The Politics of Health Care

Death With Dignity

2013-05-15T10:48:00Z

Earlier this week, Vermont legislature became the first legislative body in the nation to approve death-with-dignity legislation, with Gov. Peter Shumlin vowing to sign the bill into law. In a press release issued by end-of-life choice advocacy group Compassion & Choices , President Barbara Coombs Lee, PA, FNP, JD, said, "This historic legislative victory proves that the aid-in-dying issue is no longer the third rail of politics. In fact, it’s a winning issue on which Gov. Shumlin campaigned....(read more)

Six Ways the 2014 Fiscal Budget May Change Healthcare

2013-04-30T18:19:00Z

(Editor's Note: This guest blog was written by Michael LaMagna.) With all of the talk regarding the sequester and budget cuts, I decided to focus on what the fiscal 2014 budget would mean to the 54 million+ Medicare beneficiaries, if the budget was passed in its current state. Currently, the 2014 proposed fiscal budget contains $4 trillion in cost savings, with almost $400 billion in Medicare spending reductions over the next decade. The cost-saving provisions are spread amongst all beneficiaries...(read more)

HHS: Affordable Care Act Extended Free Preventive Care to 71M with Private Health Insurance

2013-03-18T18:17:00Z

Health and Human Services (HHS) Secretary Kathleen Sebelius announced today in a press release that about 71 million Americans in private health insurance plans received coverage for at least one free preventive health care service, such as a mammogram or flu shot, in 2011 and 2012 because of the Affordable Care Act (ACA). Additionally, an estimated 34 million Americans in traditional Medicare and Medicare Advantage plans have received at least one preventive service, such as an annual wellness visit...(read more)

Bill Introduced to Improve Advance Care Planning with the Help of EHRs

2013-03-15T12:29:00Z

This week, Congressman Earl Blumenauer (OR-03) introduced The Personalize Your Care Act, bipartisan legislation that will provide Medicare and Medicaid coverage for voluntary consultations about advance-care planning every 5 years or in the event of a change in health status. The bill also provides grants to states to establish or expand Physician Orders for Life Sustaining Treatment (POLST) programs, and ensures that an individual’s electronic health record is able to display his or her current...(read more)

HHS Approves Four More States to Run State Partnership Marketplaces

2013-03-08T13:56:00Z

Health and Human Services (HHS) Secretary Kathleen Sebelius has announced in an HHS press release that more states are moving forward to implement the healthcare law and establishing Health Insurance Marketplaces. HHS conditionally approved Iowa, Michigan, New Hampshire and West Virginia to operate State Partnership Marketplaces, which will be ready for open enrollment in October 2013. "HHS will continue to work collaboratively with all states to build the marketplace," Secretary Sebelius said. "Working...(read more)

Healthcare Law Glitch Will Leave Many Without Insurance

2013-02-08T16:21:00Z

(Editor's Note: The guest blog was written by Michael LaMagna.) In somewhat unexpected news, there appears to be a serious crack in the healthcare law, one which may "price out" millions of families from healthcare coverage altogether. The issue recently came to light when confusing language in the new law appears to carve out lower income families who do not qualify for Medicaid, requiring them to either pay more for their employee sponsored health insurance or go without insurance. The problem...(read more)

HBMA: Congressional Delay Could Cost Providers Millions

2012-12-20T15:00:00Z

In a recent press release, the Healthcare Billing & Management Association , a non-profit educational resource and advocacy group representing third-party medical billing companies and billing professionals, announced that it is urging Congress to avert the pending 26.5% reduction in the Medicare physician fee schedule (MPFS) Conversion Factor on Jan. 1, 2013, and impose the longest possible Medicare sustainable growth rate (SGR) fix immediately this year, in 2012. HBMA members believe that should...(read more)

