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HealthBeat Special Alert: Health Care Reform Series

Healthbeat Special Alert: Health Care Reform Series focuses specifically on health care
reform issues pertinent to physicians.
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January 3, 2011
Medicare Fee Cut Slides Through Again

On Dec. 9, 2010, the House of Representatives approved a bill that will prevent the 25 percent cut in the Medicare physician fee schedule proposed to take place Jan. 1, 2011, under the statutory "sustainable growth rate" formula. This article explains the effects of the sustainable growth rate formula.

June 24, 2010
Agreement to Postpone Medicare Cuts-Effects on Providers

On Friday, June 18, 2010, the Senate adopted a measure to stall the 21 percent Medicare price cut and add a 2.2 percent increase for another six months or through the end of November. This article explains what this change will mean to providers.

May 27, 2010
Expanding Access to Primary Care Services and General Surgery Services

Section 5501 of The Patient Protection and Affordable Care Act (PPACA) (H.R. 3590) includes provisions to expand access to primary care and general surgery services by amending section 1833 of the Social Security Act. This article discusses the qualifications a physician must have for a bonus payment under PPACA.

May 19, 2010
Medicaid Reimbursement to Increase for Primary Care Physicians

The Health Care and Education Reconciliation Act ("H.R. 4872") expands the recently enacted health care reform legislation. It includes a provision to help alleviate the declining reimbursement issues that many primary care physicians face. This article covers the goals and details of the act.

May 17, 2010
Prohibition on New Physician Hospital Ownership

The Patient Protection and Affordable Care Act ("Reform Law"), signed into law by President Obama on March 23, 2010, dismantled the physician self-referral (Stark) Law's "whole hospital exception" that previously allowed physician ownership and investment in hospitals, effectively ending new physician ownership and severely limiting those grandfathered-in under the law. This article discusses the major provisions and exceptions of the act.

May 6, 2010
Health Care Reform Act Calls for Increased Transparency in Physician Relationships

Part A of title XI of the Social Security Act was recently amended by section 6002 of the Patient Protection and Affordable Care Act of 2010. This article explains the new requirements, penalties for noncompliance and the public availability of information.

May 4, 2010
A Look at Tort Reform

As the health care reform bills were being debated in the House and Senate, one of the items that caused a deep divide along party lines was the issue of tort reform as it relates to medical malpractice.　This article discusses arguments for the proponents and opponents of the tort reform.

April 16, 2010
Accountable Care Organizations:  Providing Care to a Defined Medicare Patient Population

Succinctly stated, the goal to improve our nation's healthcare quality while reducing the costs to deliver the same is intended to result in a final product that increases healthcare value. The foundation for true healthcare reform will be the implementation of industry-wide, complete adoption of an electronic health records (EHR) platform. This significant and compelling first step will set the tone for important initiatives to follow, including but not limited to Value-Based Purchasing, Reducing Preventable Readmissions, Bundling Payments, Managing Radiology Benefits and Creating Accountable Care Organizations (ACO).

April 12, 2010
Stark gets its own self-disclosure rules

The Patient Protection and Affordable Care Act of 2010, amended by the Health Care and Education Reconciliation Act of 2010 (Health Care Reform Law), provides for the resolution of a controversial development related to the Federal Physician Self-Referral (Stark) Law. This much awaited change has the potential to result in significant impact on physicians and hospitals with whom they have referral relationships.

April 6, 2010
Hold on payment of claims for providers paid under the Medicare Physician Fee Schedule

The Patient Protection and Affordable Care Act (H.R. 3590), signed into law on March 24, 2010, did not repeal or revise the Sustainable Growth Rate (SGR) methodology for establishing Medicare reimbursement to physicians and other providers. Neither did the Health Care and Education Reconciliation Act of 2010 (H.R. 4872), and unfortunately, the SGR Temporary Extension Act of 2010 expired March 31, 2010, resulting in a 21.2 percent reduction of allowable rates. This article explains the reason for the hold on payments of claims for providers.

April 5, 2010 
Expanded coverage requirements and potential increased demand on physicians

Expanded coverage is set to begin January 1, 2014, and continue through 2019, eventually providing access to approximately 32 million individuals currently considered uncovered. All U.S. citizens and legal residents will be required to obtain coverage or incur a tax penalty. In response to the increasing numbers of insured, the demand for additional healthcare providers is initially expected in primary care specialties, and then expanding to other specialties. This article explains the options of the expanded coverage.

 
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