February 1, 2014 Legislation

Healthcare

Hospitals

Physicians

Healthcare

The administration again changed the horses in mid stream.  They have now decided This is to allow those who are receiving therapy currently to continue until they can get on Obamacare. This is a good plan but should have been announced in the fall when the problems were apparent.  

In another order the administration unilaterally decided to delay enforcement of Obamacare that would prevent top executives from getting better health coverage than their employees.  The IRS is said to have problems with the definitions of highly compensated and discrimination.   The IRS wants to know what would happen if employers offer the same policy to all employees but the lower paid turn it down for the exchanges. This becomes very complicated if the company is self insured versus using a commercial insurer.  The administration had years to consider this and failed to do so. 

In the continuing changing Obamacare, IRS has decided that people with non-compliant plans were OK and would not have to pay a penalty.  What a joke.

CMS has finally believed that the new people on Medicaid will inundate the nation's EDs.  They have offered suggestions for the states to implement to reduce the influx of new Medicaid patients.  They also recognize that the new Medicaid patients will have a difficult time finding physicians to treat them.  The agency suggests setting up help phone lines and medical homes for the patients.

The Senate Republicans have finally articulated a semblance of a plan to replace Obamacare.  It is still a work in motion but it does get rid of the idiotic mandates to reduce the costs of the policies.  The size of tax subsides for premiums would be based on age and income and be available to the unemployed as well as those seeking individual coverage and working in small companies.  It would also get rid of all the tax increases currently in place.  It would get reduce of the tax exemption that is currently allowed for health insurance premiums from 100% to 65%.  Employers would continue to deduct the full cost of insurance for their employees.  

Knowing that it will increase premiums up to $44 per month the idiots at Covered California are mandating that all children's exchange products have pediatric dental coverage.  This is currently a side benefit for those who want it.  The head idiot said they noted that only 27% of those on the exchange took the elective coverage.  He went on to state the obvious that it was too expensive.  So now all will pay it including those who did not want or could not afford it in the past.  How many private dentists will see the kids?

The VA and the People's Republic of Massachusetts have something in common.  They do not care about it's people.  Both are considering allowing nurse anesthetists and advanced practice RNs to practice without supervision.  To date 60 state and national physician groups have condemned the thought and 40 nursing  groups have endorsed it.  In the Republic the nurses would also be allowed to dispense narcotics.        Top

Hospitals

The People's Republic of Massachusetts is investigating two maternal deaths at South Shore Hospital.  They both occurred in the past 11/2 months.        Top

Physicians

HHS has issued a ultimatum to physicians who cheap on caring for Medicare patients.  They will be fined and removed from the program.  This comes after HHS has been chastised for not removing physicians from the program who have been convicted of fraud.  Tavanner stated that this would only be for "recalcitrant providers".  This is defined as one who is abusing the program and not changing inappropriate behavior even after extensive education to address these behaviors.  The feds estimate that up to 10% of Medicare payments are improper.  They will be targeting those physicians who have the highest Medicare billing.  Most of them are in IM, Radiation Oncology and Ophthalmology.  The feds of course take no blame for the problem.  They do no acknowledge that they have a process that is meant to be used poorly.  In a related action CMS is planning to release the names of the high Medicare receivers.

The American Board of Obstetrics and Gynecology has again reversed itself and now states that their people may see both sexes for any reason.  They at first said no males could be seen.  Then they went to it's OK for fertility.  Now there is no restriction.  The board members refused to be interviewed for obvious reasons.  The only reason the board relented is a threat to sue them for antitrust if they did not.  Nice job Tom.        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.