January 1, 2009 Legislation





In another article regarding CMS pushing physicians into writing prescriptions on line, the AP clarified the 2% bonus will only be for several years and then it's gone.  The 2% penalty will be until one changes to spending money for e-prescribing.  There are more physicians using the e-prescribing as long as the patient's pharmacy can receive the prescription. I continue to wonder why the major push, quality or money.  One tends to use cheaper drugs which saves money for the insurer with e-prescribing.  There continues to be push back by the DEA on triplicate drugs. 

The GAO has issued a report on the Democratic health reform proposals.  They are very expensive and would result in only modest savings.

HHS has issued a rule that will take effect prior to Obama taking office.  This concerns conscience protections for healthcare workers.  This protects physicians and other healthcare workers that for religious reasons do not wish to participate in abortions or dispensing abortion meds.  The Dems plan on passing legislation to get rid of the rule. 

The Congressional Budget Office (CBO) states that moving away from fee for service will save $5 Billion over the next 10 years.  If the government changes the sustainable growth rate it will cost hundreds of billions of dollars.  If primary care physicians were paid 75% of Medicare and a monthly per member fee they would make an additional $9.2 billion but cost the specialist $14.4 billion, making up the $5 billion mentioned above.  If payment rates were frozen as of today the government would pay $218 billion in 10 years.  If the current law is unchanged healthcare will make up 25% of the GNP by 2025.  About the only thing government can do to affect the bottom line positively and significantly is to raise taxes on sugar drinks and cigarettes.  However, if physicians do all the right things and patients begin to live longer the government will lose more money.   

Joe Biden stated that the new economic package that should be ready about the time of the inauguration will include help for those who lost their job and health insurance and for health IT.

The People's Republic of Massachusetts health reform is again going to cost more for the third straight year.  For those who do not get the state mandated standard they will be fined $1068 per year.  The penalty is tied to cost of insurance and these are continuing to increase because of the state mandate that insurance in 2009 include drug coverage.  This will apply to about 5% of the state's adults. 

The Republic's Governor has cut $9 million from the mental health budget. This will close multiple day care centers and day treatment centers.  Ah yes, government medicine is good medicine.

In one of the best bits of news in 2008 is the resignation of Roberta Kalafut from the presidency of the Texas Medical Board.  Now hopefully the attorney for the Board will do likewise.  It is hoped that the legislature will open hearings on the physicians targeted by the Board during her reign of terror.  

The NHS in Jolly Olde is increasing the drugs that are available for the end of life.  The drugs are only for about 7000 who have less than two years to live.  These drugs are high cost and will extend life for several months instead of curing.  The drug budget will remain the same so other drugs will suffer.  The author of the bill says this will have to suffice since to allow more people will cost too much.        Top


Senator Grassley is planning to target non profit hospitals this year.  He wants legislation to say how much charity care these must give, limit executive compensation and conflicts of interest to get the tax exemptions.  He is considering penalties on hospitals for excessive compensation or contracts tainted by conflicts of interest.   

The Joint Commission has issued a warning regarding computers and medical errors.  This is a sentinel alert message.  The JC states that 25% of all medication errors are computer related.  The technology depends on human users and they err.  GIGO.      Top


Pennsylvania has passed legislation to prohibit nurses and other healthcare workers, except physicians, from doing forced overtime.  The law prohibits any retaliation for refusing to work past one's shift.  The law also does not allow on-call time to be a substitute for mandatory overtime.        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.