form and notice of significant contract changes. If the insurer does not conform then it is deemed unfair trade practices and allows the Department of Insurance to intervene and censure a plan.
The CMS has decided to raise the payments to Medicare Advantage insurers by 3.6%. This is lower than the projections were but higher than the zero percent it should have been. These insurers suck about 13% more than traditional fee for service money out of the system.
Senator Baucus the Democratic head of the Finance Committee has stated he is attempting to get a law passed to rescind the physician pay cuts for 18 months. What this means is instead of fixing the problem, in 18 months the physicians will be faced with a 20% pay cut in Medicare. This does not bode well for those coming into the program finding a physician. Congress is trying to fix this as they consider more scholarships for medical students to get more to go into the profession to be paid less. Top
The Joint Commission in its Online March newsletter states that the work of the MS 1.20 committee will continue. The deadline for its recommendations on the implementation is the May 31 meeting. A major problem is the possibility of the committee changing the wording and the meaning of the rule. The Board has approved an equal number of hospital and medical staff attorneys on the committee and a public neutral to chair the committee. The next meeting is this month. MS 1.20 becomes effective in 2009. This is again being delayed since as of this writing the JC can not find anyone to be the neutral.
The JC has also added a new sentinel event, thanks to the California screw-up on the twins of an actor, Dennis Quaid. The JC wants all children weighed on admission in kilograms since the meds are usually in x mg. per kg. Top
The Tennessee House has passed a bill that would require a plaintiff in a med mal suit to give 60 days notice prior to filing and to have an independent expert evaluate the merits of the suit prior to filing. This will stop the glut of frivolous suits in the state. The bill passed 59-1. A similar bill passed the Senate last year. There is no cap on non economic damages in the state. The bill should go the the Governor soon. Top
It is hard to believe that there are some legislators that still believe the courts will allow them to stymie abortions. The Florida Senate is considering a bill that would force women who want an abortion to have an ultrasound to see their fetus. This would be found illegal. The state currently has a law that requires an ultrasound if a woman wants an abortion in their 2nd or 3rd trimester. The new proposed illegal law would force the woman to view the ultrasound unless they signed a waiver. 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.