August 2022
MICRA wars: A new compromise bill signed into law will limit non-economic damages to $350K ($500K if involving patient death) starting Jan 1, 2023, increasing to double that amount over the next 10 years, and 2% annual inflationary adjustment thereafter. This removes the attorneys’ November ballot initiative to eliminate the cap. The law also establishes protections for benevolent gestures and statements of fault made in relation to an adverse patient safety event or unexpected medical outcome.
California’s COVID-19 test positivity rates are hovering around the threshold for mask mandates. Sewage in LA County is monitored for molecular traces of the virus, to estimate the unknown positivity rate of home testing which is not reported. Hospital admission rates trail this parameter by 1-2 weeks. The current strain is somewhat less susceptible to vaccine protection, and more contagious but less serious. Many people have gotten recurrent infections while we await updated vaccines. “Long COVID” (symptoms longer than 3 months, even in some of the mildest initial cases) is affecting an increasing number of people, causing cognitive, cardiac and immune dysfunction and chronic fatigue. The duration is unpredictable, and may be permanent in some.
New state regulations (Department of Health Care Access and Information) will require reporting full patient address, housing status, and several other data elements (to align with national standards), for Hospital discharges and Emergency Department and Ambulatory Surgery encounters after January 1, 2023.
A new federal law requires health plans and insurers to verify their contracting providers’ demographic information every 90 days. Failure to comply risks payment delays and removal from the provider directory.
Abortion wars: Since the US Supreme Court’s Roe v Wade decision on June 24, 11 states in the South and Midwest have banned abortion either completely or after 6 weeks of pregnancy (before many women know they are pregnant). Up to 26 states are expected to have some degree of ban. Other states, including California, are expecting an influx of out-of-state patients (those who can afford to travel) seeking abortions here. There is concern for doctors in abortion-restricted states being in legal jeopardy for treatment of ectopic pregnancies and miscarriages. This is a good argument for expanding primary care for more-effective prevention. (Meanwhile, internet abortion pills are available online, without effective supervision.)
A modest Congressional compromise agreement on Gun Reform establishes a “red flag” provision to keep deadly weapons out of the hands of individuals deemed to be a significant danger to themselves or others, support school security and mental health services, create enhanced review for buyers under 21 and penalties for “straw” purchases, and prohibit domestic partners from owning a gun if convicted of domestic violence. Unlike the original bill, it did not include restrictions on large-capacity ammunition, sale of semiautomatic firearms to buyers under 21, restrictions against gun trafficking, ghost guns (without serial numbers), or regulation of residential firearms storage.
