scoanet

Modern Physician Reports on CMS Concerns that Senate Bill will Drive Providers out of Medicare

Modern Physician is reporting on a new report released by the Centers for Medicare & Medicaid Services that expresses concern that the current health care reform legislation in the Senate will drive providers out of the Medicare program. 

Clear here to read the full story:

http://www.modernhealthcare.com/apps/pbcs.dll/article?AID=/20100109/MODERNPHYSICIAN/301099995/-1

Senate bill passes procedural vote, but with opposition.

The Washington Post reports that several members of the Senate Democratic caucus have reiterated their opposition to a government-run healthcare plan, despite voting in favor of moving the Senate’s healthcare reform bill to the chamber floor for debate. Sens. Joseph I. Lieberman (Ind.-Conn.), Ben Nelson (D-Neb.), Mary Landrieu (D-La.), and Blanche Lincoln (D-Ark.) are opposed to a provision that would create a so-called public option while allowing individual states to opt out of participation. However, other legislators state that they will fight to keep the current bill largely intact.
Read more...

AAOS has previously announced that it will actively oppose this legislation, which would further bureaucratize the Medicare system, institute a mandatory and punitive physician quality reporting program, decrease funding for patient access to specialty care, and impose restrictions on physician-owned hospitals. The bill also lacks a medical liability reform component, a repeal of the sustainable growth rate formula, and a cost-effective way to provide access as well as coverage.
Read the statement from AAOS President Joseph D. Zuckerman, MD… (member login required)

HR 3961 Passes House

The US House passed HR 3961 yesterday afternoon that repeals the Sustainable Growth Rate formula and replaces it with a new formula.  This action would prevent the 21% reduction in Medicare physician reimbursement scheduled to take effect in January.

This legislation still needs to be taken up by the US Senate to avoid these cuts.  It is unclear at this point if the Senate will include a fix in their overall health care reform legislation (that is not included currently) or if they will decide to pursue separate legislation similar to the House.  

We will keep you posted on any movement in the Senate on physician reimbursement.  Thank you very much to all of you who sent in emails and phone calls to Members of Congress requesting their support. 

Health care bill passes House

The U.S. House of Representatives passed H.R.3962, The Affordable Health Care for America Act, by a vote of 220-215 late on Saturday, Nov. 7. In response to the bill's passage, AAOS President Joseph D. Zuckerman, MD, highlighted several concerns regarding the bill, including: provisions that call for the formation of a new advisory body, similar to the CMS Innovation Center proposed in the Senate, because of its lack of opportunity for physician input and concerns about regulatory agency accountability; the redistribution of residency slots with a sole focus on primary care; restrictions on physician-owned hospitals; and the establishment of a public national medical device registry which lacks privacy protections for physician level data.

While the bill is not ideal, it does contain several positive provisions that are supported by the American Association of Orthopaedic Surgeons, but a permanent repeal and replacement of the Medicare sustainable growth rate (SGR) formula is in a "companion bill" that has yet to be voted on. Among the elements supported are:

• A provision eliminating the longstanding antitrust exemption for health insurance and liability insurance companies
• No punitive Physician Quality Reporting Initiative provisions
• No Independent Medicare Advisory Council

The nearly 2,000 page bill is expected to cost more than $1.2 trillion and to cover 96 percent of all Americans.

Read More...

Read Dr. Zuckerman's announcement (login required)...

Read the AAOS analysis of the bill (login required)...

House Democrats release healthcare reform bill

The Washington Post reports that Democratic leaders in the U.S. House of Representatives have released the newest version of healthcare reform legislation. The Affordable Health Care for America Act (HR.3962), which is expected to cost $894 billion over 10 years, contains a public insurance option and a mandate requiring most individuals to purchase insurance. It does not, however, contain a fix for the Medicare Sustainable Growth Rate (SGR) formula, which currently calls for a 21 percent reduction in physician reimbursement for 2010. Legislation to address the SGR has been moved to a different bill, which would eliminate the reduction in physician reimbursement, erase the accumulated debt, and base future updates on the Medicare Economic Index. Additionally, the legislation would create two separate targets for physician services: one for evaluation and management services and one for all other services.

