September 15, 2011 Legislation
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CMS has given some extra time for providers to ask for a hardship financial exemption for CPOE. They now have until November 1, 2011 to apply so they will not be penalized the 2% for not having CPOE along with EMR. The rule may be found in the September 6, 2011, Federal Register.
HHS will release this month regs that will hopefully save $3 Billion over five years for the health care industry. They will eliminate outdated reporting measures and streamline the current reporting and paperwork.
After the above they are canceling the savings by having a regulation that will be very expensive to providers. Patients will have the right to add to their medical recorders and also the providers see what they have written. They will also have the right to have their lab tests sent directly to them by the lab without the provider explaining them to the patient.
Apparently when nobody read Obamacare before they passed it they missed the part where worker's families that turn down employer coverage no matter the cost can not get subsidies to get into the government exchanges. Somebody now found the problem and the libs are screaming to change the regs. Obama changed some regs but not that one.
USA Today wrote a piece about the women's health part of Obamacare. They wrote that women can starting next summer get free preventative care. They list what can be obtained for no out of pocket expenses. They include all sterilization as well as contraception procedures, a "well woman" annual check-up, screening for gestational diabetes in the pregnant woman, screening for HPV every three years, annual HIV screening and counseling, breast feeding support and supplies and domestic violence screening and counseling. If anyone thinks these are free they belong in the loony bin. They may be no out of pocket expense but they will all be paid for by all taxpayers. It is funny that men have no problems that need screening. Men have the same or higher amount of HPV as women. HPV has been implicated in penile cancer in uncircumcised men. Men need "well men" check ups as much as the females need theirs. There is no question that vasectomy is preferred over tubal ligation as it is safer and easier. Yet, this is not covered. There is no mention of condoms being a covered item either. Could all this have anything to do with Sebelius being female?
NICE, the British cost arm of the NHS, has denied three drugs used for colon cancer because they are too expensive. The drugs are Avastin, Erbitux and Vectibix. There is evidence that at least two of the drugs prolong life. The drugs were just not cost effective unless you are the one with the metastatic cancer. Wake up America! This is coming to you with Obamacare.
Ain't the People's Republic of Massachusetts great. It brings a tear to my eyes to think that the Republic is considering cutting payments to the highest paid hospitals and providers (used to be physicians) and redistributing the largesse to those who are paid less. They must be taking lessons from Chairman Obama.
Money is the issue. Illinois is no longer using non generic meds for Medicaid psychiatric patients. If a physician wants a patient to have the meds they must take the time and energy to justify it. This is to trim $90 million a year from the $14Billion Medicaid budget. Top
California has decided that there are not enough votes in the Senate to pass a bill to regulate health insurance rates. This is the fourth year running that the majority Democrats could not muster the votes to pass the legislation in the state senate. Top
Parkland Hospital in Texas used to be one of the premiere hospitals in the country. It has gone to seed. They have now agreed to pay the state and the feds a total of $1.4 million for allegations they violated the False Claims Act. They did this by submitting claims for teaching physicians who did not do what they claimed they did. This was a whistleblower case filed by the former chair of the hospital's burn unit. The hospital admitted no liability but that means nothing. Parkland has also been cited for patient jeopardy by the CMS. Parkland's CEO has lost his job. After the CEO said bye-bye Parkland got its Medicare license back providing they work with an outside consultant to fix their problems.
Parkland is not alone. Dallas' Methodist Hospital has also been cited for immediate patient jeopardy. There are multiple concerns with Methodist but the most pressing is EMTALA violations.
California has fined twelve hospitals for various violations. The hospitals are Alameda Hospital fined $50,000 for one patient dying and others put at risk for increasing doses of fentenyl patches, Brotman Hospital fined $50,000 for letting an 82 year old patient fall and die from a subdural, California Men's Colony for giving the wrong patient methodone and the patient died, Dominican Hospital got a $75,000 fine for a third violation for giving the wrong dose of a medicine for four days and no one caught it, Emanuel Medical Center also got a $75,000 fine for a second violation in leaving a guide wire in a patient, Kaiser Vallejo only got fined $50,000 for it's second violation for giving a patient a wrong intraocular lens, Los Angeles County Southern California got it's fourth penalty of $50,000 for giving brain anoxia to a patient due to a nurse anesthetist breaking protocol, Riverside Hospital got fined $50,000 for leaviing a hemostat in a patient after the report stated all instruments were accounted for ( I guess they knew about the one left in the patient), Stanilaus Surgical Hospital was fined $50,000 for a wrong site surgery, Sutter Delta Hospital was fined $50,000 for failure to apply rapid cardiac monitoring resulting in cardiac arrest, Torrence Memorial was also fined $50,000 for a retained foreign body during a colonoscopy necessitating a second procedure, and the Univ. of California San Francisco was fined$50,000 for failure to remove a lap pad. It was their fifth penalty. Top
There are about 100,000 providers who
have not applied for either a waiver or stated that they are EMR
compliant. The chance to apply for a hardship waiver is fast
approaching. November 1 is the deadline. If you don't have a waiver
you will be docked 2% from your Medicare receipts starting January 1,
2012. This means you must have compliant EMRs and CPOEs. The waiver
affects the CPOE component and there is a laundry list of potential reasons why
you are not compliant. If you were good children and not only had your EMR
homework done on time but also did at least 25 CPOE during this year you will
get a bonus of 1% payable sometime later in 2012. Of course as of now you
will also get a 30% decrease in pay due to the nasty SGR. If you want a
hardship waiver and have a letter from your parent and are an individual you can
sign up by November 1on www.qualitynet.org/portal/server.pt/community/
communications_support_system/234. If you are a group you
need to write snail mail to CMS.
Bahrain physicians who opposed the Sunni rule were arrested in March and have just been released from jail after a 9 day hunger strike. The charges against the physicians have not been dropped. Most of the arrested physicians are Shi'ite. Wonder if American physicians could face the same if they stop seeing Medicare patients when the SGR comes to pass. 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.