August 1, 2018 Legislation




Medicare is proposing one payment for all office visits.  This would free up a lot of time for physicians by it not making any difference what code is used and not justifying the level of service.  The down side is those with sick patients would get underpaid and others may try to game the system by submitting less information.  The outcry is from the oncologists and rheumatologists along with the academic centers.  

The House has voted to repeal the medical device tax.  This was a 283-132 vote, bipartisan.  

The House also voted to delay the tax on Ocare products, again with bipartisan support.  They also voted to allow HSA users to purchase more products including exercise and fitness programs and to pay for concierge physician fees.  They now go to the Senate where their fate is uncertain.

The administration has said that they will resume the payments of the risk adjustment program.  

The administration issued new rules for a 12 month insurance plan with renewals.  The plans do not have to cover pre-existing conditions nor have the mandates of Ocare plans.  Azar stated that these may not be right for everyone but it is an option. Those with special interests decry the plan but they are only thinking of their own constituents and not a choice.  California is its usual obstructionist self.    The legislature want to take away choice it its rtush to do nothing Trump.  They want to ban these plans in the state.  Penalties would not apply since they have been removed by the feds.

Kentucky's Governor is reversing his decision to cut vision and dental benefits for Medicaid patients.  Governor Bevins originally cut the benefits due to a problem with payments for it.  

New Jersey has fined UnitedHealthcare $2.5 million for breaking insurance laws.  They sent patients with hemophilia to providers that were not certified by the state as hemophilia providers.  In a second problem it sold polices with no medical underwriting after it said it offered no plans without medical underwriting.


I am using this heading since it covers both physicians and non-physicians.  

The SEIU pushed for a law in California that went into effect on July 1 has made working in a nursing home harder.  The law put in new staffing requirements for direct caregivers and specially for CNAs.  Quality has always been lacking in nursing homes and that is why the new measure was put into law.  The new law requires 3.5 hours of direct nursing care up from 3.2.  At least 2.4 of those must be from CNAs.  There are no CNAs in California to fill the needed position as the pay is averaging $13.96 per hour for a licensed position.  Can you see nursing home either closing or paying the large fines?   The law does allow waivers which most will apply for.  The waivers are for homes with no dings who reach the 3.5 hour staffing but not the 2.4  or they can not hire due to workforce shortage.  The later is limited to two consecutive years for the waiver.  

Alaska Medicaid screwed up.  They overpaid physicians in error and now want their money back.  They want $15 million from 1100 doctors.  There was supposed to be a 10% reduction in payments but the department did not cut the payments.  The providers have already spent the money.

California is looking to remove the medical license of Dr. Michael Arata of Newport Beach.  He is doing the vein opening procedure on people with chronic cerebrospinal venous insuffiency tha may be linked to MS.  


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.