Healthcare Law Briefs
October 19, 2004
1. Pennsylvania Supreme Court Adopts
New Rules for Reducing Jury Damages Awards in Malpractice Cases
On
September 2, 2004, the Pennsylvania Supreme Court announced new trial
court rules encouraging "remitter", i.e. a process allowing the judge to
reduce the amount of a jury award for non-economic damages in a medical
malpractice case. New Rule of Civil Procedure 1042.72 will govern
post-trial motions in which the defendant in a medical malpractice case
challenges an award of non-economic damages on the ground that it is
excessive. The new rule will take effect December 4, 2004 and expire
after five years. The defendant bears the burden of convincing the court
that the damage award is excessive by establishing that it "deviates
substantially from what could be considered reasonable compensation."
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2. CMS Announces Coding To Increase
Payment for Cancer Treatment
The Centers
for Medicare & Medicaid Services in 2005 will implement 14 new and
refined codes for physician billing of oncology services to allow
doctors to bill Medicare for a wider variety of care related to the
administration of cancer drugs, the agency has told lawmakers. An
official form the American Society of Clinical Oncology told BNA Oct. 13
the changes would increase Medicare reimbursement for cancer care by
about $100 million a year, which is a "positive movement." However,
Deborah Kamin of ASCO also said this total was not enough to offset the
approximately $500 million in spending reductions expected between 2004
and 2005 due to congressionally mandated payment cuts in reimbursement
for Part B drugs. BNA Health Care Daily, Thursday, October 14, 2004.
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3. GAO Issues Report On Medicare
Physician Payments (GAO-05-85)
The
Medicare Prescription Drug, Improvement and Modernization Act of 2003
required the General Accounting Office to conduct a sturdy to review
alternatives to the SGR component of the Physician Fee Schedule. SGR
means "Sustainable Growth Rate"; it is the concept used in the Fee
Schedule to adjust the payment rate, i.e. the RVU conversion factor, to
match spending targets. The Fee Schedule is predicated upon the concept
that unit value will be adjusted to assure that increases in intensity
(i.e. utilization) will not result in total payments in excess of
projected "budgets". Therefore, if actual intensity growth exceeds
projected intensity growth, the payment rates will be reduced, or
perhaps just increased at a reduced rate, to keep expenditures within
budget.
The GAO's
conclusion was that SGR does depress payment rates but, since concluded
that a policy choice must be made between stabile fee increases and
fiscal discipline.
The Report
can be accessed on the GAO website:
http://www.gao.gov/new.items/d0585.pdf
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>For more information about the
topics presented in this newsletter please contact one of the
Healthcare
Attorneys:
Read
the September issue of our
HEALTHCARE NEWSLETTER.
 Tucker Arensberg,
P.C.
1500 One PPG
Place Pittsburgh, PA 15222 412/566-1212
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