News in brief - Feb. 14, 2011

AMA, CMA support hospital's fight against Medicare audit - States could opt out of health reform provision under federal bill - Family physician tapped as Alabama Medicaid director

AMA, CMA support hospital's fight against Medicare audit

The American Medical Association has filed a joint friend-of-the-court brief with the California Medical Assn. in support of a hospital's challenge to a Medicare audit.

The argument comes in response to a dispute between Escondido, Calif.-based Palomar Medical Center and the Dept. of Health and Human Services over an HHS attempt to reopen one of the medical center's Medicare claims 20 months after the initial payment. The medical center went through several rounds of administrative appeals to argue that the audit was unnecessary, but HHS said reopening a claim was not subject to appeal.

Southern District of California Court Judge Roger Benitez ruled in favor of HHS in July 2010. The case is on appeal in the U.S. Court of Appeals for the 9th Circuit.

The AMA called the HHS policy "arbitrary and capricious," and said the rules infringe on the right for judicial review. The medical associations are asking that the lower court decision be reversed and remanded.

States could opt out of health reform provision under federal bill

A bill introduced on Feb. 1 by Sen. John Barrasso, MD (R, Wyo.), would allow states to adopt legislation to opt out of the health system reform law's Medicaid expansion, its requirement for employers to provide insurance, and its mandate for individuals to have minimum levels of health coverage.

"Instead of requiring states to follow Obamacare's one-size-fits-all health care policy, our bill lets states decide what works best for them," said Dr. Barrasso, who introduced the legislation with Sen. Lindsey Graham (R, S.C.). The measure, known as the State Health Care Choice Act, has one other co-sponsor.

Graham said he's confident many states would choose to reject provisions of the health reform law. "As more states opt out, it will have the effect of repealing and replacing Obamacare."

Family physician tapped as Alabama Medicaid director

R. Bob Mullins Jr., MD, has been named Alabama Medicaid commissioner by Alabama Gov. Robert Bentley, MD. Dr. Mullins was president of the Medical Assn. of the State of Alabama from 2004 to 2005, and he has practiced as a family physician for 37 years in Valley, Ala.

The governor said his new Medicaid chief "understands the issues our Medicaid agency faces from the provider side as well as the patient and health care institutions' perspective. I have every confidence that he is the right man for the job and will work with all those affected by our Medicaid agency."

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