May 1, 2007  Legislation


Joint Commission



In the People's Republic of Massachusetts the state board in charge of setting up their universal health insurance has unanimously passed the affordability standards.  The board allowed 60,000 or 1% of the people to be exempted from the law due to unaffordability.  The affordability of the policy will be on a sliding scale and if one cannot find a policy for the required price, they will be exempt. The board also pushed through the insurance would be purchased on a pre-tax basis.  This could allow the people to deduct the fees on their tax returns if they are over the 7.5% floor.  All those eligible for Medicaid must participate in that program.  

The Pentagon has, under pressure, decided to look at their processes and attempt to fix the red tape associated with the vets attempting to get disability and care.  There are several studies under way to help improve the quality of care but none of them will look at bringing the vet into the practice of medicine outside the poorly run VA system.

The Center for Budget and Policy Priorities have shown that Medicare HMOs are much more expensive (12%) than fee for service Medicare. The Center fees that the higher costs a burdening the non HMO patient to pay higher costs to make up for the waste in the HMO system.  The increased money Medicare pays out is also hastening the demise of the program.  

The demise is coming soon.  By 2012, over 45% of the money for Medicare will come from the general funds.  It is currently at 42% and will be insolvent by 2019.  After seeing the numbers the Democratic majority stated that they don't want to make any cuts or increases in the program that will hurt seniors.  Of course, none of them have Medicare.  The same study showed that Social Security will be exhausted by 2041. 

The hospitals are against receiving less money from CMS.  I didn't hear anything from them when the physicians were being squeezed.  They will not hear anything from the physicians when they are squeezed.   

Medicare has proposed that all hospitals owned by physicians, not just specialty hospitals, disclose their physician owners.  The physicians would also have to disclose to the patients their ownership interest in a hospital. 

CMS has clarified that all hospitals, not just those with EDs, must provide emergency care and not just call 911. This is in the Conditions of Participation.

Finally, a Democratic idea.  In the Senate, a bill has been introduced that would give all Americans a choice to continue their own insurance, enroll in Medicare or in one of the many Federal Employee Health Benefit Program plans.  All costs would be on the government.  There would be a tax of 7% on business and 1.7% on all workers.  The idea may save approximately $308 Billion per year over the current inefficiencies.  

The Texas Governor has been overridden in his attempt at making the Herpes shot mandatory.  The legislature has said there will be no mandatory shot for at least four years.  This is stupidity as there are many women who may be saved during this time span.        Top

Joint Commission

In a major mistake the Joint Commission has tossed out interim standard MM4.10.  The interval standard allowed a retroactive look at first-dose meds given in the ED by a pharmacist.  The removal of the standard mandates that a pharmacist review all orders unless for an emergency or the independent practitioner not only prescribes but prepares and administers the medication himself.  This will make ED work even harder than it already is.  The ACEP has been in contact with the Joint and they will re-look at the policy again.        Top


The California Chiropractic Board is continuing under fire.  The newest ideas are to increase the public members to dilute the power of the Chiropractors, the appointments must be approved by the legislature and permission to amend the Chiropractic Act in the future.  This started because several Chiropractors forgot who they worked for, the people and not the Chiropractors.        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.