September 1, 2004 Legislation

Funding

Birth Control

Physicians

Malpractice

Taxation

Funding

In California, the decrease in funding for the regulatory boards has stopped the Medical Board from sending investigators into poor neighborhoods to catch non-licensed people practicing medicine.  The Board also has stopped investigating internet drug sales.  The problem stems from a hiring freeze and borrowing by former Governor Davis. 

Governor Terminator has signed legislation to mandate the genetic testing for newborns.  There will be 76 more disorders tested for under the new rules.  This will bring California into line with 42 other states in their testing of newborns.  

Now on the Terminator's desk is a bill that would limit how much hospitals could charge the uninsured for their care.  The hospitals would be forbidden to charge those with incomes less than 400% of the federal poverty level more than Medicaid would pay.  The hospitals would also be not allowed to lien homes on these people or do other major collection efforts.  There are voluntary guidelines in place in the state but they are just that, voluntary.  There is also the possibility that the legislation may be in conflict with Medicaid rules and therefore would be illegal.   

In July, the CMS put out a policy that would give hospitals $1 billion over four years to help pay for the uninsured medical care.  The kicker was they had to ask the patients their immigration status.  There are now hospitals in California and elsewhere that will turn down any federal money with those strings attached.  The feds state they only want the information to track the legitimacy of the funds.  And there's a bridge in Brooklyn that I'll sell you.    Top  

Birth Control

Wisconsin has followed California in mandating birth control must be offered to all with prescription plans.  This includes the morning after pill.  This came from a formal opinion of the Wisconsin Attorney General.  There were no exceptions to any Catholic organizations.         Top 

Physicians

The California legislature has passed a bill that would allow oral surgeons to perform facial cosmetic surgery.  This would include Botox and eye lifts.  The oral surgeons would need to pay a fee to the state and get separate training in the field.  the measure now goes to the Governor for signature or veto.  The California Medical Association has dropped their opposition to the bill since the legislature has put in greater oversight since the inception of the bill.        Top

Malpractice

The Maryland Senate President is calling for a special session to address the malpractice issue in the state.  The Democratic leader wants the session to instigate a special $50 million fund to help private insurers fund payouts after their own funds are used up.  This, of course, would never happen.  The insurers would freeze the rates at their current level.  How to pay for the fund was not discussed.  However, the largest carrier in the state has just asked for a 41% increase.  The Senate leader is not interested in malpractice reform as it would take too long to have any effect.  This is true but there is no reason why both the immediate fund and the long term reforms could not be enacted.        Top

Taxation

New Jersey is not only in a snit over its Governor's antics but the cosmetic surgeons starting September 1, 2004, will start to be taxed 6% on cosmetic surgical procedures.  This could raise the cost of some procedures dramatically and make patients go to neighboring states to avoid the tax.  There is also a problem with the definition of a cosmetic surgery.  What if a surgical procedure enhances the patient but also is for a medical condition, such as a nose job?  The provider of the service physician, anesthesiologist, hospital, surgical center would have to collect the tax on their portion of the bill and remit it to the state.  This will cost all involved money to do the bookkeeping and remittance of the tax.  I would hope that most of the physicians have hospital privileges in other states.  

One of the states I wouldn't want to have a license in is Massachusetts.  The People's Republic continues to make it difficult to practice profitably there.  They have a tax on payments to hospitals and ASCs in the Republic.  The tax is actually assessed against all third party payors who pay the two classes of institutions.  They have just cut the tax from 3.25% to 2.9%.  The money is used to fund a pool to  reimburse hospitals for uninsured care.      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.