September 1, 2010 Legislation




Obama is again appointing a person to the HHS during a recess.  He knows he cannot get his appointees through the Senate during a regular session.  There will be others.

Sebilius has stated that if states do not put in insurance regulation or other parts of Obamacare, the feds will do it for them.  She considers this a partnership and not socialism.  The Kaiser Foundation states that the feuds between states and the fed are the biggest roadblocks with many Governors up for re-election and many changes expected.

Remember when the CBO stated how much Obamacare would save?  The CBO was given instructions by the Democrats as to what to figure.  The thing that they were told to leave out was the cost of physicians.  The CBO has just listed that cost at an additional $330 Billion, which wipes out all the "savings".

The feds have released $1 million to 45 states for setting up insurance regulators.  They have also given $250 million in grants to build clinics and increase services at clinics already in business taking care of illegal aliens, homeless, and the needy.  The administration has set aside $11 Billion for these clinics over five years.  The problem is there are few physicians or nurses that are willing to work in the clinics.

New York has a new rule that prior to any breast removal for cancer that physicians are required to tell patients of the potential for breast reconstruction, inform them of insurance coverage and refer them to other hospitals for the reconstruction surgery if necessary.  Congress had made universal coverage for breast reconstruction surgery a guarantee for Medicaid.    

California lawmakers have sent many healthcare provisions to the Governor for his approval or veto.  They include a mandate that all private and group health plans include maternity care. Another one is that plans must cover mental health including smoking addiction.  Yet again they will attempt to pass a single payer bill that is routinely vetoed by the Gov. Health insurance companies could only raise rates once a year.  It is always interesting how these bills come the last few days of a session and how they add to the cost of healthcare.  

The VA continues to throw money away.  They consider Agent Orange used in Viet Nam a cause of diabetes.  There has been no evidence that it is true.  All a vet must do is state he/she served or even went thru Viet Nam and has diabetes or many other diseases in order to be covered by the VA and have the care paid for by the taxpayers.  The new regs state it is now presumed that the vet got the disease in Nam.  It is a rathole of money.  The Vets deserve the best care in the country.  They deserve not to have to travel long distances to get care.  They deserve to get their care at the local hospitals and have the care paid for by the government.  A second shadow system is not necessary.  

Avastin is known to help people with colon cancer and is somewhat iffy in breast cancer.  However, it is expensive and therefore NICE in Britain says it is not good enough for even colon cancer.  This is where Obamacare is taking this country.  Britain is the only country not to allow Avastin for colon cancer therapy.           Top


Obamacare states that physicians with CT, MRI or PET scanners must tell patients that they own the machines if they send Medicare or Medicaid patients to their scanners.  They will also need to tell the patients where else they can get the test within 25 miles.  This rule starts on January 1 but offices need to start collecting the information and writing the memo in the near future.  Remember to thank your local radiologist for this extra work.  It is their association that pushed Congress to include it in Obamacare.  This law truly is only a make work rule since those on Medicare or Medicaid have their tests paid for by others and don't have any incentive to care to find other places that may be cheaper.   

New York now has a law that requires physicians to discuss end of life care with patients.  This lengthy discussion will not be paid for.  The next step is to follow California in requiring all physicians to take a course in end of life care.   

If you have already purchased your EMR system I want to wish you the best of luck.  HHS has just named the first two companies to give the final say if a system is sponge worthy per Elaine Benis of Seinfeld.  The two companies are CCHIT and the Drummond Group.            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.