January 15, 2016 Recent News







Who is one of the biggest HIPAA screw-ups??  Kaiser Permanente.  ProPublica says the HMO repeatedly violates the law with little or no repercussions.  They had 146 reports of problems in the past four years.  The OCR is only fining those with massive breaches not the multiple little ones that hurt the individual.

ProPublica has released a report about the VA and privacy in general and Minnesota's VA in particular.  It shows the VA is just as bad as private hospitals in maintaining privacy under HIPAA.  As is usual in the government the ones who do the stupid things do not get disciplined but may get promoted.  The Peter Principle at work.        Top


The University of Washington has a new physician union to bargain with.  The interns and residents have joined and are wanting money and benefits comparable to the lowest paid physician assistants.  The hospital said that they are being paid enough and are earning between $53,268 and $69,792 a year.  They also believe that their poop doesn't stink and that the residents should be happy to be at the wonderful hospital.  The city of Seattle is now on the side of the physicians.

St. John Providence Heath System has fired 68 nurse anesthetists who have refused to be hired by an outside firm.  The hospital wants to outsource their minions to get rid of the headaches of being an employer.  The nurses do not want to join the outside firm run by an anesthesiologist with privileges at the hospitals not because of pay but the physician.

The San Francisco Business Times reports that in the Bay Area Marin general Hospital has partnered up with Royal Philips in a $90 million 15 year partnership to provide the hospital with advanced technologies such as imaging, telehealth along with clinical informatics along with consultations.          Top


The NYT says that many would rather pay IRS penalties than get the high price Obamacare insurance.  It continues to be much cheaper to remain healthy and pay the fine than to get the insurance.  The numbers of those not getting insurance is slowly shrinking.  Last year it was down to 10.8 million people eligible for Obamacare going without.  The holdouts are the healthy ones and are the ones the insurance companies are counting on to make money.  

The bill to gut Obamacare would cost $42 billion less than originally thought and would save the taxpayers over half a trillion dollars over a decade.  

The Washington Post reports that the feds are incompetent.  They can not verify that Obamacare did not pay subsidies to the people who did not pay their premiums.  They rely on insurers to do their work.  HHS agrees that they should be tracking this.  Duh!!!!

Some insurers in large cities are giving patients free doctor visits.  They hope this will lessen hospitalizations.  Of course, with no skin in the game many will use this to over utilize physician visits.  Some can do this if they own the physicians and others will increase premiums.

The feds are paying for medical people to hook patients on Medical and Medicaid to needed social services.  They will fund with $157 million up to 44 experiments over five years.  

The administration is optimistic about reaching sign up goals in Obamacare.  They made their expectations low enough to reach them.  The young people are signing up in the same percentage as they had the last two years.  Insurers want more of these.  New consumers were about 29% in healthcare.gov but only 19% in the states. It seems like the black population is still not enamored of the law and are not signing up.  Latinos are somewhat better.

About 43,000 people have just lost their Obamacare subsidy because they failed to file a 2014 tax return. They had been sent reminders but just didn't care.  Next year those that do not file the form comparing their income to their tax credit will also lose their credits.

The feds will start to crack down on those who attempt to enroll in Obamacare only when they have a major illness.  They say that some special enrollment periods will be eliminated.  They did not specify which ones.

The radiologist have stated that the new mammogram criteria of the idiots at the USPSTG have decided upon will cause thousands of women to die needlessly of breast cancer.  Most physicians will ignore the recommendations and still advise women to start getting mammograms beginning at age 40.

CMS has said that even thou the MU will be phased out this year about 209,000 physicians will see a 2% reduction in their Medicaid payments for 2016 due to failing to meet standards in 2014.  The majority will get a reduction of less than $1000.

Obama is nothing if not stubborn.  He knows that the red states will not put in Medicaid for Obamacare.  The nineteen states have now been told that no matter when they decide to  expand Medicaid the feds will still pay the first three years.  He only forgot one thing, that in order for that to happen it has to get through Congress.  No way.

California is in serious financial trouble and really doesn't know it.  They have a surplus in the budget but now one in three are insured by Medicaid.  This is huge and will bankrupt the state.  Prior to the surge in enrollees the plan was underfunded and very few physicians took the insurance.  This forces the Medicaid population to the hospital ED for care which costs huge money to the program.  So far the price tag has risen from $59 Billion to $91 Billion and this is with the very low fees paid.  As of now the state only pays minimal for the care but this will change in 2017.

Great Britain is now under the first physician strike in 40 years.  The junior doctors are striking over the government's new weekend rules.  The doctors would get an increase in basic pay but they would get paid less on the weekend.  Officially they only work a 48 hour week but that is calculated over a 26 week period so they can work long stretched especially on the weekends.  The physicians believe that is unsafe.    This caused the postponement of about 3500 non emergency surgeries.  This will be repeated again in several weeks but for a longer time.  This will be followed by a one day strike where no care will be rendered.        Top


Aetna is the third insurer to jump ship off the sinking America Health Insurance Plans.  Marilyn Tavenner, the former head of HHS, who is now the head of the AHIP defends her turf.

California has fined the LA Care Health Plan $150,000 for paying the wrong interest payments and did not respond timely to over 20% of disputed claims.        Top


The NYT has a great article about Portland, Oregon's PeaceHealth Sacred Heart Medical Center.  The article tells the story of a newly hired administrator trying to make his bones and wanting to outsource the hospital owned hospitalists to a management company.  The hospitalists said o and finally became a union to the chagrin of the hospital.  The administrator has since left but the problem remains of attempting to reach a bargaining agreement with two sides that see the same thing so differently.  The hospital thinks of money and the physicians think about work life balance.  It has now been about one year and the two sides are still not in alignment.  

In much of the same vein, a physician Dr. Robert Steves, was fired from his position at a Family Care practice in Tennessee for unknown reasons.  He has gone against the non complete clause on the advice of his attorney and set up a competing practice in the same town.  He is using money raised by some patients on a Go Fund Me account to start the practice.  It should be interesting to see what comes of the practice and the expected law suit by the hospital that let him go.        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.