Health Care Reform in Nevada

Posted on July 29, 2010 by Tim Titolo

Nevada Senator Harry Reid has helped the President accomplish the greatest social overhaul since President Roosevelt.  In July, Heath Care begins to reshape this country by providing benefits to those who were previously denied access to health care.  As with the creation of social security, more Americans can live with the security of health care.

As provided for in the Patient Protection and Affordable Care Act, on July 1, 2010, the Department of Health and Human Services launched the website www.HealthCare.gov to make accessing and choosing health insurance easier. By providing consumers with many informative health resources, this website will allow you to take control when making decisions regarding your health care coverage.

 How Health Insurance Reform Is Benefitting You

Pre-Existing Condition Insurance Plan – Nevada residents who are uninsured and have been denied coverage because of a pre-existing condition can apply for the Pre-Existing Condition Insurance Plan (PCIP) created by the Patient Protection and Affordable Care Act. PCIP will cover a broad range of health benefits, including primary and specialty care, hospital care, and prescription drugs. All covered benefits are available, even to treat a pre-existing condition. To learn more about the PCIP program and apply please visit www.HealthCare.gov.

Early Retiree Reinsurance Program – The rise of health insurance costs have made it difficult for some employers to continue to provide health insurance for their retirees. At the same time, Nevada’s early retirees who are not yet eligible for Medicare face serious difficulties in obtaining coverage in the individual market. In order to enable employers who are offering retiree coverage to continue to do so in these tough times, the Patient Protection and Affordable Care Act provides assistance for employers starting this year. To learn more about this program and to download the application please visit www.HealthCare.gov.

Money for Rate Review - Under the Patient Protection and Affordable Care Act, the Secretary of Health and Human Services will work in conjunction with state insurance commissioners across the country to place additional oversight on health insurance companies so that people are assured of value for the premiums they pay. While the new law will take over time, PPACA provided $250 million in funding to states from 2010-2014 to ensure they have the resources they need to review insurance premium increases. With this money, states can review premiums, and take action if insurance companies are not able to justify increases. This funding will provide the participating states the tools they need to work with consumers when examining health insurance premiums while we transition to a reformed health system. 

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Key speech on medical errors

Posted on November 23, 2009 by Tim Titolo

I met Congressman Braley last season in Washington DC.  He strikes me as a man to watch.  Issues like health care reform, tort reform, patient safety, consumer safety, are so media drenched it is hard to understand them.  Well here is what  Bruce Braley has to say.  And you might consider that the people who hate trial lawyers only do so until they need one!

In Case You Missed It:

Times Union (Albany)

Key speech on medical errors
Advocates seeking action on issue heartened by congressman's talk

By CATHLEEN F. CROWLEY, Staff writer
Monday, November 23, 2009
http://www.timesunion.com/AspStories/story.asp?storyID=869285&category=REGION&TextPage=1

WASHINGTON – A short but fiery speech made on the floor of the House of Representatives has raised the hopes of patient safety advocates across the nation.

Rep. Bruce Braley, a second-term Democrat from Iowa, gave a speech about medical errors moments before the House voted on the health reform bill earlier this month.

Braley, 52, a trial lawyer who specializes in malpractice, said he had two minutes to prepare his speech. As he spoke, he was taunted by Republicans shouting "trial lawyer." But Braley impressed Helen Haskell, whose son died from a medical error.

"I was very pleased that somebody was standing up for patient safety. I thought the heckling was unbelievable," said Haskell, of South Carolina. Her son Lewis Blackman, 15, died in 2000 after a minor surgical procedure.

Haskell called Braley's office the next day to thank him.

Patient safety activists are cautiously optimistic that Braley may be the champion they need for their cause. "He's definitely an emerging leader and he seems to be very passionate about (patient safety)" said Lisa McGiffert, who heads Consumers Union's Safe Patient Project.

"Who will speak for the patients?" Braley said in his House speech. Referring to an Institute of Medicine report, Braley said "They told us the most significant way to reduce the cost of medical malpractice is to emphasize patient safety by reducing the number of preventable medical errors."

Consumers Union invited Braley to speak at its conference on patient safety in Washington, D.C., last week.