Medicare Settles Lawsuit: Many Will Gain Access to Services

2012-12-13T13:32:00Z

(Editor's note: This guest blog was written by Michael LaMagna.) If any readers have patients Medicare refused to pay for skilled nursing, home care or other outpatient benefits because their condition was "stable, chronic, not improving or that the necessary services were for maintenance," keep reading because there is some very good news. In early October, CMS settled a class action lawsuit filed by the Center for Medicare Agency and Vermont Legal Aid. According to the settlement, CMS will reverse...(read more)

Medicare Premiums to Rise in 2013

2012-11-21T20:07:00Z

(Editor's Note: This guest blog was written by Michael LaMagna.) The premium for Medicare Part B, which is the voluntary Medical insurance covering medically necessary doctors' services, preventive care, durable medical equipment, laboratory tests, x-rays, limited home health and ambulance services will rise by $5 in 2013. This increase will offset the Social Security cost of living increase for 2013 of 1.7%, or an average of $19 per month. The new Part B cost for the majority of beneficiaries will...(read more)

Two More Provisions of ACA Now in Effect

2012-10-31T15:41:00Z

(Editor's Note: This guest blog was written by Michael LaMagna.) As of Oct.1, 2012, two very important provisions of the Affordable Care Act (ACA) went into effect, which will significantly impact hospitals and other healthcare facilities. The two provisions are: 1) penalizing hospitals for readmitting patients within 30 days of discharge and 2) utilizing hospital value-based purchasing, which ties hospital payments to achieving clinical thresholds. It is anticipated that more than 2,200 hospitals...(read more)

Projected Costs of Health Care Law Changing

2012-09-26T19:30:00Z

(Editor's Note: This blog was written by Michael LaMagna, a partner at Timins & LaMagna, LLP) The Congressional Business Office (CBO) reports that in 2016, which is when the 2010 health care law becomes fully in effect, 2% of Americans, or roughly 6 million individuals, will be subject to the health care penalty tax. This is significantly higher than the estimated 4 million, in large part due to higher than anticipated unemployment, lower wages and salaries as well as changes to the law since...(read more)

Preventing Healthcare Fraud

2012-07-26T16:01:00Z

According to the Health and Human Services (HHS), HHS Secretary Kathleen Sebelius and Attorney General Eric Holder announced the launch of a ground-breaking partnership among the federal government, State officials, several leading private health insurance organizations and other healthcare anti-fraud groups to prevent healthcare fraud. This voluntary, collaborative arrangement uniting public and private organizations is the next step in the Obama administration's efforts to combat healthcare fraud...(read more)

Healthcare Law Provides Rebates, Saves Consumers Over $1 Billion

2012-06-21T19:00:00Z

Earlier today, Health and Human Services (HHS) Secretary Kathleen Sebelius announced that 12.8 million Americans will benefit from $1.1 billion in rebates from insurance companies this summer, because of the Affordable Care Act's 80/20 rule, also known as the Medical Loss Ratio (MLR) standard. These rebates will be an average of $151 for each family covered by a policy. The healthcare law generally requires insurance companies to spend at least 80 percent of consumers' premium dollars on medical...(read more)

The Trouble With Metadata & Health Privacy

2012-06-14T12:48:00Z

(Editor's note: This blog was written by ADVANCE editorial intern Rebecca Hepp.) Advances in technology over the past decade have raised serious concerns for patient privacy, an issue that sparked an intense panel discussion at the Second International Summit on the Future of Health Privacy, held last week in Washington, DC. Panelists debated current legislation's ability to properly protect patients in the age of smart phones, tablets and electronic records. For James Pyles, a health law attorney...(read more)

Pharma Industry Persuaded to Embrace Healthcare Law

2012-06-07T19:30:00Z

(Editor's Note: This guest blog was written by Michael LaMagna.) In a rare glimpse into political backdoor dealing, emails were released this last week revealing exactly how the White House was able to convince the pharmaceutical industry to embrace the controversial healthcare law. The emails, which were released from the Pharmaceutical Research and Manufacturers of America show that in exchange for their support of the law, the White House pledged to abandon price controls for prescription drugs...(read more)