MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'health law'. Sat, 03 Sep 2011 02:11:46 +0100 http://www.medworm.com/index.php?rid=5181735&cid=t_149015_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F09%2F01%2Fimplementing-health-reform-association-health-plans%2F The Affordable Care Act comprehensively reforms health insurance in the United States.  Its central reform provisions apply to “a group health plan and health insurance issuer offering group or individual health insurance coverage,” that is, to individual, small group, large group, and even self-insured coverage. In fact, however, the ACA does not cover all forms [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5181735 Thu, 01 Sep 2011 20:35:54 +0100 5181735 http://www.medworm.com/index.php?rid=5159351&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FdflHJn4aeTM%2Fbundled-payments-for-care-improvement-initiative-announced-by-cms-center-for-innovation.html Many health care provider organizations have not been overly eager to jump onto the Accountable Care Organization (ACO) bandwagon, citing high startup costs and uncertain returns on investment given the complexity of the program.  Well, recently, the CMS Center for Innovation has announced the Bundled Payment for Care Improvement initiative.  This initiative incorporates elements of earlier CMS demonstration projects -- the gainsharing demos and ACE (acute care episode) bundled payments demonstrations which the HealthBlawger has helped a number of clients around the country qualify for in the past -- and builds on the broad authority granted to the CMS Center for Innovation under health reform. The advantages to proceeding with a Bundled Payment for Care Improvement project include the... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=5159351 Thu, 25 Aug 2011 11:17:08 +0100 5159351 http://www.medworm.com/index.php?rid=5139674&cid=t_149015_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F08%2F16%2Fthe-legal-battle-over-health-reform-analyzing-the-11th-circuit-opinions%2F Editor’s Note: Below, William Sage analyzes Friday’s federal appellate court decision regarding the Affordable Care Act. See Timothy Jost’s earlier post for more on this decision. On August 12, a divided three-judge panel of the US Court of Appeals for the Eleventh Circuit ruled in State of Florida v. Sibelius that the individual mandate contained [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5139674 Tue, 16 Aug 2011 19:40:18 +0100 5139674 http://www.medworm.com/index.php?rid=5130719&cid=t_149015_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F08%2F15%2Fappellate-court-individual-mandate-falls-but-rest-of-affordable-care-act-survives%2F Editor’s Note: Below, Tim Jost analyzes Friday’s appellate decision regarding the Affordable Care Act. Watch for more coverage of this decision and its significance on Health Affairs Blog. One August 12, 2011, in a case brought by 26 states and various private parties, the Eleventh Circuit Federal Court of Appeals handed down the first federal [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5130719 Mon, 15 Aug 2011 18:20:51 +0100 5130719 http://www.medworm.com/index.php?rid=5130872&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FX8JuuH6We8U%2Fpartners-health-care-acquiring-neighborhood-health-plan-the-800-pound-gorilla-and-the-fig-leaf.html Partners Health Care (the dominant provider network in Greater Boston) and Neighborhood Health Plan (a local mostly-Medicaid HMO) just announced that the former intends to acquire the latter, and maintain it as a separate operating entity.  No money will change hands between the parties, but an unspecified amount of money will be given by Partners as grants to community health centers where NHP members receive much of their health care services. Gary Gottlieb, CEO of Partners, graciously allowed that it would not seek to interfere with the current referral patterns of NHP members to the two local safety-net hospitals (which get disproportionate share hospital payments; Partners hospitals do not). The deal is contingent on several layers of regulatory review, including review by the Commo... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=5130872 Sun, 14 Aug 2011 20:35:15 +0100 5130872 http://www.medworm.com/index.php?rid=5118592&cid=t_149015_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F08%2F09%2Fa-legal-challenge-to-cms-reliance-on-the-ruc%2F This week in a Maryland federal court, six physicians based at the Center for Primary Care in Augusta, GA filed suit against HHS Secretary Kathleen Sebelius and CMS Administrator Donald Berwick. The complaint, spearheaded by Paul Fischer MD with DC-based lead counsel Kathleen Behan, alleges that the doctors have been harmed by the Medicare payment [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5118592 Tue, 09 Aug 2011 18:28:22 +0100 5118592 http://www.medworm.com/index.php?rid=5069597&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2F-8F6F2av9PI%2Frural-health-white-paper-released-by-unitedhealth-group-think-tank.html The UnitedHealth Center for Health Reform and Modernization released a white paper today on Modernizing Rural Health Care.  To quote from the UHG presser, [The paper] projects an increase of around 5 million newly insured rural residents by 2019 – even as the number of physicians in rural America lags Quality of care is rated lower in rural areas in 7 out of every 10 health care markets; both physicians and consumers in rural areas more likely to rate quality of care lower than those in urban and suburban markets Innovations in care delivery – particularly telemedicine and telehealth – can absorb future strain on rural health care systems The paper inventories the current state of health care for the 50 million Americans living in a rural setting -- and it's not pretty.�... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=5069597 Wed, 27 Jul 2011 03:23:08 +0100 5069597 http://www.medworm.com/index.php?rid=5062347&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FVbefN6-mntM%2Fhealth-information-technology-tweeps-to-watch-the-hit100-list.html Michael Planchart, aka @theEHRguy, put out the call last month for nominations to the #HIT100, intended to be a list of key health IT folk engaged in social media.  The crowdsourced #HIT100 list -- Michael tabulated the nominations -- is posted on several blogs, including @nateosit's (linked to above).  Keith Boone (aka @motorcycle_guy put together a twitter list of all #HIT100 nominees.  (Nate and Keith both ended up near the top of this list.) Update 7/25/2011:  Nate reports that Keith's final list is more accurate.  Many folks I interact with on a regular basis on line and in real life are on this list, and I am honored to be included in it as well.  (Check out this photo of Keith wearing a @reginaholliday jacket from The Walking Gallery at the tweetup I organized w @bobcoffield... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=5062347 Mon, 25 Jul 2011 16:26:38 +0100 5062347 http://www.medworm.com/index.php?rid=5057810&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2Fs59FGFWkjts%2Fhealth-care-social-media-getting-health-care-providers-off-the-dime.html I had the opportunity to share some thoughts recently aimed at getting health care providers off the social media bench and into the game in a new online community / group blog, HealthWorks Collective.  I invite you to check out the community at large, hosted at Social Media Today, and to check out my post there, in particular.  I opened with one of my favorite explanations of why health care provider organizations should be involved in social media.  