While some members of Congress have led efforts to increase the public reporting of hospital-acquired infections, few have embraced the larger issue of medical errors. Nearly 200,000 Americans die each year from errors made during their medical care and from infections acquired in the hospital. The lack of progress in reducing errors was the subject of a Hearst Newspapers series that can be read at www.deadbymistake.com.

"I am so grateful to Hearst publications for their Dead by Mistake series to put the human face on the problems that bring you all here today," Braley said to the audience at the Consumers Union conference. Braley said he has passed the series to other members of Congress to bolster support for patient safety initiatives in the health reform bill.

Braley grew up on a small farm in Iowa. His father was seriously injured in a fall from a grain elevator and his mother went back to work as a teacher to support the family. His father eventually went into the insurance business, while Braley began working in his teens to help the family.

He was a successful lawyer in Waterloo, Iowa, when he ran for an open seat in the House of Representatives in 2006.

In his short political career, Braley has rapidly climbed the ladder of leadership in the House.

Braley founded and chairs the Populist Caucus, which is a congressional group devoted to economic issues of the middle class. He was named vice chairman of the Democratic Congressional Campaign Committee, the campaign arm for House Democrats. Braley leads the committee's "Red to Blue" effort to capture Republican House seats.

During his second term, Braley was appointed to the powerful House Energy and Commerce Committee.

He also is past president of the Iowa Trial Lawyers Association.

"When my colleagues chose to attack me by screaming 'trial lawyer, trial lawyer' it wasn't affecting me in the least," Braley told advocates last week at the Consumers Union conference. "I was thinking of people that need someone to stand up for them when it comes to important issues of patient safety."

Braley said he fought for an initiative in the House health reform bill that will require Medicare to revamp its reimbursement system from a fee-for-service model to a pay-for-performance model. He believes it will reduce errors and improve quality, and he said he hopes to sponsor more legislation to improve patient safety.

"Unless medical consumers know that they have a system that is going to protect them, that is going to give them access to information to make them informed consumers," Braley said, "we will have missed a great opportunity to transform our system of health care delivery."

 

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BIAA Health Care Reform Update

Posted on November 16, 2009 by Tim Titolo

 The Brain Injury Association of America's Sarah D'Orsie reports:

Health Care Reform Update

On November 7, 2009, the House of Representatives approved their health care reform overhaul package by a vote of 220-215.  The bill includes the provisions below: (provided by Congressional Quarterly, CQ Today)

Coverage Requirements

Individual Mandate
* Requires nearly all individuals to obtain health care coverage beginning in 2013.
* Permits individuals to keep their current health plan as a "grandfathered" plan.
* Excludes from the mandate those exempt from filing income tax returns and others who receive a hardship waiver.
* Subjects those who do not obtain coverage to a penalty tax of 2.5 percent of adjusted gross income above a   threshold.

Employer Mandate
* Requires employers to offer their employees health care insurance, or make an insurance contribution on their behalf, starting in 2013.
* Exempts firms with payrolls of $500,000 or less.
* Subjects businesses that fail to provide coverage to penalties of up to 8 percent of their payroll.

Purchase of Coverage

Health Insurance Exchange
* Creates a federal exchange, to begin operation in 2013, that would allow individuals and small businesses to purchase health insurance from insurers participating in the exchange.
* Allows states to apply to operate their own state-based health insurance exchanges.

Public Option
* Requires the establishment of a public health insurance option within the insurance exchange by 2013.
* Directs the Health and Human Services Department to run the public option and negotiate with providers to determine rates.
* Requires those rates to be no lower than those under Medicare and no higher than the average for private plans.

Additional Options
* Authorizes loans to entities that want to create health insurance cooperatives.
* Permits states to enter into compacts that allow for the sale of insurance across state lines.

Affordability

Individual Subsidies
* Provides affordability credits to individuals and families with incomes of up to 400 percent of the federal poverty level.
* Requires that subsidies would be used to reduce premiums and out-of-pocket costs.
Small Businesses
* Provides tax credits for certain small businesses that offer health insurance to their employees.

