July 1, 2006  Legislation

Loss of Money

Privacy

Physicians

Healthcare

Parole

Stark Law Changes

Accreditation

Loss of Money

California lost $2.65 million in federal funding due to their not collecting information required by the CDC.  This money loss was to partially fund breast and cervical cancer screening in the state.  The computers are there.  The information is there.  The transfer is not. The money will be replaced by using the tobacco money that was earmarked for other things.  Somebody loses.       Top

Privacy

Sen. H. Clinton (D. NY) addressed the liberal legal group, American Constitution Society for Law and Policy, on privacy.  She wants a privacy czar in the White House to help keep leaks like the VA disaster from occurring.  She had her personal life divulged during her term as first lady but that was her own and her husband's doing.  She forgets that her husband signed into law the original HIPAA which would have so onerous that no information could have been given to treating physicians or to anybody for payment or internal operations.  This would have crippled the US healthcare more than what she would have done if her ill fated healthcare plan would have been enacted. 

She also, in another speech, touted electronic medical records.  She equated not having EMRs with not getting what we pay for in healthcare.  She did not address the potential for death increase with EMR nor the cost.  

CMS is proposing a change in the physician fee schedule.  This would include an increase in the E and M codes as well as a change in the practice expense methodology.  This would start in 2007.       Top

Physicians

The House Ways and Means Committee led by Republican Bill Thomas of California has voted out a bill to prevent reducing Medicare payments for providers.  This would reverse the current Medicare Sustainable Growth Rate formula which is supposed to reduce physician rates each year but has never gone into effect.  This would end the yearly Congressional hassle of reversing the current law and allow Congress and physicians to focus on other problems. 

A new Washington law bans the use of cursive for prescriptions by physicians.  The prescription must be printed, typed or electronically generated.  

Governor Jeb Bush has signed a law that would restrict how many satellite offices a physician may have.  Primary care physicians may only have four offices.  Specialists, outside of Derm, could have two.  Derm can have two offices but they must be within 25 miles of each other if in the same county or within 75 miles if in different counties.  This will be reduced to one office in 2011.  All primary care physician are limited to doing aesthetic service to their primary office.  Plastic surgeon and Dermatologists can do them in their satellite offices.  Spas are a satellite office.       Top

Healthcare

On the left coast, the mayor of San Francisco in collaboration with the city Board of Stupes, has stated that San Francisco will cover all its inhabitants for their healthcare.  The plan is place the people in a city HMO and to finance it by a voluntary monthly co-pay by the covered citizens that varies between $3 per month to $200 per month depending on income.  Also paying will be taxes and businesses will also be forced to contribute an hourly premium (tax) on each worker, up to $1.60 per hour per employee. The measure would not cover anyone who goes for care outside of the city. The covered people would have to go to city clinics and the public hospitals.  The private physicians, even those that take Medicaid, will not have to take this insurance.  He will also lose some of his tax base when some of the small businesses fold or leave the city.   

San Francisco's city controller issued a report on the hardships the Board of Stupes' health plan would be on small businesses.  The Board said the report was not accurate and small businesses would rebound.  The Board is anti business and pro socialistic. 

On the other coast in the People's Republic of Massachusetts, the business community awaits the details of the state plan to cover all the uninsured and what the terms "reasonable and fair" mean in relation  to how much a business is now paying for healthcare.  Those that are already paying will not be assessed the $295 per employee tax.   

The Republic's hospitals are also upset that physicians have found a way to take their MRI business out of the hospital.  The Republic used to give out exemption letters for MRI's to hospitals.  Some hospitals have sold these to physician or for profit groups who have started private MRIs.  One hospital was upset that patients were taken away but they still have a 1-2 week wait for the exam instead of their usual 2-4 week wait.  patients are able to be seen and diagnosed quicker.  The Senate has started an investigation into the self referrals of MRI's.          Top

Parole

Harvard Pilgrim HMO has been released from parole.  Six years ago in the People's Republic the insurer was broke and losing $200 million annually.  The state put it into receivership.  It, like other HMOs, have begun to make money by increasing prices and paying less.         Top

Stark Law Changes

CMS has changed the definition of radiation services under the Stark law.  Medical people have until January 1, 2007 to unwind their involvements in nuclear medicine, both therapeutic and diagnostic.  No physician may refer any Medicare patient to any nuclear medicine unit that he/she has any direct or indirect financial interest.  The only way if the referral falls into one of the enumerated exceptions such as rural or group practice.        Top

Accreditation

CMS has delayed the application of TUV Healthcare Specialists (TUVHS) due to the potential for a massive switch of hospitals from the Joint to the new deeming organization.  TUVHS did not have the manpower to cope with the potential switches.  The organization will not be given deeming status until January. 

The United Transplant Board approved the plan of St. Vincent's Hospital in Los Angeles after their liver transplant fiasco.  The hospital had to pay $412,000 to cover the administrative and legal costs of the transplant network and it has cost the hospital over $1 million to make the improvements.  This is the hospital that made a bunch of money for putting a Saudi ahead of others for a liver transplant. The network will not lift its sanctions until the hospital proves it can continue its improvement.       Top

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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.