If you are interested in learning more, please watch this space for announcements of upcoming webinars and speaking engagements (some are listed here), and feel free to contact me if you'd like to arrange to have the HealthBlawger present to your group, or facilitate a retreat.  David HarlowThe Harlow Group LLCHealth Care Law and Consult... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=5057810 Fri, 22 Jul 2011 19:18:36 +0100 5057810 http://www.medworm.com/index.php?rid=5028119&cid=t_149015_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F07%2F12%2Fimplementing-health-reform-health-insurance-exchanges-part-2%2F Editor’s Note: Below, Timothy Jost continues his Health Affairs Blog series analyzing regulations implementing the Affordable Care Act. Health Affairs Blog will also offer additional perspectives on the newly released regulations governing the state health insurance exchanges established under the Affordable Care Act. This is the second part of a three part analysis of the [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5028119 Tue, 12 Jul 2011 21:18:05 +0100 5028119 http://www.medworm.com/index.php?rid=5028631&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FrNePQpCmHgk%2Fhealth-insurance-exchange-regulations-are-out-and-they-make-me-feel-like-a-visitor-from-the-future.html Health Insurance Exchange regulations were released by HHS yesterday -- in a DC hardware store, for local color and homespun truths -- with a go-live date of January 1, 2014, per the Affordable Care Act, and a key interim approval deadline of January 1, 2013, by which date each state needs to demonstrate that it has its act together and is on a glide path to the go-live date.  Despite the rancorous opposition to the ACA (consider, for example, the views of the Virginia Attorney General -- who is leading a multi-state charge against the individual mandate -- expressed at the American Health Lawyers Association Annual Meeting last month, where he was an invited keynote speaker, and later tweeted a tone-deaf assessment of the audience and an unkind skewering of a questioner who didn't share ... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=5028631 Tue, 12 Jul 2011 15:11:10 +0100 5028631 http://www.medworm.com/index.php?rid=5028121&cid=t_149015_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F07%2F11%2Fnew-health-policy-brief-legal-challenges-to-the-affordable-care-act%2F A new Health Policy Brief from Health Affairs and the Robert Wood Johnson Foundation examines the issues inherent in the lawsuits filed by state governments, organizations, and private citizens challenging the Affordable Care Act. To date, about 30 legal challenges have been filed. Federal District Court decisions have been split, with four judges ruling that the [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5028121 Mon, 11 Jul 2011 15:51:20 +0100 5028121 http://www.medworm.com/index.php?rid=5028632&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2Fj1wDO3_RgCk%2Fhealthcare-associated-infections-what-is-the-message-and-what-can-we-do-about-them.html   The good people at GE and JESS3 have come up with an HAI infographic.  It's pretty, and it conveys the horrible information that many of us already know -- healthcare associated infections kill about 100,000 people a year, and add $35 billion a year to our collective health care bill (here in the US of A); 5% of hospital inpatients end up with an HAI. So what do we expect the world to do with this infographic?  The FDA has rolled out new cigarette package warnings, including graphic photos, that are presumably intended to so sicken potential purchasers of cigarettes that they drop the pack of cigarettes and run screaming from the counter.  In more measured terms, the FDA says: The introduction of these warnings is expected to have a significant public health impact by decreasing... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=5028632 Fri, 08 Jul 2011 18:18:39 +0100 5028632 http://www.medworm.com/index.php?rid=5008414&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2F5bURn4uodAs%2Fsgr-in-the-mpfs-again-duck-season-wabbit-season-doc-season.html It's doc season again, that time of year when the sustainable growth rate rules are trotted out, and physicians are informed that they will face catastrophic rate reductions courtesy of Medicare (29.5%, effective January 1, 2012, per the July 1 announcement).  There will be much breast beating about how we've gotten into this fine mess, and what we should cut instead in order to maintain physician reimbursement levels (suggestions I've seen range from cutting the defense budget to eliminating Medicare coverage for dialysis).  Docs will say they've had enough and are opting out of Medicare.  We can look back to MedPAC recommendations on how to fix this so we don't need an annual doc fix, or look forward to a permanent fix, for which Don Berwick made an impassioned plea, even as he annou... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=5008414 Thu, 07 Jul 2011 16:40:12 +0100 5008414 http://www.medworm.com/index.php?rid=5008415&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Fhealthblawg.typepad.com%2Ffiles%2Fregina-herzlinger-on-healthblawg-w-david-harlow-07-2011.mp3 I spoke with Harvard Business School professor Regina Herzlinger this week about health reform – the good, the bad and the ugly – touching on ACOs and demonstration projects under the Affordable Care Act; innovations coming down the pike in the private sector either because of the law or because of market forces; social media in health care; and two key fixes to the ACA that she believes are absolutely necessary in order to make it work, or work as best it can. First of all, she expressed her delight at the passage of a federal law nudging us ever closer to universal coverage, combined with dismay at its failure to address rising costs (noting that we're looking at policies yielding an accumulated Medicare deficit of $90 trillion, as compared to an annual GDP of $12-14 trillion) and a... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=5008415 Thu, 07 Jul 2011 15:39:44 +0100 5008415 http://www.medworm.com/index.php?rid=5008115&cid=t_149015_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F07%2F05%2Fjosts-look-at-court-fight-over-reform-tops-ha-blogs-june-most-read-list%2F Tim Jost’s analysis of crucial appellate arguments over the constitutionality of the Affordable Care Act leads June’s list of most-read Health Affairs Blog posts. Jost examines the arguments before the federal Eleventh Circuit Court of Appeals in a challenge to the legislation brought by more than half the states and the National Federation of Independent [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5008115 Tue, 05 Jul 2011 16:31:47 +0100 5008115 http://www.medworm.com/index.php?rid=4984408&cid=t_149015_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F06%2F30%2Fin-first-appellate-case-a-significant-victory-for-the-affordable-care-act%2F On June 29, 2011, the Sixth Circuit federal court of appeals held that Congress has the power under the Constitution to adopt the minimum coverage requirement of the Affordable Care Act. The decision in Thomas More Law Center v. Obama is very significant for several reasons.  First, it is the first ruling by a federal [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4984408 Thu, 30 Jun 2011 11:22:04 +0100 4984408 http://www.medworm.com/index.php?rid=4976011&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FgOiD_T8Xjis%2Ftweets-from-american-health-lawyers-association-annual-meeting-2011.html Here's a window into the American Health Lawyers Association Annual Meeting this week in Boston: Tweets by me and a few others from the event.  