November 1, 2002 Legislation

California Laws

JCAHO

People's Republic

Marijuana

Mississippi Malpractice

Oregon Universal Health Plan

Kaiser Rx Request Denied

Gifts to Physicians 

Medicare Cuts

California Laws

Governor Davis has signed the following bills relating to healthcare in California:

SB 1950 that requires the Medical Board of California to disclose settlements in low risk specialties such as FP get three or more settlements over $30,000 over a ten year period.  In high risk specialties it would be 4 or more in the same period.  Settlement amounts will not be told but the public will be told how the settlement compares to others in that field.  Physicians must report settlements to the Board. The penalty for practicing without a license will be increased and allows automatic revocation for certain sexual offenses.  This will increase court cases and decrease settlements. 

AB 2872 restarts the "fifth pathway" for physician license in California.

AB 3006 reinstates an increase in MediCal reimbursements to providers that had been previously eliminated by Davis.

AB 925 requires state agencies to come together to cover the cost of personal-care services for the disabled who are in the workplace.

AB 1825 mandates 30 days of additional sick leave for those who donate organs and 5 days for a bone marrow donor.  The employee must use their own sick days prior to utilizing the additional days.

AB 1908 eliminates that the CalPers employee cover their own long term care insurance and allows employers to assist in the payments.

AB 2006 mandates LA County must give health benefits to unionized physicians.

AB 2817 requires student health sex education include information regarding the giving up an infant younger than 72 hours in any ED or other designated area.

SB 398 requires health insurers to meet with the Department of Managed Health Care at least 10 days prior to declaring bankruptcy. If an emergency they can meet within 24 hours of filing.  The new law also requires health plans that are withdrawing from rural areas to hold public hearings and the drafting of regulations to establish an extended geographic accessibility standard for rural health plans.

Governor Davis vetoed the following:

AB 481 which would have required school nurses to administer insulin and test and monitor blood glucose under physician request.  This would cost money and there is already a law allowing school staff to treat students with a written statement from physicians and a written request from parents.

AB 523 would have restored MediCal pharmacy payments to pre-2002 Budget Act levels.  Too expensive.

AB 687 required local authorities to establish trauma care systems.  Too expensive.

AB 1905 to establish a diabetes screening program.  Too expensive.

AB 2930 would have required physicians to inform pregnant women of their intention to provide HIV tests.  This would have made a mandatory HIV test for pregnant women and potentially reduced the persons willingness to obtain care.

SB 1785 would have allowed pharmacists to sell up to 30 needles per month to adults without a prescription.  Davis stated that this would not have allowed a one for one exchange therefore increasing public contaminated needles.        Top

JCAHO

The Joint responding to the justified criticism of their accreditation process announced a new process that will look at patient safety and quality of patient care.  This will come in over the next two years and will include self assessments by the providers in mid cycle with plans of correction if necessary.  There will be validation surveys at the 3 year survey.  There will be pre review of ORYX, sentinel reviews and MedPar data.  The garbage paperwork will be reduced.  They will look at performance improvement more closely along with actual patient care.  They will also drop the competitive scoring now utilized.  The final will either be accredited or accreditation pending (fixing of deficiencies).

Money continues to be a driving force for the organization.  They will continue to charge the same $22,000 per survey.  This is in spite of no new resources and less work being utilized for the new survey. In 2000 their profit was double of any previous year.  Last year they made even more money, $14.3 million.  This is a 12% profit margin.  The Commission has also spun off a not for profit arm where the big money and confidential contributions of about $750,000 go.        Top

People's Republic

Massachusetts has relented on its severe pharmacy reimbursement curbs.  They will cut back but not enough to make the large pharmacies leave the program. This will cost the state about $25 million more than anticipated.  The pharmacies showed that the state can not unilaterally change significantly terms of an agreement.  The liberal Democrat who spearheaded the bone head idea had no comment on the new emasculation of his proposal.  

The legislature is still trying to raise money by a provision to charge pharmacies a per-prescription assessment for each non-Medicaid prescription filled.  They hope to raise $36 million with this maneuver.  The pharmacies are going to attempt to have this levy passed on to the health plans or consumers directly.  

The Republic has also officially chastised Mt. Auburn Hospital where the physician left a patient on the OR table while he ran to the bank. The Republic stated that the hospital violated the patient's rights by failing to inform him that the physician had been suspended, failing to tell him a new physician was now in charge and failing to allow him a choice in the decision of the physician.  There was nothing in the report about the care received by the patient.     Top

Marijuana

A City of San Diego Committee approved guidelines for medical marijuana usage.  They recommend a person with medical prescription could have three pounds of the weed and could grow up to 72 plants for home use.  Caregivers for those with medical marijuana prescriptions could store up to 12 pounds and grow up to 90 plants.  This would be a 24 month pilot project.        Top

Mississippi Malpractice

Mississippi has passed a malpractice reform start.  It caps the malpractice at $500,000 for pain and suffering for six years and then goes to $750,000 for six years and then to $1 million.  They also got venue so the attorneys must bring the case in the county where the alleged action took place.  The area of joint and several liability was terminated so one is now only liable for the amount of their negligence.          Top

Oregon Universal Health Plan

A November 5 ballot measure, if passed, would give all people of the state full medical insurance without co-payments or deductibles. The plan would be financed by a new payroll tax of up to 11.5% on business and an increase in the personal income tax from 9% to 17%.  This would cost more than the entire state budget.  This would also lead to the removal of all health insurance in the state since no one would want to pay twice.  There are no limits on coverage as long as it is medically necessary as decreed by any state licensed health care practitioner.        Top 

Kaiser Rx Request Denied

Kaiser requested and was denied by the California Department of Managed Care a $500 ceiling on prescriptions on some premiums.  The Department believed the policy had the potential to do great patient harm.  Kaiser had withdrawn their request the day prior to the letter denying their request being sent to them.  California law allows no drug benefit but if any benefit is allowed diabetes, contraception and pain management must be covered.  This only applies to non-Medicare HMO coverage.        Top

Gifts to Physicians 

The Inspector General of DHS warned the pharmaceutical industry to stop offering any financial incentives to any physician, pharmacy or other health care provider to induce a prescription or a switch of prescription.  She warned this could be against the fraud and abuse laws. This does not have any force behind it but could lead to costly investigations and even attempted prosecutions.  She also warned the drug companies about over paying physicians as consultants or advisors as this may be fraud and abuse.  The new rules will eliminate the local dinner meeting with a guest speaker.          Top

Medicare Cuts

Providers are taking it again.  It is almost time for the new reduction in Medicare payment of 4.4%.  This would make it 10% in the past two years.  Why take the patients if you lose money on him/her?        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.