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Obamacare Crashes Again?
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OUR HEALTH POLICY MATTERS
Paul Gionfriddo
There are bad reviews and then there are bad reviews. But it would be difficult to imagine some worse headlines than the ones Obamacare has received during the past month.
My favorite for over-the-top headline? How about this gem from the National Journal: "Why Obamacare May Be Obama's Katrina, Iraq." That's right. An initiative to insure millions of Americans has been equated with the most frightening American natural and man-made disasters of the 21st century.
In a world in which we have come to expect tight plotlines, heroic successes, and quick and satisfying endings, I imagine that a blockbuster like Obamacare was never going appeal to critics.
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www.MFHealthcare.com
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 A World Renowned Children's Hospital
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Pot Shots Fired - Recreational vs. Medicinal in Washington State
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AMELIA THOMSON-DEVEAUX
As Washington begins to accept applications for the state's first regulated recreational pot shops, cries of protest about the state's plans for medical marijuana are coming from unexpected quarters: the left. A year after voters put their state on track to become one of the only places in the world where marijuana can be legally owned and sold for purely recreational use, the state legislature still has to decide what to do with its rickety fifteen-year-old medical marijuana system. With the Department of Justice's hawkish eyes trained on the state, determined to ensure that the drug, which is still illegal under federal law, remains under strict control, some bureaucrats and lawmakers are afraid that Washington's unregulated medical marijuana system could doom the whole experiment.
In October, a working group commissioned by the legislature recommended that lawmakers should fold regulation of medical marijuana into the new recreational system, with a tax break for patients but few other concessions, like a personal growing exception for medical use or separate stores for therapeutic weed. The new framework would also scale back pot patients' existing privileges, reducing the amount of marijuana they can possess at a given time and cutting back on the diseases that qualify for a medical card. Patients, many of whom wanted the state to establish a separate regulatory system for therapeutic pot, were outraged.
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Medicare Q & A with Ben Frosch
Interest Charged on Overpayments?
Q: I just received a letter from Medicare informing me of a substantial overpayment. My staff researched this issue and we concluded they are correct with the overpayment determination. The letter we received states that it is a follow-up letter. I never received the initial notification of an overpayment from Medicare. My question addresses the interest on this overpayment. What are the rules on Medicare assessing interest on an overpayment? Internist Miami, FL A: Medicare does not charge interest on overpayments that are received within thirty-days. After the thirty day period, interest is assessed for the first thirty-day period and an additional thirty-day period. Interest continues to accrue for each subsequent thirty-day period for which payment is not received by Medicare. When money is offset (withheld from Medicare payments), it is applied to the accrued interest first and then to the principal. The follow-up overpayment letter probably does not imply you have another thirty-day period to refund the amount nor does it prevent Medicare from withholding future payments after the thirty-day period has elapsed. If you do not refund the overpayment within forty-days from the date of the initial refund request letter, Medicare may initiate offsets and pursue other efforts of recovery of the identified overpayment. The bottom line is, once you receive notification of the overpayment; return the monies as quick as possible. The overpayment is considered a debt owed to the United States Government and you can always appeal if you feel that Medicare is incorrect with the allegations of the overpayment or the interest payment. About the Author Mr. Frosch is the President of Frosch Medical Consultants, Inc. in Plantation. Got a question for Ben? Click Ask Ben.
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Meaningful-use deadline pushed back one year
The CMS is giving providers another year to show they've met the  Stage 2 criteria of the federal government's incentive program to encourage the adoption and meaningful use of electronic health records. That means the start of the next phase will be pushed back a year.
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Source: Modern Healthcare_________________________
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Cheaper or Better Care
Bernd Wollschlaeger, MD, FAAFP, FASAM
According to the attached article, published in HEALTH AFFAIRS (November 2013 vol. 32 no. 11 1977-1984) titled "Scope-Of-Practice Laws For Nurse Practitioners Limit Cost Savings That Can Be Achieved In Retail Clinics", the authors claim that the elimination of restrictions on NPs' Scope of Practice could have a large impact on the cost savings that can be achieved by retail clinics.
Using multi-state insurance claims data from 2004-07, a period in which many retail clinics opened, the authors analyzed whether the cost per episode associated with the use of retail clinics was lower in states where NPs are allowed to practice independently and to prescribe independently. They also examined whether retail clinic use and Scope of Practice were associated with emergency department visits and hospitalizations. The authors found that visits to retail clinics were associated with lower costs per episode, compared to episodes of care that did not begin with a retail clinic visit, and the costs were even lower when NPs practiced independently.
We have to be prepared to counter these arguments by pinpointing the interface of quality and costs of care and that family physicians have the experience to achieve BOTH. Focusing on costs alone may have a detrimental effect on the quality of care rendered.
Source: Florida Docs Blog
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Inside FloridaHealthIndustry.com
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