December 15, 2006  Legislation



Joint Commission


The great paragon of virtue, Pete Stark, who made money selling his bank to a foreign national and then made a law to ban that act from occurring in the future is back at it.  His dander is up for P4P in Medicare.  He states it is wrong to pay more for appropriate care.  Instead, those not performing should get less money.  This puts him in direct conflict with the new CMS director.  

Of course Congress has rescinded the 5% scheduled decrease in physician reimbursement that all knew would happen.  What they also did was allow no increase in fees for physicians unless they report how often they provide quality care, as defined by the no nothing government. The question is cook book versus increase quality of care as defined by politicians.  The sides are balanced on both sides of the aisle.  One said it best.  "It's pay for compliance, not pay for performance".  

Pennsylvania Governor Randall is all about money and not medical quality.  The Gov wants to revamp healthcare by allowing nurse practitioners more ability to treat.  The less trained mid practitioners would be able to do anything they are capable of. Currently the NPs can evaluate, prescribe and provide some therapies.  With the new lessening of restrictions there would be no safety net of a physician overseeing and ultimately responsible for the care.  In this physician unfriendly state, I wonder what the malpractice premiums for these unsupervised mid level practitioners would be.

On the left coast, California Senate Democrats have offered a solution to the state's uninsured problem.  It is the mandate that all employers provide insurance for all employees, even if they only work on a very part basis.  Workers would also contribute as they do now for state unemployment and disability insurance.  There would be federal money needed but no state money.  The employers do not like the bill but the Gov. is pleased with its entry into the hopper.  He will release his own proposal nest month.  The Senate plan would provide for basic coverage at negotiated rates and the capping of administration costs.  The employee can purchase more coverage if they wish.  The people would be required to show proof of medical insurance when they pay their state taxes.  Many people do not file state tax forms as they have no money.  This bill is alot better than the one last year for universal healthcare, which was rightfully vetoed.  

The San Diego Union newspaper blasted the Senator's plan as foolish, dangerous and expensive.  The paper is looking forward to the Terminator's plan next month.

In the more moderate Midwest, Ohio is soon to have a law that will allow small businesses to join forced for purchasing health insurance for their employees.  This would allow the companies to get the same lower premium as larger companies.  

To no one's surprise the Washington politicians have again shown why they are regarded in such low esteem.  Politicians from both parties slipped into a bill passed last week allowing healthcare pork for their home states.  This was done after the bill cleared the Joint Conference Committee and without the knowledge of all but a very few.         Top


In yet another too little, too late scenario that is common for the United Network for Organ Sharing (UNOS) they have finally taken away the valued "good standing" token from Kaiser.  This is of course after Kaiser has been publicly humiliated by being caught lying for their shady kidney transplant doings and been fined heavily by the state. It is hard to believe that anyone in Kaiser would deny that there were serious problems with the program but that is what apparently happened in a meeting with the UNOS.   

Idaho has decided to allow a new neurological specialty hospital to be built in Boise.  The vote was 7-1 in the advisory board to the Department of Health.  The state has no CON laws and the board stated that there was no legal power for them to regulate hospital building.  They recommended the legislature take it up at their next session.   

CMS has change the rule regarding restraints.  The hospitals must provide patients or their family with a formal notice of their rights and who the hospital must inform if a death associated with the use of restraints occurred.  Also now nurses and others may do the one hour requirement for face to face exam after a patient is put in restraints.  That person must then notify a physician or other licensed independent practitioner as soon as possible. 

The Catholic hospitals of the People's Republic are not following the law to offer emergency contraception  to rape victims.  In order to be eligible for the treatment the patient had to undergo a rape exam and then it was still up to the physician as to whether or not the patient would be told about the treatment.  The Catholic Caritas Christi Health Care stated they would not provide the treatment even if the patient was raped.    Top

Joint Commission

The Joint has put our two more new field surveys.  The first one is on disruption of anyone in the hospital including the Board and CEO.  The terms are vague and may not be related to quality of care or outcomes.  The second one is for conflict of interests.  These are requirements that do not have anything to do with the Medicare Conditions of Participation and are more good reasons why hospitals should use other organizations to be deemed in compliance.        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.