In this issue:
- Truth and Transparancy Bill
- Truth in Advertising
- Office-Based Surgery
- Cost Control the Next Step for Mass. Health Reform
- Special Feature: Update on Wisconsin, By Steve Grindel, MD (WI)
Truth and Transparency Bill - From ASPS
Reps. John Sullivan (R-Okla.) and David Scott (D-Ga.) recently re-introduced H.R. 451, the Health Care Truth and Transparency Act of 2011. The bill empowers patients to make informed and accurate health care decisions, and reduces uncertainty between patients and providers caused by ambiguous or misleading advertising.
The bill, which aims to increase transparency and strengthen the patient-physician relationship, contains the following provisions:
- Prohibits health care professionals' misrepresentation of education, training, degrees and state licenses, or clinical expertise
- Requires physicians to identify their license when advertising
- Directs the Federal Trade Commission (FTC) to conduct a study of misleading statements made by health care professionals, determine their frequency and effect on patients, and report these findings to Congress for further review and action
- Authorizes appropriation of funds to the FTC through 2016 for enforcement activities
Truth in Advertising - From ASPS
Truth in advertising bills were introduced in Colorado, Indiana, Mississippi, Montana, Nevada, New Mexico, New York, Utah and Wyoming in January. These bills would provide a variety of protections to ensure patients understand the qualifications of their health care provider. http://www.psnextra.org/Columns/Breast-Implant-Registry.html
Office-Based Surgery - From ASPS
The California Senate on Jan. 11 introduced legislation that would require health care providers to include the specific educational degree they hold in advertisements. S.B. 100 would also require all physician-owned accredited office-based surgical facilities to be licensed by the state. Additionally, the bill would require the Medical Board of California (MBC) to adopt regulations regarding the appropriate level of physician supervision of non-physician use of lasers.
In New York, legislation (S.B. 396) was introduced Jan. 5 that would require health plans to reimburse a physician for the use of an office-based surgical facility while performing a medically necessary procedure in an accredited office-based practice.
The Virginia Board of Medicine's Ad-Hoc Committee on Outpatient Surgery met Jan. 11 to discuss potential rules that would tighten up the state's regulation of office-based surgery. The Ad-Hoc Committee subsequently recommended that the Board of Medicine draft a guidance document on office-based procedures. The document will be used to develop proposed regulations to protect patients from the threat of inadequately trained providers who offer cosmetic and other surgical services in outpatient settings. http://www.psnextra.org/Columns/Breast-Implant-Registry.html
Cost control the next step for Massachusetts health reform - From AMA
In February, Massachusetts Gov. Deval Patrick unveiled his cost-containment plan to follow up on the landmark 2006 coverage expansions. If approved by legislators, it would define and encourage accountable care organizations within the state; give the state insurance commissioner the ability to scrutinize insurers' rates, including underlying physician pay, and disapprove rates that are excessive; and revamp the medical liability system to try to resolve disputes more quickly and curb defensive medicine. "We're optimistic that this bill highlights the fact that whatever pay reform we do, it needs to introduce flexibility, and the transition to health payment reform needs to be voluntary," said Alice A. Tolbert Coombs, MD, president of the Massachusetts Medical Society.http://www.ama-assn.org/amednews/2011/03/28/gvsb0328.htm
Special Feature: Update on Wisconsin
By, Steve Grindel, MD (Milwaukee, WI)
For better or for worse, the state of Wisconsin has been in the headlines since our new Governor took office in January.
Wisconsin, like many states, has found itself in a major budget crisis. In an effort to combat a $3.5 billion budget gap Governor Walker has proposed unprecedented cuts to education, state and local government, healthcare and many other sectors.
While the plight of our state employees has made national news, other far reaching effects of Governor Walkers proposed cuts have not been fleshed out. The current budget proposal calls for an increase in spending for Medicaid and BadgerCare Plus (Wisconsin’s healthcare alternative for uninsured children) by $1.3 billion. This increase however is expected to fall short by nearly $500 million needed to cover the increasing demand for Medicaid and BadgerCare Plus due in part to our current economic situation and expected reduced federal funding. Large changes and cuts are projected for programs aiding the elderly and disabled. SeniorCare recipients that are also eligible for Medicare Part D prescription drug benefit will be required to enroll in the federal program. With this shift the direct benefit to the patient should not change but the cost will be shifted to the federal government.
Currently in Wisconsin low income adults with household incomes below 200% of the national poverty level are eligible for Medicaid or BadgerCare Plus coverage. Governor Walker’s budget calls for tightening the eligibility standards for these programs by increasing the income threshold to 133% of the poverty level. This is expected to eliminate coverage for nearly 55,000 adults. He is also seeking permission from the federal government to cut off people receiving benefits who are found no longer eligible for coverage.
It has been reported that many of the budget changes could be accomplished without any legislative oversight at the discretion of the state health secretary. Some fear that with these changes it will be difficult to enroll and stay in these government programs.
Elsewhere in Wisconsin, there has been much debate about 2009 Wisconsin Ac 106- Practice of Radiography. This act creates a law relating to the regulation of the practice of radiography. Essentially this law affects those physicians that utilize in office X-ray. Despite no current or historical claims of injury from radiation exposure in an outpatient setting, this act calls for the creation of a Radiology Examining Board. The board has only one physician member, a radiologist, while there are two public members and three licensed radiographers (x-ray techs). This law prohibits the practice of radiography by a non-licensed radiographer unless you are a physician, PA or a student in a radiography program. Under this law medical assistants and nurses who typically perform X-ray functions in a private practice will no longer be allowed to do so. Interestingly, "a person under the direct supervision" of a Chiropractor, Dentist, or Podiatrist will be exempt from the law and allowed to take X-rays. There is no waiver for an employee working under direct supervision of a physician.
There is a growing group of physicians spearheaded by our own Greg Watchmaker MD, who are working for replacement legislation creating a board composed of physicians that utilize X-ray in their practice. We are also asking for amendment legislation allowing physicians offices the same exemptions as the Chiropractors, Dentists and Podiatrists.
These are the hot items we are facing in The Dairyland State this first quarter of 2011.