AAOS will continue to provide updates as it analyzes HR.3962. AAOS President Joseph D. Zuckerman, MD, reports in his latest healthcare reform update, "we are disappointed that the SGR reforms are not included in the overall healthcare reform legislation. We will continue to work to ensure that this important issue is addressed by Congress."

Read More...

Read a summary of HR. 3962...

Read about the SGR bill...

CBO estimates tort reform could save $41 billion over 10 years.

In a letter to U.S. Sen. Orrin Hatch (R-Utah), the Congressional Budget Office (CBO) states that there is evidence to suggest that implementing a typical package of tort reform proposals could reduce healthcare spending in the United States by approximately 0.5 percent, or about $11 billion in 2009. CBO defines a typical package in part as a $250,000 cap on noneconomic damages, along with a cap on punitive damages of $500,000 or two times the award for economic damages, whichever is greater. The agency estimates that enactment of such a package would reduce mandatory spending for Medicare, Medicaid, the Children’s Health Insurance program, and the Federal Employees Health Benefits program by roughly $41 billion over the next decade.
Read More... (registration required)

Read the letter (PDF)...

Read the AAOS Position Statement on Medical Liability Reform (PDF)...

Trade group says Finance Committee plan would increase insurance costs.

The Associated Press reports that industry trade group America's Health Insurance Plans has released the results of a privately conducted study finding that adoption of the U.S. Senate Finance Committee’s healthcare reform bill would add $1,700 per year to the cost of family coverage by 2013 and that premiums for a single person would go up by $600 more than would be the case without the legislation. The study, which also projects that in 2019 family premiums could be $4,000 higher and individual premiums could be $1,500 higher, comes on the eve of a committee vote on the bill, which CBO has estimated would reduce the federal deficit while covering 94 percent of Americans.

Read More...

Poll finds strong public support for medical tort reform.

A national poll conducted by the nonpartisan reform coalition Clarus Research Group and the non-profit Committee for Economic Development finds that 83 percent of U.S. voters want Congress to address reform of the medical liability system as part of healthcare reform efforts, and 72 percent believe the fear of being sued often changes the way physicians deal with patients. Americans are also aware of the impact of medical liability on the practice of defensive medicine and medical costs. When asked "Do you think the fear of being sued is causing doctors to order unnecessary medical tests and procedures just to protect themselves from possible lawsuits?" 74 percent of respondents answered yes, and more than half of those who responded in the affirmative identified such defensive medical practices as a "major cause" of increased healthcare costs. The poll was conducted via live telephone interviews August 14-18, 2009, with a sample of 1,003 registered voters and a margin of error of +/- 3.1 percent.

Draft bill would remove health insurers’ antitrust exemption.

CQ Politics reports that draft legislation introduced in the U.S. Senate would repeal health and medical liability insurers’ exemption from federal antitrust laws, subjecting those companies to antitrust regulation by the U.S. Justice Department and the Federal Trade Commission. The bill’s sponsor, Sen. Patrick Leahy (D-Vt.), states that the measure would help make the health insurance industry more competitive and potentially drive down costs. Insurers gained statutory exemption from federal antitrust laws in the 1945 McCarran-Ferguson Act, and have opposed bills repealing the exemption, arguing that they are still prohibited from price fixing and collusion on claims settlements and that the limited exemption helps lower costs by allowing insurers to share data about losses and set more accurate prices. If the bill advances, the Senate Judiciary Committee would be added to the list of committees reviewing healthcare reform legislation.
Read More...

Senate Finance Committee Released Health Care Reform Proposal

The Senate Finance Committee today released its long-awaited healthcare reform bill. 

 

Please click on the link above to view their legislative proposal.