MALPRACTICE INSURANCE: CLAIMS MADE vs. OCCURRENCE POLICIES Professional Liability and Malpractice Insurance Lecture - Jeff Nicholson, PA-C, PhD
Where a policy is written on a "claims-made" basis, this means that the policy in force at the time a claim against you is made will pay for losses, regardless of when they occurred in the past. (Assuming no retroactive inception date restriction).
With an "occurrence" based policy, even though the policy may have expired, providing the policy was in force at the time the the bodily injury or property damage occurred, a claim can... Read remainder of the article HERE
PAs Providing Hospice Care for Medicare Patients The 112th Congress is well underway. Hopefully you've had the opportunity to reach out and connect with your new and returning Members. It is not time to begin laying the foundation for action on our priority issues.
All PAs are urged to contact Senators and Representatives and urge them to make changes to Medicare to allow PAs to provide hospice services to Medicare patients. Currently, PAs are barred from providing hospice care to beneficiaries, even though it is allowed by state law. Language to correct this was included in early committee-passed versions of health care reform last year, but was removed prior to final passage by Congress. The inability of PAs to provide hospice care for their terminally ill Medicare patients places an unconscionable burden on the patient to find alternative care and denies patients access to their "medical home" at a time then they are the most vulnerable.
Please contact your legislators and tell them of the critical need for PAs in hospice medicine. Ask them to make this technical correction to Medicare this year.
In 1997, the 105th Congress passed the Balanced Budget Act (BBA). The BBA made it clear that medical services provided by PAs, as allowed by state law, are covered by Medicare in all settings at one uniform rate.
Unfortunately, the former Health Care Financing Adminstration (now the Cetners for Medicare and Medicaid Services) decided that the BBA's Medicare provisions regarding coverage of services provided by PAs did not apply to hospice care. As a result, PAs are not permitted to provide hospice care to beneficiaries
who elect the hospice benefit. It makes no sense that Medicare beneficiaries woh routinely receive full-spectrum medical care from a PA and who elect to receive the hospice benefit are not able to receive hospice care by their PA.
Allowing PAs to provide hospice care does not change the PA/physician relationship, not does it increase cost (as PAs are reimbursed at 85% under Medicare). What it does do is increase patients' access to care, and improve continuity of care, especially in medically underserved areas.
Without this technical fix, beneficiaries will continue to face delays and denial of medically necessary care covered by Medicare.
Please contact your legislators today and urge them to take action this year.
Thank you for your advocacy in action!
House Bill 323, State Bill 308 Signing
MARYLAND CODE - HEALTH OCCUPATIONS Changes to Title as a result of the passage of House Bill 323 and Senate Bill 308
Title 15 - Physician Assistants
* (b) Alternate supervising physician - deletes the language "during the absence of the supervising physician and "
* (c) Defines "Ambulatory surgical facility" - "means a facility that is credentialed by
1. The American Association for Accreditation of Ambulatory Surgical Facilities;
2. The Accreditation Association for Amulatory Health Care;
3. The Joint Commission on the Accreditation of Health Care Organizations;
4. Certified to participate in the Medicare Program, as enacted by Title XVIII of the Social Security Act."
* (d) Deletes "certification"
* (j) Defines "dispense" - "means to dispense drug samples or starter dosages."
* (k) Defines "Drug sample" - "means a unit of a prescription drug that is intended to promote the sale of the drug and is not intended for sale."
* (L)(3) Adds to the definition of "hospital" - An emergency room that is physically connected to a hospital "OR A FREESTANDING MEDICAL FACILITY THAT IS LICENSED UNDER THE TITLE 19, SUBTITLE 3A OF THE HEALTH - GENERAL ARTICLE."
* (m) Defines "License" - "means a license issued...
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MedChi Survey Results: The Impact of Patient Health Insurance Protocols on the Maryland Physician's Ability to Provide Care
Some of the results from the survey;
95% of Maryland physicians surveyed said that health insurer protocols that impact how and what treatments physicians can prescribe their patients had a "somewhat" or "very negative" effect on the doctor's ability to effectively treat patients;
88.5% of physicians identified insurance barriers such as pre-approvals, step therapy, drug switching, and other protocols as "burdensome", "very burdensome" or as a "major hassle"; and
94%of survey respondents said that health insurance companies in Maryland delay or deny prescription medications or diagnostic testing for patients.