If you are within range of Boston and would like to join health lawyers, health IT, health care social media, Health 2.0 and related communities for a tweetup, we'd like to see you, after the social media sessions at the Annual Meeting (whether or not you are attending the Annual Meeting).  Feel free to read more more about the social media sessions (I'll be speaking on the subject this afternoon) and please RSVP to the #AHLABostonTweetup invite if you can join us at 5:30.   <a href="http://www.coveritlive.com/mobile.php?option=com_mobile&tas... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4976011 Tue, 28 Jun 2011 06:18:17 +0100 4976011 http://www.medworm.com/index.php?rid=4976010&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2F34OX0bwEwBo%2Fdavid-harlow-presents-social-media-session-at-american-health-lawyers-association-annual-meeting.html I am speaking today at the American Health Lawyers Association annual meeting on the uses of social media by attorneys. I am sharing two versions of my slides from this session: one that is text-rich and full of useful links, and one that is much nicer to look at and more engaging for a live audience. Enjoy one or both, and let me know what you think in the comments.  If you are off-site, please tweet a shout-out to me @healthblawg tagged #AHLABoston a little after 3 p.m. ET, so we can show the folks in Boston the reach of Twitter, and let us know where you're tweeting from. AHLA Annual Meeting 2011 Social Media Legal Marketing Resources by David Harlow View more presentations from David Harlow. AHLA Annual Meeting 2011 Social Media for Lawyers by David Harlow ... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4976010 Tue, 28 Jun 2011 05:56:01 +0100 4976010 http://www.medworm.com/index.php?rid=4968661&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2Fxx0GnFs4A0k%2Fmassachusetts-healthcare-reform-experiment-analyzed-attoney-general-martha-coakley-are-we-ready-for-global-payment-.html Massachusetts Attorney General Martha Coakley released her office's second annual report, An Examination of Health Care Cost Trends and Drivers (PDF; see also press release), which contains a wealth of critical data analysis -- and also highlights how little we know about certain things -- providing some important context for the discussion of the proposed Part III of Massachusetts health reform, a bill filed by Governor Patrick which would create all-payor ACOs and a system of global payments. At this late date, few would argue against a move a way from fee-for-service reimbursement for health care, or adding quality metrics to the mix, and tying financial rewards to providers to their performance measured against these metrics.  (Consider the Massachusetts Blue Cross Blue Shield ACQ (a... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4968661 Fri, 24 Jun 2011 17:50:55 +0100 4968661 http://www.medworm.com/index.php?rid=4968662&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FJsCTlY3xPP4%2Fspeaking-engagements-health-care-social-media-acos-and-more.html I spoke recently at a MassMEDIC conference about the FDA and social media, and on a webinar presented by the Mayo Clinic Center for Social Media (with which I am associated, as a member of its external advisory board) and Ragan Communications, and I will be speaking at a number of upcoming conferences.  It occurred to me that it would be worthwhile to share information about these events for those who may be interested. Feedback I've received from some program participants is that topics covered in an hour-long session on health care social media sometimes get short shrift.  For those who may be interested in more in-depth treatment of some issues, I'll call to your attention the webinar series to be held in mid-July (four hours over two days).  Let us know about any particular areas o... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4968662 Thu, 23 Jun 2011 04:58:49 +0100 4968662 http://www.medworm.com/index.php?rid=4953082&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FPE8g9xAh860%2Ftweetup-at-the-ahla-annual-meeting-in-boston.html Come join Bob Coffield (@bobcoffield) and me, together with other speakers, attendees and camp followers from the American Health Lawyers Association, for a tweetup next Tuesday, June 28, 2011, at 5:30 or so at BrasserieJO, at the Colonnade Hotel, 120 Huntington Avenue, Boston.  We hope to introduce the AHLA to some members of Boston's Health 2.0 community and other folks interested in all (or some) things healthcare, legal and/or social media. Check out the TwtVite, let us know if you'll be joining us, and spread the word. As Bob posted earlier today: The TWEETup follows an afternoon of health care social media and the law sessions held as a part of the AHLA Annual Meeting. For full details of the sessions and registration information check out the AHLA Annual Meeting schedule here (P... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4953082 Tue, 21 Jun 2011 20:49:31 +0100 4953082 http://www.medworm.com/index.php?rid=4921370&cid=t_149015_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F06%2F09%2Fanalyzing-a-crucial-battle-in-the-legal-war-over-health-reform%2F For a lawyer, the argument of Florida v. the Department of Health and Human Services before a three judge panel of the Eleventh Circuit Federal Court of Appeals on Wednesday, June 8, was a beauty to behold.  (For a non-lawyer it was probably tedious, repetitive, and much too long).  Three active and very well-prepared judges [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4921370 Thu, 09 Jun 2011 13:44:03 +0100 4921370 http://www.medworm.com/index.php?rid=4893643&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2F2B2X0b39ekw%2Faco-pgp-demonstration-cms-dont-kick-a-unicorn-when-its-down.html There has been a significant outcry against the proposed ACO regs: everything's wrong and nothing's right about them, or so some would have us believe.  (The comment period is still open, and CMS is still soliciting input; much of the outcry is a form of posturing and negotiation ... not that there's anything wrong with that.) Today's "nattering nabobs of negativism" focus on: the estimated price tag for complying with the regulatory requirements (IT and other infrastructure incuded), the slim chance of success by ACOs in righting the wrongs of decades of bloat in the health care system, the premature pledging of allegiance to an idea only partly proven through the PGP demo, the likelihood of failure due to the whole endeavor's being tied to FFS reimbursement, on the one hand, and due to... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4893643 Fri, 03 Jun 2011 12:40:18 +0100 4893643 http://www.medworm.com/index.php?rid=4893644&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FSki4I6PoVRM%2Fhipaa-disclosure-accounting-rules-nprm-revisited-per-the-hitech-act.html HIPAA regulations long on the books require that covered entities (i.e. health care providers, payors and clearinghouses) provide patients with accounting of disclosures of their protected health information (PHI) for any purpose other than treatment, payment or health care operations (TPO). The HITECH Act upped the ante, requiring accounting of disclosures of PHI for TPO as well.  Regs implementing this requirement were to be keyed off of the meaningful use regs, and they have now arrived. Stage 1 Meaningful Use requirements do not include EHR capability to track PHI disclosures made for TPO purposes (though that capability was in the draft requirement for Stage 1), potentially making the process more manual than it ought to be.  In addition, despite the fact that patients and patient a... