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California has ordered Anthem Blue Cross to stop attempting to collect overpayments on old medical claims. The law states that insurers can only collect overpayments on debts one year old or younger. Anthem attempted to collect debts from longer ago than one year. An investigation by the State found no evidence of fraud or misrepresentation by the providers which is required to collect debts older than one year. Top
The USPSTF is at it again. They have recommended getting rid of mammography for some, Pap smears, PSA screening, and now routine EKG and stress testing. It is OK to do the test if one has symptoms but not in symptomatic people. I can not wait for the first physician to be sued for following the panel's guidelines. I would love to be the attorney against the physician. The panel wants the physician to talk to the patient about the medical histories. Sure in the routine 10 minute visit and the five minutes for the EHR. I believe this recommendation has some merit as opposed to the other ones.
The Republicans are attempting to dismantle Obamacare in small increments. They are defunding several entities that make up the program. The budget would cut funding for the IPAB, small amounts for various entities and Planned Parenthood. It would cut $135 Billion over 12 years.
The GOP wants to also take money from the Agency for Healthcare Research and Quality (AHRQ), the agency the is to put in the guidelines for all to use. Of course, the agency guidelines really to not affect outcomes. Some believe that hospitals need more standardization so all can deliver the same type of care to the same type of patient. This is also called cookie cutter medicine.
The CBO has reassessed Obamacare after the Supreme Court ruling. It shows that now the law will decrease the national debt by $84 billion (physician fees of over $300 Billion is not included in this figure) and will reduce coverage by 30 million people.
The feds are finally attempting to get something right. CMS and private insurers will begin to share information in an attempt to head off paying fraudulent claims and then chasing the money. They could have done this in the past but did not.
It is expected that 13 states will not give Medicaid as the CMS wants. They will not expand the program to include all. In those states it will be harder than in the other states for some people to see physicians. Although with the amount paid by Medicaid it is possible that few physicians will see the people even with insurance. The states will also cut benefits.
All is not well in the People's Republic of Massachusetts. As the bell ringer for Obamacare the state's health program is continually short of money. The Republic's House has a plan to save money by putting on a luxury tax on hospitals that charge 20% or more of the Republic's median price for a service. They would be charged 10% to help those hospitals that serve the needy. The Governor wants an investigation into any provider that either does or is considering charging more for its services due to market share. This investigation may be done by the Attorney General who has nothing else to do. This in any other form or forum is called blackmail.
The Republic's House and Senate have reached a compromise on the very expensive cost of free medicine. They are to pass a bill that says premiums may not rise faster than the state's economy overall until 2017 and then no faster than 0.5% less than the economy. If premiums rise faster the insurer will get a hand slap and then a $500,000 fine. Currently the healthcare premiums have been double the Republic's growth, 6% versus 3%. One of the good things was luxury taxes against the rich hospitals and physician groups did not pass. The Patrick bill outline in the prior paragraph did make it into the bill.
Los Angeles has taken all of it's medical marijuana shops and with a unanimous vote of the Board put them out of business. There are currently 762 legal dispensaries in the city. Individuals and their caregivers will be able to grow enough weed for up to three people. Top
Kaiser South Bay Hospital in Los Angeles has been fined by the state for putting medical waste in the regular trash. They have to pay a fine of $73,615.40 to the Los Angles city attorney. They also have to train its staff or proper handling of medical waste. Top
There have been three bills introduced into the House regarding the SGR. The first and the one most likely to pass is the kicking the can a year down the road. Another bill introduced would scrap the SGR, fee for service payments and replace everything with a payment for high quality low cost care. This is called the Medicare Physician Payment Innovation Plan of 2012. This will never pass this year since it will cost alot of money. It would be paid for by money saved from the troop pullout in Iran and Afghanistan. The third bill, which also has no chance of passing would get rid of the SGR and give physicians annual raises up to the Cost of Living or 3% which ever is lower. This would be paid by defunding Obamacare. 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.