June 15, 2007  Legislation

Medications

Plan B

Medical Boards

Healthcare

Hospitals 

Medical Malpractice

Insurers

Medications

New York's new Governor Eliot Spitzer has spoken out in favor of medical marijuana.  The legislature of the state has taken up the issue. The Assembly has passed the measure but it is doubtful if the Senate will pass the measure prior to the end of this session.       

The Connecticut legislature has passed and sent to the female Republican Governor a bill that requires all hospitals to offer rape victims emergency contraception.  The bill allows a third party to give out the medication. 

Texas has overruled the Governor's ruling that all females must receive the HPV vaccine for entering school.            Top     

Medical Boards

North Carolina is considering adding lay members to the Medical Board.  There is also a suit filed to prevent the Medical Society from nominating the members for the Board.  In the past 10 years public members of state Medical Boards nationwide have gone from 10% to 24%.      

In California the fight over the Chiropractic Board continues.  The legislature is considering a bill to add public members to the Board, all appointees be confirmed by the Senate and permit the Legislature and Governor to amend the Chiropractic Act in the future.    Top

Healthcare

In a recent letter to the MedPAC, it was noted that for the same service the Medical Advantage programs are being paid 12% more than regular Medicare. 

A bill has been proposed in Congress to not allow CMS to pay physicians for billed services if the physician has not paid owed federal tax.  The bill would also allow the recovery of child support owed as well as student loans.   

The VA has been caught with its hand in the cookie jar.  They exaggerated claims about the quality of its health care system.  

Physicians will be monitored by CMS for their use of resources.  This will only focus on money and not quality of care and will be based strictly on claims data.  This will also bundle episodes of care.  This is another poor designed method to reduce costs by fear and without any mention of quality. 

The People's Republic of Massachusetts has come to grips with reality and states that they must decrease the utilization of resources in order for their magic bullet of universal healthcare to work.  The idiots at the State Senate want to mandate electronic health records without any funding.  They also want to give financial incentives to those who go into primary care and not use resources.  To date, nobody knows how much money any proposal will save, if any.    Top

Hospitals 

A new CMS ruling states that all physician owned  hospitals, not just specialty hospitals, must disclose to all patients a list of all physicians owners on the medical staff of the hospital.  The CMS also wants all physicians who are owners of hospitals to tell all patients referred to that hospital that they are owners of the hospital.  Physician owned hospitals are all hospitals in which a physician has any financial finger in the hospital.  

CMS has put into the Conditions for Participation for hospitals that all hospitals to provide emergency services, even those without an emergency room.  They must be able to evaluate, treat or transfer patients and cannot rely on 911 in lieu of providing services.

CMS has proposed to cut about $25 Billion over five years from hospital payments under Medicare.  This effects both the billing and the capitol improvement reimbursements.    

Paradise Valley Hospital in Southern California has been deemed to have corrected its deficiencies and will be allowed to keep receiving Medicare payments.

The Joint has finally caught up with its boss, CMS.  They have modified the PC 12.90 standard to let nurses do the one hour evaluations in patients in restraints and the Standard PC 2.120 allowing H&P to be done 30 days prior to admission with updates just prior to admission.  

Kaiser in Los Angeles has settled with the State in a criminal and civil case regarding patient dumping.  The HMO will provide more training for employees and allow for monitoring of its progress.  The HMO apologized for the patient dump.  Kaiser will also pay $5000 in civil penalties, $50,000 in investigative costs and $500,000 to a charitable institution to fund electronic systems to monitor beds in shelters.  If the HMO reneges in any of its promises, the court can levy fines or jail time.

A second Los Angeles hospital has agreed to the terms dictated by the Kaiser settlement with California regarding patient dumping.  Hollywood Presbyterian Medical Center has also agreed to get new discharge protocols and better training for its staff.      Top 

Medical Malpractice

The North Carolina legislature has passed a bill that says nothing.  It states that if both sides submit to binding arbitration, the total monetary damages can not be more than one million.  How many cases where the potential for the damages are at least one million do you think will be sent to arbitration?  This is to take the place of consideration of a cap on pain and suffering.    

Illinois has again come into play.  A new proposal in the legislature would allow family members of someone who has died to get damages for "grief, sorrow and mental anguish." This is a way to get around the $500,000 cap on non economic damages.     Top

Insurers

Nebraska has fined and United Healthcare has paid $650,000 for the companies claims processes.  This is the second and largest fine for the company for their attempts at stiffing those who submitted claims.        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.