February 15, 2005 Legislation

Medicare

Malpractice

Medicare

Medicare is starting a pilot program with ten medical groups to determine the efficacy of pay for performance.  The groups will get their normal fee for service fee plus will get extra if they decrease Medicare payments by doing chronic disease managed care as well as preventative care for their entire Medicare population. 

Medicare on occasions does not know when they are well off.  the have proposed to eliminate about 100 procedures from the list the will be allowed do be paid if done in an ASC. These procedures will either have to be performed in the physician's office or the hospital outpatient setting.  Since most physicians will not upgrade their offices to allow for the necessary monitoring, the cases will be shifted to the more expensive hospital outpatient program.  Medicare will then be upset at the additional money it is paying out because of it's own regs.           Top

Malpractice

The med mal debate is beginning in North Carolina.  the first piece of legislation backed by 2 Democrats and all the republican members was placed in the hopper.  The bill is a copy of the California bill (MICRA) that has been so successful.  It includes the $250,000 cap on non economic damages, placing percentage caps without waivers on attorney fees, allowing the jury to be told of any insurance the plaintiff may have to cover medical injury, and payments graduated over time.    

Georgia is on its way to putting in place a med mal reform bill.  the Assembly passed a bill to cap non economic damages at $350,00 or just over 1 million if multiple defendants were involved.  The Senate defeated the measure by one vote.  There should be a compromise bill passed shortly.    Top

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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.