May 1, 2009 Legislation

Healthcare

Physicians

Healthcare

The public gave testimony to the panel who will be doing the Comparative Effectiveness Research (CER).  The panel is to gather the strength and weakness of various modalities.  The researcher urged that true research on patients not administrative be performed.  One should look at real world and not just clinical trials. This should not be a substitute for physician judgment.  Another said that the panel should have good data on the use of treatments and their outcomes.  He also emphasized real world and not laboratory outcomes.  Still another recommended the panel go away from prior literature search and recommended claims databases.  Still another said not to use insurance data.  If insurance data is used new things will be denied and there will be an attempt to shoehorn all into a single mode of care.  It should be interesting how much of this the panel takes in and actually uses. 

The Administration's heath care advisor Nancy Ann DeParle is now pandering a compromise for the left's public insurance plan.  She said that a compromise might be that the plan can not pay less than private plans for the same coverage. They could still cost less and drive private insurers out of business since the government does not have to make a profit.  

The US Senate has announced its first version of changes in the payments to hospitals and physicians under healthcare reform.  They want to pay more to hospitals and physicians who meet federal healthcare standards and less to those who don't.  They do not define what federal healthcare standards are.  They do want more of the providers to use comparative effectiveness research which no one can agree upon.  Should be interesting times.   

Next year physicians will need to write an essay to get patients into hospice.  The rationale is that patients are not dying fast enough now at hospice and the feds don't like to pay money for those who don't die when they are supposed to. The essay will be graded for telling why the patient will die within six months. There will also be a planned 1.1% decrease in hospice payments.     Top

Physicians

Some physicians (as noted in the Recent Legal section) are being paid less than their counterparts in the next county due to the disparity between rural and urban payments.  Congress is now going to take up a bill to equalize the payments.  They will take from the rich and give to the poor since the same total payments must remain the same.  That is unless your Congressman has the ear of the Party Chair.  Congressman Farr of Carmel, California is fronting a bill to pay $50 million to physicians in seven California counties including his.  This same type bill died in the Senate two years ago. 

Hospital attorneys are a kick.  They leave out that which is harmful to hospitals and leave in that that is harmful to physicians.  Two hospital attorneys just wrote an article on The Joint Commission's Disruptive Behavior Policy.  They say the policy is good and related to quality of care but omit that the policy affects not just physicians but also nursing and administration.  The latter two may also be disruptive by their actions or inactions to the orderly flow of the hospital.        Top

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DISCLAIMER: Although this article is updated periodically, it reflects the author's point of view at the time of publication. Nothing in this article constitutes legal advice. Readers should consult with their own legal counsel before acting on any of the information presented.