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4893644 Wed, 01 Jun 2011 16:40:13 +0100 4893644 http://www.medworm.com/index.php?rid=4883724&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2Fm16_TJ37BMQ%2Fonc-federal-health-it-strategic-plan-comments-filed-on-behalf-of-the-society-for-participatory-medic.html We e-patients are an impatient lot, and therefore we may not be big fans of the Five-Year Plan approach to creating change.  The Office of the National Coordinator for Health IT released a draft federal health IT strategic plan in late March, via blog post (the plan itself is linked to from the post; a copy is posted here). The ONC post says: The Plan demonstrates how we will build off the foundation of meaningful use to unlock the power of information to: Enhance our ability to study care delivery and payment systems Empower individuals to improve and participate more in their care Improve care, efficiency, and population health outcomes, through tools such as clinical decision support, real- time feedback of performance to clinicians, and targeted public health campaigns The... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4883724 Tue, 31 May 2011 14:01:00 +0100 4883724 http://www.medworm.com/index.php?rid=4862487&cid=t_149015_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F05%2F25%2Fpioneer-acos-the-right-direction-but-whats-the-goal%2F Editor’s Note: The post below discusses the recent announcement regarding accountable care organizations by the Center For Medicare and Medicaid Innovation. This is also the topic of another post, by Douglas Hastings, published today on Health Affairs Blog. For large entities that already successfully participate in managed care, the recently announced Center for Medicare and [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4862487 Wed, 25 May 2011 15:31:01 +0100 4862487 http://www.medworm.com/index.php?rid=4862488&cid=t_149015_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F05%2F25%2Fpioneer-acos-surging-to-a-new-level-of-integration%2F Editor’s Note: The post below discusses the recent announcement regarding accountable care organizations by the Center For Medicare and Medicaid Innovation. This is also the topic of another post, by Steve Lieberman, published today on Health Affairs Blog. In a speech on February 1, among other comments, Dr. Don Berwick, the Administrator for the Centers [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4862488 Wed, 25 May 2011 15:28:44 +0100 4862488 http://www.medworm.com/index.php?rid=4841689&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FZ9Inn_LpIEY%2Fwhy-do-10-of-cancer-patients-on-oral-meds-stop-taking-them-.html Ten percent of cancer patients failed to fill their initial prescriptions for oral anti-cancer drugs, according to a new study published jointly today in the Journal of Oncology Practice (JOP) and American Journal of Managed Care (AJMC)[, based on data]... Read the full post on HealthBlawg. (Source: HealthBlawg :: David Harlow's Health Care Law Blog) HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4841689 Wed, 18 May 2011 02:36:35 +0100 4841689 http://www.medworm.com/index.php?rid=4841690&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FFtmKA-h810c%2Fis-the-aco-doa-reasonable-minds-can-improve-the-draft-regulations.html In the current all-ACO, all the time, health care policy news cycle, we've been inundated with declarations that the ACO is dead, because a handful of big boys say they don't want to play. Today, CMS announced that it is... Read the full post on HealthBlawg. (Source: HealthBlawg :: David Harlow's Health Care Law Blog) HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4841690 Tue, 17 May 2011 19:35:33 +0100 4841690 http://www.medworm.com/index.php?rid=4820976&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FY1gJh4slHcI%2Ffda-social-media-david-harlow-presentation-at-massmedic.html This study captures a snapshot of the the way we use the internet to solve health problems -- and many, if not most, of us are doing that one way or another.  Research conducted by Susannah and the Pew Internet & American Life Project can help folks tailor messages and tactics to be used in the deployment of health care social media -- both in the realm of health care and in the realm of pharma and devices.  Perhaps some day (soon!), the FDA will call on resources such as the Pew Research Center to turn around some illuminating studies within a short timeframe.  Until then, we're stuck with the pushmi pullyu approach to social media in the FDA-regulated space --regulators and the regulated community looking away from each other and not.  (Another aspect of this approach: the FDA us... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4820976 Fri, 13 May 2011 11:45:00 +0100 4820976 http://www.medworm.com/index.php?rid=4820798&cid=t_149015_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F05%2F12%2Fwonk-review-includes-ha-blog-post-on-aca-legal-fight%2F Hank Stern has posted a “Spring Cleaning” edition of the Health Wonk Review on InsureBlog. Among the posts Hank highlights is Tim Jost’s Health Affairs Blog post on the first appellate arguments over the constitutionality of the Affordable Care Act. Health Affairs Blog will host the next Health Wonk Review two weeks from today, on [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4820798 Thu, 12 May 2011 20:48:16 +0100 4820798 http://www.medworm.com/index.php?rid=4813230&cid=t_149015_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F05%2F10%2Fhealth-reform-the-legal-fight-moves-to-the-next-level%2F Today, May 10, the Fourth Circuit federal court of appeals heard oral arguments in two Affordable Care Act cases (ACA), Liberty University v. Geithner and Virginia v. Sebelius. In the Liberty University case, Judge Norman Moon of the Western District of Virginia had upheld the constitutionality of the Affordable Care Act against a challenge brought [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4813230 Tue, 10 May 2011 23:57:38 +0100 4813230 http://www.medworm.com/index.php?rid=4780284&cid=t_149015_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F05%2F03%2Fhealth-affairs-briefing-reminder-environmental-challenges-for-health%2F Tomorrow, on Wednesday,  May 4, Health Affairs will hold a Washington D.C. briefing in connection with its first ever issue on environmental health. National environmental health and policy experts will discuss the state of environmental health and its future, and will present new research in the field. The briefing and Health Affairs issue on environmental [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4780284 Tue, 03 May 2011 16:30:33 +0100 4780284 http://www.medworm.com/index.php?rid=4734298&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2Fhr-rV71sI-c%2Fhealth-care-social-media-policies-facebook-misstep-costs-ri-physician-fine-job.html In recent years many health care providers and managers have told me, time and again, that the health care world is accustomed to managing confidential patient information, and therefore doesn't need much in the way of social media training and policy development.  This week brings news that should make those folks sit up and take notice.  A physician in Rhode Island, who was fired for a Facebook faux pas, has now been fined by the state medical board as well.  The physician posted a little too much information on Facebook -- information about a patient that, combined with other publicly available information, allowed third parties to identify the patient.  The details of the story are available here and here. The key takeaway from this story -- and the Johnny-come-lately approach to ... