March 15, 2013 Legislation



The National Commission on Physician Payment Reform has added another log on the fire to get rid of fee for service and replace it with the nebulous quality pay.  This commission was started by the internists and is headed by surgeon and former Senator Bill Frist.  The cost of getting rid of the SGR along with the fee for service would be $138 Billion which is doable.

For another lesson on why the government can not be trusted to run medicine, the GAO ha found that CMS paid Medicare Advantage $5.1 Billion too much from 2010 t0 2012.  They screwed up on the risk adjustments.  They do not intend to ask for the money back.  Without knowledge of the above CMS is cutting MA plans by 2.3%.  It should be more.

April Fool!  The physicians will receiver their 2% sequester cut starting that date.  It seems interesting that CMS can do this but not pay the primary care physicians on time for their Medicaid patients.  It should also be noticed that although the cost of running a medical office has increased by 20% since 2001 the Medicare increase in pay has been a paltry 4%.  The 2% reduction will also go to patients who pay for their care and are reimbursed by Medicare. 

HHS states they recovered $4.2 Billion last year on Medicare fraud.  Sounds good but it is actually a small percentage of the amount paid fraudulently by HHS.

The Senate agreed with the House to get rid of $1 Billion from the Obamacare budget.  This is money that would go to fund the federal exchanges.  Obama agreed with the decision.

HHS is doing some good things.  One of them is attempting to take care of the problem of patients thinking they were in the hospital but were, in fact, in an outpatient observation status.  This was costing patients a significant amount of money when they were kept intentionally ignorant by the hospitals.  HHS is now willing to pay the claim under Part B after it is denied under Part A.  

A California legislator put three bills in the hopper to allow NPs, optometrists and pharmacists to be able to treat patients in the state.  The California Medical Assoc. is against the bill and wants an increase in residency slots in its stead.

The head of the Medical Board of California went before a legislative committee to answer questions as to why they weren't going after physicians who over prescribe.  The answer was very simple except to the people who testified against the Board and the legislature.  There is no legal method to do so.  The legislature must act to give money and authority first.  They have not done so.        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.