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November 27, 2012
CMS has issued a request for comments, including a list of questions, on how to redesign health care through the Exchanges. It's under the rubric of Obamacare's "National Quality Strategy" (Section 3011) and it follows the Section 1311 requirement that Exchanges pay health plans more if they improve health outcomes through government reporting, case management, care coordination, chronic disease management, medication and care compliance initiatives, health IT, wellness activities, and reduction of "health disparities." Read the questions for clarity of intrusions to come.
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November 20, 2012
On November 16, Wisconsin Governor Scott Walker sent a letter to Secretary Sebelius saying, "...we have determined Wisconsin will not develop a partnership or state-based exchange."
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November 19, 2012
On November 15, Texas Governor Rick Perry wrote a letter to HHS Secretary Kathleen Sebelius refusing to install the Obamacare exchange: "It is clear there is no such thing as a state exchange. Instead, this is a federally mandated exchange with rules dictated by Washington...the notion of a state exchange is merely an illusion...Our state will not be a party to helping facilitate the taxastion of millions of Texans, at an unknown cost, to implement bad public policy."
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November 06, 2012
As reported by Bloomberg/BNA's Health IT Law and Industry Report (10/29/12), Tom Frieden, director of the CDC wasnts doctors and hospitals to use EMRs to "track and refer tobacco users to public hotlines that offer support to patients working to quit smoking." In Stage 2 of "meaningful use" (MU), doctors and hospitals receive incentive payments if they record the smoking status of more than 80 percent of all patients 13 years or older. Patients may of course refuse to answer the questions or assist in the data collection. The CDC letter also suggests that EHRs should "automatically retrieve information from immunization registries." Click to read the CDC's letter.
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November 06, 2012
Jeffrey Shuren, FDA: "...To date, FDA has largely refrained from enforcing our regulatory requirements with respect to HIT devices. Nevertheless, certain HIT vendors have voluntarily registered and listed their software devices with the FDA, and some have provided submissions for premarket review. Additionally, patients, clinicians, and user facilities have voluntarily reported HIT-related adverse events. In the past two years, we have received 260 reports of HIT-related malfunctions with the potential for patient harm —including 44 reported injuries and 6 reported deaths. Because these reports are purely voluntary, they may represent only the tip of the iceberg in terms of the HIT-related problems that exist...."
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November 01, 2012
The Complaint: "Plaintiffs the American Hospital Association, Missouri Baptist Sullivan Hospital, Munson Medical Center, Lancaster GEneral Hospital, and Trinity Health Corporation ("Plaintiffs") bring this action to end an unlawful government practice: The Medicare program has been refusing to pay hospitals for hundreds of millions of dollars' worth of care provided to patients, even though all agree tha tthe care provided was reasonable and medically necessary as the Medicare Act requires. The government's refusal to pay for this care is harming hospitals and patients. More pertinent here, it violates the Medicare Act and is otherwise unlawful. Plaintiffs seek a declaration to that effect as well as monetary and other relief." - AHA, et. al. vs Kathleen Sebelius, HHS, November 1, 2012.
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October 22, 2012
WALTER MCCLURE, who worked with Paul Ellwood to create the HMO, was interviewed in August 2012. Minnesota's health care system is close to where he wants health care to be with outside analysis of patients and doctors. From the Interview: "When [McClure's] team started on [cost and quality] assessment in the 1980's, the idea that someone would be looking over a physician's shoulder was considered communism. Physicians were convinced of their right to autonomy. However, by 2008 Minnesota's private and voluntary sector had accomplished a sea change in this culture with 85 percent of providers in the state participating in having their outcomes measured." [our emphasis]
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October 18, 2012
Four U.S. Senators, including Senator Tom Coburn (R-OK) sent a letter to HHS asking several questions about "the final rule fo rthe Stage 2 of Meaningful Use for the adoption of electronic health records." Doctors and hospitals can receive taxpayer funds for adopting EMRs. Penalties for failure to adopt EMRs begin in 2015. In their fourth and final bullet, the Senators cited an article, "More voices raised against EHR incentives," discussing CCHF's concerns about EHRs and MU.
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October 08, 2012
A report from PriceWaterhouse Cooper (PwC)'s Health Research Institute says, "By 2021, the size of the exchange market is projected to more than double, marking the single largest expansion of health coverage in this country since the creation of Medicare in 1965...Public exchanges will create an irreversible shift in the insurance market that will ultimately change the way medical care is sold in the US. For the insurance industry, the new state-based exchanges represent a major business opportunity—an estimated $205 billion in premiums by 2021" Other reports say 98% of new spending in Obamacare -- $1 trillion -- is going to the health plans through the exchanges.
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August 24, 2012
However, I will inform the U.S. Department of Health and Human Services that no final decisions regarding Minnesota's Health Insurance Exchange can be made by my administration prior to the upcoming election. Legislators will have the opportunity thereafter to review options and participate in the final decisions.
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