Healthcare Law Briefs
1. PA Insurance
Department Approves Highmark UCR, Premier Blue and Keystone Health Plan
West (KHPW)
The December 2002 Highmark PRN
announced PA Insurance Dept. approval for a wide range of reimbursement
increases. KHPW plans are Keystone Blue, Community Blue HMO and POS,
Select Blue, Direct Blue and Preferred Blue.
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2. CMS Delays Physician
Medicare Enrollment
Due to the delay in finalization of the 2003
Medicare Physician Fee Schedule, which cut physician reimbursements by
an average of 4.4%, the deadline for participation has been delayed
until February 28, 2003. (Transmittal AB-02-181)
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3. Anthem Blue
Cross/Blue Shield Slapped with $30 Million Punitive Damages for Denial
of Care
The Ohio State Supreme Court, upheld a
Licking County Common Pleas Court decision ruling that Anthem Blue
Cross/Blue Shield acted in bad faith when it denied continued payment
for experimental cancer treatments. The original judgment was $51
million; the Supreme Court reduced that to $31 million. The balance of
the award in excess of actual damages, attorneys fees, and $10 million
of the punitive damages will be paid by court order into a cancer
research fund. (Dardinger v. Anthem, Ohio, No. 2001 - 1222, 12/20/02)
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4. Health Law Advisors
Board Identifies Top Issues for 2003
A survey of the advisory board members
of the BNA Health Law Reporter identified the following issues as the
top 5 for 2003:
1. Restructuring of Medicare/Medicaid
2. Business/Business/Corporate responsibility for the
healthcare industry
3. Fraud and abuse enforcement
4. HIPAA compliance
5. Professional liability reform
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5. 2003 Medicare
Physician Fee Schedule
CMS's calendar year 2003 physician fee
schedule final rule was published in the December 31, 2002 Federal
Register. This final rule is effective on March 1, 2003.
The file is in Adobe
Acrobat and make take a few moments to open because of the size of the
document.
2003
Physician Fee Schedule
You must have Adobe Acrobat to read
Physician Fee Schedule.
Click
on the Adobe link to download.
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6. Rendell Proposes
MCare "Amnesty"
Pennsylvania Governor-Elect Ed Rendell
has pledged to propose legislation to provide certain high risk
physicians, whose malpractice premiums have skyrocketed, a one year
amnesty for Mcare payments. MCare is the state professional liability
program that replaced the CAT Fund. To cover the expected $200 million
in lost premiums, Rendell has proposed an assessment on all companies
that write health insurance in Pennsylvania.
I guess he missed the articles about
the sky rocketing health insurance premiums!
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>For more information about the
topics presented in this newsletter please contact one of the Healthcare
Attorneys:
>Read
the Fall 2002 issue of our HEALTHCARE
NEWSLETTER.
 Tucker Arensberg,
P.C.
1500 One PPG
Place Pittsburgh, PA 15222 412/566-1212
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