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Some things that happen in the People's Republic of Massachusetts are beyond ridiculous. Their latest bit of stupidity is to license pharmaceutical representatives, who have no medical or any other training. Why? So they can regulate what they offer to physicians for inducements to use their products. The national PhRMA rule is not good enough for the Republic. They are also looking at criminal penalties in the sharing of information between the agent and the physician regarding the risks and benefits of a medication. I wonder how this will be enforced? Will they hire people to monitor the discussions? The bill would require all reps to have courses prior to licensing and then have continual education courses. Of course, there would be a fee associated and that money would go to the Attorney General and the Board of Pharmacy.
At the far side of country in distance but not leanings, the California Medical Board has been charged by the Legislature to revamp its structure by 2008. The Board hopes to come up with the proposed revamp shortly. They are considering having an Administrative Law Judge make the final determination about a discipline proceeding and not just a recommendation back to the Board who takes final action. They are also considering combining the two division of licensing and discipline into one section for both and reducing the size of the Board from its current 21 persons. Top
Staying with the People's Republic. They are looking for ways to reduce the state's payments for healthcare and to boost the presidential stripe for the Governor, Milt Romney. The newest thing is to force the non custodial parent, especially the fathers of children who have never married the mothers, to pay for the children's healthcare. The state would take up to 5% of the salary for payment into MassHealth. It sounds good but there is only so much money and many will not pay anything to the mother or child if they have to pay for healthcare. This will play well with the potential conservative wing of the Republicans in Romney's run for the Presidency.
Senator Grassley is calling for an IRS investigation into tax exempt organizations. He wants to make sure the organizations, including hospitals, are serving the public interest. In hospitals, the Senator wants special attention paid to the definition of charity care, the definition of joint ventures, the payment of excessive compensation and the definition of community benefit.
The community hospitals are trying to deflect criticism from themselves by again pushing CMS to limit specialty hospitals. CMS has decided to cut the payment of certain procedures at all hospitals and wants to see how this works. The hospital association doesn't want this and just wants the whole hospital exception to be tossed.
A new law goes into effect in July that requires states to make sure those that receive Medicaid are truly entitled to receive the benefit. The states will need to see proof of citizenship within 45 days or 90 days if they are disabled. This replaces the past declaration of proof of citizenship that was required. The new law states that while the Medicaid recipient is attempting to get the required information, they will not lose their Medicaid eligibility.
California has decided that since the final regs are not in place they will delay implementation of the immigration law. The state will hopefully use that time to inform all Medicaid recipients of the new regs before they start removing them from the program.
A proposed new regulation by CMS has drawn the ire of the AHA, who is not doing well lately. The proposed reg will force the hospital to give each Medicare inpatient a notice of their appeal rights the day prior to their discharge. The hospital association says this may trigger more appeals. They forget that that is the reason for the reg. I do agree that the CMS proposal is not well thought out and the hospitals have a legitimate gripe on the timing of the required notice. Top
JCAHO has published on its website the proposed 2007 changes for the hospital medical staff. It details what must be in the bylaws and how credentialing must be done. It would behoove all those interested in this subject to see the changes.
Hopefully, there will finally be another alternative to the above self serving organization. TUV Healthcare Specialists will hear this month if their application to join JCAHO, AOA and the state Departments of Health in the accreditation morass will be accepted. TUV will add ISO 9001 process to the CoPs. This is alot more applicable to patient care than the antiquated and ever expanding JCAHO self dealing organization.
JCAHO is now in the business of running hospitals. They are requiring that all hospitals give flu vaccinations to all employees with patient contact. This would be annual and include all medical staff and employees. The hospital would also need to train all the independent physicians and staff on the flu and keep records of flu cases, documented or not. Still another reason to not be accredited by this organization. Top
The Feds have stated in a new rule that in a public disaster, informed consent will not be necessary and will be waived by law to run experimental blood tests to determine the cause of the disaster or how to treat the victims. Some privacy gurus think that all should wait until adequate informed consent can be gotten from people that are not present. Somehow, I don't believe the gurus have common sense. Top
The Arizona Governor has vetoed a law that would have raised the standard of proof required to sue an emergency room physician from the preponderance of evidence to clear and convincing. Top
In another guideline that has no significance, the AMA has stated that physicians, especially psychiatrists, can not participate in prisoner questioning. This supposedly undermines the physician's role as a healer and he/she loses trust. Of course, those that want to will use it as a crutch and those that don't, will ignore it as it is without meaning.
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.