Healthcare Law Briefs
1.
Tucker Arensberg Attorney Receives Health Care Lawyer of the Year Award
Michael A. Cassidy, Chair of the firm's Health Care Practice Group,
was awarded the Health Care Lawyer of the Year by the Pennsylvania Bar
Institute (PBI). Click
here for the PBI press release.
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2.
Medicare Update
On October 24, 2003, the Centers for Medicare and
Medicaid Services published three Federal Register notices concerning
Parts A and B premium, deductible and coinsurance amounts effective for
calendar year 2004.
Effective January 1, 2004, the inpatient hospital
deductible will be $876 (up $36 from 2003). The daily coinsurance
amounts will be $219 (up $9 from 2003) for the 61st through
90th day of hospitalization in a benefit period, $438 (up $18
from 2003) for lifetime reserve days, and $109.50 (up $4.50 from 2003)
for the 21st through 100th day of extended care
services in a skilled nursing facility in a benefit period. 68 Fed. Reg.
60,995 et seq.
The monthly Hospital Insurance (Part A) premium for the
12 months beginning January 1, 2004 for those who otherwise do not meet
the requirements for entitlement to Medicare Part A, and who enroll
voluntarily is $343 (up from the 2003 premium of $316). 68 Fed. Reg.
60,997 et seq. The monthly premium for those individuals subject
to the 45 percent reduction in the monthly premium is $189.
The monthly Supplemental Medical Insurance (Part B)
premium for 2004 is $66.60 (up from the 2003 premium of $58.70). 68 Fed.
Reg. 61,002 et seq.
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3. 2,800 Privacy Complaints
The Office of Civil Rights has reported that over 2,800
privacy complaints have been filed under HIPAA, primarily against
hospitals, pharmacies and private practices. Surprisingly, one of the
frequent complaints is that patients are being denied access to their
own medical records.
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4. U.S. Supreme Court to Hear ERISA Preemption Cases
Federal appeals courts have been asking the Supreme Court
to resolve the ERISA preemption issue involving malpractice claims
against health plans. When patients sue health plans alleging
malpractice, a frequent defense is that ERISA preempts the claim and
limits the available remedies. Appeals courts are divided on whether
these claims are malpractice claims governed by state law or employee
benefit issues governed by ERISA. The Supreme Court has agreed to hear
two Texas cases (Aetna Health, Inc. v. Davila and
CIGNA Healthcare of Texas, Inc. v. Calad), and now "has an
opportunity to make a definitive statement regarding the remedies
available to patients who are affected by the treatment and coverage
decisions of HMOs and PPOs." BNA Health Law Reporter, Analysis and
Perspective
11/13/03
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5. Federal District Court Grants Physician Access to Peer
Review Records
In Rdzanek v. Hospital Services District #3,
the U.S. District Court for the Eastern District of Louisiana ruled that
the Health Care Quality Improvement Act from obtaining discovery
concerning certain peer review documents complied regarding his peer
review proceedings.
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>For more information about the
topics presented in this newsletter please contact one of the
Healthcare
Attorneys:
>Read
the September 2003 issue of our HEALTHCARE
NEWSLETTER.
 Tucker Arensberg,
P.C.
1500 One PPG
Place Pittsburgh, PA 15222 412/566-1212
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