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Teaching Hospital Update - April 29-May 3, 2013


Email Alert

May 3, 2013

Authored and edited by Amy Kaufman*

Bill Could Reduce Barriers to Immigration for International Physicians

American Medical News (4/29) reported that proposed legislation to reform immigration policy introduced on April 16 could make it easier for foreign physicians and medical graduates to immigrate to and work in the United States. The bill, known as the Border, Security, Economic Opportunity, and Immigration Modernization Act, would include additional visa waivers for physicians from oversees who would be willing to practice medicine in areas with underserved patient populations upon entering the country. To be eligible for these visas, a J-1 physician must agree "to be employed in a health professional shortage or medically underserved area for three years; be under contract at a health facility in that area; obtain a 'no objection' letter from his or her home country; and begin work within 90 days of receipt of the waiver." Other sections of the bill, such as one that exempts medical residents and physicians from global immigration gaps, also could reduce the burden for physicians to immigrate to the United States.

Receipt of Gifts and Payments Prevalent Among Massachusetts Physicians

Boston White Coat News (5/1) reported that "[o]ne in four physicians in Massachusetts received at least one gift or payment from pharmaceutical or medical device companies valued at $50 or more" since the Bay State began to require the tracking of payments in 2008. In November 2012, the legislature relaxed the state's prohibition on physicians accepting insignificant gifts and meals from industry. An analysis published in The New England Journal of Medicine on Wednesday suggests that specialists, rather than primary care physicians, are more inclined to accept some form of payment.

MGMA Survey Shows Wide Discrepancies in Pay across Specialties

MedPage Today (5/1) reported numbers from Medical Group Management Association's (MGMA's) Medical Directorship and On-Call Compensation Survey, showing that on-call pay for physicians differs significantly by specialty. For example, median pay for family medicine physicians equaled $150 and $100 in 2012 and 2011, respectively, while median pay for neurologists equaled $600 and $650 for the same years. Todd Evenson, the director of data solutions at MGMA-American College of Medical Practice Executives, explained that survey data were based on responses from 3,950 providers in 295 groups.

Possible Strike of Patient-Care Worker at University of California Hospitals

The Los Angeles Times (4/29) reported that the union for patient-care workers at University of California (UC) hospitals planned to take a strike vote on Thursday, May 2, and to announce the result of that vote next week. During the past year, the workers have been negotiating with the university over changes to staffing, salaries, and pensions. According to Kathryn Lybarger, Union president, the university prioritizes profits over patient safety. Tom Rosenthal, chief medical officer of the UC Los Angeles Health System, indicated that his staff is undergoing necessary preparation in case the union proceeds with strike.

CMS Fails to Address Penalties for Readmissions Unrelated to Initial Treatment in IPPS Proposed Rule

Law360 (5/1) reported that the fiscal year 2014 Inpatient Prospective Payment System Proposed Rule, which the Centers for Medicare & Medicaid Services released last week, failed to address whether hospitals can expect to incur readmissions penalties when patients return for additional care that is unrelated to their original reason for admission. According to Marie Watteau, a spokeswoman for the American Hospital Association, "[t]his sets up the absurd situation where a medically necessary readmission unrelated to the initial reason for the admission is counted against a hospital." Under current policy, hospitals can be dinged with a 1% penalty when patients are readmitted within 30 days of being treated for heart failure, a heart attack, or pneumonia. Next October this penalty will apply when patients whose treatment relates to hip or knee replacements or chronic obstructer pulmonary disease are readmitted as well. The penalty will also increase from 1% to 2%, and eventually to 3% by the end of next year. (Note: registration is required to access the full article.)

*We would like to thank Amy E. Kaufman, Esquire (Patton Boggs LLP, Washington, DC), for providing this week's update.

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