February 15, 2011 Legislation




The House has passed a permanent "doc fix" for Medicare payments.  The bad part is they attached it to the bill that would repeal Obamacare.  This will pass the House but never the Senate nor the veto.  They will need to carve out a separate bill and have it passed.  The real problem is how to come up with $300 Billion over ten years to replace the money lost by the permanent fix.  The latest thought is to cut spending in the Obamacare bill to pay for it. 

Obama has proposed in his budget to Congress a two year "doc fix".  This would be paid for by reducing the Medicaid provider tax threshold, reducing Medicaid outlays for DME and speeding generic drugs to the market.  This would raise $62 Billion and the doc fix would cost $65 Billion for the two years.  He hopes after two years to have a permanent fix but he may not be in office and has no idea how it will be financed.

The House passed a repeal of the Obamacare program by a 245-189 vote, along party lines but with three Democrats also voting with the Republicans.  Senator Reid said the Senate will never vote on the bill.  He was challenged by the Republican leader.

Senator Reid had to eat his words but got the last laugh.  There was a vote on the Obamacare repeal in the Senate and the repeal was defeated as expected.  Those Senators on both sides of the aisle are now on the record and will have to defend their votes in 2012.

The Senate has repealed the hated 1099 reporting requirement by a vote of 81-17.  This now goes to the House.  Obama has already stated he would sign it.  It will be paid for ($19 Billion) by requiring the Office of Management and Budget to find the funding in unspent but appropriated funds.

Possibly the next to go is the tax on medical devices that is in the Obamacare law.  This is an additional 2.3% tax that will hurt the medical device industry.  Thee is no offset in the proposed bill.

The GOP is also planning to dismantle the feared Medicare advisory board which would essentially bypass Congress in setting Medicare rates.  This will pass the House with some bipartisan support.  It's fate in the Senate is more precarious. 

The above Board has recommended that Medicare recipients pay more money for home health care.  The vote was 13-1.  According to Obamacare, if Congress does not act on the recommendation it will become law and binding on Medicare.

The House Republicans and one Democrat has proposed a change in the med mal laws on a federal basis.  The proposed law would set a $250,000 limit on non economic damages, has a three year statute of limitations post injury and sets punitive damage reforms. This would save the federal government $54 Billion over ten years. 

In the near future the government will need to pass a bill to allow spending for the remainder of the year.  House Republicans are considering stripping all funding for reform.  The Senate would not go along with that and it is possible that without a compromise the government will shut down.

The Senate Republicans are looking to allow states to opt out of the Obamacare program. They feel it is wrong to allow waivers for insurers and not states.

The House Republicans are looking to shut down abortion spending by changing the definition of rape to include the word "forcible".  The majority of the bill has been law for many years but requires yearly renewals.  This would make it permanent.  This is going against the Senate Democrats and will not pass.

The Obama administration is getting into the act by considering requiring insurers to offer free contraceptives.  The question is whether or not this is a preventative health service as defined by Obamacare.   

If one wants to know why healthcare costs so much one need look no further than California's bill the would require maternity coverage for all individual policies sold in the state whether the people want it or not.  

Again the People's Republic of Massachusetts with the prototype for Obamacare has needed more money.  They have received an additional $150 million to keep their ill thought out program afloat.  This is beyond the already given $300 million for the program. 

California has passed more laws.  One is to allow the Attorney General to enforce the federal law that requires insurance companies to spend a certain percentage of their money on medical care.  The other is to require insurers to give a 30 day notice prior to any rescission.  This also gives time for an appeal of any decision.   Top


Physicians Beware!!!  The meaningful use rules that you must abide by to get paid extra states that you only have to use five of the ten required rules.  However, your program must have the capacity for all the rules not just the ones you are using. If you don't purchase the entire system you will not be certified and therefore will not be eligible for any money.       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.