September 15, 2016 Legislation
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The feds will screen some but not all people who apply for Ocare insurance on Healthcare.gov during the special enrollment periods. They earlier this year finally put in some safeguards where people applying in these periods would have to provide documentation to confirm their eligibility. This led to a 15% drop in these sign-ups. People would now have to be prospectively approved for the new sign-ups. The feds were forced to do this because the insurers were dropping the program. People were easily gaming the system by getting insurance under false pretenses, getting a procedure and dropping the insurance. This will be a pilot program with perimeters to be determined.
The FDA has banned 19 chemicals that are used in antibacterial soaps. These had been marketed to consumers as being more effective than other soaps. Manufacturers have one year to get rid of the offending agents. This does not apply to the soaps used in hospitals and food service settings. This ban does not apply to toothpaste. The feds say that there is no proof these products work any better than plain soap and water.
CMS has issued a disaster readiness rule that requires all providers to get up to speed wherever they are to prepare for local disasters. The goal is good but it will be hell on some small providers and outpatient facilities.
CMS has modified their MACRA rule by giving physicians more alternatives to hang themselves. They can not get less payments in 2019 by submitting some data to the QPP to test the systems. The next option is partial participation in 2017. The third option is full participation in 2017. The fourth and last option is participation in an advanced APM in 2017 such as Medicare Shared Savings Track. This gives some practices some more time before they retire.
Obama continues to rule by fiat. Now, he proposed to not allow states to withhold Title X federal family planning money from any organization for any reason other than the provider's "ability to deliver services to program beneficiaries in an effective manner. This cuts out states from defunding Planned Parenthood. Top
The California Attorney General's office has ordered Saint Agnes Medical Center of Fresno to pay $2.1 million to nonprofit organizations that provide direct health care services. This needs to be done by the last day of October. They had wanted a lowering of the $7 million annual charity care minimum required for patients who had no insurance or no means to pay for their care. The AG said no. They wanted this reduction because there was less uninsured since Ocare. This minimum was set for this hospital by the AG when a merger occurred between Trinity health and Catholic Health East. Top
In California one can not have an opinion that is against the law of the state. Dr. Bob Sears, an Orange County pediatrician, does not agree with the state's law regarding vaccinations. He routinely gives mothers medical excuses to get out of immunizations. While I personally think he is wrong, I, unlike the State, would not take away his medical license to practice. The medical board has accused him of gross negligence and endangering the child and the public. The board looked for a reason to get rid of him and will do so. He believes in immunizations at a slightly later time of life than the current recommendations. 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.