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The feds have finally set a date. October 1, 2015 is the start date for ECD 10. This should give plenty of time to contemplate retirement versus changing all the codes.
CMS has at least temporarily stopped the verification system of Pharma payments to physicians. At least one physician reported that payments were attributed to him that were actually made to another physicians with the same name. It is difficult to log in to see if any payments are allotted to the physician and then to find gross errors is disturbing.
Transparency of the Obama regime was a pledge but a failure. First there was the Lerner IRS email scandal and now the same has come to Marilyn Travenner. HHS has "lost" some of her emails regarding the ill fated launch of the website. It seems that about 20 witnesses in the investigation have some lost emails.
Obama signed the VA bill giving a lot of money to the VA and some but not enough changes to the culture.
The feds have stopped reporting on serious hospital errors like retained foreign bodies. Last year CMS denied it was making changes to not let the errors be found. This year the changes are complete. More transparency. They removed the information on the website so researchers can no longer get the information on eight items. It is interesting that the AHA was against having these on the site.
Patients have to stay in the hospital for three days prior to going to a SNF if Medicare is to pay. CMS is now doing a project to see in bundled care payments or in Pioneer ACOs if this can be eliminated. They are attempting to see if there will be less hospital admissions and what will happen to SNF admissions. They did this once in 1988 and found no decrease in hospital admissions and a huge spike in SNF payments. In 1989 the reinstated the three day rule.
NICE cut off the patients in England from the Roche drug Kadeyla used in breast cancer because it costs too much. It costs $152,850 for the average course of treatment. Patients can get the drug only by applying to a Cancer Drugs Fund. Roche had refused the asked for 60% price cut wanted by NICE. The Fund has received 233 requests for the drug in the first quarter of this fiscal year.
California's Department of Managed Care has fined six HMOs in 2014 for poor payments. The six fined for not paying timely are alameda Alliance, Anthem blue Cross, Cigna, Contra Costa Health, Sharp, Simnsa Health Plan and United Concordia Dental. Top
Brooklyn's Brookdale Hospital has been fined by OSHA $78,000 for knowing and not protecting its staff from violent attacks by patients and injury from falling objects. This hospital has been on the verge of closing for years and probably should be closed. In 2012 alone it was the target of over 100 lawsuits for negligence or medical malpractice. Top
Illinois has suspended indefinitely the medical license of Dr. Michael J. Reinstein of Chicago for over prescribing Clozapine for financial gain. He is currently being sued for fraud by the feds for the same thing. Teva Pharmaceuticals, generic maker of the drug, has agreed to pay the feds $27.8 million to settle allegations that they induce him to prescribe the drug. Top
In May HHS issued a memorandum that targeted all efforts of mediation in medical malpractice. The memo stated that all pre-litigation settlements that have any payouts no matter what the state law says are reportable to the NPDB. This is aimed at Oregon whose law stated that certain settlements are not reportable. Thank Public Citizen for this as they are the ones that wrote Sebelius about it and complained that this lets people off. 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.