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Doctors Caught Between Patient Pain, Prescriptions – HealthLeaders Media
For some physician leaders, pain management may become a significant boon to their business, especially as the U.S. population ages. In a Health Leaders Media Industry survey this year, 37% predicted pain management will grow 1 to 5% over the next five years.
But doctors are on a precipice as they prescribe pain medication, especially long-acting and extended-release opioid analgesics such as oxycodone. Most are aware of the persistent potential for abuse, misuse, or mistaken use of the highly potent prescription drugs among patients. And the stress is mounting – for the docs.
States are tightening treatment requirements, while the federal government weighs the possibility of mandatory educational plans for doctors in their handling of opioids, putting federal officials at loggerheads with much of the medical establishment.
Some physicians are so upset over what they term the “bureaucratic” infringements, that they are considering no longer seeing patients who seek pain treatment. Instead, they would prefer to refer those patients to colleagues who are willing to prescribe potent analgesics.
See on www.healthleadersmedia.com
For an aggregation of other articles on Hot Topics in Healthcare Law, go to my magazine on Scoop.it – Hot Topics in Healthcare Law and Regulation and my newspaper on Paper.li – Hot Topics in Healthcare Law.
For an aggregation of other articles on improving healthcare, go to my internet magazine Scoop.it! Changing Health for the Better.
U.S. Officials Brace for Huge Task of Operating Health Exchanges
See on Scoop.it – Hot Topics in Healthcare Law and Regulation
Obama administration officials are getting ready to set up and operate new health insurance markets in about half the states, where local officials appear unwilling or unable to do so.
The markets, known as exchanges, are a centerpiece of President Obama’s health care law, and running them will be a herculean task that federal officials never expected to perform.
When Congress passed legislation to expand coverage two years ago, Mr. Obama and lawmakers assumed that every state would set up its own exchange, a place where people could shop for insurance and get subsidies to help defray the cost.
But with Republicans in many states resisting the creation of exchanges or deterred by the complexity of the task, federal officials are preparing to do the job, with or without assistance from state officials.
“We realize that not all states will be ready to establish these exchanges by 2014, so we are setting up a federally facilitated exchange in those states,” said Michael Hash, the top federal insurance regulator. “We are on track to go live in October 2013, which is the beginning of the first open season for the individual and small group markets.”
Governors of 13 states with nearly one-third of the United States population have sent letters to the Obama administration saying they intend to set up exchanges. Complete applications are due on Nov. 16, just 10 days after the presidential election.
See on www.nytimes.com
Reform Driving Physicians Out of Private Practice to Reduce Costs
See on Scoop.it – Hot Topics in Healthcare Law and Regulation
So, the question is: Is driving a systemically distressed, contracting, dissatisfied and undercompensated physician sector to be forcibly absorbed by a traditional antagonist, but symbiotic hospital sector on the edge of distress itself and binding them together with miles of red tape and questionably reachable incentives going to reduce costs?
See on member.ubmmedica.com
Judge Backs Firm’s Catholic Owners on Contraceptive Rule
See on Scoop.it – Lawyering in a Modern World
What exactly does separation of nchurch and state mean anymore — can anyone with a religious belief interfere with the proper functioning of government in exercising its legitimate powers?
Are there religions that advocate racial, religious, or other cultural purity? Will adherents to such religions be allowed to discriminate on the basis of religion or race? I believe this is one more slide down the slippery slope of theocracy that the Founding Fathers clearly were opposed to.
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By Louise Radnofsky:
A federal judge on Friday granted a temporary injunction sought by Catholic owners of a Colorado heating-and-cooling company who had objected to new federal requirements that they provide contraception coverage in workers’ health-insurance.
See on legalnews.findlaw.com
House Bill to Press for One-Year SGR Delay – HealthLeaders Media
Rep. Michael Burgess (R-TX) said on Wednesday that he will submit legislation this week to delay for one year the implementation of the sustainable growth rate formula (SGR). Without the delay, or other action, physicians face a 28% cut in Medicare reimbursements in January 2013.
Burgess made the announcement at a meeting of the House Energy and Commerce Committee called to discuss innovations to reform Medicare physician payments.
He said that the SGR delay would allow Congress to get past the uncertainties presented by the upcoming elections, the expiration of existing tax policy, the extension of unemployment insurance, as well as potential debt limit debates.
The SGR formula was put in place as part of the Balanced Budget Act of 1997 to help control Medicare spending. It soon became apparent that significant cuts in physician reimbursements would be required to help reduce spending but since 2003 Congress has routinely declined to make those cuts.
See on www.healthleadersmedia.com
For an aggregation of other articles on Hot Topics in Healthcare Law, go to my magazine on Scoop.it – Hot Topics in Healthcare Law and Regulation and my newspaper on Paper.li – Hot Topics in Healthcare Law.
For an aggregation of other articles on improving healthcare, go to my internet magazine Scoop.it! Changing Health for the Better.
Colorado Shootings Put Docs vs. Glocks Law in Spotlight – HealthLeaders Media
Should doctors warn patients about the risks of guns in the home?
In Florida, physicians who did just that could have lost their medical licenses—until recently.
Weeks before one of the worst gun violence incidents in U.S. history, a group of physicians won a court victory in a little-noticed case against a Florida law that threatened to strip doctors of their medical licenses if they warned patients about the risks of guns in the home.
