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On January 1, California's new laws take effect. There
are many that affect health care in the state.
SB 1077 This is one that affects al physicians in the state either now or in the
future. It has always been the law that when a physician retires he/she
has the ability to keep an active license and partake in the necessary CME units
or go to a inactive license with less pay and no CME units. This latter
license allowed a very limited practice of medicine. The new law does away
with this choice. Now you either have an active license or you have no
license. The same law does away with the fictitious name requirement that
had been needed to be issued by the Medical Board. It still needs to be
issued by the local agency and by the Department of Corporations if the entity
is a corporation. This also applies to accredited ASCs as well as
physicians.
SB 420 directs the Department of Health Services to issue ID cards for those that qualify for the use of medical marijuana.
SB 2 is the controversial play or pay law that will go to the voters for a thumbs up or down vote in November.
SB 244 states that enrollees of managed care organizations may continue to see their health care provider even if the provider is no longer contracted with the plan.
SB 853 is an unfunded mandate by the state to managed care plans and their contract organizations to provide interpreters for the enrollees.
SB 969 states that if call centers are utilized only licensed professionals may give advice. The rub here is can non-licensed operators give written instructions based on a decision tree. The law seems to state "no", but Kaiser is taking the opposite approach.
SB 292 In another unfunded mandate the pharmacies will be required to not only label the medication with the name, physician, dosage and instructions as presently done but will also have to include the physician description of the medication on the label. This should confuse patients so they will not be able to read the instructions.
AB 663 prohibits people in medical training from doing unconsented to pelvic exams on female patients while they are under anesthesia unless it is part of the surgical or diagnostic procedure being performed.
SB 151 removes the triplicate narcotic forms that have been used in the state and replaces them with special forms which are onerous to the physicians prescribing the medications since the physicians will be required to keep a daily log of the prescriptions written and submit them monthly to the state and to put on the prescription an identifying number of the pharmacy that will fill the prescription. This does not give the patient choice in finding the most economical place to purchase the prescription.
SB 376 allows certain money losing rural district hospitals to employ not more than two physicians with concurrence of BOTH the hospital AND medical staff, not just the executive committees.
There are many others but these seem to me to be the most important from either a positive or negative perspective. Top
The Joint has quietly abandoned its standard to get rid of the ED overcrowding in the hospitals. They have now changed the standard to help facilitate movement of patients throughout the hospital, another meaningless standard. They had a chance to do something meaningful for the ED patient flow but backed off after hospital pressure and diluted the standard for the entire hospital. This gives the hospital much more wiggle room. Top
In this time of acute short staffing of patients due to the lack of nurses, the NY nursing board is proposing that all RNs get a college nursing degree within ten years to retain their state license. This is running into the expected opposition to the stupid idea since there aren't enough nurses now. There will be more comment before any regulatory or legislative changes are to be made. Top
EMTALA has changed the Medicare billing for hospitals. It was the law that if the final diagnosis did not go along with the tests the hospital could not expect to get paid for the tests. This is no longer the case. Now if the test is indicated because of the initial symptoms the test will be paid for, no matter the final diagnosis.
Illinois has passed a law taxing hospitals in the state that serve Medicaid patients. The tax would be $85 per patient day. This will raise about $430 million per year. Those hospitals will then receive about $300 million in return and the additional $140 million will be used for other state healthcare expenditures, including accelerating payments to providers. The bill was written by the Illinois Hospital Assn. Top
The administration has requested an additional $5.6 billion for VA care in the next fiscal year. The main question is, why? Not why the increase, but why is their a VA system at all? This unnecessary system is pure pork for the areas where hospitals or clinics are located. There is no reason why they should be in existence. The men and women who have true service connected disabilities can and should be treated by the best trained and best equipped people and places in the country. This can be accomplished with the use of the community or university hospitals and the bills paid by the government for not only their outpatient and inpatient care but also for their prescriptions. They can be given Medicare with full prescription benefits with much less money than building more hospitals and clinics that stand next to or in close proximity to excellent civilian facilities. The newly requested budget seems to be slowly heading in that direction by now paying for non-veteran hospital urgent or emergent care and ending copays of the POWs and pharmacy copays for indigent vets. Those veterans, such as myself, who have no service connected disability and who use the VA only because they are too cheap to obtain prescriptions or care with traditional insurance should not be given those privileges.
The Department of Veteran Affairs advisory panel has just met and sent its recommendations to Secretary Prinicipi who will either agree, disagree or change the recommendations depending on the needs and the political climate. Top
The Washington State Senate has approved a bill for a $350,000 cap on non-economic damages as well as other changes. The bill now goes to the House where it met its death last year.
Missouri has passed a bill out of committee to the House floor on a straight party line vote. The bill would reduce non-economic recovery from the current $565,000 to $400,000. It would also limit forum shopping and reduce the damage exposure to those found under 50% liable. One of the trial lawyer bought Democrats on the committee stated that the way to keep malpractice insurance premiums down was to keep doctors from committing malpractice. Duh! Are there any physicians who state "well today has been slow, I think I'll commit malpractice on the next patient". Top
Pennsylvania is attempting to resurrect a bill to give protection to people reporting health care quality problems. This bill stems from the fine articles in the Pittsburgh Post Gazette by Steve Twedt that spotlighted the problems where physicians were removed form the staff as "disruptive" after reporting problems. This bill would not allow the institution to retaliate against the whistleblower for filing a complaint in good faith. The hospitals questioned the need for the bill. They obviously didn't read the articles about physicians who's lives were ruined after reporting lapses of care. This bill is co-sponsored by 138 bipartisan legislators and has a good chance of passage. I also wonder if the Sarbanes-Oxley Act of 2002 would be of any benefit to those who report corporate misconduct. 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.