September 1, 2016 Legislation



CMS is looking to make rules to prohibit third parties from paying for patients to get into Ocare.  Companies like dialysis companies are paying to get patients that need their services into Ocare so they can get higher payments than if the patient was on Medicaid or Medicare. 

The administration is attempting to resuscitate Ocare by regulation.  The regs would allow insurers to come back into the fold without waiting the five years that is presently required.  It would finally tighten the law to prohibit people from only using the insurance if they have a problem.  

The FDA has put out a guideline that requires all blood and components in the country to be tested for Zika.  This will raise the costs of blood dramatically but it is for safety with a population that travels as much as ours does. They expect this to be place in all states in about 3-4 months. 

New York has passed two new laws.  the first requires hospitals to post notices of patient rights including the right to designate a caregiver to receive post discharge instructions and to protect them against surprise medical bills by informing them of the right to submit these bills to  independent dispute resolution.  The second law requires the medical examiner from handing over unclaimed bodies to any university etc. without the next of kin consent.  This will put a real problems for medical schools to get cadavers for teaching.  From now on the schools will only use bodies from volunteers who donated their remains to science.

Massachusetts has a new data bank for physicians to query before prescribing controlled substances.  At the same time the state is attempting to teach PAs and nurses safe prescribing strategies.  The new bank is to attract physicians to actually use the program.  The new data bank is mandatory any time one prescribes narcotics.  The new system syncs with EMR and also can access data from the surrounding states.   

Pennsylvania has begun its data bank for prescriptions for use by pharmacies and also requires physicians review prescription histories with first time patients prior to prescribing narcotics.

California has a new law that will force insurers to get their physician lists correct.  If an insured gets a bill for an out of network provider and the insured relied on a published list for the provider name, the insured will not be liable for anything over the in network amount.  This law covers all but Medicare.  The health plans must update lists weekly if providers report changes and quarterly otherwise.  The list must be published online and be available to all.  If there are errors there must be a way to report the error and the error must be corrected within 30 days.  Providers must tell the health plans within 5 days if they are no longer accepting or they will start accepting new patients.  If the provider does not answer inquiries then the health plan may stop payments.  

Yet another bill in the golden state awaits signature requires hospitals to inform patients that if they are on observation status and not admitted their insurance may be affected.  The law also requires the nurse patient ratio of the state to apply to any separate observation units that may exist.  

Hooray for California.  The legislature has passed a bill that awaits the Guv's signature requiring all California high school graduates to be taught hands only CPR and AED use.        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.