May 1, 2016 Recent News





To no one's surprise a study by the U of Chicago found that as hospitals purchase oncologists the cost of chemotherapy goes up.  As the purchased physicians rise by 1% the cost increase rises by 34%.  Part of the rise was due to facility fees that Medicare and insurers allow but shouldn't.  The study showed that patients should get their chemo at community based practices rater than hospitals or hospital based clinics.

The VA is still at it.  The bosses at least 7 VA facilities continue to pressure their staff to falsify wait times.  These happened at facilities in California, Florida, Arkansas, Delaware, Texas, New York and Vermont.  In some cases the schedulers actually had separate lists outside the scheduling system.  The VA says they have corrected many of the problems.  They continue to tell the big lie.

After the above came out the VA said they will have same day appointments at all their facilities and use smart phone apps to help with the process.

UnitedHealth is exiting Obamacare in all but a few states and counties.  This will limit competition and drive up costs.  The reason is that is was losing money on the program.  The administration continues to downplay the departure but should be and probably is very worried.

In a separate report the healthcare insurers warned that continued losses for Obamacare are unsustainable.  They will either drop or raise premiums to higher levels.  CMS says there is not a risk of a death spiral but there is.

Watch for large price premium increases for 2017 by the Obamacare insurers.  Most are now losing money and in order to stay in the program will have to raise the rates.  The administration says that factoring in the subsidies would make the raise inconsequential.  What about those with no subsidies??  Only about 85% of those with Obamacare get subsidies.

Remember the glee when the SGR went out?  Now, the tables are turned.  The SGR loss gave CMS the ability to change how physicians are paid.  They are doing just that.  They are going to give more money to those who do "quality" and pay less to those that don't.  

Oklahoma dropped its payment rates to physicians for Medicaid by 25%.  The state medical society is advising its physicians to consider not taking Medicaid patients.

California has a Medicaid computer system that needs updating.  They will get rid of the entire $179 million program and start anew.  It boggles the mind to consider how much a new system will cost.

Covered California continues to make the news for its ineptitude.  This time they are dropping pregnant women who report their pregnancy to the insurer.  They are then put into Medicaid automatically.  It's not the fault of the insurer it is due to the computer problems.  This is also happening at  

California is experiencing a large amount of fatal overdoses on a pill disguised as Narco but is really Fentanyl.  This is now concentrated in the Sacramento and Bay Area cities.  

North Carolina Blue Cross is delaying payments to physicians due to their own computer crash.  In that state if a physician does not timely bill they lose the claim but the same is not true in reverse.  They do have to pay a 18% per annum interest on claims not timely paid.

New York insurers have finally agreed to cover treatment for hepatitis before the patient has advanced liver disease.  The state AG reached agreements with seven insurers to cover the disease treatment.     

Great Britain is at war with its junior physicians.  They have had a strike including emergency care.  The government wants them to take a 13% raise on their base pay but get a reduction in other aspects to make up for it.  This includes a decrease when they work nights or weekends. Raises would be for training and experience not time on the job as it is now.  Those that take a break would get less.  As the government hems the physicians are leaving the country.  Last year about 4500 left and this year over 2000 already.   The leftist Jeremy Corbyn is backing the physicians.   Top  


In a saga that will only continue, the Broward Health system is under fire.  First, the ousted chair of the board found a tracking device in his car which he states he took off hi car and placed it in his garage.  He then stats that the device was stolen.  Following that, there was a report that the late CEO was threatened by County Commissioner unless he got a larger advertising contract.  A outside investigator hired by the board cleared the board of any corruption.  We all know how that goes.  The Florida governor Rick Scott says that the board blocked a state investigation of the system which is why he fired the bard chair.  This statement was in response to a lawsuit filed by the ousted chair stating he did nothing wrong.  A judge then ruled that the governor didn't follow the law in the ouster and so he was reinstated and the state appealed.  Following the reinstatement the chair resigned.  The governor then appointed an old friend to the position who is a partner in a law firm and practices healthcare law.  She will fill out the remaining term of the chair.

Following that the Governor of Washington fired the head of a state psychiatric hospital after a man charged with murder escaped from the locked facility.  This followed multiple assaults at the hospital.

A Las Vegas collection agency, CP Medical LLC,  hired by a St. Louis hospital system SSM has begun filing lawsuits against the St. Louis people for treatments from many years prior.  SSM is a Catholic non profit hospital system but the suits actually come from Schumacher Clinical Partners, a for profit that runs local ERs.  Schumacher sold the debt to the collectors.  

King's Daughter Health in Indiana shut down its computers after a ransomware attack.  

Sutter is attempting to flex its muscle in northern California.  They are requiring that employers sign an arbitration agreement to resolve disputes when they sign up with the system.  If they do not sign the arbitration agreement they must pay much higher rates of 95% of full charges for out of network care at its hospitals surgery centers and clinics.  Blue Cross is good with the arbitration but Blue Shield is not.

California has a law that hospitals need to be seismic ready by 2030.  Sutter Health has determined that Alta Bates Hospital, the only acute care hospital in Berkeley, will not be ready and will be shut.  

The Old Grey Lady, Cook County Hospital, may have found a new use.  The hospital is 102 years old and has been vacant for many years.  The county wants to use it for a hotel, apartments and a shopping mall.        Top


Thousands of New York physicians did not get the message.  They missed the deadline for the use of e-prescriptions.  Some have not completed the process to allows them to do the e-prescribing.  Others have EHR that can not do the job.  There is a waiver in place and so far almost 5000 have requested one.  Of course the count is not accurate since the state counts a hospital entity as one and does not count each physician.          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.