February 1, 2015 Legislation

Healthcare

Insurers

Healthcare

In a bipartisan manner the House and Senate have both introduced legislation to get rid of the medical device tax under Obamacare.  It should easily pass both houses and be signed by the Prexy.

Aetna screwed up and CMS is allowing their Part D enrollees to switch to other plans because of it.  They misled people as to which pharmacies could fill their prescriptions.  Until February 28 the enrollees can use any pharmacy.

The Medicare Payment Advisory Committee ( MEDPAC) is recommending the freezing of payments to Ambulatory Surgury, Dialysis locations, Long Term Hospitals and Hospices.  They also want to keep the 10% pay increase to primary care physicians who see Medicaid patients.  They are getting smart wanting the same pay for services in physician's offices as in hospital outpatient settings.  This would get rid of the higher costs in hospital acquired offices.

The VA paid money and reversed firings of over two dozen people who were whistleblowers at the organization.  Good on them.

CMS has stated that in 2016 hospitals and physicians will be paid differently.  The true fee for service system will be replaced by a hybrid system.  The new system will be initially 30% tied to "value"  meaning cost and "quality", whatever that is.  This will raise to 50% by 2018.  Fortunately there will be someone else in the White House by then and this may be undone.  As you have probably guessed it will rely heavily on computer based billing and records.  The AMA and AAFP are for this plan. Providers will make more money if they do less.

The IRS has decided to waive penalties to those who owe tax due to Obamacare.  This applies only to people who received subsidized insurance in 2-14.  If they received more money and did not ask the feds to altar the subsidy they will owe money.

Maine's Governor has signed legislation to make convicted felons be tested for drugs prior to getting welfare money.  Other states that have made all people getting welfare test for drugs have been struck down.

NY mayor De Blasio has a dilemma.  He wants and needs the religious Jewish vote but also wants to stop the ultra orthodox Rabbis from sucking he blood away from the incision of  the penis post circumcision.  There have been outbreaks of herpes from this practice.  He is trying to be all things to all people by making the parents aware of the potential problem instead of banning the procedure.  This has been on the books but no one pays attention.        Top

Insurers

California has fined Health Net $200,000 for "lost" data.  They fined Aetna the same for failure to correct defects. 

California has also fined Kaiser $90,000 for failure to redact the information on arbitration cases they sent to to the Department of Managed Health.        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.