Health Care Reform

The Academy of Medicine of Cleveland & Northern Ohio (AMCNO)
Outlines Position on Health Care Reform

April 9th update

Health Insurance Reform Legislation Background

AMCNO Members interested in learning more about H.R. 3590 – the Patient Protection and Affordable Care Act (PPACA) or in reviewing a timeline on the implementation of the legislation can go to the following links:

Legislative links:

H.R. 3590, Patient Protection and Affordable Care Act (PPACA)
http://www.gpo.gov/fdsys/pkg/BILLS-111hr3590ENR/pdf/BILLS-111hr3590ENR.pdf

H.R. 4872, Health Care and Education Reconciliation Act of 2010 (The Reconciliation Act) http://www.gpo.gov/fdsys/pkg/BILLS-111hr4872EH/pdf/BILLS-111hr4872EH.pdf

Kaiser Family Foundation Resources - Implementation Timeline & Comparative Chart

http://www.kff.org/healthreform/8060.cfm

http://www.kff.org/healthreform/sidebyside.cfm

Details on the House Merged Health Care Bill

The leadership of the U.S. House of Representatives has formally introduced comprehensive health care reform legislation HR3962. The measure was developed by merging the different versions of the bill separately approved by the House Energy and Commerce Committee, the House Education and Labor Committee and the House Ways and Means Committee. Along with the text of the bill leaders also issued numerous other resources for evaluating the measure. To view the entire bill (this is very large – almost 2,000 pages) go to http://docs.house.gov/rules/health/111_ahcaa.pdf

To view a summary of the bill go to:
http://waysandmeans.house.gov/media/pdf/111/hcare/summary_final.pdf

To view an overview of the bill go to:
http://waysandmeans.house.gov/media/pdf/111/hcare/HR3962SECBYSECFINAL.pdf

To view a timeline of the bill go to:
http://waysandmeans.house.gov/media/pdf/111/hcare/itline_final.pdf

The schedule for official consideration and amendment of the measure remains unclear. The AMCNO board of directors has sent comments to our Congressional leadership over the past few months with regard to the health care reform debate as well as providing detailed physician survey responses from AMCNO members regarding how the practice of medicine could be impacted by health care reform. AMCNO will continue to monitor the health care reform debate and provide additional input as the debate continues.

Health Reform Comparison Tools Now Include New House Leadership Bill

Kaiser Foundation has updated its key health reform resources to reflect provisions of the new House bill. Specifically, the House leadership bill has been added to the Foundation’s interactive side-by-side health reform comparison tool, http://www.kff.org/healthreform/sidebyside.cfm, which now allows users to compare it with 12 other reform plans, including the plans approved by the three House committees with responsibilities for health care, the Senate Finance Committee and the Senate Health, Education, Labor and Pensions Committee. Users can choose which proposals to compare, as well as specific characteristics about those proposals, including coverage, cost containment and financing.

AMCNO Health Care Reform Survey

Results (PDF)

AMCNO Letter to Congress sent with Survey Data

View letter (PDF)

AMCNO provides input to Northern Ohio Congressional leaders regarding H.R. 3200

The AMCNO executive committee discussed H.R. 3200 at their July meeting and as a result, Anthony E. Bacevice, Jr., M.D. AMCNO president, prepared and sent a letter to members of the Northern Ohio Congressional Delegation. In his letter, Dr. Bacevice identified several provisions in H.R. 3200 that would benefit physicians and their practice. He also identified several problems in the draft that the AMCNO would like to see addressed during the discussions taking place in Congress. The AMCNO will monitor the debate on health care reform as the debate continues in Congress.

View a copy of the AMCNO letter to Congress here

Links to additional information regarding health care reform legislation:

The Kaiser Family Foundation(KFF) has also compiled an interactive tool to compare the leading health reform proposals. To view the information provided by KFF go to: http://www.kff.org/healthreform/sidebyside.cfm

To view H.R. 3200 go to: http://thomas.loc.gov/cgi-bin/query/z?c111:H.R.3200:

To view the Congressional Budget Office report on H.R. 3200 go to:

http://www.cbo.gov/cedirect.cfm?bill=hr3200&cong=111

House reform bill includes Medicare improvements

Listed below are the details of the Medicare provisions in "America's Affordable Health Choices Act of 2009" H.R. 3200 that would affect physicians. The most significant of these is the repeal of the sustainable growth rate (SGR) formula. The new system that would replace the SGR would provide for an update equal to the Medicare Economic Index, or MEI, for 2010 instead of a 21.5 percent cut; completely eliminate all the SGR debt that has accumulated after years of temporary, unfunded fixes; establish two new targets with higher utilization growth allowances than in the SGR; permanently exclude the cost of physician-administered drugs and laboratory services from the new targets; and include all evaluation-and-management services in the highest of the two new target growth rates, regardless of physician specialty.

The bill also calls for other Medicare payment improvements for physicians, including:

A 5 percent increase in Medicare payment rates for primary care physicians starting in 2011—with no offsetting rate cuts for other physician services—and a 10 percent increase for those practicing in primary care Health Professional Shortage Areas.
A 5 percent bonus payment for physicians in localities with relatively low Medicare spending from 2011 through 2013.
An extended work geographic practice cost index, or GPCI, floor for physicians in localities with low geographic adjustment factors. The floor would be extended through 2011, and $8 billion for revised geographic adjustment factors would be provided.
Extending the 5 percent mental health service add-on payment for psychiatrists for an additional two years.
$300 million for California physicians to revise Medicare payment localities in the state.
$1.5 billion for physicians who administer adult vaccines to provide Part B coverage for all vaccines recommended by the Advisory Committee on Immunization Practices.
Timely feedback reports and an appeals process for physicians who participate in the Physician Quality Reporting Initiative (PQRI).
Waiving all Medicare cost-sharing for preventive services.
A demonstration project to provide grants to offer language services to patients with limited English proficiency.