Monday, June 28, 2010

21 Percent Physician Reimbursement Cut Delayed

On June 25, President Obama signed The Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010.

The law cancels a 21 percent physician Medicare reimbursement cut that CMS began enforcing on June 18. The law also increases physician reimbursement by 2.2 percent through November.

The temporary increase is a sign that Congress still needs to take action to address the sustainable growth rate, which factors into the reimbursement rates. There have been estimates that the physician payment cut may reach as high as 30% by January if Congress does not find a long-term solution, or implement another "patch" when the reimbursement increase expires in November.

CMS will begin processing all claims at the new rate by July 1.

Source: BNA

Wednesday, June 23, 2010

President Obama Urges Insurance Companies to Control Costs

On Tuesday, President Obama urged insurance companies not to increase the price of premiums despite the rising cost of healthcare and health reform. Health reform does not allow the government to regulate the cost of insurance; however, there are safeguards in place such as requirements that companies be transparent with cost increases, and exchanges that allow for competitive markets.

This warning from the President is a reminder that the health reform plan passed by Congress will not be the final solution to solve current problems with healthcare costs and access. In addition to the government, insurance companies, hospitals, healthcare professionals, and everyone involved in the delivery of care must work together to create a better healthcare system.

Source: The New York Times

Monday, June 21, 2010

FTC Expected to Grant Temporary "Red Flags Rule" Exemption to Health Care Providers

An attorney from the Federal Trade Commission's (FTC) Office of General Counsel says that the agency is close to completing an agreement that would give health care providers a temporary exemption from the "red flags rule."

The exemption would remain in place until the U.S. District Court for the District of Columbia makes a decision in the AMA v. FTC case. The American Medical Association brought the suit against the FTC, to prevent the agency from enforcing the rule against health care professionals.

The attorney for the FTC stated that the agency should reach an agreement on the temporary exemption in the next few days.

Source: BNA

Wednesday, June 16, 2010

AMA and GWU Focus on Need for More Physicians

The American Medical Association (AMA) adopted new measures to address the growing physician workforce shortage. The AMA is pushing for public and private payers to increase the number of residency positions for new graduates. The new policies will also focus on attracting students from underserved areas into the medical profession, with the hope that they will return to their communities to provide needed care.

The AMA's announcement comes as a George Washington University (GWU) study is released, stating that medical schools are not producing enough primary care doctors to meet patient needs. The study noted that public medical schools were more likely than prestigious private schools to produce primary care physicians, since the public schools were more likely to advocate a "social mission" or community care mission. The study also notes that the primary care shortage is mainly rooted in the fact that medical school graduates with massive debt are more likely to choose research or specialty positions over a low-paying primary care profession.

The health reform plan sets aside $1.5 billion for primary care doctors interested in working in underserved areas. Hospitals are in support of efforts to boost the primary care field, fearing that their emergency rooms will be flooded with patients if they are unable to access primary care treatment.

Sources: PRNewswire

The Baltimore Sun,0,6289224.story

Thursday, June 3, 2010

Expect Questions on Medical Coverage for New Graduates

One of the popular provisions of the health care reform plan allows young adults to stay on their parents' health plans until age 26. Currently, many young adults are removed from their parents' plan when they complete school. This has posed a problem for many new graduates who were unable to find employment immediately after school, or who were offered jobs or internships without coverage.

Although many are excited about this new provision, there are some who may be ineligible due to a coverage gap. An article in the New York Times states that the law goes into effect on September 26 of this year, but employers are not legally required to comply until January 2011. As a result, this year's graduates hoping to rely on their parent's coverage may have to wait if their parents' employers do not revise their plans immediately.

Patient Access staff may see an increase in questions from parents and patients regarding whether or not adult children are eligible under their parents' plan. This will include answering questions about whether or not the child is eligible for coverage under a parents' plan if he or she is employed, and if and when children would be eligible to rejoin their parents' plan if they were employed but lost their job.

Financial counselors and other access staff will need to work with patients and their families to determine eligibility in coverage, and if gaps in coverage do occur, what can be done to cover those gaps.

Source: New York Times

Brenda Sauer, CHAM is the Chair of the NAHAM Government Relations Committee.

Tuesday, June 1, 2010

"Red Flags Rule" Delayed Again until December 31

Implementation of the "red flags rule" has been delayed by the Federal Trade Commission (FTC) until December 31, 2010. The delay gives Congress time to determine whether or not healthcare providers should be subject to the rules.

There are currently two bills in Congress that would create exemptions for healthcare providers. S. 3416 has been introduced in the Senate. H.R. 3763 would exempt providers with 20 or fewer employees from the rule.

This most recent delay follows a challenge by the American Medical Association and several other medical groups, claiming that healthcare providers should not be defined as "creditors" subject to the rule.