October 15, 2014 Legislation



The GAO states that the administration (HHS) can not lessen the financial burden on insurers without authorization from Congress.  This affects the risk corridors that is used to stabilize the exchanges allowing those companies with less losses to pay those with high losses via the government.  The potential problem is if all insurers have higher than expected losses then this could be another bail out.  The GAO states that the government does not have the ability to use the general Obamacare fund to pay these losses.  This legal opinion is opinion and not binding.

California's governor has signed a bill that mandates hospitals develop safety plans to minimize violence in the workplace.  The plans must evaluate staffing to determine if low staffing increase the risk of violence. Also plans must consider the availability of security personnel and areas of the hospital.  At the same time Brown vetoed a bill that made a legal presumption that hospital employees who developed staph infections got it at work and therefore qualify for workers' compensation coverage. He then signed a bill to allow the Dept. of Managed Care to review the Medicaid plans sold by the state Obamacare for compliance with timely access.  

The Kaiser Health News reports that Medicare has fined 2600 hospitals for violating the 30 day readmission rule.  It seems as if 18% of the Medicare patient fall into this category.  The fines consist of less payments for all Medicare admissions for the next year.  This affects the majority of hospitals in 29 states.  39 hospitals will have their payments reduced the maximum of 3%.  The hospitals do not like the penalties but the physicians and nurse do to get the attention of the administrative offices.

CMS has announced that Medicare Part B premiums and deductibles will be the same in 2015 as this year.  Great news for us old fogies.  However, Part A deductible will go up $44.  The new deductible is $1260.  The reason is Medicare spending has had a very small increase over the past four years.  The average rate of increase has been only 0.8%.

The Pentagon has announced that for TRICARE providers that work with autistic children their payments will be halved.  The pay will be reduced from $150 per hour to between $50 and $80 per hour.  The Pentagon says coverage will continue as prior but the providers who were never consulted on this say they can not work in the new program.  About 7800 military children are affected.            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.