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There are several new laws in California affecting medical
care. The first is tougher penalties on healthcare workers that access
patient information illegally.
Another makes insurance coverage available to family members who's coverage has
been terminated. Insurers are also now responsible for paying medical
bills of members injured while under the influence. HMO insurers must also
pay for translators for their members and cover HIV screening for all members.
Hospitals must screen high risk patients for MRSA and report to the state.
Physicians who treat terminally ill patients are now required to tell them of
all options including no treatment and hospice
care. Top
Congress has passed the Bush vetoed SCHIP bill and sent it on to the Senate. Stuck in the bill was a prohibition on physicians owning after 1/1/09. This would not apply to ASCs. If physicians already owned part of hospitals on the above date the percentage would not be able to be changed. This is why the AHA has been paying off legislators these years so the item could be snuck into a bill with no discussion. The Senate can still stop the bill and maybe the Republicans will again block the entire bill.
A study funded by hospital and insurance companies have found that if Medicare and Medicaid paid physicians and hospitals more the public would pay less for private healthcare premiums. The medical establishment would require less money from private payors if they did not have to cost shift due to the low reimbursements from the federal and state programs. If fed med increased fees and private med decreased fees equally the family of four could reduce its premium by about $1788.
California physicians and hospitals have been warned that they may owe a use tax on items purchased out of state in the past three years. The individual or business would then be required to send money to the state equal to what the sales tax would have been if the goods were purchased in California. If the people and companies do not comply they could be audited for the past eight years.
Idaho dialysis centers are sitting empty and patients are traveling long distances for the service. The reason is the state's negligence in not inspecting the centers. The state says it only inspects centers when directed by the feds to do so and they have not been so directed. A real cop out.
The hospitals have much more money than the physicians so can pay off the legislators easier, at least in the People's Republic of Massachusetts. The hospitals paid enough to make the state apply CON laws to surgical centers that effectively complete against inefficient and expensive hospitals for outpatient surgery. The US Justice Department states that CON laws stifle competition and access to low cost high quality care. The rules ban multispecialty centers.
In Pennsylvania, physician owned surgical centers continue to flourish and the hospitals cry foul and will not compete on quality.
CMS is partnering with several sites that will test the concept of bundled payments for both the hospital and physician fees for a patient admission. The infighting in hospitals that do not employ physicians should be fantastic.
Wellpoint has been barred from enrolling any more Medicare patients due to their denying prescriptions to the Medicare patients and endangering their lives.
The People's Republic of Massachusetts continues to attempt to hold costs down with their insurance for all fiasco. The Governor is still asking for insurers and hospitals to rein in costs. He is threatening them with government regulation if they don't. The Governor is still not happy about the illegal deal between Partners and Blue Cross that is costing the citizens of the Republic mucho dinero. Top
California is probing whether Kaiser is practicing medicine without a license by the use of their call centers. The patient calls the center and gives the person answering the phone the symptoms. The person then uses a prewritten script to determine what to tell the patient based on the answers the patient gives to the prewritten questions. The problem is the person giving the information may be a clerk with a possible high school education. There is a law prohibiting what Kaiser is doing with their call centers but it is not being enforced. The state has been asking for the scripts the clerks use but Kaiser says the information is proprietary and will not release the scripts. The Kaiser nurses are the ones pushing the state to do a specific investigation of the process. If you are calling for an appointment and have shortness of breath do you want to talk to a clerk with no experience or a nurse who can help you now. Kaiser continues to believe they are above the law and can interpret the law to their liking.
The Nevada Board of Medical Examiners is asking the legislature to pass a law enabling patients to testify at medical license hearings. The NMA agrees with the proposed changes that also include time lines for applications and decisions by the Board.
The Dallas Morning News is doing an expose on the lack of oversight and bed partners of the hospitals and the legislators. It is a shabby tale of very poor care by the for profit Psychiatric Solutions Inc. (PSI) and the lack of oversight and reductions of penalties by the state. It is not surprising that these bedfellows are in Texas where the Medical Board is also filled with politics. Top
The JC has changed its accreditation process. There are many changes that go into effect now but will not be scored until July. Many of the changes are just common sense and are probably already being done by hospitals. The major changes come in the leadership and restraint categories. The JC now states that a physician or equivalent is responsible for the organization and conduct of the medical staff. This may be hard to swallow for hospital CEOs and attorneys. Hospital staff bylaws must now have that H&P be done by a physician or other as defined by state law and hospital policy. The bylaws must have a statement of the duties and privileges related to each category of the medical staff. The medical staff executive committee must have a majority that are fully licensed members of the medical staff actively practicing at the hospital. The other significant change to me is the Rights section. The hospital must acknowledge significant patient complaints and notify the patient of the follow-up. The hospital must notify the patient of the relevant state authority to which they may complain. There is to be a grievance committee if the governing body doesn't resolve grievances. The hospital must tell the patient who the contact person is, what steps that person is doing to resolve the problem, the results and the date of the completion of the process. I hope Kaiser reads this. 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.