April 15 is the deadline for the Senate to act on the “doc fix”—the Boehner-Pelosi bill, HR 2, the Medicare Access and CHIP Reauthorization Act (MACRA). CMS is holding Medicare claims until then, which is 2 weeks after the deadline to implement the 21 percent fee cut required by the Clinton-Gingrich sustainable growth rate (SGR) formula. If the Senate fails to pass the bill before April 15, CMS said it will be forced to put the payment cuts into effect, though the agency said doctors could be retroactively repaid. http://thehill.com/policy/healthcare/237658-medicare-agency-congress-must-pass-doc-fix-deal-before-april-15
Nancy Pelosi’s website proudly lists organizations supporting the bill, including Center for American Progress, Families USA, Center on Budget and Policy Priorities, Center for Law and Social Policy (CLASP), United Way, and SEIU, along with the American Medical Association, the American College of Physicians, and the American College of Surgeons. http://www.democraticleader.gov/newsroom/fact-sheet-some-of-the-groups-supporting-h-r-2-medicare-access-and-chip-reauthorization-act-of-2015/
The medical groups likely want a lucrative role in deciding “quality” metrics and selling materials to “help” doctors comply so that they can get paid.
The new payment system, which is meant to move away from paying for volume toward paying for quality and outcomes, is “basically a replacement of a blunt technocratic instrument with a fine technocratic instrument—and fine technocratic instruments are very often even worse, indeed much worse, than blunt ones,” writes Yuval Levin. “The portion of the bill laying out how this is supposed to work adds up to a 120-page demonstration of why the government should not be acting as a health insurer.” http://www.nationalreview.com/corner/415981/fix-doc-fix-yuval-levin
The bill also has a “fair number of further elements that aren’t really about Medicare, most of which just offer proof that ‘temporary’ means ‘permanent’ when it comes to federal benefit programs.”
Those concerned about fiscal responsibility note: MACRA is s spending binge, only 3 percent paid for, writes John Graham. http://blog.independent.org/2015/03/26/this-doc-fix-is-an-outrage/
The switch to “value-based” payment is evidently seen as a bonanza to Blue Cross Blue Shield, which has invested $71 billion in the idea. http://www.bcbs.com/healthcare-news/bcbsa/bcbs-companies-continue-to-lead-nations-path-to-value-based-healthcare.html
At the head of CMS, the agency in charge, is Andy Slavitt, who pocketed at least $4.8 million tax free from the healthcare industry on joining government. http://www.againstcronycapitalism.org/2015/03/health-industry-paid-acting-centers-for-medicare-chief-4-8-million-tax-free-when-he-joined-govt/
Implementing the value-based system will require massive data. MACRA incorporates part of Rep. Michael Burgess’s “interoperability” legislation that would require private electronic healthcare record (EHR) companies to provide unrestricted, one-stop access to patient medical records. Patient data, without need for consent, would be entered in data registries accessible to myriad government-authorized users. http://www.cnsnews.com/news/article/barbara-hollingsworth/under-draft-bill-authorized-users-would-get-complete-access
“Have House Republicans cast their first vote for ObamaCare?” asks John Graham. http://www.forbes.com/sites/theapothecary/2015/03/31/have-house-republicans-cast-their-first-vote-for-obamacare/
Social Media
@dramerling @kksheld @Senate_GOPs @TeamCavuto Doc Fix" is ObamaCare in Medicare clothing- House Republicans duped or complicit- vote no HR 2
— Jane Hughes,MD (@janehughesmd) April 2, 2015
Letter 2Senators-Fix the Doc Fix http://t.co/CbCdeGH4jO via @kksheld Please share with Senators before it's too late #nixthefix @AAPSonline
— Kris Held,MD (@kksheld) March 31, 2015
FRI. APR 3 – COMMENT DEADLINE on @ONC_HealthIT "Interoperability Roadmap." (Nat't EHR Sys). My Comment: http://t.co/nMsW2OcDw3 @kksheld
— Twila Brase (@twilabrase) March 31, 2015
DO BY FRIDAY: Comment on Nat'l Medical Records & Patient Tracking System: http://t.co/ILE2bxsmdJ (see 1st tweet) @drscott_atlanta @BradMD
— Twila Brase (@twilabrase) March 31, 2015
