August 3, 2009

IN THIS ISSUE

Editor's Column: What The Surcharge Means To Us
Waxman, Blue Dogs Agree To Use Negotiated Rates For Public Plan
Senate: Committee Near Accord On Bill
Chair Of Emergency Medicine At Henry Ford Hospital Appointed
St. John Ranks As 'One Of The Best' In Neurosciences
DMC Among Nation's Best In Multiple Specialties
Office Visit Documentation And Coding Event
DMN Reader Survey 2009


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Editor's Column: What The Surcharge Means To Us

By JOSEPH WEISS, MD
The talk on health reform centers in part on how to pay for it. At the moment, the Democratic Party’s answer is a surcharge on the wealthy, presently defined as any individual or family reporting an income of $350,000 or more a year.

In 1988, Congress passed ground breaking legislation: The Medicare Catastrophic Coverage Act. The bill provided much more then unlimited hospital coverage for catastrophic illness. Other provisions capped Medicare beneficiary out-of-pocket expenses and initiated government payment for prescription drugs. To pay for these benefits Medicare recipients were assessed an additional premium of $4/month plus a monthly drug premium of $1.94/month. In addition, those individuals or couples earning more than $30,000, (about $65,000 in 2008 dollars) were charged an added amount not to exceed $800/person or $1,000/couple.

The elderly called the surcharges a “pernicious tax”, and one year later, Congress, for the sake of simplicity, called the whole act a catastrophe and repealed it completely.

The same will happen this year with the proposed surtax on the wealthy. The only difference is that unlike 1988, the people on whom the tax is to fall will shipwreck the tax provision before it gets out of Committee rooms and onto the floor of the House or Senate.

Likely, no substitute will be found for the estimated $540 billion the tax on wealth was to bring in over the next ten years. Instead, Congress will take a look at cutting costs of care. For Capitol Hill politicians denying physicians’ request for payment reform is the easiest cost cutting measure available. All that Congress needs to do is continue the present SGR and the formula of granting a reprieve from its onerous mandate by giving us ½ percent increase every 18 months to two years.

For physicians, the 2009 reforms in health care mean no transition, no change, and no hope that we will be heard, let alone understood.

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Waxman, Blue Dogs Agree To Use Negotiated Rates For Public Plan

(The following is from the AMA) The House Energy and Commerce Committee announced last week that an agreement has been reached between Chairman Henry Waxman (D-CA) and Blue Dog Health Care Task Force Chairman Mike Ross (D-AR) on revisions to HR 3200, the American Affordable Health Choices Act of 2009. Importantly, it was reported that both sides agreed that payments in the proposed public plan option should be based on negotiated rates rather than on the Medicare fee schedule. Also, it has been said that states would have the option of establishing health insurance co-ops in addition to a public plan, and that they would be given the opportunity to establish their own state-based health insurance exchanges.  Additional language emphasizes that participation in the public plan would be optional for physicians.  All these changes were recommended and supported by the AMA. 

Other reported revisions to the bill include raising the small business exemption to include companies with payroll expenses up to $500,000, with tax penalties phased up to $750,000. 

At the end of the day, the committee planned to resume mark-up on July 30, with efforts underway this evening to assure all elements of the agreement would be supported broadly by committee members.

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Senate: Committee Near Accord On Bill

Finance Committee Negotiators Near Accord On Bill

[Jul 29, 2009]

The Washington Post: "Three Democrats and three Republicans on the Senate Finance Committee are expected to wrap up their arduous multi-week talks in the coming days, and Majority Leader Harry M. Reid (D-Nev.) said he expects a panel vote before the Senate recess, which will begin Aug. 7. Assuming the fragile committee coalition holds, the legislation it produces would scramble the reform landscape by introducing policy ideas that have their origins in the political center. The bill is bound to disappoint liberals."