Requirements for Insurance Companies

Pre-Existing Conditions
* Bars insurance companies from denying or reducing coverage based on pre-existing medical conditions, beginning in 2013.
* Restricts how long insurers can continue to limit coverage for pre-existing conditions until the full ban takes effect.
* Prohibits companies from considering domestic violence a pre-existing condition.

Coverage Caps
* Prohibits annual or lifetime coverage limits.

Premiums
* Limits variations on premiums based on the age of the beneficiary to a ratio of 2-to-1.
* Permits variations on premiums based on geography and family size.

Out-of-Pocket Expenses
* Limits annual out-of-pocket expenses to $5,000 for an individual and $10,000 for a family.
* Guarantees no out-of-pocket costs for preventive care.

Essential Benefits Package
* Requires all qualified health benefits plans to provide coverage that meets or exceeds the standards of an "essential benefits package."
* Requires an essential benefits package to, at a minimum, cover hospitalization, outpatient hospital and clinic services, professional services of physicians and other health professionals, prescription drugs, rehabilitative services; mental health and substance use disorder services; preventive services, maternity care, well-baby and well-child care, and medical equipment.
* Establishes a Health Benefits Advisory Committee, chaired by the surgeon general, to make recommendations to HHS regarding the details of covered health benefits included in the essential benefits plan.

Medicare and Medicaid

Medicaid Expansion
* Expands eligibility for Medicaid by allowing enrollment for those making up to 150 percent of the poverty level, beginning in 2013.
* Beginning in 2015, states would pay 9 percent of costs associated with the expanded coverage.
* Requires Medicaid to cover newborns during the first 60 days of life.

Medicare Advantage
* Reduces payments under the Medicare Advantage program over a three-year period beginning in 2011.
* Makes the rates for Medicare Advantage the same as those for traditional fee-for-service Medicare by 2014.
* Provides bonus payments to insurance plans in the program that offer high-quality insurance plans in low-cost areas.

As part of the debate, Congressman Bill Pascrell, Jr., Co-Chairman of the Congressional Brain Injury Task Force, offered a statement including BIAA's guiding principles for health care reform.  Also included in the statement, which can be viewed by clicking on the link below, was language regarding payment initiatives such as the bundling of services. 


http://www.biausa.org/elements/policy/2009/house_cr_statement_bp.pdf  

The statement detailed BIAA's position that "post-acute payment systems must facilitate, not impede, improvements in functional status of individuals with brain injury and their ability to return to their homes and communities. BIAA supports a deliberative planning process and rigorous pilot testing."

Congressman Pascrell has been a true champion in the fight for securing access to care for persons with brain injury during the health care reform debate.  Please take a minute to click on the link below and thank him for his dedication to this important issue:

http://pascrell.house.gov/contact/  

It is also important to note that BIAA's Business and Professional Council was integral in creating the content of BIAA's health care reform guiding principles.

Now that the House has passed its measure, BIAA is monitoring Senate activity closely.  Senate Majority Leader Harry Reid has alluded to Senate action on their leadership bill as soon as next week. 


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Five Myths About Medical Negligence

Posted on November 6, 2009 by Tim Titolo

American Association of Justice published "Five Myths about Medical Malpractice Negligence."  I reprint it below.

It is especially interesting since the Nevada Supreme Court is currently considering whether to make the "Keep Our Doctor's in Nevada" bill, passed in 2004, retroactive.  A woman is suing her lawyer for taking 40% of her over $5,000,000 award for a lawsuit she retained him for in 1999.  She is arguing that the attorney fee limits should apply retroactively and the attorney's fees be reduced.  Interestingly she is not arguing that her recovery be limited retroactively to the current ceiling on medical malpractice cases of $350,000.

Those opposed to real health care reform are flailing to come up with real, alternative solutions to our current crisis. With all the talk of death panels, government takeovers, and rationing of care, now tort reform has been thrown into the mix.

Yet it will do practically nothing to lower health care costs, and certainly will not fix our broken health care system. However, it will most definitely hurt patients injured through no fault of their own. Seemingly, the effects of legislation on real people have somehow evaporated from the discussion.

