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DJP Update 7-1-2010 What others are saying “health care reform law”; comment; Lagniappe re longevity!

DJP Update 7-1-2010 What others are saying “health care reform law”; comment; Lagniappe re longevity!

Health Affairs Blog article by Stephen Langel – interview with Rep. (Dr.) Michael Burgess of Texas.

Read entire article at: http://healthaffairs.org/blog/2010/07/01/rep-burgess-gives-physicians’-take-on-new-health-care-law/

EXCERPTS

Texas Republican Rep. Michael Burgess took a strong stand on the new health care reform law yesterday morning, arguing that opponents must stop its implementation by targeting its funding. He also predicted that there would not be a permanent fix to the Medicare sustainable growth rate until at least after the 2010 election.

……

The congressman also panned the bill’s widely supported effort to base doctors’ payment upon quality, rather than quantity, of care. Instead, Burgess came to the defense of the current fee-for-service system where the provider is paid for each individual service rendered to a patient. The congressman argued that doctors are “so goal directed that we need that impetus” of FFS as motivation to provide the best possible care. But he conceded that the vast majority of people do not take this view.

……

His hope is that even if Democrats maintain control of the House, the heat they take for this new law will make many of them more open to stopping it. He also predicted a possible “sea change” in Congress, with more physicians seeking House seats than any time in the past 100 years. There are 46 doctors, 40 of whom are Republicans, who are vying for seats, he added. This is the result of doctors’ dissatisfaction with the new law and the way it was passed, Burgess said.

Part of physicians’ concerns involve Congress’ failure to fix funding of the sustainable growth rate (SGR), which ties physician payment rates to Medicare spending for physician services and the growth rate of the overall economy. Doctors recently faced a 21.5 percent cut in their fees, which was later addressed by a temporary extension. Instead, lawmakers should have found a permanent fix for the SGR, Burgess said, adding that the specter of cuts is the number one roadblock for the elderly to get health care.

Part of the blame for this falls on the American Medical Association, who helped negotiate the final bill language. They failed to adequately represent their members, he said. “Why they didn’t do a better job, I don’t know.”

Despite this pressing need, Burgess told reporters that there is no chance a permanent fix will take place before the 2010 election. The temporary extension runs out on November 30, but there just isn’t the time for the lame duck Congress to make long-term changes, he said. Instead, another short-term extension or “budget gimmick” will be necessary. However, when an attempt at a permanent fix occurs, Republicans are not unified on whether the permanent fix needs to be completely paid for or if it can add to the deficit, he said.

Finally, Burgess saw no benefit in the law’s plan to reduce Medicare costs through a payment advisory board. Even though Congress could not be trusted to act on its own to fix the SGR, an independent panel is also not the answer to problems with the healthcare system, he said, counting repeal of the proposed Medicare Independent Payment Advisory Board as one of his top targets. Other targets include a new tax on medical device manufacturers.

……

DJP Comment: Too bad Dr. Burgess doesn’t mention balance-billing and private contracting! Perhaps he did and the reporter did not write about that part of the discussion. Balance-billing and private contracting need to be emphasized in every interview! Price-fixing and central control by government are doomed to failure. We need patient-centered care; patients in control with the doctor as trusted advisor; patients making decisions and having responsibility for making prudent decisions. Let not the greatness of America diminish. Let us not repeat the errors of failed economies. How many times do we have to see the repeat of this admonition from Nobel Prize winner William Butler Yeats. America found the golden fleece in the Declaration of Independence and the U.S. Constitution. We don’t need to reinvent and revert to the failures of other countries. Unchain the people and America will shine brightly again. That is our goal & gold.

EXCERPT:

Another Troy must rise and set,

Another lineage feed the crow,

Another Argo’s painted prow

Drive to a flashier bauble yet.

——

And don’t forget the warning in Ozymandias by Percy Bysshe Shelley

EXCERPT:

`My name is Ozymandias, King of Kings:

Look on my works, ye mighty, and despair!’

Nothing beside remains. Round the decay

Of that colossal wreck, boundless and bare,

The lone and level sands stretch far away”.

DJP Comment: Let not pride and arrogance in Washington, DC lead to our demise. The people want LEADERS, not power-brokers. Stop coercion. Listen up, Washington!

Lagniappe: Here is a fascinating story about a new discovery concerning longevity.

www.twitter.com/DJPNEWS

Exciting RT @WSJ Scientists..discovered a genetic signature of longevity; free test will be available to public http://on.wsj.com/9DcgBf

——-

Stay well,

Donald

P.S. Stop by http://twitter.com/djpNEWS and sign up for DJPNEWS to get tweet alerts that may not make it into DJP Updates. Twitter is free and takes minutes to join. Put email in and pick password. Great source of breaking news and you don’t flood your email with it. You can get free app for BlackBerry or IPhone etc and you check on tweets when you want.

Also, recent selected DJP Updates can be found at: http://www.intrepidresources.com/html/djp_update/

Donald J. Palmisano, MD, JD
Intrepid Resources® / The Medical Risk Manager Company
5000 West Esplanade Ave., #432
Metairie, Louisiana USA 70006
504-455-5895 office
504-455-9392 fax
DJP@intrepidresources.com
www.intrepidresources.com
www.onleadership.us

This DJP Update goes to 2262 leaders in Medicine representing all of the State Medical Associations and over 100 Specialty Societies plus some other friends.
You can share it with your members and it has the potential to reach 800,000 physicians.
To join the list, send me an email stating “Join DJP Update” To get off the list, state “Remove DJP Update”. Best to put in Subject line so I can do immediately.

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DJP Update 6-30-2010 Some tweets Oil Spill in Gulf, Supreme Ct decision re gun ownership, HSAs & SGR/private contracting, and “Mockingbird”

DJP Update 6-30-2010 Some tweets Oil Spill in Gulf, Supreme Ct decision re gun ownership, HSAs & SGR/private contracting, and “Mockingbird”

First, let us all hope the folks in Texas and in Mexico and neighboring areas are not hurt by the Hurricane. Those who have suffered from past hurricanes understand the anxiety, pain, and loss.

Tweets follow. Powerful YouTube video of Plaquemines Parish President Billy Nungesser. Sad times for those in his parish, the state, and all lovers of seafood and nature.

On one of my lecture trips to China, I was picked up at the airport by students assigned to take me to hotel. One asked me in the car if I had ever read “To Kill a Mockingbird”. He told me that was his favorite book. His comment told me a lot about the universal love of justice, liberty, fair play, and the antagonism against discrimination. See tweet about author, Harper Lee.