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4734298 Thu, 21 Apr 2011 14:34:10 +0100 4734298 http://www.medworm.com/index.php?rid=4714710&cid=t_149015_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F04%2F14%2Fthe-proposed-accountable-care-organization-antitrust-guidance-a-first-look%2F Editor’s note: This post, by Joe Miller, is part of a series of Health Affairs Blog posts examining the proposed rules and guidelines implementing the Medicare Shared Savings Program, issued March 31 by the Centers for Medicare and Medicaid Services and other agencies.  You can read other posts in the series by Mark McClellan and [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4714710 Thu, 14 Apr 2011 19:11:59 +0100 4714710 http://www.medworm.com/index.php?rid=4684250&cid=t_149015_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F04%2F05%2Fthe-medicare-aco-proposed-rule-legal-structure-governance-and-regulatory-sections%2F Editor’s Note: This post, by Douglas Hastings, is part of a series of Health Affairs Blog posts examining the proposed rule implementing the Medicare Shared Savings Program, issued March 31 by the Centers for Medicare and Medicaid Services. Hastings’ post offers a first look at the rule’s legal structure, governance, and regulatory sections. You can [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4684250 Tue, 05 Apr 2011 15:38:18 +0100 4684250 http://www.medworm.com/index.php?rid=4670203&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FEuBxzB-YbdY%2Faccountable-care-organization-aco-regulations-first-look.html ACO regulations and related federal issuances hit the street last Thursday, after several months of waiting -- from CMS, OIG, FTC, DOJ and IRS.  They cover the waterfront, ranging from the central regulation defining the structure and workings of the ACO, to  limited Stark self-referral ban and anti-kickback statute waivers in the fraud and abuse arena, to new frameworks for antitrust analysis, to rules governing joint ventures involving taxable and tax-exempt organizations.  I had the opportunity to discuss the regs the day after they were issued on a special edition of the Blog Talk Radio show, ACO Watch, hosted by Gregg Masters (@2healthguru).  Gregg's guests included Mark Browne (@consultdoc), Vince Kuraitis (@VinceKuraitis), Jaan Sidorov (@DisMgtCareBlog) and yours truly (@health... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4670203 Sun, 03 Apr 2011 14:07:31 +0100 4670203 http://www.medworm.com/index.php?rid=4664312&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FwCXPiE0r0eI%2Faccountable-care-organization-proposed-regulations-released-for-public-comment.html The long-awaited ACO regulations were released by CMS in draft form today, accompanied by a series of conference calls for different constituencies.  Here is a mirrored copy: Medicare Program; Medicare Shared Savings Program: Accountable Care Organizations - Proposed rule. // <![CDATA[ // <![CDATA[ // <![CDATA[ // <![CDATA[ // <![CDATA[ // <![CDATA[ // <![CDATA[ // <![CDATA[ // <![CDATA[ (function() { var scribd = document.createElement("script"); scribd.type = "text/javascript&... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4664312 Fri, 01 Apr 2011 07:10:32 +0100 4664312 http://www.medworm.com/index.php?rid=4626900&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2F5lFwrspL-kI%2Fsocial-media-in-health-care-david-harlow-quoted-in-recent-articles.html Recent health care social media articles in the American Academy of Physician Assistants magazine, PA Professional (Social Media for Health Professionals - Avoiding the Pitfalls) and in SELF magazine (The Health Dangers of Facebook Posts) feature my advice to health care providers and the general public on the careful use of social media in the health care context.  In addition, it is important to note that social media does not exist in a siloed environment.  As I said to the PA Professional reporter, "In this day and age, you can't be patient-centered and promote patient engagement without using social media tools."  The key is to use them effectively and safely.  For more on the subject, see these HealthBlawg posts and resources on health care social media David HarlowThe Harlow G... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4626900 Wed, 23 Mar 2011 20:02:00 +0100 4626900 http://www.medworm.com/index.php?rid=4622346&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FE8rEfKQoxlA%2Fwho-owns-patient-data-the-walgreens-edition.html Walgreens is being sued by customers who are not happy that their prescription information – even though it has been de-identified – is being sold by Walgreens to data-mining companies.  The data privacy and security concerns surrounding the transfer of de-identified data are significant.  To “de-identify” what is otherwise protected health information under HIPAA, some outfits will simply strip data of 18 types of identifiers listed in federal regulations.  However, the relevant regulation (45 CFR 164.514(b)(2)(ii)) also provides that this only works if “the covered entity does not have actual knowledge that the information could be used alone or in combination with other information to identify an individual who is a subject of the information.” Thus, the problem with thi... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4622346 Tue, 22 Mar 2011 02:20:09 +0100 4622346 http://www.medworm.com/index.php?rid=4615243&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FJNZ-0UqD4To%2Fdirect-project-reaches-critical-mass-interoperability-on-the-horizon.html The ONC announced today that the Direct Project now has commitments from about sixty health care and health IT organizations to support its vision of secure direct messaging of health information.  Given the level of support across twenty states, a number of integrated delivery systems and many EHR vendors, the Direct Project will allow for secure health information messaging for up to 160 million Americans.  Specifications for the Direct Project are now final, and draft documentaiton is available, too.  (For more information, see the anouncement about the widespread adoption of the Direct Project, complete with links to more detail on its website.  For further background, see the Direct Project's earlier announcement of its first live secure transmission of medical records.  For a ... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4615243 Mon, 21 Mar 2011 13:45:15 +0100 4615243 http://www.medworm.com/index.php?rid=4605917&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2Fi-01zzjbNUg%2Fpartisan-politics-it-was-ever-thus.html To those of you out there who are horrified by the depths to which our elected representatives in Washington and in the states have recently sunk in the pursuit of partisan goals, let me say: there's nothing new under the sun. Exhibit A: The emails I keep getting from the Health Care Compact Alliance, an outfit that seems to be a darling of Tea Party adherents, which has latched onto the idea of the interstate compact as a a way to generate sufficient pressure on Congress to repeal health reform, which it could do by ratifying the interstate compact. This is of course too clever by half. In order to work, most states must enact legislation supporting the compact (not very likely) and then Congress must ratify it. (Psst: The very neutrally-entitled bill "To repeal the job-killing health c... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4605917 Thu, 17 Mar 2011 22:52:21 +0100 4605917 http://www.medworm.com/index.php?rid=4592508&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FQiaI8SEw5AU%2Fhealthnet-and-hipaa-again-so-does-hipaa-work.html HealthNet either lost, or had stolen from it, computer hard drives with PHI of 1.9 million subscribers that had been in a California facility.  