December 1, 2012 Legislation




The administration has again pushed back the deadline for when states have to notify the feds whether or not they will do an "exchange".  This is the second time the deadline has moved.  The new deadline is December 14, the same day that the states have to have a skeleton of a plan in place.  

The House has a bipartisan agreement on a bill to allow individuals opting out of healthcare insurance for religious reasons.  However, if they later used healthcare under the law they would have their exemption removed and need to pay a penalty.  This would be monitored by the IRS.

The administration has listed the key mandates of Obamacare.  Shopping for healthcare will begin next October.  About 15 states will let the feds run the show.  Insurers will have to cover 10 basic benefits including emergency, maternity, prescription newborn and hospitalization among others such as rehab, preventative care, lab work, mental health and substance abuse treatment and children's dental and vision care.  The drugs may vary from state to state.  There is some accommodation to business such as higher deductibles for small businesses and actual enrollment dates. For some reason they are not talking about price for the insurance.

The feds who run the exchanges that the states refuse to do will be responsible for the IT systems that has to speak to the states.  That will be huge both in expense and upkeep.  Will it be ready be the October deadline.  Doubtful.

The IRS is supposed to be the overseer of the money.  It is also doubtful if they will be ready by the deadline.  They need to get tax credits out to those who need it to purchase insurance.  The problem here is that the money to be paid is based on old information.  Also they will be diametrically opposed by the HHS.  They also will need to get money back if people have been overpaid.  That should be fun trying to get money back from people who have little.  They will also be answering a lot of questions and there will be little money to hire new agents.

While all of the above is going on there is still the small matter of physicians getting a huge decrease in payments due to the outmoded SGR.  It is expected that Congress will do their usual job of not facing a problem but "kicking a can".  The one year kick will cost $25 Billion and not solve any problem.

The OCR has issued vague guidelines for de-identifying patient records sent to researchers.  They can either get an expert to certify that the ability to identify the individual is very small or they can actually remove certain identifying information and certify that they have no knowledge that any remaining information could be used alone or in combination with other information to identify the individual.  How they would know that is unknown.

New Jersey, a backward medical state where the hospitals affiliated with universities attempt to hold back their country cousins, is now considering whether or not to go with the rest of the country and allow hospitals to do angioplasties without a cardiac surgical unit onsite.  

Ireland has a law in the constitution that no hospital can do an abortion.  The Supreme Court said the law is illegal but it has never been removed from the constitution.  Because of the law, a woman has died.  She had a placental event but the fetus was still alive.  When the fetus died then a D & C was performed but she died of sepsis.  Most Irish women go to Britain for their abortion but some are too sick and the end point is potentially death for the woman.        Top


Georgia is forcing physicians and others to leave practice.  They have a law that requires all licensees to prove citizenship when they renew their license.  The problem is that the state does not have the manpower to process the requirement resulting in providers having to stop practice as they can not practice without a license.  The idiots in the state government forgot to say that this only needs to be done once.        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.