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CMS has been busy. They now have a new confirmed head who the ED physicians have no faith in. They believe she needs education after she stated the ED care was the most expensive and least effective means of healthcare. She mistakenly (hopefully) stated that the overcrowding in the EDs are the reason we need healthcare reform. The facts are only 12% of ED visits are for non-emergencies.
CMS has decided to keep hospital payments essentially flat for the next year. The reason is the belief that the hospitals are liars regarding how sick their patients are. There will be a reduction in payments for the next two years thereafter.
Congress is proposing not cutting physician payments for the next two years and also do away with the stupid formula that is now in place and is never followed.
CMS is planning to cut skilled nursing facilities almost 2% due to a different patient mix.
Patients have won a major victory against the formulary of Medicare prescription plan D. A single patient with cancer could only be helped with a drug that wasn't on the formulary. She fought the ruling and it is now legitimate for peer review literature to show an off label use for a drug is legitimate. It will still be on a case by case basis but at least there is now some precedent.
Medicare will be getting more of the social security checks the retired are to live on. There will be no cost of living increases for 2010 or 2011 thanks to Obama. There will be an increase in the amount removed for Medicare Part B and those with Part D will also see an increase in payments. Keep those budget increases coming Mr. President.
Medicare is already paying out more than it takes in ( sounds like a physician in an HMO). The program will go broke in eight years. This means that there must be some changes made to the age of the recipient and to what is covered. There is no way that covering more people under "healthcare reform" will allow more money for Medicare. CMS has started correctly by disallowing "virtual colonoscopy". This is a procedure that has flaws and will lead to more real colonoscopies. Top
Michigan is in desperate financial need with the loss of a huge part of its tax base. They need to cut spending and so they are cutting Medicaid by 4% to hospitals and providers. Hospitals have no choice but providers do. It should be interesting how access changes with the new budget. Top
Maryland has followed California's example and shifts the burden of proof to the insurers if they want to cancel a medical policy retroactively.
California lawmakers really understand how to increase costs in healthcare. By making mandates they increase costs. The latest in their meddling is to set time limits for for how soon patients must be seen in HMO physician offices depending on the illness and the type of physician. This means physicians will have to hire physician extenders or squeeze more patients into the day by rationing their time. It also means the HMOs will have to renegotiate their contracts to take into account these new time elements. Top
The Medical Board of California has mandated another sign for the physician waiting room. This one will state that physicians are licensed by the Medical Board of California and will give their contact information. It will need to be in 48 point type. Those without offices will need to give patients written notices signed by the patient stating that they understand the physician is licensed and by whom. If the above is not done then the physician may be subject to fines or other penalties. The Medical Board should be ashamed of themselves.
I am not sure how the Medical Board of California is chosen but it is surely not for any type of common sense. After this above idiocy, they are now looking to make all physicians go through a Wellness Program. This is to be paid how? Is there any work that shows this will decrease "disruptive physicians"? This same Board did away with the confidential abuse program that worked but not perfectly. Mainly the problem was the Board's for not doing any type of follow-up. 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.