September 1, 2013 Legislation

Hospitals

Physicians

Insurers

Hospitals

Obamacare is now found to require breast pumps be available for free to all women that require one.  However, they are only okaying the most expensive pumps via only certain DME suppliers.  Since most DME suppliers never handled breast pumps before a new niche for small business to become DME suppliers became available.  

In what be a terrific or a terrible move the LA Board of Stupes has given the go ahead for $29 million more to be spent on building a new MLK Hospital.  This makes the total $281.4 million.  The cost overruns for the government project is now at about $50 million.  There will be more in the near future.  After the needed hospital is built it needs to be staffed and the Board needs to keep it's grubby hands off the running of the hospital except for long distance oversight.  They screwed up the last hospital and caused it to close along with poor hiring practices of nursing.

The Joint Commission revoked its accreditation of New Life Surgical Center and the San Diego Ambulatory Surgical Center.  The reasons are unknown but all appeals have been exhausted.  The Centers had been associated with the notorious 1-800-Get- Thin advertising campaign.  A third affiliated center was placed on a watch.  That is the Valley Surgical Center.  These were run by the Omidi brothers.  Julian Omidi lost his license several years ago and Michael is now under investigation.

CMS has found that 40% of the patients at Rawson-Neal Psychiatric Hospital in Nevada were bused to other states.  This occurred without follow-up plans. CMS has stated that this was against EMTALA and fines may occur.  This is in spite of the fact that the hospital has no emergency room.           Top

Physicians

The Connecticut Medical Board has changed its composition in order to get rid of some of the delay in their discipline of physicians.  The Board has been increased by six members to a total of 21.  The legislature has also mandated the physicians respond to inquiries in a more timely fashion and that the Board get involved earlier in the investigation.  One of the Board members said that the changes are not going to help the speed of the investigation as the bottleneck is the Department of Public Health employees who investigate but who also have other duties and do not have the time to do their job quickly enough.  Connecticut is one of the few states where the Board does not have their own investigators and attorneys.  It also does not have its own budget.  She also said the attorneys for the Board are very slow.

To date, only six states have paid the primary care physicians the promised raise to see Medicaid patients.  They are supposed to have been paid Medicare rates as of the first of the year.  It is only supposed to last for two years.  The problem seems to be instead of just paying the physicians each state which did not set up it's own exchange has to get permission from CMS for this and CMS is slow.        Top

Insurers

California has forced Unitedhealth to pay for speech therapy.  It did the same to Kaiser last year.  Unitedhealth will pay for medically necessary speech therapy in the future and reimburse those who had to pay out of pocket in the past.  There were no fines assessed.         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.