——–

www.Twitter.com/DJPNEWS

Gulf #oilspill #BP Gov #Jindal “time for the feds to lead or get out of the way” http://tinyurl.com/3xns4hy @BobbyJindal

2 minutes ago via web

Disaster if forced out RT @HeartlandInst Another victim of Obamacare- Say goodbye to your health savings accounts http://bit.ly/cVu92Q #hcr

about 3 hours ago via Echofon

Powerful view #leadership Billy #Nungesser Prez #Plaquemines Parish #oilspill #BP http://www.youtube.com/watch?v=1jQUfOZTK-Y

about 18 hours ago via web

A reasoned view RT @ThomasSowell Column: Gun Control Laws http://bit.ly/cKtivG #guns #2ndAmendment

1:13 AM Jun 29th via Echofon

RT @DrBob_Southlake PrivContracting/FreeEnterprise will Fix Medicare. Gov Price Fixing..impacting access to care.http://tinyurl.com/254xp44

11:24 PM Jun 28th via Echofon

Yes & allow balance-billing RT @DrBob_Southlake Our Coalition responds to Medicare Meltdown in USAToday http://tinyurl.com/22olrwx #hcr

9:55 PM Jun 28th via Echofon

Leadership RT @JindalNews Governor Jindal Calls On Feds To Get In The War To Win It http://twurl.nl/q5pyk2 #oilspill #BP#Jindal

9:04 PM Jun 28th via Echofon

Big deal, for sure! #SupremeCourt decision right to bear arms @WSJopinion http://tinyurl.com/27ugpl7 #guns #IIAmendment

6:58 PM Jun 28th via Echofon

#Mockingbird ! RT @PublishersWkly Harper Lee speaks to Daily Mail: long article, very short interview http://bit.ly/b9ZPfJ

6:43 PM Jun 28th via Echofon

———

Stay well,

Donald

P.S. Stop by http://twitter.com/djpNEWS and sign up for DJPNEWS to get tweet alerts that may not make it into DJP Updates. Twitter is free and takes minutes to join. Put email in and pick password. Great source of breaking news and you don’t flood your email with it. You can get free app for BlackBerry or IPhone etc and you check on tweets when you want.

Also, recent selected DJP Updates can be found at: http://www.intrepidresources.com/html/djp_update/

Donald J. Palmisano, MD, JD
Intrepid Resources® / The Medical Risk Manager Company
5000 West Esplanade Ave., #432
Metairie, Louisiana USA 70006
504-455-5895 office
504-455-9392 fax
DJP@intrepidresources.com
www.intrepidresources.com
www.onleadership.us

This DJP Update goes to 2262 leaders in Medicine representing all of the State Medical Associations and over 100 Specialty Societies plus some other friends.
You can share it with your members and it has the potential to reach 800,000 physicians.
To join the list, send me an email stating “Join DJP Update” To get off the list, state “Remove DJP Update”. Best to put in Subject line so I can do immediately.

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DJP Update 6-27-2010 Negative view of AMA by Wall Street Journal; “If Dr. Wilson is lucky, Congress will give his members another helping of gruel.”

DJP Update 6-27-2010 Negative view of AMA by Wall Street Journal; “If Dr. Wilson is lucky, Congress will give his members another helping of gruel.”

I certainly agree with The Wall Street Journal editorial criticizing AMA’s approach to health system reform and the issue of the SGR. But once again, I will be repeating myself to give my opinion of the flaws in the AMA’s negotiating position. Read the DJP Updates of the past year. Suffice it to say that Congress should be told that doctors and patients have a right to be free of coercion and price-fixing. And remember, changing from the SGR price-fixing formula to another price-fixing formula with a Orwellian name is no win! Too many brave people died giving us liberty in America and we should not dishonor them and ourselves by genuflecting to power-brokers in Washington, DC.

More “gruel”? That nails it. That is the impression of the world about AMA. And only AMA and the House of Delegates can change that impression. Be strong, have courage, be a leader! With every action, ask the question: Is this in the best interest of the patients AND DOES IT ALLOW THE DOCTORS TO REMAIN FREE AND THEIR PRACTICES VIABLE? If no doctors, no patient care.

New AMA leadership in place. Let’s see the performance. Let’s see if AMA waits until after the November elections and thus lose more negotiating power. The 6 month “fix” of the SGR was not a random number. Remember, the folks in Congress do no heart transplants and no removal of blood clots from brains. Nor any of the other wonderful life-saving acts that doctors do every day. That is reality. Stop being a victim. Learn from failure. Thomas Edison did. Hard to be forgiving when an organization refuses to listen, learn, and change direction.

Here is the article:

——

The Wall Street Journal

http://online.wsj.com/article/SB10001424052748703615104575328761237843010.html?mod=rss_opinion_main

REVIEW & OUTLOOK JUNE 26, 2010

A Beltway Public Service

Stimulus III goes down. World cheers.

EXCERPT:

The night’s most conspicuous loser was the American Medical Association, the doctors lobby that endorsed ObamaCare as a quid pro quo for ending the Medicare price-control formula that automatically cuts physician payments every year. Democrats were game until they realized that ending this “sustainable growth rate” would add a quarter-trillion dollars to ObamaCare’s total cost and thus make it harder to pretend to reduce the deficit.

Inexplicably, AMA president James Rohack accepted liberal blandishments and, in return for being played like a Stradivarius, his successor Cecil Wilson and doctors nationwide got a five-month patch plus a reversal of the 21.5% cut that kicked in June 1. Mrs. Pelosi then finally allowed a vote on this separate “doc fix” bill that the Senate passed a week ago but she had withheld from the floor as tax-extenders leverage. The cuts will be delayed until January, when they’ll hit 30% and if Dr. Wilson is lucky Congress will give his members another helping of gruel.

Even to “pay for” this $6.4 billion doc fix, Democrats had to game the budget window via tweaks to pension-funding laws. Democrats have exhausted every “fiscal responsibility” trick in the book, except actual fiscal responsibility, which they inadvertently committed on Thursday.

——-

Two of my tweets today at www.Twitter.com/DJPNEWS

Failure discussed! How others- @WSJopinion – see #AMA and the #hcr & #SGR debacle http://tinyurl.com/33k9y8w

25 minutes ago via Echofon

A tale of graft vs “donations” by excellent editorial writer @jarvisdeberrytp http://tinyurl.com/2449nfj #NOLA #church #S&WB

about 6 hours ago via Echofon

—-

Stay well,

Donald

P.S. Stop by http://twitter.com/djpNEWS and sign up for DJPNEWS to get tweet alerts that may not make it into DJP Updates. Twitter is free and takes minutes to join. Put email in and pick password. Great source of breaking news and you don’t flood your email with it. You can get free app for BlackBerry or IPhone etc and you check on tweets when you want.

Also, recent selected DJP Updates can be found at: http://www.intrepidresources.com/html/djp_update/

Donald J. Palmisano, MD, JD
Intrepid Resources® / The Medical Risk Manager Company
5000 West Esplanade Ave., #432
Metairie, Louisiana USA 70006
504-455-5895 office
504-455-9392 fax
DJP@intrepidresources.com
www.intrepidresources.com
www.onleadership.us

This DJP Update goes to 2262 leaders in Medicine representing all of the State Medical Associations and over 100 Specialty Societies plus some other friends.
You can share it with your members and it has the potential to reach 800,000 physicians.
To join the list, send me an email stating “Join DJP Update” To get off the list, state “Remove DJP Update”. Best to put in Subject line so I can do immediately.

