November 1, 2012 Legislation

Healthcare

Hospitals

Physicians

Healthcare

After the House Republicans asked CMS for a meeting to discuss the EMR meaningful use requirements and receiving no answer, four Republican members of the Senate now have asked for the same thing.  They want more specific answers to questions asked.

Attention all hospitals and physicians!  The OIG has given out its new workplan for the coming year.  This is what they are going to focus on.  They are planning on bundling services performed within 14 days instead of 3 day prior to an admission into the DRG. They are looking at non hospital owned physicians billing under provider status is within the rules.  They are to look at cancelled surgical DRGs.  Hospitals better look for the length of mechanical ventilation.  It better be at least 96 hours for a higher DRG.  They will look at same day hospital readmissions.  They are hopefully looking hard at observation services provided by hospitals and the cost to the patients.  They will look to make sure anesthesia services billed as AA were actually done by an anesthesiologist.  The are looking hard at eye services in the office.  Make sure you have a real address for your medical practice and not a POB.  They will look at both lab and x-ray utilizations.  They will look at payments for services in the global period and whether or not the physician is correctly coding where the service is taking place.  Also all better have good Compliance practices in place.

The People's Republic of Massachusetts is finally catching up to the world.  They are going to vote on whether or not to allow active euthanasia.  The initiative would allow a patient who is terminally ill to request and receive a prescription for meds that he/she may take to end their life.  The patient would have to make three requests, the first two orally and the third in writing.  This would be equivalent to the Oregon measure in which very few people have actually gone the whole way.  Of course, Oregonians are a heartier bunch that the Socialists of the Republic.  

After years of complaints and now the severe outbreak of meningitis cased by a Republic compounding pharmacy, the Republic is finally trying to revoke the license of the pharmacy for selling in bulk and not individually as required.  The outbreak now is at least 18 states and at least 28 have died.   The FDA reports that the compounding pharmacy knew of the problems for almost a year but did nothing. 

California is looking into HealthCare Partners, a presumptive HMO.  It appears they may not have done all the things they were supposed to when they declared themselves an insurer.      Top  

Hospitals

CMS is threatening to remove Exeter Hospital in New Hampshire from the Medicare ranks for its refusal to clean up it's mess with infection control and several other CoPs.  Of course it will never happen.        Top

Physicians

Starting November 1 and going through the end of January physicians may apply for hardship exemptions for eRx.  If one does not get an exemption or comply with the program expect a 1.5% decrease in Medicare reimbursement.  

The OIG has given its blessing to what has been going on in the medical community for many years.  They said it was ok to pay physicians a per diem for taking ED call.        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.