To break through all the hyperbole, lies, and distortions, the American Association for Justice today released a new report, "Five Myths About Medical Negligence." The next time a cable news pundit or opponent of health care reform starts talking about tort law changes, chances are this manual will rebut their claims.

As the health care debate moves forward, here are the key myths and facts:

Myth #1: There are too many "frivolous" malpractice lawsuits.
Fact: There's an epidemic of medical negligence, not lawsuits. Only one in eight people injured by medical negligence ever file suit. Civil filings have declined eight percent over the last decade, and are less than one percent of the whole civil docket. A 2006 Harvard study found that 97 percent of claims were meritorious, stating, "portraits of a malpractice system that is stricken with frivolous litigation are overblown."

Myth #2: Malpractice claims drive up health care costs.
Fact: According to the National Association of Insurance Commissioners, the total spent defending claims and compensating victims of medical negligence was just 0.3% of health care costs, and the Congressional Budget Office and Government Accountability Office have made similar findings.

Myth #3: Doctors are fleeing.
Fact: Then where are they going? According to the American Medical Association's own data, the number of practicing physicians in the United States has been growing steadily for decades. Not only are there more doctors, but the number of doctors is increasing faster than population growth. Despite the cries of physicians fleeing multiple states, the number of physicians increased in every state, and only four states saw growth slower than population growth; these four states all have medical malpractice caps.

Myth #4: Malpractice claims drive up doctors' premiums.
Fact: Empirical research has found that there is little correlation between malpractice payouts and malpractice premiums paid by doctors. A study of the leading medical malpractice insurance companies' financial statements by former Missouri Insurance Commissioner Jay Angoff found that these insurers artificially raised doctors' premiums and misled the public about the nature of medical negligence claims. A previous AAJ report on malpractice insurers found they had earnings higher than 99% of Fortune 500 companies.

Myth #5: Tort reform will lower insurance rates.
Fact: Tort reforms are passed under the guise that they will lower physicians' liability premiums. This does not happen. While insurers do pay out less money when damages awards are capped, they do not pass the savings along to doctors by lowering premiums. Even the most ardent tort reformers have been caught stating that tort reform will have no effect on insurance rates.

Over 98,000 people die every year from preventable medical errors. That's like two 737s crashing every day for a whole year. Instead of focusing on tort law changes that won't fix health care, let's make sure people aren't injured in the first place. Not only will that lower costs, but most importantly, will improve health care for everyone.



Read more at: http://www.huffingtonpost.com/anthony-tarricone/calls-for-tort-reform-des_b_345438.html&cp

You can view AAJ President Anthony Tarricone’s article on the Huffington Post and link to the article by clicking here.

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Malpractice Tort Reform Update

Posted on November 2, 2009 by Tim Titolo

President Obama continues his quest to appease skeptics of his health care reform:

Since President Obama proposed using $25 million to test new ways to handle malpractice lawsuits, suitors have been lining up, the The Associated Press reports. One leading idea is to appoint expert panels to sort fact from fiction in malpractice claims. The "American Hospital Association has been shopping a new plan to lawmakers," and malpractice reform advocates are expected to propose another strategy for a pilot program at a Health and Human Services hearing next week. Doctors say they perform extra tests on patients because they fear lawsuits.

Read More Here.

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Tort Reform Experimentation

Posted on October 21, 2009 by Tim Titolo

President Barack Obama can look to a variety of models as he seeks to fulfill a pledge to fund state tort reform experiments, a longtime wish-list item for physicians, the New York Times reports. States have so far tried a few approaches, with mixed results, and considered more.

They include, a cap on non-economic damages supported by the American Medical Association; medical screening panels that "attempt to weed out frivolous suits;" "apology statutes" that ban physicians admission of error from being used as evidence in court; early compensation offers by physicians and hospitals that preclude law suits; safe harbor systems that protect doctors from law suits when they follow practice guidelines; birth funds that compensate families for childbirth injuries and are financed by physician surcharges; and, special medical courts that would approach malpractice cases with more specialized expertise (Underwood, 10/13).

This information was reprinted from kaiserhealthnews.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Health Policy Report, search the archives and sign up for email delivery at kaiserhealthnews.org.

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