June 15, 2008 Legislation




In a telling blow to the AHA's hope for removal of physician owned specialty hospitals was a letter to the Senate Appropriation Committee blasting the "earmark" of the amendment to the war supplement spending bill. The bill even has earmarks for certain hospitals with good lobbyists.   The bill is currently at the House to consider prior Senate changes.  If the House passes it like it is the President will veto it.  There is not a veto proof majority approving the bill. There are some Democrats, like New Jersey's Frank Pallone, who speak AHA tongue so well state that unnecessary procedures are done at the hospitals.  Even the evil AHA wouldn't go that far.  They just want the same procedures performed elsewhere performed in their bailiwick so they can get the money.  It is all about money and nothing else.   

Sen. Grassley wants to look at the collection policies of the non profits as a way to reduce medical costs.  He is the Republican who thinks he's a Democrat.

The California Department of Public Health has fined three health centers after investigating patient deaths.  These were Gramercy Court in Sacramento ($90,000), Atherton Healthcare in Menlo Park ($100,000) and Care Center of Rossmoor ($60,000).        Top


The Senate Finance Committee will get competing bills to discuss regarding physician Medicare reimbursement.  Grassley the Republican who acts like a Democrat, wants as does Baucus an 18 month moratorium on the 10% decrease in pay.  The major difference is that Grassley wants a 1.1% pay increase for the physicians and Baucus wants 0.5%.  They need to get this to the floor quickly to avoid the cut and see Medicare physicians stop taking new patients.  

Baucus did not get enough votes to get out of committee.  Looks like Grassley will make it.  The hospitals paid alot and got alot.  They did not get anything relating to ultrasound imaging.  They did get the monies they were seeking as well as allowing the Joint Commission some well deserved competition.  It also allows payments for emergency health services for undocumented aliens through 2010 up to $200 million per year.   

It appears that the 10% decrease will go into effect since Congress as usual can not get its act together in a reasonable time.  There will be a rescission but CMS will need time to get their computers to figure out who has been paid the low amount and needs to be made whole or who has not been paid.  This will cause further confusion and delay.  Congress had six months but waited until the last moment to address the problem.  They never even took up the issue of the yearly charade of decreasing physician payments that will never happen.    

The problem will be to keep the physician payments fiscally neutral.  The only way to do that is to raise the money from some other source.  It looks like the source may be the Medicare HMOs who are now being paid the ridiculous sum of about 13% to 17% above standard Medicare rates for cheap care. Even the AARP is for cutting the rates to these plans since less than 20% of Medicare beneficiaries are in these plans.   Both plans on the table will increase physician payments for using electronic prescribing which is controlled by several companies.   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.