February 15, 2015 Legislation




The feds have now said that all electronic medical records will be interoperable starting in 2017.  This is to move 50% of the Medicare fee for service payment to quality-care providers by 2018.  This means the cheap providers.  Two days later the USA Today had a front page article on the physician response to the stick approach.  They hate it since electronic records do not help anyone at this point and are taking time away from clinical work.  

Obama's proposed budget, which all know will not even be read by the Congress, has in it a proposal to allow HHS the ability to negotiate for drug price reductions in Part D.  It would also decrease the patent time from 12 to 7 years.

The Obama budget would also squeeze Medicare and Medicaid beneficiaries by requiring co-pays on new enrollees who use home health benefits.  Of course, that means they may need longer more expensive hospital treatment. They would also reduce pay to teaching hospitals and small rural hospitals as well as HMOs.  In keeping with his socialist background he would also raise the amount the wealthy would pay for Medicare.  This in spite of the higher amounts they have already paid into the program.  As said above the Congress will not look at the budget.

The Senate unanimously passed the Clay Hunt Act to help reduce the huge suicide rate of the veterans.  About 22 die each day of suicide.  The Prez signed the bill.

Medicare has finally decided to pay for the use of CT scans to prevent lung cancer.  They are willing to pay for the preventative study if the patient has a 30 year smoking history and is between the ages of 55 and 77.

The Republicans are at it again, but this time with some thought.  They want to get rid of Obamacare and replace it with their own plan which keeps many of the good aspects of Obamacare and gets rid of some of the subsidies and mandates both individual and benefits.  The benefits and payments would be up to the state and not Washington.  They have yet to put into legislative language.

In something that I have been involved with for the last five years, the California schools have now mandated cardiac screening for all high school athletes prior to participating in sports.  It is about time.  In the last screening I participated in we screened 77 kids and found 5 that needed further follow-up.   

CMS has announced a new payment model for oncologists starting in 2016.  They will pay each oncologist $160 per month for six months per patient receiving chemo in exchange for having 24/7 outpatient centers to handle common complications instead of sending patients to the hospital.  Oncologists will also share with Medicare savings during the six month periods.  Oncologists will also have to have EHR, provide patient navigation and analyze data for quality improvement.  They will want to see less imaging and prescriptions.  CMS also will want your first born.     Top


California has fined ten hospitals for putting patients lives at risk.  The hospitals are:
Beverly Hospital $50,000 for allowing an inexperienced nurse to attempt to insert a NG tube five times with bleeding that required surgery to fix
JFK Hospital $100,000 for sending a liver failure patient to another hospital by car.
Kaiser Woodland Hills $50,000 for allowing a family member to give 19 doses of PCA in six hours which killed the patient.
Loma Linda University $50,000 when a physician misread an xray and a feeding tube went into the right lung instead of the stomach
Mark Twain Hospital $50,000 for leaving a towel inside the abdomen.  Patient died.
Palomar Hospital $50,000 when patient fell from bed and died
Rideout Memorial Hospital $50,000 patient died after receiving 10times recommended dose of methodone and no drug reversal
Southwest Healthcare $100,000 was kept in ER for stabilization instead of ICU
UC San Diego $100,000 patient death and panic button never installed
UC San Francisco $100,000 patient had multiple surgeries due to wrongfully administered chicken pox vaccine.

HCA Midwest Health has paid a fine of $15 million to settle allegations that it did not live up to its share of charity care over 10 years.  The payment goes to the Health Care foundation of Greater Kansas City.        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.