May 15, 2012 Legislation

Healthcare

HIPAA

Hospitals

Healthcare

CMS has changed the PECOS program for physicians for the better.  Physicians will not have to give a patient a referral for a visit to a specialist as they would have under the old rule.  Physicians will still have to use the NPI to register to care for Medicare or Medicaid patients.  CMS also come into the new century albeit 12 years late by allowing on line enrollment and not paper.

Hey, fellow physicians!  You have until June 30 to send 10 prescriptions to a pharmacy by CPOE in order to prevent having your hand slapped for being a bad physician.  This will cost you money in 2013, 1.5% of your Medicare billings.  By the way faxes do not count, only computer to computer prescriptions.  If you are a rural physician and want an exemption you must apply by June 30.  You must do a lot more than the above not only to avoid the penalty but also to get a bonus.  

The GAO wants to change horses in mid stream.  They believe that physicians should submit even more data if they want to get meaningful use money.  They believe that the physicians will game the system and it will be hard to get the money back once the scofflaws are found.  The detail of the information to be required may tip the balance in favor of forgetting about using EMR.

The CMS HIT committee is debating whether or not to make physicians into typists.  The debate centers around whether or not the typing into an EMR must be done by the physicians, wasting his time, or can be done by a scribe.  If it is the latter then the physician will miss out on the wonderful decision tree that only pops up once and will have to rely on their own knowledge and experience.  Of course, if the typist is not the physician, the physician will still have the liability for what is typed and any consequences that ensue.      

HHS has announced that Obamacare will bring primary care physicians caring for Medicaid patients up to the same pay as those who care for Medicare.  You will probably notice an announcement of some good from the law several times a week until either the Supreme Court rules or the election or both.

Remember two years ago when McAllen, Texas, got the bad rep from the east coast writer.  It was touted as a place that cost Medicare way too much money.  It is, after some more information came to light, a cheaper place for Medicare than many hospitals including Washington, DC's Medstar Hospital.  The article two years ago was wrong as was Obama to rely on it without any investigation as to the facts.  He has done this several times.

The Obama administration is attempting to sway the Supreme Court's decision on Obamacare by quietly telling the Court what would happen to Medicare if the law is overturned.  Medicare was never mentioned in the suit.  They warn that the payment system could freeze up if Obamacare is overturned.  Of course it was there prior to the law being passed and has not changed since the law was passed.  It is possible that Medicare physicians might be entitled to refunds if the law were repealed and that may force delays.  Alas, poor Berwick, also moans that the quality aspect that physicians were being paid on would also be gone.  Of course the quality aspects were about money and not true quality.  

If people wonder why California is in the financial bind that it is in, wonder no more.  Outside of the massive legislative entitlements, CalPERS, the organization that runs the public employees retirement has just announced a 5.7% increase in contributions to all state employee pensions.  Governor Brown, who has no power over the organization, called it dumb.  California's Governor Brown has removed from a state agency a physician who is advertising against state proposition 29, a $1 tax on each pack of cigarettes.  The physician has caught flak from other physicians who back the proposition.  The physician has the side backed by the tobacco industry and this is being used to scare off other physicians from speaking their mind.      Top

HIPAA

As usual once people become comfortable with a law, it changes.  A new requirement would force all companies that deal with health care data to be liable for breaches.  This include all business entities as well as such far flung companies as those that provide cloud services that have health care services on them.        Top

Hospitals

Since Governor Quinn of Illinois promised to make non profits live up to their name or lose their designation 17 hospitals have applied for non profit status and none have been given the designation.  There has been significant lobbying in the known crooked state against the state's position.         Top

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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.