The House and Senate with bipartisan support both passed a law to protect small and midsize business from increases in insurance premiums. The removes a portion of Obamacare that expands the definition of small employer to include companies with 51-100 employees. This allows states to determine to determine if these businesses should be defined as small businesses and subject to the onerous insurance conditions under Obamacare.
The do nothing Senator Sanders has finally done something. He has co-authored a bill to get rid of the dreaded Cadillac Tax. This is the second bill on this subject initiated in the Senate and there is a bill in the House also going forward.
The HHS has released the new Meaningful Use rules. The changes include giving providers more time, new providers getting a 90 day reporting period, providers who start to attest for stage 3 get a 90 day period, changed in stage 2 the requirement that 5% need to view their records to one patient and gets rid of the 5% of patients need to exchange messages with their providers to that the providers only have to have the capability to do the messaging. There are multiple other changes and some require protection of patient records. This means all hospitals will fail.
The Budget Bill has passed both houses of Congress. The Bill contains several changes to healthcare in the country. It changes how much seniors will pay for Medicare. In Part B about 15% of Medicare people will see raises from $104.90 to $120 per month plus a $3 surcharge. The rest, those who are now having Medicare Part B taken out of SS will see no change except for the $3 surcharge. Another change would be in Obamacare where businesses with 200 employees or more no longer have to sign up all employees in an exchange. The means that those that do not want the insurance would have to opt out instead of opt in. The hospitals will be affected since they will no longer be able to say acquired physician offices will be hospital outpatients. A great change. The problem is that the existing ones can still do this terrible practice. Physicians are also on the hook as the 2% sequestration reduction will now go to 2024 instead of 2021. Pharmaceuticals who manufacture generics will have to pay the feds a rebate if a drugs price outpaces the inflation rate.
In a proposed rule CMS providers will be required to develop a discharge plan for patients within 24 hours of admission or registration and would have to complete that prior to transfer. This affects inpatients and observation status patients. All discharged patients will need a medication reconciliation, discharge instructions, a post discharge follow-up process and for those transferred a specific medical information sent to the receiving institution. Patients will also be involved in the discharge planning since they will see the scores for any home health or long term placements.
Governor Brown of California has had a busy month. He has signed and vetoed many health bills. He has signed the bill to allow assisted suicide in the state. This is amazing since it goes against his Jesuit background. The bill will allow physicians to prescribe to mentally competent people who have six months or less to live. Brown also signed into law bills that require accurate health provider directories by requiring updating on a weekly basis. Another bill signed was the capping of out of pocket costs on prescription drugs. This will raise the price of the premiums for the insurance as the cost must be paid for somewhere. Other bills signed were to require Worker Comp to develop a closed prescription drug formulary by July 2017, require crisis centers to provide information on abortion, contraception and prenatal care (this has been questioned in court), and require anyone seeking a license to run a residential care facility in the state to disclose prior ownership in any facility in any state. Brown did veto bills on increasing the Medicaid roles citing the expected budget shortfall and he also vetoed the right to try bill stating he wanted the new federal law to take effect first.
California has now allowed Medicaid patients who are fee for service to be admitted to the hospital without pre-authorization. They will have to follow national guidelines to determine whether a patient should be admitted. This will be in full force by 2018. Top
California is busy again fining health facilities for breaching privacy laws. The Dept. of Public Health has fined Dominican Hospital in Santa Cruz $247,600, UCLA fined $250,000, Lucille Salter Packard Children's Hospital fined $250,000, Planned Parenthood of the North valley fined $2500, Queen of the Valley fined $77,500, San Francisco General fined $25,000 and Stanford fined $50,000. This is typical of hospitals in the nation unwilling to spend money to protect patient records. The Dept. also fined Oakpark Healthcare Center in LA $75,000 for screwing up physician orders directly leading to a patient death.
The California Department of Managed Health has fined the San Francisco Community Health Authority $30,000 for screwing up their billing system and not correcting it fully. Top
Wisconsin will discuss a bill to sue for med mal up to the age of 27 of the child if the adult child dies. They currently have a law that prohibits adult children even if a dependent from suing for med mal if a parent dies as the result of medical error. The Democrat state senator thinks it is awful that Wisconsin physicians pay fewer malpractice claims per capita than their peers in all other states. 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