This latest HealthNet data security breach, which may have included names, Social Security numbers, addresses, health information and financial information comes a little over a year after a widely-reported data security breach by HealthNet in Connecticut which resulted in the first state Attorney General action under the HIPAA amendments contained in the HITECH Act.  HealthNet is notifying affected individuals and is offering two years of no-cost credit monitoring and fraud resolution services, and credit restoration and identify theft insurance as needed. It's both surprising and unsurprising that this has happened again to HealthNet.  In the... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4592508 Tue, 15 Mar 2011 19:19:03 +0100 4592508 http://www.medworm.com/index.php?rid=4580971&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FzNuaBRS5t4o%2Fdavid-harlow-quoted-in-ama-american-medical-news-story-on-daily-deal-websites.html Groupon, LivingSocial and other daily deal websites are being used by health care providers -- though thus far mostly by those that are not covered by traditional commercial or governmental health insurance (e.g., dental, chiropractic, acupuncture services).  Read the American Medical News story on Groupon, where I was quoted, and please take a look at my blog post on the subject as well -- at the Mayo Clinic Center for Social Media blog -- entitled: Groupons for Health Care Services: No-Brainer or Legal Minefield?  In that post, I observed: There are a number of legal issues, and their resolution will depend, in part, on where you are situated, since many of the relevant rules are state laws, which vary.  For example: Groupon collects 50% of the price of the groupon as its fee; is th... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4580971 Mon, 14 Mar 2011 00:48:42 +0100 4580971 http://www.medworm.com/index.php?rid=4545046&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2F022E30UK3-k%2Fmedicaid-busting-the-budget-buster-with-real-innovation-or-rearranging-the-deck-chairs-on-the-titani.html Medicaid has been front and center this week as President Obama addressed the National Governors Association, and several governors testified before the House Energy and Commerce Committee.  Obama told the governors that he supports the Wyden-Brown bill, which would accelerate the availability of waivers under the Affordable Care Act, so that states would not have to first create health insurance exchanges under the law, and then have the right to dismantle them and replace them with other mechanisms to achieve coverage goals of the law without additional cost to the federales.  (See Wyden-Brown fact sheet)  The sponsors' home states, Oregon and Massachusetts would otherwise have to dismantle parts of their own health reform efforts in order to align with the federal mandates.  (Wyden... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4545046 Thu, 03 Mar 2011 22:30:45 +0100 4545046 http://www.medworm.com/index.php?rid=4536039&cid=t_149015_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F03%2F01%2Fhealth-affairs-blog-most-read-posts-for-february%2F Timothy Jost’s examination of a Florida federal court decision striking down the Affordable Care Act was the most-read Health Affairs Blog post for February. Next on last month’s top-ten list comes John Goodman’s post on the future of consumer-directed care, followed by Kavita Patel’s look at health care in President Obama’s fiscal year 2012 budget. The list [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4536039 Tue, 01 Mar 2011 22:17:44 +0100 4536039 http://www.medworm.com/index.php?rid=4532332&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FbC1QuIaSDxA%2Fputting-patients-into-menaningful-use-regulators-and-providers-are-catching-up-with-e-patients.html The Health Research Institute at PricewaterhouseCoopers released a report last week entitled Putting patients into "meaningful use." It begins with the anecdote I've blogged about previously regarding a diagnosis by Facebook in lieu of a PHR, which some have highlighted as a great success for social media in health care. I am much less sanguine on that front. The PwC report, of course, has much more than that story in it; here are the key takeaways, backed up with some survey data and interviews: Engaging external constituents may postpone achievement of "meaningful use." Patient awareness of and access to available health IT tools is low; social, expectation, and education hurdles also exist. Patient engagement in "meaningful use" is still low, despite consumer interest. "Meaningful ... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4532332 Tue, 01 Mar 2011 15:40:00 +0100 4532332 http://www.medworm.com/index.php?rid=4517237&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FAzBqEbNiTwg%2Fmass-general-ocr-hipaa-1-million-dollar-settlement-or-the-medical-records-that-never-returned.html   OCR announced today that Massachusetts General Hospital settled a HIPAA violation claim, without admitting liability, for $1 million and an agreement to revamp procedures for taking patient records off premises.  The case involved a stack of paper records left on the T (Boston's subway) consisting of protected health information for a couple hundred patients, including patients on the HIV service.  (As an aside, HIV records are subject to super-deluxe Rube Goldberg-esque privacy protections in Massachusetts -- they need to be flagged so that patients can sign an additional release before they are shared, since even the fact of testing is private, though in my humble opinion the flagging vitiates some of the privacy we want to afford these records). For those of you keeping score a... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4517237 Fri, 25 Feb 2011 03:16:47 +0100 4517237 http://www.medworm.com/index.php?rid=4517238&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FAn_6nUBQAZo%2Fdavid-harlow-interviewed-on-social-media-for-health-care.html Last month, Elissa Weitzman and others, researchers at the Children's Hospital Boston informatics program, published a paper in the Journal of the American Medical Informatics Association entitled "Social but safe? Quality and safety of diabetes-related online social networks," finding that only half of the ten communities they surveyed presented content consistent with diabetes science and clinical practice.  The study found that the quality of clinical information, as well as privacy policies, varied significantly across these sites, and that some of the sites were wanting in terms of scientific accuracy, safeguards such as personal health information privacy protection, effective internal and external review processes, and appropriate advertising.  (See InformationWeek for more.)  I... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4517238 Thu, 24 Feb 2011 04:55:30 +0100 4517238 http://www.medworm.com/index.php?rid=4512469&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2F9IgldPbFntI%2Fhipaa-cmps-whats-the-point.html Yesterday, the federales announced: HHS Imposes a $4.3 Million Civil Money Penalty for Violations of the HIPAA Privacy Rule.  The OCR Notice of Final Determination was issued to Cignet Health of Maryland, a health plan that had not responded to members' requests for records, had not responded to OCR's requests for records once compaints had been filed with OCR, had not responded to a subpoena, and did not even bother to defend itself in federal court when OCR filed for a court order to enforce the subpoena.  I've written about the rule that allows HHS to go for fines of up to $1.5 million per offense where the covered entity's noncompliance is willful.  This is the first example of that rule being tested to the max. OK.  We get it.  The government is Very Serious about HIPAA and HITE... