March 15, 2017 Legislation

Healthcare

Hospitals

Healthcare

It is starting.  The GOP has entered a bill in the House to repeal and replace Ocare.  The bill which some Republican conservatives senators may not back gets rid of the individual mandate as well as mandated group insurance and makes medical insurance voluntary.  Tax credits of up to $4000 for those over 60 would be allowed instead of most subsidies. These would be phased out for incomes over $75,000 for singles and $150,000 for couples. For those who have flaunted insurance and only purchased when they want insurance there would be a 30% penalty.  There would be no tax credits for policies that include abortion and defunds Planned Parenthood for one year.  Many taxes that are now in place would be repealed.  Those on Medicaid would feel the pinch as the bill would reduce payments for many. States would receive a fixed allotment of money per Medicaid person to be used as each state sees fit.  Kept were the provisions for pre-existing conditions, the ban on lifetime caps and allowing those under 26 to remain on the parent's plan.  The GOP also wants to get rid of the subsides based on income as well as the tax on high income people to fund the program.  Insurance policies would not have the ridiculous mandates that are now required.  

The US has fined UnitedHealthcare $2.5 million for not following the Medicare rules for prescription drugs.  

The UK has rejected Keytruda for initial treatment in lung cancer.  It states it is OK for melanoma and for patients with lung cancer who have had prior treatment.  The reason is money but they give a secondary reason as the survival benefit is not reliable enough.        Top  

Hospitals

The Joint Commission has finally added a new Sentinel Event.  This one makes administration leadership sit up and take notice in developing a safety culture.  This acknowledges the systemic flaws that cause the most safety lapses. The Joint says that admin types do not support reporting, do not support rapid feedback to those who report safety problems, allow intimidation for those who report problems, refuse to prioritize and implement safety recommendations and not addressing staff burnout. 

The ACGME has decided that first year residents can start forgoing sleep as their more senior residents do.  Starting on July 1 first year residents will be allowed to be on call for 24 hours but no more than 80 hours per week.  This new rule is based on one of two recent studies showing no change with the longer hours.  The other newer study showed problems.        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.