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Friday, February 26, 2010

Medicare cuts: The Senate leaves you with the bill

Monday is March 1. That's when Medicare payment rates will drop by 21 percent unless Congress does something. And the Senate won't do anything until Tuesday at the earliest. What does that mean? The (informal) word from the Centers for Medicare & Medicaid Services is that "the bottom line is that there will be a 10 day hold and hopefully by that time we will have a statutory fix."  So physicians should submit claims as usual.

The way things stand on the Hill is this, according to the AAFP's Washington office:

Yesterday afternoon, the House passed a bill that contains an extension of the SGR [sustainable growth rate] until March 31.  The Senate Majority Whip, Sen. Dick Durbin (D-IL) attempted several times to pass the bill with the unanimous consent of the Senate, but each time Sen. Bunning (R-KY) objected because he wanted to have a vote on his amendment to have the bill paid for with TARP [Troubled Asset Relief Fund] money.  Later last night, Sen. Bob Corker (R-TN) joined Sen. Bunning in objecting because he felt that Sen. Bunning was not given sufficient notice that the bill would be taken up.  The problem with Sen. Bunning's demand for a vote on his amendment is that the Senate has no scheduled roll call votes until next Tuesday.

The Senate has adjourned for the weekend and will not return for votes until Tuesday noon. Past performance would suggest that the Senate will somehow untangle its feet and prevent the 21 percent cuts for a while at least, even though belatedly. On the other hand, the current state of party politics suggests that past performance may not be an indicator of future results. This might be a good time to e-mail your senators and remind them of the number of lives they're playing with.

And since I imagine you're probably as tired as I am of reports that Congress continues to do nothing, we'll hold off on further updates until something really happens.

Thursday, February 25, 2010

More on Medicare cuts: The axe is still poised to strike

An update from the AAFP Washington office to yesterday's post on the impending Medicare physician payment cut: "Yesterday, Senate Majority Leader Harry Reid (D-NV) proposed a one-month extension of the current physician payment rate and asked unanimous consent from the Senate to approve the measure and send it to the House. However, Senator Bunning (R-KY) objected on behalf of Senate Republicans because the bill (which cost about $1 billion) was not fully paid for. Senator Reid is holding the Senate in session today (although no votes will be taken or decisions made during the President's Health Summit) and tomorrow, and will try again to get unanimous consent before they leave for the weekend. The likely compromise would be a two-week extension that is fully paid for."

Evidently, even putting off until next month what you don't want to deal with today is hard for Congress. Three days remain before the threatened 21 percent cut goes into effect. Stay tuned.

Wednesday, February 24, 2010

Medicare cuts: A (short) stay of execution?

Counting the days until the threatened 21 percent cut in Medicare payment rates kicks in on Feb. 28? Good news (maybe)! Word from the AAFP's Washington office is that the Senate is prepared to approve a two-week suspension of the cuts -- by unanimous consent -- with the House following suit today or tomorrow morning.

Why only two weeks? It seems likely they need more time to figure out how to pay for a few years' postponement of the day of reckoning -- the day when they, or someone with enough political courage, can actually clean up the mess instead of just shifting the problem from their shoulders back to the shoulders of the physicians who have been carrying it for the past several years. Stay tuned to this blog or FPM's Getting Paid blog for more as the saga continues.

Friday, February 19, 2010

Health care reform: What farming can teach us

Should health care reform really take its cues from American farming? Atul Gawande, MD, MPH, author of a thought-provoking New Yorker article, thinks so. In "Testing, Testing," Dr. Gawande explains how government-sponsored pilot programs such as those used to reform agriculture in the early 1900s could help us find answers to the health care problems we face today.

Read the article, and let us know what you think.

Monday, February 15, 2010

Get the 2010 immunization schedules on your smartphone, PC or PDA

Need a quick reference to the latest immunization schedules for children, adolescents and adults? Check out "Shots 2010," which you can download for free to your PC, iPhone, iPod Touch, Blackberry Storm, Palm Pre, Pocket PC or Palm device. The application was developed by the Group on Immunization Education of the Society of Teachers of Family Medicine.

Friday, February 12, 2010

Three new HIPAA rules take effect this month

Over the next two weeks, three significant HIPAA changes mandated by the Health Information Technology for Economic and Clinical Health Act will take effect. Is your practice ready?

Beginning Feb. 17, your practice's "business associates" (i.e., any organization to which your practice submits electronic patient information) must comply with the HIPAA security rule, and your agreements with these entities must be amended to reflect their new obligations. Your agreements should outline the responsibilities of each party in the event of a breach, including how long the business associate has to report a breach to your practice once it has been discovered and who will cover the costs of notifying patients about a breach.

Beginning Feb. 18, if a patient is paying in full out of pocket for health care services, he or she may request that your practice not disclose his or her medical information to a health plan or other entity, including state pharmacy registries. You must comply with these requests.

Beginning Feb. 22, enforcement of the Breach Notification Rule goes into effect. The rule requires HIPAA-covered entities (e.g., physicians, hospitals and health plans) and their business associates to notify patients of breaches of their health information. For breaches involving 500 people or less, you must provide written notice to each affected individual, describing the nature of the breach, the type of patient information disclosed, steps they can take to protect themselves and steps your practice is taking to remedy the situation. If the breach affects more than 500 individuals, you must notify prominent media outlets in the area and must immediately report the incident to the Department of Health and Human Services.

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The views expressed here are those of the individual authors. They do not necessarily reflect the opinion of Family Practice Management (FPM) or the AAFP. The FPM blogs are not intended to provide medical, financial or legal advice. For more information see Terms of Use.