April 15, 2015 Legislation

Physicians

Healthcare

Physicians

The Arizona Medical Board was out of compliance with the state laws according to the Auditor General.  It was using outdated forms to credential physicians.  Aftr the report the Board changed all and are now in compliance.  They will be reviewed again in six months.  This is a difficult board to be on.  The legislature said they had to fingerprint all physicians for criminal background checks and make the information public.  The FBI balked at the public disclosure so they stopped doing fingerprints.  The physicians had already paid money which the legislature had to fund a refund for.          Top

Healthcare

Missouri had passed a law that required all people helping others to apply for Obamacare be licensed by the state.  the reason was to make sure the people got good information.  The law was challenged by some organizations that are losing federal money by not being able to give information.  The 8th Circuit agreed that the challengers of the law may succeed in their challenge and have blocked that aspect of the law. 

The DHS has stated that the Democrats who want to add a special Obamacare sign-up for pregnancy will not get their wish.  They acknowledge that for once they do not have the authority to make this an exceptional circumstance.  They can enroll in Medicaid but not Obamacare.  Do not take this as the final answer.  Obama will do an executive order.

CMS has fined 10 Medicare Advantage plans a total of $2.5 million in the first quarter of 2015.  This equates to the $50,000 fine on one organization in the same quarter last year.  The largest fine was to Citizens Choice in Orange, California for $669,000. The MA plan denied the prescription drugs to the members and did not state timely the coverage decisions nor allow appeals.  Nearly all the fines involved noncompliant drug formularies.  So far in the second quarter Aetna has been fined $1 million for having inaccurate information on which pharmacies were in network.  Health First Health Plan in Rockledge, Florida, has also been fined $420,000.    

The Texas Medical Board has cracked down on telemedicine.  The Board has prohibited Texas physicians form giving prescriptions to patients they have never met.  They need to have a defined patient physician relationship. The Board expressly allowed the covering call arrangements.  The AMA has a similar position but that is not binding.  The Texas Board has a separate policy for video consults.  It allows them if the remote consult takes place in an established site such as a physician's office or retail clinic with a provider standing by.         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.