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DJP Update 6-24-2010 AMA featured in Roll Call article & some recent tweets PLUS breaking news from AMA about SGR

DJP Update 6-24-2010 AMA featured in Roll Call article & some recent tweets PLUS breaking news from AMA about SGR

http://www.rollcall.com/issues/55_152/lobbying/47622-1.html

AMA Chief Has Internal Divisions to Stitch Up

By Bennett Roth

Roll Call Staff

June 23, 2010, 12 a.m.

In a speech last week marking his ascension to the presidency of the American Medical Association, Cecil Wilson, an avid sailor and former Navy doctor, couldn’t resist tossing out some precautionary sea tales.

….

Excerpts:

Son of a Preacher Man

Wilson’s backers say the 75-year-old former naval surgeon, who grew up in south Georgia as the son of a Methodist minister, possesses the even temperament needed to lead the organization in this fractious period.

“One thing about him, he always keeps his cool,” said Russ Jackson, senior vice president of Florida Medical Association, where Wilson once served as president.

———

Despite the considerable resources it pours into influencing Congress and the executive branch, some health care experts say AMA’s clout has waned.

Robert Moffit, a health care specialist at the conservative Heritage Foundation, said at one time “the AMA was not only respected, it was feared.”

But he said over the years the proliferation of specialist groups has diluted the group’s influence.

Many of these specialists, particularly surgeons, were among the most critical of the Democratic health care reform proposals. Among AMA members, there was vocal dissent when the group threw its support behind the House and Senate bills, endorsements that were viewed as crucial in swaying some undecided Democratic lawmakers.

……..

Intensive Care

But in his address at the AMA convention in Chicago last week, Wilson promised to mend those divisions and hold regular conference calls to reach out to the group’s members.

The tensions over the direction of the organization were reflected in a rare three-way race to become the group’s next president-elect, which was held at their Chicago meeting.

Peter Carmel, a pediatric neurosurgeon from New Jersey, won that race, and he will take the helm of the organization in June 2011.

Carmel vowed to take a tougher stand toward Washington.

“The AMA is going to be more insistent and little edgier with its relationships with Congress and the administration in demanding some of the things we doctors need,” Carmel told the Chicago Tribune.

But for the time being, even one of the more outspoken AMA members said he was willing to give the new leadership a chance.

Donald Palmisano, a New Orleans physician who was active in the conservative faction opposing health care reform, called Wilson “a fine gentleman.”

But Palmisano, a former AMA president, noted that the group’s leaders are bound by policies set by its board of delegates. The test for Wilson, he said, is whether he will be able to effectively communicate those policies on issues such as Medicare physician payment formula.

“I’m going to give Dr. Wilson the benefit of the doubt,” he said.

———-

DJP Comment: I just wrote the reporter who was very nice during the interview, complimented him on the article, and thanked him for calling and interviewing me. I also pointed out:

————

You wrote: “policies set by its board of delegates.”

It should be “policies set by its House of Delegates.” (approximately 535 delegates)

Second point:

You wrote: “…faction opposing health care reform, ”

It should be: “…faction supporting health system reform but opposing the bill that became law.”

If there is an opportunity to put that in a posting on your Website, you have my permission.

———–

Here are some RECENT TWEETS I posted at www.Twitter.com/DJPNEWS

Depressing! #oilspill #BP via @sonodoc99 @jaketapper@DJPNEWS Re: Gulf Oil Crisis – Doomsday Scenario http://tinyurl.com/2dft84t

about 5 hours ago via Echofon

RT @CDCgov CA: Whooping cough epidemic in Calif. Teens & adults can infect babies. Get your Tdap booster shot. http://is.gd/d0QE4

about 7 hours ago via Echofon

Wow! #MichaelBarone in #IBD “Chicago Way…Gulf Crisis” & quote #RandSimberg re Dunkirk! http://tinyurl.com/2bh3qyo#oilspill

about 18 hours ago via Echofon

RT @BobbyJindal Shutting down dredging while oil hits our shores is absolutely absurd. We need to act now.http://twurl.cc/2zuk #oilspill

about 19 hours ago via Echofon

Crisis! RT @CatoInstitute The Jones Act used to just kill free trade. Now it’s killing beach and sea life too http://bit.ly/aUNBZE #oilspill

2:18 PM Jun 23rd via Echofon

Teach cooperation with prison guards? RT @AmerMedicalAssnFind success with new payment models during July seminar http://bit.ly/aMeYaa

2:11 PM Jun 23rd via Echofon

England: “to pay the bills of past irresponsibility” more taxes; & #VAT, value added tax, rises to 20% in Jan. Via Times/London

11:55 AM Jun 23rd via Echofon

New research option: Data sets & powerful computers re #Parkinson’s disease: see #Wired Magazine July 2010 “Sergey’s Search”

9:02 PM Jun 22nd via Echofon

Will Congress be able to operate on seniors and families of military? Shame on Congress for SGR and 21% cut. Show some leadership!

8:15 PM Jun 22nd via Echofon

Price-fixing disaster! RT @SenateDoctors ABC News: Medicare Havoc is Here – 50 Million Medicare Claims Get Trimmed http://bit.ly/c0UFJR

8:12 PM Jun 22nd via Echofon

Cost Sharing RT @NCPA current health insur: govt isn’t telling you to be in poorly-designed plan. ..about to changehttp://bit.ly/bO6aul

8:03 PM Jun 22nd via Echofon

Should only be Opt In; not Auto r Opt Out” RT @AppleMacGeek Apple Updates #Privacy Notice with Locationhttp://bit.ly/cP1CdV

11:13 PM Jun 21st via Echofon

————

Breaking news from AMA:

The AMA learned that the House intends to consider the Senate-passed bill (H.R. 3962) that would provide a 2.2 percent Medicare fee schedule update for physician services through November 2010. This update would replace the 21 percent cut currently in effect, and be applied retroactively to claims for services provided on or after June 1. The bill will be considered on the House floor under suspension of the rules at about 5:30 EDT this evening.

Terri Marchiori

American Medical Association

Director, Federation Relations

312.464.5271

terri.marchiori@ama-assn.org

————————–

Stay well,

Donald

P.S. Stop by http://twitter.com/djpNEWS and sign up for DJPNEWS to get tweet alerts that may not make it into DJP Updates. Twitter is free and takes minutes to join. Put email in and pick password. Great source of breaking news and you don’t flood your email with it. You can get free app for BlackBerry or IPhone etc and you check on tweets when you want.

