June 15, 2011 Legislation





Maine's Senate passed and sent to the Governor a bill that will allow interstate health insurance purchases.  It will not allow large increases in rural insurance nor allow travel long distances for care.  It is for individuals and not groups.  

Maine has a new law creating a new high risk pool and allowing smaller companies to band together to get better insurance rates.  They hope to drive costs down with this approach, something that Obamacare has not considered.  There will be a surcharge of $4 per year on every person in the state with insurance to help pay for the new entity.  Individuals will also be able to buy insurance from insurers in surrounding states as well as Maine.  

San Francisco is at it again.  This time some crazies want to ban all circumcisions in the city.  It actually garnered the required 7500 signatures to make in on the November ballot.  Of course, it is illegal as it is against religion.  It also is stupid since it has been shown that circumcised men pass less HIV on to their spouse. That is the basis for the AUA sending teams of urologists to Africa to do circs at the behest of the governments. 

Starting in September health insurers will be required to tell the state regulators any time they raise premiums by 10% or more.  However the law (Obamacare) does not give any power to the regulators to regulate.  The law only states the insurers must post their reasons for the increase and tell the public the reasons why.  There is nothing in the law that after they disclose the insurers may still raise the rates as much as they want.  If the state already has a law allowing the regulators to order less of a raise that law holds over Obamacare.   

The rules have said those with pre-existing conditions and not having any health insurance for the past six months could apply for and get health insurance.  Almost nobody in the country did since the rules are strict and the cost astronomical.  HHS is like any commercial venture, when no one buys you lower the price.  The feds have lowered the price by up to 40% in 18 states and have  changed the rules so all that is needed is a physician letter stating they had a pre-existing condition in the past year.  This program is to run thru 2013. 

The government's ACO program was so flawed that no one wanted to sign up for the pre program.  It should be interesting how many sign up for the still flawed program before the July 18, 2011, deadline for an early start in October.  The costs to start up an ACO is huge and the rules make it unlikely to get any money back.   

CMS will give more waivers for not penalizing physicians 1% of their Medicare billings if they don't have electronic medication prescribing.  Those that would be spared the penalty are those who have certified electronic medical records but not the prescribing part.

The Medicare Trustees are sounding the alarm loud and clear, there will be no money in the program unless something drastic is done.  At the current rate the program will be exhausted five years earlier than predicted last year.  The new end date is 2024.  It is also gobbling up more and more of the GDP rising to 5.2% in 2030 up from 3.6% in 2010.  These figures are for Part A and not B since B is self paid.  This will lead to drastic reductions in benefits for those entering the program if the program is not changed.  It should be noted that the above Trustee report assumes that the SGR remains in place.  If it is overturned as all expect then the Medicare is in even worse straits. 

The Senate decided that they do not want to touch Medicare so they voted 40-57 to turn down the Ryan House budget proposal.  They then voted unanimously to turn down Obama's budget as well.  

States continue to find ways to increase costs for patients.  New Jersey just passed a law that all newborns must have a pulse oximetry before discharge to pick up heart defects.

California is on the verge of passing a bill that will allow state regulators to reject or modify health insurers premiums.  This may be the reason Blue Shield recently stated it would only make 2% and refund almost $200 million to patients.  The bill passed with no Republican votes and some Democrats refusing to vote.  The insurers state that the bill will drive down access. 

California regulators have fined another 12 hospitals for endangering patient lives.  The hospitals are Palomar Medical center for giving 33 times the dose of PCA to a patient who died. Pomerado Hospital who had a patient fall out of bed and fracture his skull.  Sharp Memorial Hospital who killed a patient by giving an overdose of a medication.  Dominican hospital who left a patient on a vent unattended.  Contra Costa Medical Center for giving a patient a wrong medication. Promise Hospital for giving 10 times the normal dose of a med to a patient.  Anaheim Medical Center who had a stent inserted in a wrong ureter.  Emanual Medical Center for giving a medication without making sure the patient could tolerate the drug.  Kaiser Hospital in San Francisco for leaving a foreign body in a patient.  Mills Peninsula Hospital for leaving a foreign body in a patient.  Other hospitals with foreign bodies include a 12 inch long retractor at Scripps Memorial and a 28 inch long guide wire at another Scripps Hospital. 

Vermont's Governor has signed a law making the state the first publicly financed health care system.  It is close to a single payor system with hospitals and physicians billing as one entity.  All state residents would be eligible for coverage by the state.       Top


The Texas legislature has passed a bill allowing rural hospitals to hire physicians.  Prior to this it has been against the law for physicians to work for any person or corporation not owned by physicians.  The law specifically states that hospitals that do hire physicians can not have any policy that takes away from physician autonomy.  There must be a chief medical officer that is tasked with informing the Texas Medical Board when the hospital hires a physician and if there are any policies or any interference from the hospital.  The medical officer is designated by the medical staff and approved by the Board.

At Northside Hospital in Tampa Bay, Florida, the doctors are infighting.  One doctor, a nephrologist, has complained to the state medical board about a hospitalist not calling in specialists soon enough to save a patient. The hospital is defending the hospitalist, an employed physician.  The cardiologist called to see the patient has concerns when the hospitalist is employed by the hospital instead of being independent.  He states correctly that the hospitalist may be more interested in the length of stay and not in ordering tests that cost money for the hospital.  The nephrologist got the hospitalist canned but too late for the patient who died.

Georgia has a new rule stating that all physicians must tell the medical board whether or not they have med mal insurance.   The board will put that information on its web site.  The state does not mandate insurance to practice.  

The Missouri legislature has sent a bill to the Governor for signature that would give the medical board more power to discipline physicians. The bill originally would not give physicians the right of appeal to an administrative judge.  That appeal is now going to be routine. 

Another legislative body with no medical knowledge is planning on making medical law.  The New York legislature is looking to ban all ties, and jewelry in order to prevent infections such as MRSA.  The bill would also consider other dress codes such as "bare below the elbow."  Many believe medicine should be left to medical professionals and not lawyers.

Optometrists won the right in Kentucky to do laser surgery for some glaucoma surgery.  They are now going after other states for the ability to do surgery without adequate training.

The feds have paid $158 million to date to physicians to adopt EMRs.  Have you received your money?         Top


In a proposed rule HHS will give patients the right to know who looked at their electronic medical records.  Currently that information must be tracked but does not have to be given to patients if asked for.          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.