November 15, 2007 Legislation

Physicians

Insurers

Malpractice

Physicians

CMS has come out with their final regs showing a 10% decrease in physician payments for 2008.  Congress has not yet acted, nor are they poised to act, on removing this onerous reg.  If Congress doesn't act I believe there will be less physicians taking new Medicare patients at a time when the boomers are just beginning to hit.  As part of the regs anesthesia will get a 32% increase. The rule also will disallow any markup by physicians for diagnostic tests as well as mandating that PT and OT providers meet state licensing and other requirements.       Top

Insurers

California has ordered Blue Cross to cease and desist ordering hospitals to sign confidentiality agreements to prevent the hospitals from discussing fee negotiations.  This would have not allowed the hospitals to use attorneys or consultants in their negotiations with Blue Cross.  The order does not affect physicians and other non hospital providers. 

CMS has stated that 2008 will bring a 3.8% increase in hospital outpatient surgery but with some bundling and other onerous reporting requirements.  ASCs will get less since it costs less to perform the service in an ASC due to the inefficiencies of the hospital. 

On November 9, 2007, a final rule delaying the
 effective date of certain provisions of Phase III 
(CMS-1810-F) was made available for Public
 Inspection at the Office of the Federal Register. 
 This final rule (CMS-1810-F2), which will be
 published in the November 15, 2007 Federal
 Register, delays the effective date for one year
 (that is, until December 4, 2008) the
 "stand in the shoes" provisions of the
 Phase III final rule as to the following 
 compensation arrangements between 
the following physician organizations
 and entities ONLY:

-- with respect to an academic medical center
 as described in §411.355(e)(2), compensation
 arrangements between a faculty practice plan
 and another component of the same academic
 medical center; and

-- with respect to an integrated section 501(c)(3) 
health care system (as described in today's
 final rule), compensation arrangements between
 an affiliated DHS entity and an affiliated physician 
practice in the same integrated section 501(c)(3) 
health care system.
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Malpractice

Arizona will try again to make the standard to sue ED physicians "clear and convincing evidence" and not the preponderance.  The legislature passed this before and the trial lawyer's pawn Governor vetoed the action.          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.