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4512469 Wed, 23 Feb 2011 15:18:07 +0100 4512469 http://www.medworm.com/index.php?rid=4489784&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FszZjnknpMYs%2Fmassachusetts-health-reform-part-iii.html Today, Massachusetts Governor Deval Patrick filed health care reform legislation that, if enacted, will take the Commonwealth to the next level, taking the third step in the process that began in 2006 with the universal coverage law, and continued in 2008 with the legislation directed at containing cost and improving quality.  One of the provisions of the 2008 law established a special commission on the health care payment system that shall investigate reforming and restructuring the system to provide incentives for efficient and effective patient-centered care and to reduce variations in the quality and cost of care. The 2009 report of the special commission on the health care payment system was followed in 2010 by a report by the Office of the Attorney General and legislative hearin... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4489784 Fri, 18 Feb 2011 04:11:34 +0100 4489784 http://www.medworm.com/index.php?rid=4477885&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2Ffo8JZajtT1I%2Faqc-to-aco-as-goes-massachusetts-so-goes-the-nation.html About four years ago here in Beantown, survivors of the last big ill-conceived or poorly-executed (depends who you ask) wave of health care management and finance innovation were kicking around for a new approach to aligning payor and provider incentives, focusing on quality and cost containment. To hear Andrew Dreyfus, CEO of Blue Cross Blue Shield of Massachusetts, tell the story, the Blues wanted to address both quality and cost, and therefore (after looking in vain for a model elsewhere that could be transplanted to Massachusetts) developed the Alternative Quality Contract, or AQC, which features a global payment model hybridized with substantial performance incentives, plus design features intended to lower the cost of care over time. Many of the features put in place under the AQC w... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4477885 Mon, 14 Feb 2011 14:38:45 +0100 4477885 http://www.medworm.com/index.php?rid=4459932&cid=t_149015_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F02%2F10%2Fimplementing-health-reform-student-health-plans%2F Editor’s Note: This is the latest in a series of posts by Timothy Jost on the implementation of the Affordable Care Act.  Earlier posts have analyzed some important guidances, as well as provisions governing premium review, medical loss ratios, insurance exchanges, coverage for pre-existing conditions, appeals of coverage denials, coverage for preventive services, a patient bill of rights, grandfathered [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4459932 Thu, 10 Feb 2011 14:18:08 +0100 4459932 http://www.medworm.com/index.php?rid=4460037&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2F3iWw5K6q5Q8%2Fmeasuring-patient-experience-of-care.html There is a growing recognition within the medical-industrial complex that the patient is a key element of the enterprise, and that patient satisfaction, patient experience, patient engagement, patient activation, patient-centeredness are very important.  Some research shows that patient activation yields better patient outcomes, and that patient activation can be measured. Patient-centeredness and patient engagement are two of the key metrics to be used by the feds in describing Accountable Care Organizations (ACOs), if the internecine battles within government are resolved soon enough to actually release draft ACO regulations in time to allow for sufficient advance planning for the January 2012 go-live date.  (Wearing one of my many hats, I've had the opportunity to submit a response t... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4460037 Thu, 10 Feb 2011 04:05:44 +0100 4460037 http://www.medworm.com/index.php?rid=4455242&cid=t_149015_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F02%2F09%2Fmcdonnell-rendell-on-the-individual-mandate%2F If the Affordable Care Act’s requirement that individuals purchase health insurance is an unacceptable infringement on the liberty of Americans, is the requirement that Americans “purchase” Medicare with payroll taxes an equally unacceptable infringement of that liberty? While one can argue that the two situations are distinct as a matter of constitutional law, the philosophical [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4455242 Wed, 09 Feb 2011 23:19:56 +0100 4455242 http://www.medworm.com/index.php?rid=4424210&cid=t_149015_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F02%2F01%2Fanalyzing-judge-vinsons-opinion-invalidating-the-aca%2F Federal District Court Judge Roger Vinson’s 78-page opinion in State of Florida v. United States Department of Health and Human Services is a remarkable piece of work.  This decision, concluding a case brought by twenty-six state governors or attorneys general (in addition to two private parties and a business association, the National Federation of Independent [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4424210 Tue, 01 Feb 2011 20:57:59 +0100 4424210 http://www.medworm.com/index.php?rid=4399655&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FirOxXRmyUKA%2Fvalue-based-design-massachusetts-patrick-union.html The high cost of public sector health insurance benefits -- the albatross around the neck of many a mayor or town manager around the Commonwealth of Massachsuetts and around the country -- has once again attracted the attention of Governor Deval Patrick.  Late last week, he announced that his SFY 2012 budget proposal will include a 7% cut in local aid (state payments to cities and towns), and that he will be looking for a legislative fix to the high cost of local government health insurance premiums.  He was short on specifics, saying he's learned his lesson about being too directive in such matters, and will wait to see what emerges from the legislative process, but the outlines of what he's looking for are clear:  All municipal employees are to be insured through the state employee he... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4399655 Tue, 25 Jan 2011 15:45:18 +0100 4399655 http://www.medworm.com/index.php?rid=4355798&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FtU3q8Nwqd8A%2Fdavid-harlow-guest-on-lawyer2lawyer-podcast-on-massachusetts-health-reform-issue.html I am a guest on the latest edition of Lawyer2Lawyer, a podcast talk show on the Legal Talk Network hosted by fellow Bay State blawger Bob Ambrogi and Golden State lawyer Craig Williams, discussing aspects of the Massachusetts health reform plan, national health reform, and the lawsuit brought by their other guest, Michael Merlina, who is representing himself in seeking to overturn the denial of his application for a hardship exception from the individual mandate portion of the Massachusetts law.  He and his wife are being fined a little under $2000 because he says they can't afford a policy that would cost them a little over $5000.  Thus far, he reports that the state agency that denied his application has been ordered to review it again and provide a detailed response.  To listen to th... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4355798 Sun, 16 Jan 2011 15:11:54 +0100 4355798 http://www.medworm.com/index.php?rid=4338079&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FovujPUvWvyg%2Fpatient-engagement-and-public-dialogue-the-society-for-participatory-medicine.html I am cross-posting my inaugural post as Public Policy Committee Chair for the Society of Participatory Medicine, which went up last week on the Society's blog -- which I commend to all of you -- e-patients.net. I am delighted to offer my first report as Public Policy Committee Chair for the Society of Participatory Medicine.  