FPD1199

To help you stay informed, we now feature sections that contain a variety of information that you might be interested in.

With all the resources available, and limited time to devote to sifting through it all, we try to put together a good mix of information and resources that can help you move forward in our 21st century health care system.

If you have a topic you want to see posted, or would like to know more about, please contact lyndafpd@aol.com.

As a physician, you have to look at the new health care law from a number of perspectives - as a health care provider, as an employer, and as a consumer.

In short, the new law puts us on a path to provide health care coverage for all Americans, empowers consumers over insurance companies and ensures we are moving to reduce health care costs in the long run. Now that the bill has passed the reconciliation process and will now be law, sweeping new policies will be ushered in. Many outlets are trying to tease out what this will mean for the average consumer, what it means for health care providers, and what it means for employers. So that you may understand it all better, and because you don’t have the time to read the more than 2000-page bill yourself, we’ll help you sort it all out.

We will continue to sift through the many resources that have been providing information about this historic reform so you don’t have to. Check back often for updates. Meanwhile, look through what we’ve put together so far. And if you come across something that may be helpful to your colleagues, please contact us at lyndafpd@aol.com to let us know.

OTHER RESOURCES:

The New York Times has a great interactive summary.

CLICK HERE

Politics Daily gives a “Year-by-Year Rundown of What Happens & When”

CLICK HERE

“Republicans Set for Last Ditch Senate Assault on Reform.”

CLICK HERE

Investopedia.com lists “10 Ways The New Healthcare Bill May Affect You.”

CLICK HERE

CNNMoney.com reports “What health care reform means for your business.”

CLICK HERE

The Federation Continues to Oppose CMS’ Decision to Eliminate Billing for Consultation Codes

Many voices that speak on behalf of physicians specialty-wide have long expressed strong concerns about the Centers for Medicare & Medicaid Services’ (CMS) proposal to eliminate billing for consultation codes. These voices went unheard when CMS announced its final decision to stop paying for consultation services as of January 1, 2010.

The Federation opposes all public AND private efforts to eliminate payments for inpatient and outpatient/office consultation codes and supports legislation to overturn CMS’ decision.

HOW WILL IT WILL AFFECT YOU?

You Can Breathe A Little Easier -
“Doc Fix” Legislation Passed, You Get A Little Raise &

You Can Waive Extra Medicare Coinsurance Amount (although you may not want to)

The new “Doc Fix” legislation was signed late June, giving doctors another temporary reprieve of the 21.3% cuts to Medicare rates, which is now set for December 1. At the same time, doctors get a small “raise” of 2.2% for the next 6 months and they can waive the extra “doc fix” Medicare coinsurance amount, if they want to.

Since the raise in Medicare rates causes the coinsurance amount of patients to increase, the Office of Inspector General (OIG) issued a directive that allows doctors to legally waive the extra amount instead of going through the hassle of collecting it. Typically, under regular Medicare, patients have a 20% coinsurance (or, 20% of the Medicare allowable amount) which doctors are obligated to collect. If they don’t, they risk violation of federal fraud and abuse laws. But since the 2.2% raise to the Medicare rates is retroactive to June 1, it could be complicated to collect the increased coinsurance amounts from the Medicare patients they had seen for the past month. So, the OIG has simplified the subject for physicians.

Of course this green light to waive the extra coinsurance amounts is NOT a requirement. Indeed, for office visits it may not be worth the hassle of collecting this additional money. But for physicians who have performed surgical procedures last month, where Medicare fees are in the thousands, it certainly would be worth going after the extra money.

One more thing to be aware of is that CMS was forced to start processing claims that had been suspended under a claims-holding period, but which had expired because of Congress’ procrastination on the “doc fix” legislation. Yet, CMS has promised that its carriers would automatically reprocess any June claims paid at the lower rates to reflect the higher rates. SO start your reprocessing today!

Organized medicine, including the Federation, has long expressed outrage over this potentially devastating reimbursement reduction, and continues efforts to put an end to these temporary, “band-aid” fixes that only increase the size of the cuts and the cost of reform. Everyone knows the problem is with the flawed formula in the Medicare payment methodology that causes the annual payment cut and everyone knows that short-term fixes just cannot fixed the long-term problem. So Congress needs to find a permanent solution once and for all.

Stay tuned for the latest updates.

Health Care Bill Is Now Law

The final fixes have been signed into the health care reform bill marking the historic first steps in the largest overhaul of the American health care system since the passage of Medicare in 1965. After more than a year of legislative bickering and grueling debates, sweeping changes will now begin to be made to our health care system. Strong opinions continue to be expressed, Republicans have declared that there will be “no cooperation” from them as they work on their strategy to “repeal and replace,” and Big Insurance has already started looking for loopholes (SEE sidebar on the left). So now the real work begins.

The bill will eventually affect just about every American by 2014, but there is a list of reforms that will begin within the next 6 months, including tax credits to 4 million small businesses to cover employees’ insurance; an end to recisions by insurance companies of customers who get sick; an end to caps on coverage; and a provision to allow young adults to remain on their parents’ policies until they are 26 years old.

To help you understand how it will affect or benefit you, stay tuned here to find out how. To begin with, check out below.

As a consumer, the new health care reform law will immediately:

·	Prohibit pre-existing condition exclusions for children in all new plans;

·	Provide immediate access to insurance for uninsured Americans who are uninsured because of a pre-existing condition through a temporary high-risk pool;

·	Prohibit dropping people from coverage when they get sick in all individual plans;

·	Lower seniors prescription drug prices by beginning to close the donut hole;

·	Offer tax credits to small businesses to purchase coverage;

·	Eliminate lifetime limits and restrictive annual limits on benefits in all plans;

·	Require plans to cover an enrollee’s dependent children until age 26;

·	Require new plans to cover preventive services and immunizations without cost-sharing;

·	Ensure consumers have access to an effective internal and external appeals process to appeal new insurance plan decisions;

·	Require premium rebates to enrollees from insurers with high administrative expenditures and require public disclosure of the percent of premiums applied to overhead costs.

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