Also, recent selected DJP Updates can be found at: http://www.intrepidresources.com/html/djp_update/

Donald J. Palmisano, MD, JD
Intrepid Resources® / The Medical Risk Manager Company
5000 West Esplanade Ave., #432
Metairie, Louisiana USA 70006
504-455-5895 office
504-455-9392 fax
DJP@intrepidresources.com
www.intrepidresources.com
www.onleadership.us

This DJP Update goes to 2261 leaders in Medicine representing all of the State Medical Associations and over 100 Specialty Societies plus some other friends.
You can share it with your members and it has the potential to reach 800,000 physicians.
To join the list, send me an email stating “Join DJP Update” To get off the list, state “Remove DJP Update”. Best to put in Subject line so I can do immediately.

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ITEM ONE: DJP Update 6-21-2010 “Grandfathered” Health Plans regulation issued by HHS

ITEM ONE: DJP Update 6-21-2010 “Grandfathered” Health Plans regulation issued by HHS

And now the regulations start! Be alert and monitor these regulations that implement the disaster in the details new law. We are moving in the direction of more government control of Medicine and lack of choice by patients of Free Enterprise alternatives. You can count on it.

My CPA send me some information about “Grandfathered” health plans from a summary of the regulation at: http://www.sebsla.com/n-news/article.asp?id=40

and that link also gives the link to the Federal Website that has information of new regulation by HHS. The HHS press release of June 14, 2010 can be found at:

http://www.hhs.gov/news/press/2010pres/06/20100614e.html

Here is info from Federal Government Website that includes discussion of

“Grandfathered” Health Plans

and how that status can be lost.

http://www.healthreform.gov/newsroom/keeping_the_health_plan_you_have.html

Today, the Departments of Health and Human Services, Labor, and Treasury issued a new regulation for health coverage in place on March 23, 2010 that makes good on that promise by…

Another excerpt:

Plans will lose their grandfathered status if they choose to make significant changes that reduce benefits or increase costs to consumers. If a plan loses its grandfathered status, then consumers in these plans will gain additional new benefits including:

Coverage of recommended prevention services with no cost sharing; and

Patient protections such as guaranteed access to OB-GYNs and pediatricians.

Under the Affordable Care Act, these requirements are applicable to all new plans, and existing plans that choose to make the following changes that would cause them to lose their grandfathered status.

Compared to their polices in effect on March 23, 2010, grandfathered plans:

Cannot Significantly Cut or Reduce Benefits. For example, if a plan decides to no longer cover care for people with diabetes, cystic fibrosis or HIV/AIDS.

Cannot Raise Co-Insurance Charges. Typically, co-insurance requires a patient to pay a fixed percentage of a charge (for example, 20% of a hospital bill). Grandfathered plans cannot increase this percentage.

Cannot Significantly Raise Co-Payment Charges. Frequently, plans require patients to pay a fixed-dollar amount for doctor’s office visits and other services. Compared with the copayments in effect on March 23, 2010, grandfathered plans will be able to increase those co-pays by no more than the greater of $5 (adjusted annually for medical inflation) or a percentage equal to medical inflation plus 15 percentage points. For example, if a plan raises its copayment from $30 to $50 over the next 2 years, it will lose its grandfathered status.

Cannot Significantly Raise Deductibles. Many plans require patients to pay the first bills they receive each year (for example, the first $500, $1,000, or $1,500 a year). Compared with the deductible required as of March 23, 2010, grandfathered plans can only increase these deductibles by a percentage equal to medical inflation plus 15 percentage points. In recent years, medical costs have risen an average of 4-to-5% so this formula would allow deductibles to go up, for example, by 19-20% between 2010 and 2011, or by 23-25% between 2010 and 2012. For a family with a $1,000 annual deductible, this would mean if they had a hike of $190 or $200 from 2010 to 2011, their plan could then increase the deductible again by another $50 the following year.

Cannot Significantly Lower Employer Contributions. Many employers pay a portion of their employees’ premium for insurance and this is usually deducted from their paychecks. Grandfathered plans cannot decrease the percent of premiums the employer pays by more than 5 percentage points (for example, decrease their own share and increase the workers’ share of premium from 15% to 25%).

Cannot Add or Tighten an Annual Limit on What the Insurer Pays. Some insurers cap the amount that they will pay for covered services each year. If they want to retain their status as grandfathered plans, plans cannot tighten any annual dollar limit in place as of March 23, 2010. Moreover, plans that do not have an annual dollar limit cannot add a new one unless they are replacing a lifetime dollar limit with an annual dollar limit that is at least as high as the lifetime limit (which is more protective of high-cost enrollees).

Cannot Change Insurance Companies. If an employer decides to buy insurance for its workers from a different insurance company, this new insurer will not be considered a grandfathered plan. This does not apply when employers that provide their own insurance to their workers switch plan administrators or to collective bargaining agreements.

———-

ITEM TWO: An alert from AMA

eVoice® Alert

June 21, 2010

How will you get paid for your Medicare claims?

You may have received conflicting reports about how Medicare claims for services provided on or after June 1, 2010, will be processed since Congress failed to send legislation to President Obama in time to avert implementation of the scheduled 21 percent payment cut.

The AMA checked again today with senior officials at the Centers for Medicare and Medicaid Services, and physician claims submitted for services provided in June are in fact being processed under the reduced payment rate on a rolling, first in/first out basis. In other words, claims submitted earliest are now being paid at the reduced rate, while newer claims will continue to be held for a 10-day period until the president is able to sign legislation into law.

The AMA still anticipates that whatever legislation is passed will apply retroactively to all services provided since June 1, and that claims that have already been processed will be adjusted automatically without physicians having to resubmit them.

The AMA expects Congress to resolve the issue before the end of the week and will keep you updated on new developments.

————

DJP COMMENT: I had a dream that AMA advocated in the press for AMA policy of private contracting and balance-billing without penalty and ran large ads nationwide. But, alas, it was a dream! Help turn the AMA House of Delegates policy into reality. Write AMA and tell AMA to get moving on this issue.

LAGNIAPPE: Just did a tweet about this new IPhone software for IPhone 4 that will work with some of the current models of IPhone: IPhone iOS 4 Software Update now available http://bit.ly/12tj1X & works with 3GS & 3G

Stay well,

Donald

P.S. Stop by http://twitter.com/djpNEWS and sign up for DJPNEWS to get tweet alerts that may not make it into DJP Updates. Twitter is free and takes minutes to join. Put email in and pick password. Great source of breaking news and you don’t flood your email with it. You can get free app for BlackBerry or IPhone etc and you check on tweets when you want.