"The finance panel's legislation is expected to include incentives for employers to provide health insurance for their workers, rather than a more punitive coverage mandate. The committee is also likely to endorse narrowly targeted tax increases, rejecting a controversial tax surcharge on wealthy households that the House adopted and limits on deductions for upper-income taxpayers that Obama is seeking" (Murray and Kane, 7/29).

NPR's Steve Inskeep interviewed Sen. Charles Grassley, R-Iowa, who discussed the bipartisan negotiations: "We have made great progress. Every day we make progress. Will we get it done by this weekend? .... We're restructuring one-sixth of the economy, we think it ought to be done right." (Morning Edition, 7/29).

Senators negotiating in the Finance Committee are close to reaching a deal that would save $35 billion in Medicare spending during the next decade by assigning an independent commission to examine changes, The Associated Press reports, quoting sources.

"Under the plan, an independent commission would be empowered to recommend changes in Medicare annually, to take effect automatically unless Congress enacted an alternative. In addition to saving money, the proposal is aimed at turning the program for those age 65 and over into one that more clearly rewards quality, officials said. The commission would be required to recommend $35 billion in savings over a decade from Medicare" (Espo and Werner, 7/28).

Roll Call: "Senate Finance Committee Democrats, following a meeting Tuesday morning, appeared slightly happier with the direction of ongoing health care reform talks that (Baucus) is leading with three of the panel's Republicans. ... 'It was actually a good meeting,' Sen. Tom Carper (D-Del.) said. 'I told Max -- I said: I'm encouraged'"(Drucker, 7/28).

Bloomberg: "Democratic Senator Max Baucus, leading the talks among six Democrats and Republicans on the finance committee, said they made progress and will meet again today. ... 'We reached an agreement on a couple of very key points,' Baucus told reporters after meeting with the other senators" (Litvan and Dodge, 7/29).

The Hill: "Senators need 60 votes to advance the legislation and many say the burden of resolving the healthcare dispute in their chamber will rest with (Reid), setting up arguably the most difficult decision of his career. Reid, who has already moved the floor debate to the fall, said Tuesday that Senate Democrats will spend 'many hours' in a series of meetings next week to seek some sort of consensus" (Bolton and Young, 7/28).

Politico has more on Reid's role in uniting the Finance Committee with the Health, Education, Labor and Pensions Committee: "It's a risky and unusual role for a majority leader who -- unlike his Democratic predecessor, Tom Daschle -- prides himself in taking a hands-off approach and giving his committee barons wide latitude to do their work. If Reid can bring together the sparring factions of his own caucus, he may get the credit for being the critical negotiator who made health care reform possible. But if he can't -- if the bill moves too far to the right or too far to the left or just doesn't move at all -- Reid could be blamed for missing a may-never-come-again chance to vastly expand coverage" (Raju, 7/29).

The Hill reports in a second story: "Reid stepped out to defend Baucus at a mid-afternoon press conference, but avoided details. Asked if he was confident that a bill will reach the Senate floor by the time the recess begins on Aug. 7, Reid simply said, 'Yes'" (Rushing, 7/28).

The Associated Press in a second story: "But the recess will be no vacation for the forces at work on health care, least of all Reid and Baucus. A message war will ensue, with Republicans demanding a rewrite and Democrats calling for patience. Aides will spend the summer break toiling over how to marry the Finance Committee bill with elements of less viable proposals turned out by other panels." At some point, Obama and congressional Democrats will decide whether compromising towards the center is the best strategy for passage or too risky in terms of losing support from the party's liberal base. "The next 10 days are pivotal. The onus to deliver is on Baucus and Reid" (Kellman, 7/29).

Reprinted from kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, and sign up for email delivery at www.kaisernetwork.org/dailyreports/healthpolicy . The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation. © 2009 Advisory Board Company and Kaiser Family Foundation. All rights reserved."

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Chair Of Emergency Medicine At Henry Ford Hospital Appointed

Gerard Martin, MD, has been appointed chair of the Department of Emergency Medicine at Henry Ford Hospital. He has served as interim chair for the past two years.

