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Wednesday, November 11, 2009

HOUSE PASSES HEALTH REFORM BILL WITHOUT SGR FIX OR LIABILITY REFORMS

By a five-vote margin, the U.S. House of Representatives late Saturday night passed HR 3962, Speaker Nancy Pelosi’s health system reform bill. It was mostly a party-line vote. Among Texans, all Republican representatives and Rep. Chet Edwards (D-Waco) voted against it; all the other Democrats voted for it. The bill won the American Medical Association’s support two days before the vote. A separate bill, HR 3961 — which won’t be considered until next week — eliminates the Medicare Sustainable Growth Rate (SGR) formula for physician payments with a new system that is still based on general inflation rates. It also would set future payment rate changes separately for evaluation and management services and for procedural codes. House passage of HR 3961 is, however, critical if a permanent SGR fix is going to be included in Congress’ final health reform package. HR 3962 includes a public insurance option with negotiable payment rates, a Medicare bonus for primary care practices, quite a few administrative simplifications for physicians’ dealings with insurance companies, and fines for most employers who do not offer health insurance benefits and for individuals who do not obtain insurance. It would create more than 100 new independent federal agencies to regulate health care. It would virtually prohibit the opening of any new physician-owned hospitals or growth of existing ones. HR 3962 does not include strong medical liability reforms. Thanks to an amendment from Rep. Henry Cuellar (D-Laredo), it does include some protections against federal preemption of Texas’ cap on noneconomic damages in health care liability cases. But experts from the Texas Medical Liability Trust caution that those protections are not broad enough.

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