Also, recent selected DJP Updates can be found at: http://www.intrepidresources.com/html/djp_update/

Donald J. Palmisano, MD, JD
Intrepid Resources® / The Medical Risk Manager Company
5000 West Esplanade Ave., #432
Metairie, Louisiana USA 70006
504-455-5895 office
504-455-9392 fax
DJP@intrepidresources.com
www.intrepidresources.com
www.onleadership.us

This DJP Update goes to 2260 leaders in Medicine representing all of the State Medical Associations and over 100 Specialty Societies plus some other friends.
You can share it with your members and it has the potential to reach 800,000 physicians.
To join the list, send me an email stating “Join DJP Update” To get off the list, state “Remove DJP Update”. Best to put in Subject line so I can do immediately.

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DJP Update 6-18-2010 Happening now in Congress: Senate passes six-month SGR fix; House still has to vote on this; other recent tweets

DJP Update 6-18-2010 Happening now in Congress: Senate passes six-month SGR fix; House still has to vote on this; other recent tweets

The tweet and the comment have the info.

Twitter.com/DJPNEWS

When will Congress REALLY eliminate SGR & price-fixing?!! RT @medpagetoday BREAKING: Senate passes six-month SGR fix

35 minutes ago via Echofon

—–

DJP COMMENT: This is a stand alone bill, H.R. 3962, just for the extension of the SGR passed in the Senate and it passed by unanimous consent. The House adjourned already for the weekend so the earliest the House can address this is next week. The Senate bill gives a 2.2% increase in reimbursement levels for June-November of this year.

Meanwhile, like the Spartans at Thermopylae, we anxiously await for AMA to weigh in with the need to implement the elimination of price-controls and implement the policy of AMA House of Delegates, namely, “immediately formulate legislation for an additional payment option in Medicare fee for service that allows patients and physicians to freely contract, without penalty to either party, for a fee that differs from the Medicare payment schedule and in a manner that does not forfeit benefits otherwise available to the patient.”

Let not our AMA history be the doctors in practice caring for the sick were not reinforced timely and thus suffer the fate of those brave Spartans who fought for principles and refused to give up. Crisis abounds now and no need to wait for September for the legislative language deadline in the AMA resolution!

Words mean something but resolutions passed are worthless if not implemented by courageous action. The clock continues to tick for Medicine.

—–

ADDITIONAL RECENT TWEETS

Check out this reversal of comment by the proponents of the law as to whether the new law is a tax or not!

Wow! RT @M_P_T Opinion: Obama Admin. Argues in Court That Individual Mandate Is a Tax http://bit.ly/c7FPu3 Agree?#tcot #hcr

about 2 hours ago via Echofon

Thanks! @DrBob_Southlake Check out THE highlight of..AMA meeting in Chicago http://bit.ly/ajdT38

about 23 hours ago via Echofon

Insight to leadership RT @BobbyJindal We need action down here on the Gulf Coast not just words. http://twurl.cc/2z4l

12:38 PM Jun 17th via Echofon

AmericanMedicalAssociation elects Peter W. Carmel, MD as Prez-elect & BoT winners DrAnnis, DrMcAneny, DrPermut & DrSirio

2:22 PM Jun 15th via web

More re AMA breaking news #Medicare & patients/docs freely contracting #DJPUpdate 6-14-2010http://tinyurl.com/2emnpqk #hcr

7:49 PM Jun 14th via web

AMA Breaking News! #AMA HoD passes new policy directing legislation for patients and physicians to freely contract #hcr

7:11 PM Jun 14th via web

——-

Stay well,

Donald

P.S. Stop by http://twitter.com/djpNEWS and sign up for DJPNEWS to get tweet alerts that may not make it into DJP Updates. Twitter is free and takes minutes to join. Put email in and pick password. Great source of breaking news and you don’t flood your email with it. You can get free app for BlackBerry or IPhone etc and you check on tweets when you want.

Also, recent selected DJP Updates can be found at: http://www.intrepidresources.com/html/djp_update/

Donald J. Palmisano, MD, JD
Intrepid Resources® / The Medical Risk Manager Company
5000 West Esplanade Ave., #432
Metairie, Louisiana USA 70006
504-455-5895 office
504-455-9392 fax
DJP@intrepidresources.com
www.intrepidresources.com
www.onleadership.us

This DJP Update goes to 2259 leaders in Medicine representing all of the State Medical Associations and over 100 Specialty Societies plus some other friends.
You can share it with your members and it has the potential to reach 800,000 physicians.
To join the list, send me an email stating “Join DJP Update” To get off the list, state “Remove DJP Update”. Best to put in Subject line so I can do immediately.

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DJP Update 6-16-2010 More on AMA Annual Meeting policy directing new Medicare Payment Option and drafting of legislation; Membership; Lagniappe

DJP Update 6-16-2010 More on AMA Annual Meeting policy directing new Medicare Payment Option and drafting of legislation; Membership; Lagniappe

DJP Comment: Great new policy. I gave you the exact wording in the DJP Update 6-14-2010. See http://www.intrepidresources.com/html/djp_update/6-14-2010.html

Lots of great homework and advocacy done by many doctors getting this passed. Too many to name but the Coalition of State Medical & National Specialty Societies had this item as one of its critical goals to get passed. Dr. Bob Sewell, Dr. Van Culotta, Dr. Todd Williamson, Dr. Mike Green, and Dr. Stormy Johnson are just a few of those who pushed this over the finish line. Thanks for the overwhelming vote of support from the House of Delegates in the offered amendment to the reference committee’s substitute resolution. And key help from staff of state and specialties. A team effort!

Now it needs to be implemented. And the word needs to go out to patients and Congress.

AMA leadership now says it will enhance communication with the physicians and one can hope that there will be aggressive advocacy for a policy that will give Congress financial certainty, restore liberty to patients and physicians, and keep physicians in practice. The current SGR flawed formula is a perfect example of the predicted end result of price-fixing. And the treatment of this issue by Congress is disgraceful. In the end, patients will suffer.

————-

Here is the June 16, 2010 issue of “AMA/FEDERATION NEWS: National headlines, grassroots news and important AMA announcements for Federation executives and communicators.”

*** Special AMA Annual Meeting issue ***

(EXCERPT BELOW)

TOP STORIES

1. Physicians use white coats to urge action from Congress on SGR

2. President Obama calls on Congress to act quickly to stop Medicare cut, recommits to permanent payment reform

3. 2010 Annual Meeting highlights

4. AMA adopts new policies at Annual Meeting

5. New leaders elected by AMA

6. New AMA health insurer report card finds need for more accuracy

4. AMA adopts new policies at Annual Meeting

At its Annual Meeting this week, the AMA House of Delegates (HOD) set new policy to immediately formulate legislation for a new Medicare payment option. It would allow patients and physicians to freely contract for payments that differ from the Medicare schedule, while allowing patients to use their Medicare benefits.

At the AMA Website under press releases:

http://www.ama-assn.org/ama/pub/news/news/2010-new-policies.shtml

AMA Adopts New Policies During Final Day of Annual Meeting

For immediate release:

June 15, 2010

CHICAGO – The American Medical Association (AMA), the nation’s largest physician group, voted today at its Annual Meeting to adopt the following new scientific policies.

