May 1, 2017 Legislation





CMS has put out a MACRA Participation fact sheet and an Improvement Activities fact sheet.  The former says who can participate and what they should do in order to participate.  It also states who is exempt.  The latter discusses choosing improvement activities, reporting the activities and understanding the score.

Senator Grassley of Iowa is on the warpath.  He is pushing the CMS to collect what is owed them from Medicare Advantage plans that were overpaid.  This comes from an article in Kaiser Health News that states five health plans were overpaid $125 million but only had $3.4 million returned and closed the cases.  CMS has been criticized before by the GAO for its failure to find overcharges.  The problem is the plans increasing severity of illness where none exists.

Grassley also went after HHS for not doing anything about Universal Health Service for its alleged multitude of quality of care problems.  

Trump has signed into law a bill that extends the vets use of private care.  This extends the program for one year.  

Trump has asked Surgeon General Vivek Murthy, MD for his resignation which was tendered.  He is being replaced by his deputy Rear Admiral Sylvia Trent-Adams, RN.

The idiots in the California Senate are attempting to pass universal health care for the state when the state does not have enough money to function currently.        Top  


California is again fining hospitals for quality of care items.  Bakersfield Hospital was fined $75,000 for not supervising a patient that choked to death.  The post-op patient had a regular died ordered along with supervision during meals.  Garden Grove was another of the 17 fined.  They were fined $75,000 for the death of woman from China post partum from blood loss.  They had already paid out $3.2 million for the malpractice.  The physician lost his privileges and is about to lose his license.  Multiple nurses were also terminated.  Sequoia Hospital in Redwood City was fined $47,450 for erroneously removing a woman's ovaries without permission or need.  Kaiser was fined for incidents in two hospitals.  One was for a death due to a disconnected dialysis line with no supervision and the other was for a botched trach.  Those fines totaled $147,000.  Sutter St. Luke's hospital was fined $47,450 for the death of a patient who while a patient fell, hit her head and died.  Queen of the Valley was fined $225,000 for three incidents.  They were for failing to monitor patients causing two deaths and one persistent vegetative state. 

Arizona has a new law that bans balance billing which prohibits balance billing from out of network physicians.  If they do balance bill the Dept. of Insurance will do a 3-way call to settle it and if that doesn't work then the bill goes to a private arbiter.

Pennsylvania hospitals have a new law to help them help patients.  They now on admission must find the name of the caregiver who they would rely on after discharge.  These people are then contacted and will be trained to handle the medical need post-discharge.  Those who need it will still be seen by a home health nurse.        Top


The University of Missouri School of Medicine may lose its accreditation next year due to lack of diversity.  Non-whites do not want to go there and the school is penalized.  The ones that do go there complain about being discriminated against subtly and blame the lack of diversity on their failures.  The school also has a very small percent of diverse faculty.  The location in Columbia, Missouri, which is 83% white doesn't help. Nor does the fact that there is only a small percent of diverse people to become professors at the school.  Schools are gaining diversity by admitting diverse students with low MCAT scores but "life experience".

Nebraska now requires physicians to tell patients if their mammograms show dense breast tissue.  These people have a higher incidence of breast cancer and detection is more difficult.         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.