Florida politicians, citing Second Amendment rights, were adamant that docs weren’t in the gun-counseling business, and passed a statute to thwart such discussions. The physicians, however, prevailed in federal court to halt the measure.
See on www.healthleadersmedia.com
For an aggregation of other articles on Hot Topics in Healthcare Law, go to my magazine on Scoop.it – Hot Topics in Healthcare Law and Regulation and my newspaper on Paper.li – Hot Topics in Healthcare Law.
For an aggregation of other articles on improving healthcare, go to my internet magazine Scoop.it! Changing Health for the Better.
Texas Vascular Associates Sued in Dallas for Alleged Medicare, Insurance Fraud
A former employee of Dallas’ Texas Vascular Associates is suing the company and nine physicians after being fired for allegedly refusing to fraudulently bill Medicare and private insurance companies for patient services.
See on www.marketwatch.com
For an aggregation of other articles on Hot Topics in Healthcare Law, go to my magazine on Scoop.it – Hot Topics in Healthcare Law and Regulation and my newspaper on Paper.li – Hot Topics in Healthcare Law.
For an aggregation of other articles on improving healthcare, go to my internet magazine Scoop.it! Changing Health for the Better.
In new effort to tackle health care fraud, government and insurers to scrutinize claims data
The Obama administration is upping the ante in the fight against health care fraud, joining forces with private insurers and state investigators on a scale not previously seen in an attempt to stanch tens of billions of dollars in losses.
Health and Human Services Secretary Kathleen Sebelius said in a statement Thursday that the new public-private partnership “puts criminals on notice that we will find them and stop them,” while Attorney General Eric Holder called it “a critical step forward” against fraud, an endemic problem plaguing programs like Medicare and Medicare as well as private insurance companies.
The analysis of data from Medicare, Medicaid and private health plans will look for suspicious patterns and other evidence that might indicate fraud, White House officials said. A “trusted third party” would comb through the data and turn questionable billing over to insurers or federal investigators.
See on www.washingtonpost.com
For an aggregation of other articles on Hot Topics in Healthcare Law, go to my magazine on Scoop.it – Hot Topics in Healthcare Law and Regulation and my newspaper on Paper.li – Hot Topics in Healthcare Law.
For an aggregation of other articles on improving healthcare, go to my internet magazine Scoop.it! Changing Health for the Better.
Aurora Health Care and Aetna Form Accountable Care Collaboration, Offer New Commercial Health Care Products
AETNA Press Release regarding New Commwerical ACO Venture:
Aurora Health Care has joined with Aetna (NYSE: AET) to bring employers a new type of commercial health plan designed to improve employees’ health care experience and health outcomes, while controlling costs. The Aurora Accountable Care Network offers businesses a high-quality, affordable alternative in a time of rising health care spending.
“Aetna views accountable care organizations as a model for making health care work better for everyone.”
The Aurora Accountable Care Network offers a price guarantee to employers built upon a health care model that improves quality, outcomes and the patient experience. This type of price guarantee is possibly the first of its kind among accountable care models. Employers will see real savings in what they spend on health care as a result of improved patient outcomes and greater efficiencies. Cost savings will be specific to each employer, with the potential for an average 10 percent reduction based on the employer’s past claims expenses. The plans with Aetna will be effective beginning Jan. 1, 2013.
“This is a game changer,” said Nick Turkal, MD, Aurora Health Care’s president and CEO. “We are pleased to collaborate with Aetna to make our accountable care model available to the commercial health insurance market. As an employer, we have met national quality benchmarks among our own employees, while curbing our health care costs. Now we aim to replicate this success for others.”
Mark T. Bertolini, Aetna chairman, CEO and president, said, “We are building on our strong provider relationships to establish a nationwide accountable network that offers better care at a lower cost for everyone. Aurora Health Care has revolutionized health care in Wisconsin. Aetna’s industry-leading care management programs and consumer tools together with Aurora’s outstanding patient care model will lead to a better overall health care experience.”
See on www.businesswire.com
For an aggregation of other articles on Hot Topics in Healthcare Law, go to my magazine on Scoop.it – Hot Topics in Healthcare Law and Regulation and my newspaper on Paper.li – Hot Topics in Healthcare Law.
For an aggregation of other articles on improving healthcare, go to my internet magazine Scoop.it! Changing Health for the Better.
Getting the Methods Right — The Foundation of Patient-Centered Outcomes Research — NEJM
Perspective from The New England Journal of Medicine —
Health care in the United States has changed dramatically over the past several decades. Today, patients have more options than ever. Making the right choices, whether for prevention, diagnosis, or treatment, requires a critical appraisal of the potential benefits and harms of the options, within the context of the patient’s characteristics, conditions, and preferences.
Many of these choices are available thanks to advances in medical research. Yet most patients and many clinicians find research somewhat mysterious. They have difficulty sorting through the mountains of medical evidence to identify information that is reliable and actionable for their unique circumstances. Patient-centered outcomes research and comparative-effectiveness research promise to enhance decision makers’ ability to fully understand and weigh alternatives.
See on www.nejm.org
For an aggregation of other articles on Hot Topics in Healthcare Law, go to my magazine on Scoop.it – Hot Topics in Healthcare Law and Regulation and my newspaper on Paper.li – Hot Topics in Healthcare Law.
For an aggregation of other articles on improving healthcare, go to my internet magazine Scoop.it! Changing Health for the Better.
Joseph Rugg's Health Law Blog 