July 1, 2005 Legislation





Illinois has a new law that states starting January, 2007 all hospitals and outpatient surgical facilities will need to post their costs of 30 procedures to be named later on line.  Along with the costs the infection rates, mortality rates and complications for the procedures will need to be posted on a state web site.          Top


California currently has a Department of Managed Care which oversees all aspects of the managed care industry, including patient complaints.  Now some regulators may want to switch some of the functions of oversight to NCQA, a private organization funded by the same insurers it oversees.  It may save some money for the state but I am not sure about the patient oversight aspect. 

Kaiser has been fined $200,000 for having an unsecured web site and not notifying California authorities when the security was breached.  This is the largest fine ever levied against an institution for privacy breach.  The site was set up for internal use in 1999 and never taken down.  It had patient names and lab reports and these were used without patient consent. 

It is had to believe that a Republican Governor is starting to sound like the Senior Democratic US Senator of the state.  However, in the People's Republic of Massachusetts nothing is surprising. Governor Romney has proposed a mandatory health care plan.  He wants all to be either insured or have a savings account.  Currently over one half million of the state's residents have no insurance.  This is only 9% of the state and the fourth lowest in the country.  The Governor did not address how to enforce his plan of compulsory health insurance.  The Massachusetts Hospital Association stated that the state must also pick up it's fair share as now the state pays only 70% of its mandated Medicaid bill.  The Governor also wants those people that refuse to purchase health insurance to face tax consequences and potential garnishing of their wages.  If the person is making too much to qualify for Medicaid but can not afford the insurance, the state will help with the premiums.  The question is what benefits would be covered.  

Three Democratic Senators are placating their money sources, the unions, by introducing a bill that would require all states to report the names of all companies with 50 or more employees who have any employee getting Federal money.  I wonder if this include Medicare?  In realty, this bill is against Wal-Mart and is sponsored by the United Food and Commercial Workers Union.  It would be only fair to have the employees pay for the reporting out of their union dues. 

The AHA in their usual all for them approach has sent CMS an official response to the proposal to make it harder to for the hospital to use post-acute care transfer policies to make money.  The AHA is also against the proposed rule to prohibit critical access hospitals to be more than 250 yards from existing sites.

The AHA was rebuffed by Congress who turned down their wanted amendments to a spending bill. It is nice to see Congress and CMS doing what is right and not what those who bribe (lobby) want. 

Canada has decided their southern neighbor has taken all the medicine they can.  They are planning to restrict the online sale of prescription drugs to the United States, by restricting the ability of Canadian physicians to co-sign prescriptions to those they have not examined or write prescriptions to those Americans not in Canada.  

In North Carolina, the legislature is getting rid of an unnecessary tax break for HMOs.  The HMOs of the state have been paying less than other health insurers.  This would make all on an equal footing and would cost the HMO industry another 1.9%.  The HMO industry is stating that if taxed, they will pass it on to the consumer.  That's fair.         Top


The left hand doesn't know what the right hand is doing.  The California Employment Development Department (EDD), the state tax collecting arm, has decided that locum tenens are employees of the company that hires them.  They are leveling back taxes on the companies.  Of course, California also has a statute that physicians may not be employees of companies now owned by physicians.  The EDD doesn't care that the physicians are considered independent contractors and pay their own taxes.  The legislature has now a bill pending to wipe the slate clean regarding any back taxes owed and declaring physicians as independent contractors.  None of the companies are paying the taxes.

The OIG has commented on a lab's payment to a physician office and the giving of physician free supplies fro drawing patients' blood for testing.  This would be payment for referral and not allowed.  Since Medicare already allows $3 per patient for a blood draw, the additional amount would be for an inducement for referral and prohibited.        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.