August 1, 2014 Legislation






Virginia physicians can no longer bill private insurance for a markup for work done by labs or pathology.  This has always been illegal for Medicare patients but was legal in the state until July of this year.  

Kentucky has passed a law allowing nurse practitioners who have completed a four year apprenticeship with a physician can now prescripe certain medications without the input of a physician.  The problem is to find a physician.  The law states that a committee will furnish a list of physicians willing to participate in the program.  If the NP can not find a physician after 30 days the committee must furnish one.  

Missouri has gone a step worse.  They have a law just passed that creates some kind of an entity called Assistant Physician.  This person is a medical school grad who isn't finished with training and isn't licensed as a physician.  They will be allowed to practice in rural and underserved areas where people don't know any better.  They will be supervised for 30 days and then are unleashed on the population without oversight.  Back to 1940.

CMS has released some proposed 2015 physician fees.  They include a 20.9% decrease for physicians seeing Medicare patients starting March 1 unless Congress acts.  They will again kick the can and not make a decision.  They also propose a payment for chronic care management of $41.82 monthly.  

Governor Brown of California signed into law the bill that allows medical students to become licensed in less than four years.  This is to decrease student debt according to the Democrat who initiated the bill.  This accelerated program is already at UC Davis.

Physicians have to August 27 to review the information in the Sunshine Act, detailing all payments from drug companies to them.  

Remember when primary physicians were to get a two year bump in the Medicaid rates to Medicare to see Medicaid patients.  That is expiring at the end of 2014.  To date, six states Colorado, New Mexico, Iowa, Alabama, Mississippi and Maryland along the the District have agreed to continue the payments using their own money. Alaska and North Dakota have always paid over Medicare rates.  The other 42 states are sticking it to the physicians and more importantly to their Medicaid patients who will again have problems finding physicians.  No data was ever collected to see if the increased pay ever attracted more docs to the programs.    Top


Utah has asked for and received an emergency order taking away the ability of Dr. Paul Gahlinger, a physician in Saipan, from being able to prescribe certain meds to patients in the state.  Dr. Gahlinger sees the patients via telemedicine and works with the patient's physicians.  He has 30 days to contest the action.        Top


The Senate is playing politics.  They are attempting to pass bills that have no chance to pass just to have talking points in the November election.  The same thing that the House Republicans have done.  This time the Senate is attempting to pass a bill to overturn the US Supreme Court decision on Hobby Lobby.  A lot of effort for four items.  Another is called the Women's Health Protection Act.  This piece of theater is to overturn state laws that limit access to abortion.  A bill that is possibly unconstitutional.  The Senate could not get the necessary number of votes to have the bill go forward so it died.  The Dems will still get talking points to rally their female troops.

Obama has asked the Congress to pass a law retroactive to May to prohibit companies such as Medtronic to purchase overseas companies and get out from under the huge US taxation.  He does not want to address the cause of the exodus, taxation that is 2 to 3 times more than overseas.  We have the highest taxation rate in the world by far.  The Senate Republicans have no interest in a stand alone bill to stop the inversions.  They want tax reform not the potential for overseas companies to buy American companies and move positions off-shore.

Just after the above, AbbVie closed a deal with Shire to move to Ireland.  This will take the tax from 22% in the US to 13% in Ireland.  FU Obama.  Get smart and lower the corporate taxes.  A Democratic House member wants a bill to forbid companies who do inversions from getting federal contracts.  That will never make the House floor.

Obamacare is not applicable in the US Territories as they are not states referred to in the law.  Four years after the passage of the law Obama has finally agreed to this.

In another edict without merit Obama decreed that companies that could drop contraception coverage are mandated to tell their employees that they are not covering it.  This was already the law.

The House and Senate panels without any administration input reached a deal on the VA.  The Dems get to spend money, $17 Billion for unneeded leases of buildings, unneeded more physicians and nurses and more college payments for vets (what does that have to do with the problem?).  The GOP gets the ability to send vets to private physicians and hospitals as well as easier firing of execs and streamlined appeal rights for whistleblowers.  The House almost unanimously passed the bill.  The Senate then passed it on a 91-3 vote. 

The Senate unanimously approved Robert McDonald as the Secretary of Veterans Affairs.

Where else but in the idiotic Bay Area would you find legislators wanting to have cellphones sold in their area provided with stickers stating there is a risk of brain cancer by using the phone.  San Francisco tried it and lost in court.  Undaunted Beserkly will debate a  resolution to have it done on phones sold in the city.  They will be sued the day it passes if it passes.

New York needs to pay $1.3 Billion back to the feds for getting too much money for Medicaid.  

California ha put in a pilot program to allow paramedics to make decisions in the field.  They will not automatically transport patients to hospital ERs but if needed will bring them to urgent care centers or to just give advise at the home.  The usual suspects, physicians and nurses, are wanting more oversight.        Top


The Sacrament Business Journal reports that Dignity Health has agreed to pay a fine of $1.5 million to the feds for mishandling control substances.  The system reported the loss of over 20,000 tablets of hydrocodone and an investigation by the DEA revealed other deficiencies at multiple hospitals in the system.

California has fined 8 hospitals for running afoul of licensing requirements.  The hospitals and the offenses are Desert Regional $100,000 for failing to follow surgical policies, Kaiser Anaheim $50,000 for failing to follow safe medication policies, Kaiser Riverside $50,000 for failing to follow surgical policies, Memorial Hospital in Modesto $100,000 for failing to follow surgical policies, Sharp Memorial Hospital $100,000 for failing to follow fall preventive measures, Southwest Healthcare in Murrieta $100,000 for failing to follow surgical policies, St. Bernadine in San Bernardino $50,000 for failing to follow surgical policies and St. Mary's in Apple Valley $50,000 for failing to follow surgical policies and an additional $75,000 for failing to follow patient care and treatment policies.  It needs to be noted that those with the highest fines are long time offenders.  In fact, Southwest has been fined 11 times, a very very poor record.       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.