Assuring Patient Access to Physicians Under Medicare In the wake of a Medicare meltdown caused by a 21 percent Medicare physician payment cut, the AMA voted to immediately formulate legislation for a new Medicare payment option. It would allow patients and physicians to freely contract for payments that differ from the Medicare schedule, while allowing patients to use their Medicare benefits.

“Seniors deserve a Medicare benefit that allows them access to and choice of physicians.” said David O. Barbe, M.D., AMA trustee. “Low Medicare payments, continued payment uncertainty, and a steep 21 percent payment cut have put access and choice in jeopardy. A new patient-centered category of Medicare payment will allow seniors to use their Medicare benefit fully for the health care they need.”

———

DJP Comment: And unfortunately, only one press article about the formulation of balance billing legislation. What happened to all of the newspapers that use to cover all of the AMA Meetings? Thanks, Medpage Now, for this article!

http://www.medpagetoday.com/MeetingCoverage/AMA/20685

AMA: Delegates Adopt Balance Billing Resolution

By Emily P. Walker, Washington Correspondent, MedPage Today

Published: June 15, 2010

CHICAGO — The American Medical Association’s House of Delegates has adopted a resolution directing the doctors’ group to draft legislation that would allow physicians to bill their Medicare patients for the amount of the claim that Medicare didn’t cover.

The practice — known as balance billing — is one that AMA members have long pushed for. But the resolution passed Monday evening by the House of Delegates is the first to ask the organization to create a new category of payment that would allow for both private contracting and balance billing, according to an AMA spokesperson.

The Centers for Medicare and Medicaid Services (CMS) sets balance billing limits for physicians who treat Medicare patients.

Physicians who do not “participate” in Medicare can still see Medicare patients and can bill them up to 115% of the allowed Medicare fee schedule amount. However, the allowed fee schedule amount for nonparticipators is 5% less than it is for doctors who are classified as “participating.”

“Participating” doctors get paid the full Medicare fee schedule amount, although that’s notoriously lower than private insurance reimbursements, but are not allowed to bill patients for the amount Medicare doesn’t cover.

Couple that lower reimbursement with the constant threat of major cuts — such as the one looming now that would slash payments by 21% — and many doctors are fed up with Medicare.

That frustration was the impetus for the resolution passed Monday evening by the House of Delegates.

The original report on balance billing from the AMA’s legislative reference committee would have directed the AMA to study alternative payment systems for Medicare and other federal health programs. However, two-thirds of delegates voted to replace that language with a resolution directing AMA to formulate a bill.

“It seems to me, having been around for a long time, we’re at a moment of truth,” said former AMA president Daniel Johnson, a diagnostic radiologist from Metairie, La. “What’s proposed here is a solution for both the government and the doctor.”

The amendment directs the AMA to “immediately formulate legislation for an additional payment option in Medicare fee-for-service that allows patients and physicians to fully contract, without penalty to either party, for a fee that differs from the Medicare payment schedule in a manner that does not forfeit benefits otherwise available to the patients.”

The AMA has to draft the bill and present it to members by Sept. 30.

“This is really just reaffirming what is already AMA policy, but adding some action to it, and action is what we need,” said alternate delegate Peter Lavine, MD, an orthopedic surgeon in Washington.

The AMA has several policy statements on the books regarding balance billing. They generally affirm the “free choice” of patients and physicians, and voice AMA support for pursuing a “legislative and legal means” to allow for patients to contract for medical services and for physicians to treat Medicare patients “outside current regulatory constraints.”

Delegate Tom Price, MD, an orthopedic surgeon in Georgia and a Republican congressman, has introduced a bill in Congress that would remove the 115% limit on what nonparticipating physicians can charge their Medicare patients, but the bill has yet to move out of committee.

Although most of the delegates who took the microphone during the debate on balance billing supported AMA pressure on Congress, several delegates warned that it would make the association look bad.

“This is going to make us look stupid. This is going to make us look greedy,” said delegate Lynn Parry, MD, a Denver neurologist.

—————

At least Bruce Japsen of the Chicago Tribune also was there and I did see another reporter from Modern Healthcare. Here is an interview with President-elect Dr. Peter Carmel.

http://www.chicagobreakingbusiness.com/2010/06/new-ama-leader-doctors-will-demand-more.html

New AMA leader: Doctors will demand more

Published on June 16, 2010 8:16 AM | Submit a comment

By Bruce Japsen | The new president-elect of the American Medical Association promises to lead the nation’s largest doctor group in a more demanding and confrontational relationship with members of Congress.

“The AMA is going to be more insistent and a little edgier with its relationships with Congress and the administration in demanding some of the things we doctors need,” Dr. Peter Carmel, who won a hotly contested election earlier this week to become the AMA’s president-elect, said in an interview with the Tribune.

Carmel, a 73-year-old pediatric neurosurgeon from Newark, N.J., has been on the AMA’s board of trustees for the last eight years and will serve as president-elect until next June. He will then become president, and a year later will serve as the “immediate past president” until June 2013.

In a rare three-doctor race for president-elect, he beat out two members of the 21-member AMA board of trustees that are primary care doctors: a Massachusettsobstetrician and an Indiana family doctor.

Doctors are outraged that Congress failed to avert a 21-percent cut in payments to doctors from the Medicare health insurance program for the elderly that physicians will begin experiencing this week. The cut, which has been delayed many times by Congress in recent years, took effect June 1, meaning doctor checks from claims they submitted for Medicare payment claims will be lower starting this week.

Carmel said members of Congress can expect more hard-hitting attacks from the AMA such as the recent full-page advertisements the doctors group placed in several newspapers that criticized U.S. Senators for leaving Washington for their Memorial Day recess before fixing the payment cut.

“They tell me that (Democratic Senate Majority leader) Harry Reid is infuriated with the ad and I hope so,” Carmel said. “If I had a way of infuriating his Republican counterpart (Senate minority leader) Mitch McConnell, I would do that, too.”

Obama was critical of Republicans in the Senate as well, making the Medicare fee cut a key part of his presidential radio address this past weekend.

In Carmel, the AMA elected a leader with academic and clinical expertise. Carmel is a noted neurosurgeon who maintains an active pediatric neurosurgery practice in Newark, N.J. He is also department chair at the New Jersey Medical School, which has the only neurological surgery residency program in New Jersey.

He comes from a family of physicians that includes his wife, a radiologist, and a son who is a pediatric neurologist. His father was a family practice physician and his daughter-in-law is an internist.

Some AMA observers and doctors at this week’s meeting at the Hyatt Regency Chicago say Carmel won the rare three-doctor race because he was the most critical of the health reform law than the other candidates. In addition, many AMA members feel the health care reform law favors primary-care doctors over specialists and he understands that.

