July 15, 2003 Legislation

Specialty Hospitals

License Revocation

JCAHO

People's Republic Pharmacy Tax

Smallpox

Nurse Staffing in California

CMS Medicare Physician Rules

Malpractice

Specialty Hospitals

The CMS has dropped its proposal to limit physician referrals to specialty hospitals.  It found it does not have the power under the law to do this.  The Senate added this to a Medicare prescription bill.  The proposed law is attempting to limit the whole hospital exception to the Stark rules.  Under the whole hospital exception, physicians may refer patients to hospitals they own providing they own the whole hospital. The general hospitals are afraid of losing money, a reasonable fear.  They need the law to be passed since they cannot compete with the specialty hospitals in cost or quality.  The proposed law would ban specialty hospitals not in service by June 12, 2003.  It would allow specialty hospitals in rural areas if patients have nowhere else to go.         Top

License Revocation

Dr. Moon, the Redding, California, invasive cardiologist who has been accused by the feds and the state of doing unnecessary procedures has voluntarily given up his medical license until the federal investigation is complete.  The state medical board illegally attempted to revoke his license earlier in the year and was rebuffed by the courts.  

The New York  medical board summarily suspended the medical license of Dr. Pankaj T. Desai, a plastic surgeon.  Dr. Desai has been charged with 225 counts professional misconduct which included

California Medical Board is going after the license of a Berkeley physician who has recommended medical marijuana to about 7500 patients.  He has prescribed it to no one and states he has examined all the patients he has recommended marijuana to.  The Medical Board states it has nothing to do with medical marijuana but only with not doing a physical exam.  Dr. Ted Mikuiya, a psychologist who has been in the forefront of medical marijuana, states he examined each of his patients.  This is only one of almost a dozen physicians being looked at who just happen to recommend the weed.  It is my opinion that the Medical Board and the Attorney General lie when they say it is not about going after those particular physicians for their recommendations. 

JCAHO

I am sure that all know the new medical staff standards for the JCAHO have been published.  The organization has gone against the few hospital attorneys who wished to negate the medical staff power.  The JCAHO has recommended in MS1.1.1. that neither the medical staff bylaws nor the governing body bylaws have language that provides for unilateral amendment of the medical staff bylaws and rules and regulations.  This will become important in cases such as the one in Ventura California where the governing body is attempting to make loyalty oaths for physicians mandatory.          Top

People's Republic Pharmacy Tax

The legislature of the People's Republic of Massachusetts does not give up easily.  Even when the courts have stated their ill thought out tax on pharmacies is illegal, they put it back in a budget that promised no new taxes.  The Governor has promised to veto any new taxes.  The Republic wants the feddies to match the 65 cent tax on non-Medicaid prescriptions filled.  I am sure the Bush administration will be happy to comply with the wishes of this Democratic state.  The state has been ordered to return the $18 million already collected but to date has not complied.        Top

Smallpox

The Smallpox epidemic is over.  Due to the overwhelming refusal of healthcare workers to comply with the voluntary inoculations and the pericardial complications that occurred, the CDC has advised against expanding the inoculations.  They will do a six month assessment of the program.  This means that they hope all forget about it by then. 

The Public Health officials of several states must destroy many more vial of the smallpox vaccine than they have used.  The expiration date is 90 days after the powder is mixed with the solution.  The officials did the unthinkable.  They mixed the solution prior to it being needed.  To date 38,000 of a predicted 450,000 people have been inoculated to date.        Top 

Nurse Staffing in California

The California Department of Health has issued updates for the nursing staffing rations due to come into place in 2004.  The Department has kept the 1:6 ratio for med/surg units.  They increased the ratio in step-down units and oncology on January 1, 2008.  This means that since there are not enough nurses to fill the quotas that some hospitals will close down parts of their units to meet the arbitrary quota.  The new rules also clarified that many of the RN jobs may be done by LVNs and LPTs. LVNs may take care of up to 50% of patients except on trauma and that at least one triage ED nurse must be an RN.        Top

CMS Medicare Physician Rules

There are now new rules to retain the Medicare provider numbers.  These include more contracts provisions and even potential onsite evaluations.  The comment period for these new regs was up on June 24 and will be issued in final form later this year.  The physicians would need to certify their address and their ability to treat Medicare patients (not excluded from the program).  The physician will need to supply a new form plus all supporting documentation.  This will need to be done every three years.  There may be random checks of the information and on-site inspections to determine enrollment information is accurate.  Another beautiful thing is the disallowance of any monies until the physician has a valid billing number.  This specifically disallows retroactive payments.  If the physician does not submit a claim to Medicare for six months they will be automatically disenrolled.  They must then resubmit all information.  Isn't being a physician fun??        Top

Malpractice

The trial lawyer's have paid off the Democratic US Senators.  They have received enough money to filibuster any attempt by the Republicans for tort reform.  The Republicans are not all that sad about it since they will use this against the incumbent Senators in their upcoming elections, especially in the states with the biggest problem or patients obtaining health care.  One Republican Senator with a large largesse from the Trail Lawyers is also against tort reform.  Senator Graham of South Carolina also needs to be targeted at election time.

Gov. Jeb Bush of Florida rebuked the Trial Attorneys and those in both parties that are not allowing the much needed tort reform to pass in the state.  The Governor will keep the pols in session all summer until there is a fix.        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.