|
|
Although this is a legal issue I am putting it here since it is also a legislative issue. The United States Supreme Court has in general given an OK to Obamacare. They let the mandate to get insurance pass as a tax, even though the legislature and the President told everyone it was not a tax. The only restriction came under the Medicaid section where the Court put a mild restriction on the feds. The Medicaid expansion is now optional for the states. A telling statement in Justice Roberts statement was "it is not the Court's job to save the people from the consequences of their political choices." CMS has made some dramatic changes to its rules. There is no more federal "48 hour" rule where verbal orders need to signed in that length of time. Also, covering physicians are now allowed to sign for the physician of record. However, if states require the above then hospitals must still follow those rules. The new CoPs also take away the need for training for blood transfusions. Now they must be administered according to state law and hospital rules. Hospitals will no longer, according to federal rules, be required to report patient deaths if they occur while the patient is only in two point soft restraints. The hospital must keep a log of incidents. Hospitals are now given the option of pre-printed or electronic orders if (1) they have been approved by the medical staff, pharmacy and nursing (2) they follow national guidelines (3) periodically updated and (4) being authenticated. Since it is an option hospitals may take their time developing protocols. Hospitals also have the option to develop protocols for patients to take their own meds. As you already know, hospitals do not have to have medical staff people on their Boards. This requirement was removed. MPAC, a Congressional agency, has recommended that rates be raised for those Medicare patients that purchase supplemental policies to cover their deductibles and the 20% of Part B that Medicare does not pay. It recommended a 20% increase in payments along with a $5000 maximum out of pocket annual cap. This is to have some of the burden of rising Medicare costs fall on the beneficiaries and not just on the providers. The report also asks for an increase to $500 for the deductibles for both Parts A and B. NICE of England continues to show the way of the Obamacare health potential here. They have denied Zelboraf, the treatment for melanoma for cost alone. There is no doubt of its efficacy and uniqueness. Some things are hard to believe but a court in Cologne, Germany, stated that ritual circumcision is now illegal. This only applies to this district. It is unfathomable that the government is paying twice for healthcare for Vets. Those that are on Medicare Advantage are having their care paid for by Medicare and then also by the VA system. This is costing $13 Billion. Federal law prohibits the payment of money to the VA from the Medicare system. It does not prohibit the reverse but it is in the too hard category. There are currently almost one million Vets doubly insured. Top Medicare has invalidated about 23,000 physicians and other providers who have not revalidated their Medicare numbers. This could go as high as 120,000. by next year. The Governor of New Hampshire has vetoed a bill that would have changed the way med mal is handled. It would allow a voluntary choice by the "injured" to not go to court in exchange for their medical bills and lost wages to be compensated. They would not be compensated for pain and suffering or lost future income. Top The AHA has clout. They have persuaded CMS to hold off on one the contentious COPs. There is no longer, at this time, a mandate to have a physician on the hospital board. Dr. Annette Bosworth is taking on the South Dakota Medical Board. She has publicly taken them to task for their potentially illegal questions on the physician's health, both physical and mental. She feels the questions violate the ADA and they probably do. She has had a run in prior with the same Board, was fined $5000 which she never paid and her license was renewed anyway. The Board need to get it's act together as they have a shaky past and will be taken to task over the First Amendment rights of Dr. Bosworth. They are a governmental agency and therefore must conform to the Bill of Rights. Top Alaska Medicaid screwed up big time. A portable device was stolen from a car of an employee. It had the information about patients on the device. In the course of their investigation the feds found that Alaska did not have policies and procedures in place or done much else in the HIPAA compliance arena. Alaska will pay a fine of $1,700,000. 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.
|
|