As one example, the Medicaid program for the poor will raise reimbursement rates for primary-care doctors and largely leave specialists’ rates unchanged though they vary from state to state. In addition, specialist doctors who tend to pay higher malpractice premiums were upset that health care reform did not cap malpractice awards.

But AMA board chairman Dr. Ardis Hoven said all three of the candidates for president-elect are collegial and view the health care reform law as a success and a “first step in” reforming the U.S. health system.”

“It’s not primary care versus everybody else, but the need for all physicians to get paid for what they do,” said Hoven, an infectious disease specialist fromLexington, Ky. “There are going to be multiple opportunities going forward to change and modify this law.”

Despite Carmel’s criticism of Congress, he said the AMA and its member doctors are happy the law will expand health benefits to more than 30 million uninsured Americans and eliminate hurdles to coverage such as a health plan’s ability to deny care to patients with pre-existing medical conditions.

“Doctors are pretty much pleased with the gains for patients that are in the health-care law,” Carmel added. “There is some great stuff in there. But we didn’t get our doctor issues at all solved.”

bjapsen@tribune.com<mailto:bjapsen@tribune.com>

———

DJP Comment: Finally, great advocacy by Dr. Jeff Terry, Chair of Alabama Delegation to AMA concerning the need to tell the physicians what is the current AMA membership numbers. He was terrific at the microphone and his homework and advocacy were a major factor in getting this amendment passed when Reference Committee F reports were debated:

That our AMA immediately release to each state medical society and specialty society at their request the names, category and demographics of all AMA members of that state or specialty society.

——

DJP Comment: Obviously, any member of AMA should be able to know on any day what the membership is as of that day. With modern computer systems and databases, there is no excuse for delays such as: “the final numbers are not in for the year, etc.” I made that point in the DJP Update 6-10-2010:

http://www.intrepidresources.com/html/djp_update/6-10-2010.html

Transparency, accountability, and advocacy are essential to save and enhance AMA membership. And remember, it does not help the situation to attack the messenger of bad news or the questioner who is trying to help. Always remember Hans Christian Andersen’s story, “The Emperor’s New Clothes”.

http://en.wikipedia.org/wiki/The_Emperor’s_New_Clothes

—————-

Lagniappe: Nice to see Congressional candidate Dr. Ron Kirkland of Tennessee participating in AMA meeting. His Website is: http://votekirkland.com/

Check it out.

Looks like we will have to get more doctors in Congress to fix the mess there and help Dr. Tom Price who also participated in AMA House of Delegates.

——–

Stay well,

Donald

P.S. Stop by http://twitter.com/djpNEWS and sign up for DJPNEWS to get tweet alerts that may not make it into DJP Updates. Twitter is free and takes minutes to join. Put email in and pick password. Great source of breaking news and you don’t flood your email with it. You can get free app for BlackBerry or IPhone etc and you check on tweets when you want.

Also, recent selected DJP Updates can be found at: http://www.intrepidresources.com/html/djp_update/

Donald J. Palmisano, MD, JD
Intrepid Resources® / The Medical Risk Manager Company
5000 West Esplanade Ave., #432
Metairie, Louisiana USA 70006
504-455-5895 office
504-455-9392 fax
DJP@intrepidresources.com
www.intrepidresources.com
www.onleadership.us

This DJP Update goes to 2259 leaders in Medicine representing all of the State Medical Associations and over 100 Specialty Societies plus some other friends.
You can share it with your members and it has the potential to reach 800,000 physicians.
To join the list, send me an email stating “Join DJP Update” To get off the list, state “Remove DJP Update”. Best to put in Subject line so I can do immediately.

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DJP Update 6-15-2010 AMA election results for President-elect & Board of Trustees

DJP Update 6-15-2010 AMA election results for President-elect & Board of Trustees

President-elect: Peter W. Carmel, MD

AMA Board of Trustees – The following were elected:

Joseph P. Annis, MD

Barbara L. McAneny, MD

Stephen R. Permut, MD, JD

Carl A. Sirio, MD

Run-off for one remaining slot on Council on Medical Services about to occur now.

Stay well,

Donald

P.S. Stop by http://twitter.com/djpNEWS and sign up for DJPNEWS to get tweet alerts that may not make it into DJP Updates. Twitter is free and takes minutes to join. Put email in and pick password. Great source of breaking news and you don’t flood your email with it. You can get free app for BlackBerry or IPhone etc and you check on tweets when you want.

Also, recent selected DJP Updates can be found at: http://www.intrepidresources.com/html/djp_update/

Donald J. Palmisano, MD, JD
Intrepid Resources® / The Medical Risk Manager Company
5000 West Esplanade Ave., #432
Metairie, Louisiana USA 70006
504-455-5895 office
504-455-9392 fax
DJP@intrepidresources.com
www.intrepidresources.com
www.onleadership.us

This DJP Update goes to 2259 leaders in Medicine representing all of the State Medical Associations and over 100 Specialty Societies plus some other friends.
You can share it with your members and it has the potential to reach 800,000 physicians.
To join the list, send me an email stating “Join DJP Update” To get off the list, state “Remove DJP Update”. Best to put in Subject line so I can do immediately.

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DJP Update 6-15-2010 Two articles about AMA Membership in “MedPage Now”

DJP Update 6-15-2010 Two articles about AMA Membership in “MedPage Now”

AMA: House of Medicine Shrinks Again

By Peggy Peck, Executive Editor, MedPage Today

Published: June 14, 2010

http://www.medpagetoday.com/MeetingCoverage/AMA/20676

Excerpt from article (last 5 paragraphs) Mention of Dr. W. Jeff Terry and AMA Board Chair Dr. Rebecca Patchin

This year, the AMA reference committee, which sat through more than five hours of testimony about membership and other issues dealing with AMA governance, is recommending that the AMA’s policy-making House of Delegates require the AMA leadership to release annual reports that will include information about the “age, gender, race/ethnicity, education, life stage, present employment, and self-designated specialty” of its members.

But the reference committee is not asking the AMA to open its membership book by releasing year-to-date figures, which is what W. Jeff Terry, MD, a surgeon from Mobile, Ala., has pleaded with the AMA to do.

Terry, one of the delegates from Alabama, is likely to bring up the issue when the House votes on the membership recommendations Tuesday or Wednesday. He is ardent about membership, he explained, because Alabama is one of the two red states on Patchin’s map. It, and the other red state — Mississippi — are rumored to have lost as many as 40% of their AMA members.

Although Patchin did not signal any willingness to release year-to-date numbers (she would not, for example, allow the color-coded map to be distributed) she did say that the AMA is actively reevaluating its definition of membership.

For example, she said that in the current digital age a better approach to membership might be traffic, so if a physician accesses a certain number of AMA digital services — CME, electronic journals, practice management programs — that physician would automatically be considered a member.

(Bolding of last two paragraphs added by DJP; this should make for an interesting discussion in the House of Delegates!)