During his years as interim chair, the department opened Emergency Services at Henry Ford Cottage Hospital and Henry Ford West Bloomfield Hospital.  In addition, Dr. Martin integrated Henry Ford's three suburban emergency departments into the Henry Ford Hospital and Health Network.

He has contributed significantly to the literature in the area of resuscitation, with more than 40 peer reviewed publications.

Dr. Martin served as the director of research for the Emergency Medicine department from 1988-1994. He subsequently assumed the leadership as associate medical director of the department and has served on a variety of Henry Ford Hospital and Health Network committees.

Nationally, he has been an examiner at the American Board of Emergency Medicine and a consultant to the American Journal of Emergency Medicine. He has served on the research committees of the American College of Emergency Physicians and for the Society of Academic Emergency Physicians.

Dr. Martin received his medical degree from Saint Louis University. He completed his post-graduate training at Henry Ford including both an Emergency Medicine residency and two years as a research fellow.

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St. John Ranks As 'One Of The Best' In Neurosciences

St. John Hospital and Medical Center has been recognized for excellence in neurosciences on the prestigious U.S.News & World Report’s annual “Best Hospitals” list.

SJH&MC is ranked 48th in the category of Neurology & Neurosurgery by the magazine, which will be available on newsstands on July 21. This is the 20th year that U.S News & World Report has compiled the annual rankings of America’s Best Hospitals.

The rankings, according to the magazine, are based on quality of patient care, hospital reputation, death rates and other factors such as nurse-to-patient ratio, availability of advanced technology, number of procedures performed and number of discharges.

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DMC Among Nation's Best In Multiple Specialties

The Detroit Medical Center (DMC) now has three hospitals that rank among the nation's best. Harper University Hospital and Sinai-Grace Hospital have been recognized as tops in three medical specialties (cardiac, gastrointestinal and neurology), according to the 2009 "America's Best Hospitals" survey conducted by U.S. News & World Report. This recognition follows an announcement last month that Children’s Hospital of Michigan received top national honors from the publication.

This year, DMC Harper University Hospital made its first appearance on the Heart and Heart Surgery list, following the introduction last year of the innovative onsite cardiac response team, Cardio Team One. For the third consecutive year, Harper also ranked as a top 50 hospital in neurology & neurosurgery.

DMC Sinai-Grace Hospital moved up three spots from #40 in 2008 to #37 in neurology & neurosurgery and made its third consecutive appearance as a top 50 hospital for the treatment of gastrointestinal disorders.

"Providing quality care for the patients we serve is our top priority at the DMC," said Mike Duggan, President and CEO of the Detroit Medical Center. "We are proud of the commitment and expertise of our physicians, nurses and staff and we are also proud to be the only healthcare system in the Midwest with two nationally-ranked neuroscience programs."

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Office Visit Documentation And Coding Event

Details:

Date: Tuesday, August 11, 2009

7:00-8:00 AM -Registration & Continental Breakfast

8:00-10:00AM - Dr. Steve Levinson will speak about Office Visit documentation and coding

10:00-10:30AM - The AMA will preview coding books for 2010

At the conclusion of the meeting there will be a raffle. Winners will receive one of Dr. Levinson's books.

The meeting will be held at Henry Ford Health System in the Buerki Auditorium. The fee is $10.00. All physicians will receive 2.5 CME Credits and all coders will receive 2.5 AAPC CEUs.

Please feel free to contact Rebecca Cole, CPC, Education Specialist, Henry Ford Health System

if you have any questions. My number is 313-874-9579. To register, please email tdew1@hfhs.org .

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DMN Reader Survey 2009

Detroit Medical News/WCMSSM Reader Survey August 2009

**Please feel free to cut and paste into an e-mail and send to

arj@msms.org or fax to (313) 874-1366**

 

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