June 15, 2014 Legislation






CMS has agreed to pay for hepatitis screening in two groups.  The first is individuals who are considered high risk such as current or prior injection drug use or who received a blood transfusion prior to 1992.  The other is all boomers born between 1945 and 1965.  This is where the vast majority of Hepatitis C is present.  This decision brings CMS in line with private insurers.

The GAO came out with a report blaming physicians who self refer for possibly driving up healthcare costs.  This was true, according to the GAO, for internists and primary care physicians but not for orthopedists.  This is the fourth and last GAO report on self referring physicians.  All found that those that had a service referred to it.  The Democratic Senators that asked for the self serving report are planning to use it for going away from paying per visit to "value based", what that may be.

Medicare will now cover sex change surgery.  The surgery is now safe and effective and no longer experimental.  

The Center for Public Integrity has accused CMS of paying over $70 Billion too much to Medicare Advantage plans.  The plans, they say, increase slightly the level of patient risk scores.  A small increase in the score equates to mucho dinero to the MA plan.

The Senate confirmed Burwell to take the place of the incompetent Sebelius.  She started the job on June 9.  

The Senate has agreed on a bill for the VA system.  The bill gives vets the ability to go to private physicians or hospitals if they live 40 or more miles from a VA facility or can not get a speedy appointment.  It throws more money at the system by allowing it to lease facilities and to hire more physicians.  The bill also allows as the House requested the firing of incompetent managers but with some due process.  The money may be a sticking point in the House.  The House and the Senate have both passed bills and are now in conference committee.

California has fined to Medicaid managed care plans.  Contra Costa Health Plan was fined $20,000 for not using a dispute resolution process.  Care 1st Health Plan was fined $75,000 for problems with a patient getting care in 2011.        Top


UC Davis will start this summer a pilot program for an accelerated medical school.  The California legislature is attempting to put more physicians in the field quicker by shortening the curriculum in medical schools.  The attorneys know how to push physicians into the field and sue them but not how to take care of patients.  I wonder how the other states will take to having partly trained physicians come into their states.

The Florida Medical Board has said a physician is very dangerous.  He is diagnosing prostate cancer by MRI instead of biopsy.  The board had offered Dr. Ronald Wheeler to accept a one year and an $80,000 fine for his actions.  He also sent patients he diagnosed to a Mexican clinic for some type therapy based on the MRI diagnosis.  He is a consultant at the clinic.  

Seattle physician Arthur Zilberstein, an anesthesiologist, had his medical license  suspended after he was caught sexting during a surgery.  He had done this about 250 times that the Medical Board knows about.          Top 


Several California lawmakers are also busybodies and are working with the unions.  They sent an unsolicited letter to the rating group Truven to have Prime removed from their top 25 Health Systems and have tow of their hospitals removed from their top 100 Hospitals list.  Truvin declined comment but did state that their award winners were thoroughly reviewed prior to each study release.

Massachusetts Bridgewater State Hospital got a surprise visit from the Joint Commission and was put on alert to address concern within 45 days or risk losing accreditation.  The inspection was done for patient safety concerns after a series of articles in a local paper about the facility.  The facility is actually a medium security prison with men who are diagnosed as mentally ill.  The hospital does do seclusion and restraint by the guards.        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.