———

AMA: Delegates Question AMA Role in Health Reform

By Peggy Peck, Executive Editor, MedPage Today

Published: June 11, 2010

http://www.medpagetoday.com/MeetingCoverage/AMA/20628

EXCERPT from article:

Now a year later and with healthcare reform finally a reality, some of the AMA rank and file are crying foul.

For example, as the meeting opens here, Congress has still failed to “fix” Medicare’s sustainable growth rate formula and doctors are still faced with a 21% cut in reimbursement, despite promises from a Democratic president and Democratic congress to give them a permanent fix to the yearly Medicare pay follies.

On the eve of the meeting, Louisiana’s Donald J. Palmisano, MD, JD, a former AMA president, who has been vocal in his opposition to Obamacare, tried to rally the troops with an e-mail blast.

Noting that he had attended the AMA annual meeting since the mid 1980s and had spent nine years as a member of the AMA’s Board of Trustees, Palmisano wrote, “Of all of those years of attendance, it is my view that this AMA Annual Meeting has the potential to be the most important AMA meeting of my AMA career.”

The reason, he said, is that the association, in his opinion, has lost its bearings, and he has signaled that he plans to push for a course adjustment.

“Although the AMA in theory represents all physicians via the state medical and specialty medical associations seated in the House of Delegates, the current paying membership is probably 15 to 18% of physicians in USA,” he wrote.

“How sad,” Palmisano continued. “Certainly it is the responsibility of AMA leadership to give the House of Delegates the actual membership numbers at this meeting and not give the excuse that the books are not closed yet. How many dues paying members as of the end of 2009, and how many in 2010 have sent in their dues so far? And how many of those are reduced student and resident dues? My point is the membership continues to drop. I believe the majority of physicians in the USA are opposed to the position taken by the AMA on the enacted law for ‘health system reform.'”

———-

Stay well,

Donald

P.S. Stop by http://twitter.com/djpNEWS and sign up for DJPNEWS to get tweet alerts that may not make it into DJP Updates. Twitter is free and takes minutes to join. Put email in and pick password. Great source of breaking news and you don’t flood your email with it. You can get free app for BlackBerry or IPhone etc and you check on tweets when you want.

Also, recent selected DJP Updates can be found at: http://www.intrepidresources.com/html/djp_update/

Donald J. Palmisano, MD, JD
Intrepid Resources® / The Medical Risk Manager Company
5000 West Esplanade Ave., #432
Metairie, Louisiana USA 70006
504-455-5895 office
504-455-9392 fax
DJP@intrepidresources.com
www.intrepidresources.com
www.onleadership.us

This DJP Update goes to 2259 leaders in Medicine representing all of the State Medical Associations and over 100 Specialty Societies plus some other friends.
You can share it with your members and it has the potential to reach 800,000 physicians.
To join the list, send me an email stating “Join DJP Update” To get off the list, state “Remove DJP Update”. Best to put in Subject line so I can do immediately.

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DJP Update 6-14-2010 AMA Breaking News! AMA passes new policy directing legislation for patients and physicians to freely contract

DJP Update 6-14-2010 AMA Breaking News! AMA passes new policy directing legislation for patients and physicians to freely contract

Overwhelming support 73% in vote for new AMA policy offered as amendment in Reference Committee B that enhances previous AMA policy. On final passage only a few negative votes of the approximately 530 delegates in the policy-making body of the AMA House of Delegates after a passionate and full debate. Now AMA will write legislation that can be offered to Congress. We have had good policy on this issue in past but now this enhances it and directs AMA to write legislation by September 30, 2010.

Here is what passed late this afternoon in the AMA House of Delegates:

RESOLVED, That our American Medical Association immediately formulate legislation for an additional payment option in Medicare fee for service that allows patients and physicians to freely contract, without penalty to either party, for a fee that differs from the Medicare payment schedule and in a manner that does not forfeit benefits otherwise available to the patient. This legislative language shall be available to our AMA members no later than September 30, 2010.

——

This is an important supplement to existing AMA policy which includes:

D-390.985 Medicare Balance Billing

Our AMA will (1) work on behalf of physicians to regain the right to balance bill Medicare patients for the full reasonable fees as they determine appropriate; and (2) evaluate the potential impact of the Medicare burden on its members in order to save health care for all Americans if the federal government denies the right to balance bill Medicare patients. (Res. 119, A-03; Reaffirmation A-04; Reaffirmation A-06; Reaffirmed per BOT Action in response to referred for decision Res. 236, A-06)

D-380.996 Balance Billing for All Physicians

1. Our AMA will devote the necessary political and financial resources to introduce national legislation at the appropriate time to bring about implementation of Medicare balance billing and to introduce legislation to end the budget neutral restrictions inherent in the current Medicare physician payment structure that interferes with patient access to care. 2. This national legislation will be designed to pre-empt state laws that prohibit balance billing and prohibit inappropriate inclusion of balance billing bans in insurance-physician contracts. 3. Our AMA will develop model language for physicians to incorporate into any insurance contracts that attempt to restrict a physicianís right to balance bill any insured patient. 4. Our AMA Board of Trustees will report back to our AMA House of Delegates electronically by March 15, 2008 and at every HOD meeting its progress toward the completion of all of these goals. (Res. 925, I-07)

——–

DJP Comment: The policy passed today by AMA, if passed in Congress, can keep doctors in practice and maintain access to care for patients. In addition, it allows government to determine what government can afford to pay but patients and physicians still have the freedom to freely contract for any differences needed including the right to forgive co-pays. This is akin to the Australian model that I have written about in previous DJP Updates.

A big win for liberty and freedom today!

Congratulations to the AMA House of Delegates for standing up for doctors and patients so passionately today! And special thanks to all of the doctors who drafted and fine-tuned the final substitute resolution.

Now the elections for AMA offices tomorrow morning. Choose wisely!

Stay well,

Donald

P.S. Stop by http://twitter.com/djpNEWS and sign up for DJPNEWS to get tweet alerts that may not make it into DJP Updates. Twitter is free and takes minutes to join. Put email in and pick password. Great source of breaking news and you don’t flood your email with it. You can get free app for BlackBerry or IPhone etc and you check on tweets when you want.

Also, recent selected DJP Updates can be found at: http://www.intrepidresources.com/html/djp_update/

Donald J. Palmisano, MD, JD
Intrepid Resources® / The Medical Risk Manager Company
5000 West Esplanade Ave., #432
Metairie, Louisiana USA 70006
504-455-5895 office
504-455-9392 fax
DJP@intrepidresources.com
www.intrepidresources.com
www.onleadership.us

This DJP Update goes to 2259 leaders in Medicine representing all of the State Medical Associations and over 100 Specialty Societies plus some other friends.
You can share it with your members and it has the potential to reach 800,000 physicians.
To join the list, send me an email stating “Join DJP Update” To get off the list, state “Remove DJP Update”. Best to put in Subject line so I can do immediately.

Read More