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The People's Republic of Massachusetts has done what no other state has done. They have put lower income couples spending almost 7% of their income on mandatory health insurance. All this is dependant on the state getting affordable insurance rates, which to date has not happened. If they don't, then 500,000 people in the state will not be insured. It remains to see if this elephant will fly.
All in the People's Republic agree. A State Senator stated that the health plan rates are too high. He is afraid that some low income residents may not be able to afford the plan. If rates are too high the healthy low income people won't sign up and only the unhealthy will, making the plan even more fiscally unsound. The Governor's Office has recommended higher fees for all to keep the plan in some potential for fiscal balance. Residents may opt out of the plan if they can shoe they can not afford it.
An Executive Order directs all facets of the federal government to use, if available, computer systems that communicate with one another, enact programs that measure quality of care, tell beneficiaries prices that agencies pay for common procedures, and develop and identify practices that promote high quality health care.
The California Democratic Legislature and the Republican Governor have agreed on a new prescription plan for about 5 million people with moderate incomes. The law would give drug companies three years to voluntarily re-contract with the state for discounts for those with income below triple the federal poverty level. Those that did not comply would be barred from selling drugs on Medicaid in California. Expect the law to be challenged in the courts by the drug companies but they have already lost one such battle last year when Maine won with basically the same law.
The Democratic California Assembly Committee passed a bill allowing the Department of Health to fine hospitals providing they don't fine them more than $50,000 and not for any minor infractions. The California Hospital Association, a huge contributor to the California Democratic party agreed with the bill. This is in direct response to the Kaiser and other transplant fiascos in the past year. Kaiser Health plan got fined for their fiasco and not the hospitals. The bill would allow a fine up to $25,000 for each time a hospital put a patient in immediate jeopardy if serous injury or death. That may be daily for some hospitals. The larger fines would depend on the compliance of the hospitals.
Canada is moving closer to the US. The Canadian Medical Society has elected a president that is the operator of the country's largest private hospital. He advocates a hybrid health plan like those in Europe.
MedPAC has come out with a statement that specialty heart hospitals have increased by 6% the amount of surgeries in the market they are located. Duh! The study used expected heart surgery volumes, not actual. The study did not take into account any Medicare recipients that may have come to the specialty hospital from other areas because they are better at the surgery. The study said it is possible that physicians in the specialty hospitals are more prone to do surgery than at community hospitals but they also acknowledge that the patient does better at specialty hospitals with shorter lengths of stay. In ortho hospitals the length of stay is up to 25% shorter in specialty hospitals than community hospitals. That is significant. Top
This is a reminder that the government has decided not to pay any providers between September 22 thru September 30,2006. Those payments will be made starting on October 2. This may affect your year end if it falls on September 30 as well as any compensation based on quarterly performance (receipts). There will be no interest or penalty paid on this delay. You may need to alert your banker if you have a line of credit to cover cash flow problems.
Starting January 1, there will be a means test for Medicare Part B. It will be based on adjusted gross income. Those who make more will pay more. The base amount will also increase.
CMS errored. The sent checks to about 250,000 Medicare beneficiaries to reimburse them for prescription drug benefit premiums. An erroneous letter accompanied the checks stating that money will no longer be deducted from their SS checks. It will continued to be deducted and a new letter has gone out asking for the money back and telling the people that the benefits of the Part D remains intact. Top
The JCAHO has released a new revised MS.1.20 standard to be field reviewed prior to being made the law of the land in JCAHO's eyes. The organization has bowed to its hospital constituents that pays its bills. In the last iteration, which the AHA objected to, the majority of major documents needed to be in the medial staff bylaws. Now, the medical staff has the option of where to put the documents. The hospitals did not want the documents in the bylaws since that would not allow them to push things through the Medical Executive Committee. The new iteration takes away the prohibited unilateral amendment to the medical staff bylaws. THIS NEW PROPOSED REVISION IS ONE OF THE MOST IMPORTANT REASONS WHY A MEDICAL STAFF SHOULD HIRE THEIR OWN ATTORNEY AND NOT USE A HOSPITAL ATTORNEY. Top
Iowa has filed charges of incompetency against a Des Moines Methodist Hospital surgeon, Dr. Akella Chandrasekhar. The physician stopped doing the operations in Iowa in 2003 after six of his patients died post-op . The doctor is now practicing in New York City. 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.