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Medicare: New Signup Every Three Years
The Government wants to streamline paper and processes. They do this by asking providers to re-enroll in Medicare every three years instead of once. They would also institute on-site visits to verify what the physicians have stated in their applications. The new form will be sent to the provider every three years and if nothing has changed the doctors only need to sign and send it back. If there are changes then the physicians would need to validate the changes. If providers do not timely notify Medicare of changes in their practice the CMS would institute immediate revocation proceedings. While these proceeding are taking place, no Medicare patients could be seen. The major problem will come when new physicians apply for Medicare and will not be allowed to see Medicare patients until they are certified a process that will take many months. Top
The Oregon House is considering placing a tax on provider's gross billing, not income. This would include physicians, hospitals and pharmacies. It would start 1/1/04 and the money would go to the Medicaid fund. There has been no percentage yet for the hospitals or physicians but the pharmacies would pay $1.00 per prescription dispensed. If the quarterly payment is not made there will be a $500 per day fine but this cannot exceed 2% of the assessment due. This bill needs a 60% yea vote to pass. Hopefully the parties affected can use their PAC money in concert and get this defeated. I would also think that the Governor, a physician, would have enough sense to veto this bill if passed.
This was done in the past in Minnesota but they were either stupid or bright enough to make it go to physicians who treated residents outside the state. This made it unconstitutional. Top
The Texas House has begun the tedious process of prompt payment reform. The House law would put a penalty on all clean claims not paid in 45 days. The law would direct the insurance commissioner to define a broad definition of what constitutes a clean claim. The insurance companies would need to pay a claim and if later audit showed the payment was unjustified they can be reimbursed. This allows the doctor to be paid while the insurance company investigates whether or not the claim is justified. This is a standard ploy be insurance companies to not pay claims promptly. This bill last time made it to the Governor who vetoed it. That almost cost him a re-election. Top
In Georgia, the legislature passed "tort reform". They did not put in a cap on non-economic damages. They did not use collateral source information when figuring damages. They did not put in the physician is only liable for their portion of the damages. They did not limit liability for emergency trauma. The legislature listened to the tort lawyers and only put in minimal collateral help for physicians. I believe Georgia will see a move from high risk procedures like OB and mammography to the detriment of their citizens. Top
JCAHO has again stuck it's nose where it doesn't belong. This organization that is supposed to only accredit organizations for Medicare but insists on putting in more and more "recommendations" to pass their inspections. The latest one floating is on the ED. They want all hospitals to make room in their institutions so people are not kept in the Ed for a long time. This is admirable but has nothing to do with the Conditions of Participation. Hospitals should truly consider using other organizations for their accreditation. The American Osteopathic Association will accredit any hospital and doesn't have the idiocy of the Joint. The State Department of Health will also accredit the institution at no charge.
The JCAHO if nothing else is political. Several months ago they threatened the Greater Southeast Community Hospital of Washington D.C. with loss of accreditation. I stated at that time that it would never happen since the political fallout would be too great. JCAHO's CEO O'Leary wrote to the DC Mayor stating the city would need to be involved for the hospital to keep it's accreditation. This is something that no other hospital would get. A delegation of people from DC is now in Chicago to beg O'Leary to give them a conditional accreditation for six months to fix up fire code violations and other problems. I bet that O'Leary, who does not want to upset the pols in DC, will grant the extension. Top
The DEA has proposed an increase on the fees it charges physicians to write narcotic prescriptions. The fee would go from $70 to $131 per year. The rationale for the increase is that the money is needed to pay for the the agency's prescription anti-diversion program. All practicing physicians will obviously pay this since it id difficult to practice without a DEA license. The thought processes behind the increase is flawed. The money should come from other funds and not the physicians who write legitimate prescriptions. Top
Louisiana has defeated a measure to stop the building of specialty hospitals. The bill would have mandated specialty hospitals have 24 hour emergency departments. There are about 12 specialty hospitals in the state. 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.