October 1, 2004 Legislation

Malpractice

California Laws

Criminal Checks

Physician Lecturers

Lab Fixed

JCAHO

Malpractice

Maryland has approved a 33% malpractice premium increase for its physicians.  The insurer had asked for a 41% increase.  The Governor, a Republican, has been for tort reform but has been rebuffed by the Democratic legislature.  The trial lawyers are after a state fund to pay the large awards.  More money in their pockets at the expense of the people of the state.   

In Illinois, the Governor has appointed a for chief judge of the Cook County Court to mediate the med mal discussions to be held between the trial attorneys, physicians and the insurers.  It would be nice if a mediator could bring the sides together but it somehow does not seem realistic.  The issues are too diverse and too personal.     Top

California Laws

The Guv either signed a bunch of legislative bills.  They are:

SB 1159 which may be the most important bill he ever signs.  This allows people to obtain without a prescription 10 syringes and needles.  This has the potential to save countless lives from AIDS and Hepatitis.  The flip side is that there will be more needles in the street.

SB 1325 and its companion SB 1456 or the Ventura Hospital Bill is probably the second most important bill signed.  It outlines the rights of the medical staff self governance and requires hospital boards and medical staffs to work out their differences. If the difference can not be worked out, the medical staff may ask the superior court to intervene.   This new law includes the wording that the medical staff may at their own expense hire their own attorney.  There are certain large hospital chains which forbid this currently.  This supercedes any prior language in the bylaws or by the chain regarding independent counsel.          

AB 321 which requires health plans to tell members when provider contracts expire. 

SB 635 allows Santa Barbara County to increase criminal fines to offset cost of providers giving emergency services for no money.

SB 1359 to require DHS to work with state DOJ to see what Medicaid fee for service programs are at most risk for fraud.

AB 2943 forbids the use of immunizations with more than trace amounts of thimerosal in pregnant females and children under the age of three.  

AB 2132 allowing asthmatic children to carry their own inhalers in spite of a no drug policy which had made the nurse or school official the custodian of the inhaler.  Common sense rules.

None of the above will cost the state any money.  

The Terminator also vetoed many healthcare bills:

SB 379 would have required hospitals to disclose their charity programs to the state and make the state the watchdog over the hospitals.  The Governor stated that the hospitals have a voluntary program and this needs to be given a chance first.  

AB 2532 would have mandated lift teams in hospitals causing even more money to be spent by regulation on top of the other many recent required expenditures.

AB 1555 would have required the state to go farther than the feds in requiring all health insurers to cover maternity benefits.  This takes choice away form the insureds.

AB 2874 would have mandated a six month announcement for hospital closings and penalties for hospitals that did not comply.

SB 1540 would have required a 90 day notification of EMS prior to closing of the hospitals.  The bills did nothing to improve care or keep hospitals open.

AB 2289 would have required insurers to report to the Department of Managed Care and the Department of Insurance information regarding health benefits.

SB 494 would have allowed providers to recoup reasonable and necessary charges instead of Medicaid rates for Medicaid participants involved in third party incidents.

SB 1569 would have allowed providers to sue health plans under certain conditions.

AB 750 which would have made companies with custom devices for Medicaid patients hire people to make sure they need the equipment.  The Terminator said that this would allow speech pathologists to determine things they are not qualified to do.

AB 1399 Would have required the evaluation of inmates psychosocial needs within three months of incarceration.

AB 2742 would have required all prisoners examined by outside physicians all the treatments recommended.  Too expensive.

SB 1492 would have required providers to tell patients and get the patient's permission if they use off shore companies for handling of personal medical information.  The reason is there are already federal and state protections for PHI.

In Sonoma County four years ago Palm Drive Hospital received permission from the voters to collect $60 per parcel to keep the hospital afloat.  Now they are in trouble again.  They now want $155 per parcel and they may not get it.  At some point the community must say, "How is this hospital being run?"      Top

Criminal Checks

In typical bureaucratic fashion, the state of South Carolina is considering using a battle axe to take care of a hang nail.  They have had one physician who lied on an application for a license.  However, this was caught.  Now they want to check all physicians for past criminal behavior.  They don't care that this costs money.  The one physician did not report a criminal act that happened when he was 19 and is now being investigated for an alternative medical treatment.  There are only four states that require criminal background checks within their own state and only ten require national checks.  There is no national standard as to the rationality of the checks except by those who would benefit financially by doing the checks.        Top

Physician Lecturers

Physicians who now lecture and are paid by the pharmaceutical companies are required to disclose their relationship.  Under new rules, the lecturers will have to be hired by third parties and will not only have to do the disclosure but also all the positive and negative results fro any product mentioned.        Top

Lab Fixed

Maryland Hospital laboratory after their fiasco in dry labing results, is now accredited again.  CMS has just fully accredited them after the lab hired outside consultants to correct the myriad of problems with equipment and staffing.        Top

JCAHO

The Joint continues to wave in the wind.  It has now again clarified standard MS1.20.  This bylaws standard now means that all the goodies that were in the bylaws and then moved out by some hospitals that want to control medical staffs can stay out of the bylaws.  What must be in the bylaws is the method for approval of these "administrative procedures", the criteria to identify the "administrative procedures" that can be in other documents and those "administrative procedures" in other documents are approved by the mechanisms stated in the bylaws.  The "administrative procedures" are credentialing, privileging, appointment and the fair hearing and appeal procedures.  In other words all the things of importance that the medical staff does is taken away from the medical staff vote.        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.