April 15, 2013 Legislation





Again, the lack of reading a bill before passing it is coming back of bite the Democrats in the rear.  This time is a line in the bill that allows insurance companies to renew policies through 2014, which would not allow all to get Obamacare on 1/1/14.  This may save many patients alot of money by staying with their insurance companies and raise prices dramatically for those in exchanges.  This would be for individual policies and for whichever policies (the young well patients) the insurers want to cover.  

Speaking of biting one when they least expect it, if a person gets a subsidy to help with an exchange purchase and their income rises that year they will be required to repay part or all of the subsidy when their next income tax rolls around.  This may be as much as $2500.

In Obama's proposed budget is the taking away of money from hospitals and other providers to decrease the deficit instead of taking the money from other entitlement and defense programs.  He would also decrease the money going to social security recipients.  He will also propose another tobacco tax as well as a cap of $3 million in tax deferred accounts.

House Republicans are planning to attack permanently the ridiculous SGR.  They want it repealed this year.

There is a bill in the House that takes away the monetary penalty for those physicians of retirement age and those in solo practice that do not switch to EMR.  This is smart so it probably will not pass and many physicians will retire because of it. Retirement age is defined as age 62 or older or will turn 62 by the end of 2020.  The solo practitioners would receive a three year exemption.  The new rule would also offer common sense changes like having specialists such as anesthesiologists and pathologists who do not have an office practice not need to do the medication lists nor CPOE.  As I said, since it is common sense it probably will not pass.

Primary care physicians were but have not received the increase in payments for seeing Medicaid patients.  They apparently have to see some certain percentage of Medicaid patients and have to apply to their state Medicaid program for the increase in payment.  The payment may start in another three months but don't hold your breath.  Remember, this only lasts for two years.  CMS states that the money will be retroactive to 1/1/13.

The government is after more money so they want to tax the EHR developers to pay for the Office of National Coordinator for Health Information Technology, a section of HHS, certification and standards activities.  This is in the Obama budget proposal.  The ONC's money is to expire at the end of the year.  Guess who does not want to come up with the money?        Top


Prime Healthcare has completed the purchase of two hospitals in the Kansas City area.  They purchased Providence Medical Center and St. John's Hospital.  Prime is the same company that is being investigated by the feds for overbilling and who is having problems buying hospitals in New Jersey.

The AHA is getting hit and they don't like it.  They don't want physicians to be independent.  They have written a tome to HHS crying about the new COP that requires all hospitals to have independent medical staffs and not one staff for a whole system.  This type of system would make it easier for hospitals to control physicians.

The IRS is also unhappy with the hospitals and have put in new rules for hospitals to claim non profit status.  Hospitals will have more reporting requirements and the need to do a community health needs assessment every three years as well as do what is found to be needed.  If hospitals do not comply they may lose their non profit status.  The rules include financial assistance for community members and limitations on collection actions.  They can not bill chargemaster but will be limited to what they get from insurers.  This is already in effect and has been since Obamacare was passed.

Pacific Health of California is closing three hospitals due to fraud issues.  This will cause 1900 jobs and a loss of 480 hospital beds in the metropolitan Los Angeles area.  Some experts, according to the Los Angeles Times, believe that more small and medium size hospitals will close in the near future due to Obamacare.

TJC has warned that hospital alarm fatigue may occur and be detrimental to patient safety.  They say the obvious, that caregivers get so tired of hearing the constant beeping that they disable or ignore the alarms.  TJC recommends the hospitals use common sense and only use alarms or alarm settings that are absolutely necessary for patient safety.        Top 


The University of Pennsylvania has reported to the state board a non employed cardiologist who they claim did non indicated invasive stents.  They have offered those people a non charged visit with a university employed physician or have their records transferred to a physician of their choice.  The physician, Dr. Vidya Banka, has voluntarily given up his privileges at the hospital and states he was never given a chance to give his side.  He has also been reported to Medicare for potential fraud for doing unnecessary procedures.

California has threatened to cut off funding for the Medical Board if it doesn't become more aggressive in pursuing "bad" doctors.  They want the Board to utilize their power to with interim drug suspension orders.  It also criticized the Board for not hiring more investigative officers after it gave them more money to do so.  The Board was also told to explain their stipulated judgments which lets physicians get lighter penalties if they plea bargain rather than go through the entire judicial process.           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.