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The Associated Press had an article about the risk California physicians place themselves by following state law on medical marijuana. The physician has the right under state law to assess the patient and recommend medical marijuana if deemed medically necessary. The feds say this is not so and are investigating physicians who recommend medical marijuana. The California Medical Board then starts an investigation of the physician which not only costs the physician money to defend but may end up with a license revocation. The Medical Board is going against both state and federal law by going after physicians merely for recommending medical marijuana. The Medical Board justifies its illegal action by stating that the physician must do an independent exam and not take the patient's word for the history as all other physicians do.
The North Carolina Medical Board has revoked the license of Dr. Elizabeth Robertson. She had been accused of substance abuse problems after an auto accident. Top
The People's Republic of Massachusetts has its new medical insurance for all in place. On October 1, the companies of the Republic became liable for the $295 per employee assessment. Companies with 10 or fewer employees are exempt as are larger companies if at least 25% of the workers are enrolled the companies group health plan or if the business offers to pay at least 1/3 of an individual's health insurance premium. The republic has not notified all businesses of the law.
The Republic also has minimal fines for those who do not apply for the insurance. If an individual does not take out insurance for several thousand dollars a year they would lose only their personal state exemption of several hundred dollars. They are capped at 1/2 the cost of the insurance. The business that does not comply with offering insurance pay a penalty of $295 per worker, a reasonable price versus the cost of insurance. The tincture of time needs to run.
In the recent elections several states passed anti-smoking regulations or significantly raised taxes on cigarettes. One state that refused was California. The reason was the physicians being against the measure due to antitrust relaxation of hospitals being part of the proposition. Californians also soundly defeated the California Nurse's proposition wanting some public financing of political campaigns. In South Dakota, the people turned down being guinea pigs. They defeated a strict no abortion law that was placed on the ballot for the sole purpose of eventually sending it to the Supreme Court to overrule Roe v Wade.
The AHA continues to go after anything that competes with the hospitals even when it is good for the public. In their latest missive, they continue to take on the free standing non affiliated surgical centers. They are OK if they are hospital outpatient surgical centers. What the AHA doesn't like is that CMS is making more procedures payable in these centers and taking business away from the hospitals. They don't understand that they are becoming more obsolete.
San Francisco has passed the first law in the country to mandate that all employers provide one hour of paid sick leave for every 30 hours worked by all employees. Those with 10 or fewer employees would offer a maximum of five days per year per worker. The larger employers max out at nine days. The businesses of the city are not happy and will fight the measure or drop other insurance or not hire to equal out the cost.
California HMOs have been chastised for dropping patients when they begin to cost them money. In several cases including the first one at Kaiser and then Blue Cross was hit with a $200,000 fine. Now the Department of Managed Care will propose that HMOs be required to cover those on individual policies they have accepted unless they show an individual actually lied. This will require proof and will be difficult to obtain. Misinformation without overt lying will not be enough to cancel a policy. This means the HMOs will have to start doing true pre-enrollment evaluations. The HMOs are continuing the same lies stating the they are following the law and that there is no need for the new regs. If that was true there would be no need for a law suit by the state's hospitals and the fines by the state. Top
The new Medicare payment plan is now official. Physicians seeing Medicare patients will get an average of 5% decrease in pay to about $35.98 per unit. Also the unit value will be reduced 10% across the board. This is unless the lame duck Congress makes a new law to overturn the CMS as they have in the past. As far as fairness, hospitals will get a 3% increase in pay for outpatient care. Home Health agencies will also get a 3.3% increase in pay. For those physicians in Cardiac Surgery the reduction will be 24% and for those in Urology the reduction will be 5%. Top
The New York Department of Health has issued 17 violations against Stony Brook Hospital. They are for incorrect drug doses, foreign body retainment and at least one death. The hospital also did not check the credentials of at least one physician. It sounds like the hospital is attempting to take over from Drew/King as the worst hospital in the country.
California ha a new law that goes into effect on January 1. General hospitals under AB774 will have to establish a discount payment policy and a charity care policy for patients at or below 350% of the federal poverty level. These people must be uninsured or insured but whose annual medical expenses exceed 10% of family income. The hospital must limit expected payments from eligible patients to not more that the highest amount of payment it would expect from any government sponsored plan the hospital participates in. The discount payment policy must also include an interest fee extended payment plan option. The hospitals must also provide written notice of the availability to all patients in English and any other language that makes up 5% of the service population.
Four more California hospitals have been hit with sanctions by the usually ineffective United Network for Organ Sharing (UNOS). The four new ones are Kaiser of San Francisco, UC San Diego, USC Medical Center and UCLA Medical Center. The worst sanction was given to the notorious Kaiser San Francisco transplant fiasco. It will have no significant effect since fortunately the program is going away. UC Dan Diego was recommended for probation for multiple clinical and administrative errors including entering the wrong blood type on UNOS computers and misrepresenting patients clinical conditions. At USC there were problems with its heart liver and lung programs where they were placed on the priority list even though they did not meet the clinical criteria. At UCLA, the liver transplant program again had problems with wrong information entered into the UNOS system. Prior discipline included UCI liver program that subsequently closed, St,. Vincent who falsified information to place a Saudi high on the list and Sharp Memorial for problems in the pancreas program. Sharp continued to add patients to its list but did no surgery. 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.