I encourage all of you who are not yet Society members to join, and I encourage new and old members to consider volunteering to help with the wide range of public policy issues facing us today. Over the past couple of months, the Public Policy Committee has gotten its sea legs; we are beginning to add the Society’s voice to the national discourse on patient engagement in a formal manner.  As planning for health reform and related initiatives becomes more concret... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4338079 Mon, 10 Jan 2011 15:48:02 +0100 4338079 http://www.medworm.com/index.php?rid=4326947&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2F4lx3lcbxdHg%2Fhealth-care-social-media-workshop-on-the-web-four-part-webinar-starts-january-26.html You’re invited to join Jamie Verkamp, of the health care marketing consultancy (e)Merge, and me, for a 4 part webinar series specifically tailored to healthcare organization leaders.  These workshops begin Wednesday, January 26, and will meet weekly for four weeks. Objective: To thoroughly communicate to healthcare leaders the power of engaging and interacting with patients, strengthening the experience and attracting new patients, through social media tools online, in a manner that is appropriate, effective and HIPAA compliant. Methodology: A four-part video and audio webinar workshop series starting by introducing practice leaders to the power of engaging patients through social media tools, to creation and implementation of YOUR social media strategy and guided online account set-u... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4326947 Mon, 10 Jan 2011 04:03:31 +0100 4326947 http://www.medworm.com/index.php?rid=4318409&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FhkSDEDbiKZ8%2Fdavid-harlow-quoted-in-telemedicine-article-in-ma-medical-law-report.html Telemedicine is one of the mechanisms currently being explored as a means of spreading around our unevenly distributed supply of clinicians, and to increase patient convenience.  Adoption of the technology is in its early stages, largely due to failure of most payors to pay for remote consultations.  I spoke recently with MA Medical Law Report about managing the risks of practicing telemedicine.  Please have a look at the lead article in the current edition, and consider the privacy, security, continuity of care, licensure and technological issues that may arise even if reimbursement were not an issue at all. David HarlowThe Harlow Group LLCHealth Care Law and Consulting   (Source: HealthBlawg :: David Harlow's Health Care Law Blog) HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4318409 Fri, 07 Jan 2011 04:34:30 +0100 4318409 http://www.medworm.com/index.php?rid=4318410&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FTUSQTN0muO8%2Faccountable-care-organizations-the-emperor-has-no-clothes-or-jeff-goldsmiths-plan-b.html The current all-ACO issue of Health Affairs includes a piece by Jeff Goldsmith entitled: Accountable Care Organizations: The Case For Flexible Partnerships Between Health Plans And Providers.  It is a proposal for how private sector health plans ought to pay for services, in order to save us all from what Goldsmith sees happening in the near future thanks to the Gold Rush mentality among health care provider organizations working to become ACOs before they've been defined in regulation.  He begins with a précis of how we've gotten into the health care market mess we're in, touching on the concentration of market power in horizontally and vertically integrated health care provider organizations, payors and providers mudwrestling over fee-for-service reimbursement rates, and the rise of ... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4318410 Thu, 06 Jan 2011 13:28:38 +0100 4318410 http://www.medworm.com/index.php?rid=4309578&cid=t_149015_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F01%2F04%2Ffunding-for-key-health-reform-provisions-less-endangered-than-you-might-think%2F With the shift in Washington’s political order, there’s been increasing talk about dismantling Federal health care reform. Outright repeal is highly unlikely. First, it would face opposition from the Democratic majority in the Senate. Even more critically,  President Obama would almost certainly use his veto pen on any repeal legislation and a supermajority needed to [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4309578 Tue, 04 Jan 2011 18:16:42 +0100 4309578 http://www.medworm.com/index.php?rid=4277874&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2F8bXem7TfRhs%2Fdavid-harlow-quoted-in-ama-american-medical-news-story-on-geolocation-apps.html As health care providers continue to wonder whether and how they should add social media to their mix of communications tactics, new tools -- and new uses for those tools -- continue to sprout up.  I'm quoted in the current edition of American Medical News in a story that looks at the question of whether and how health care providers should use geolocation services (e.g., Foursquare, Gowalla) as additional channels through which they may communicate with patients, colleagues and referral sources -- or through which they may encourage patients and others to communicate among themselves. I've touched on this issue in recent presentations on health care social media, and have noted that even "checking in" on line at an STD clinic -- an activity discounted by Mark Scrimshire in the article ... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4277874 Tue, 21 Dec 2010 16:59:37 +0100 4277874 http://www.medworm.com/index.php?rid=4258826&cid=t_149015_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F12%2F14%2Fexamining-judge-hudsons-decision-on-the-individual-mandate%2F On December 12, 2010, Judge Henry Hudson of the Eastern District of Virginia became the first federal judge to hold a provision of the Affordable Care Act unconstitutional.  The lawsuit was filed by the Attorney General of the Commonwealth of Virginia immediately after the reform statute was signed into law in March.  It challenges the [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4258826 Tue, 14 Dec 2010 15:47:55 +0100 4258826 http://www.medworm.com/index.php?rid=4249120&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2F1KbmMbio8qk%2Ffacebook-saves-womans-life-newt-gingrich-and-reality-based-healthcare-systems-planning.html I've seen at least half a dozen links to the op-ed coauthored by Newt Gingrich and neurosurgeon Kamal Thapar about how the doctor used information on Facebook to save a woman's life. (It was published by AOL News. Really.)  In brief, a woman who had been to see a number of different health care providers without getting a clear diagnosis showed up in an emergency room, went into a coma and nearly died.  She was saved by a doctor's review of the detailed notes she kept about her symptoms, etc., which she posted on Facebook.  The story is vague on the details, but apparently her son facilitated getting the doc access to her Facebook page, and the details posted there allowed him to diagnose and treat her condition.  She recovered fully. Newt and Dr. Thapar wax rhapsodic about how Facebo... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4249120 Fri, 10 Dec 2010 14:29:54 +0100 4249120 http://www.medworm.com/index.php?rid=4233266&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2Fw8F-cdbZISA%2Fthe-benefits-package-a-new-employee-benefits-blog-carnival.html The inaugural edition of The Benefits Package is up at Evan Falchuk's See First.  It's a new employee health benefits blog carnival that merits your attention, as employers and other purchasers of health care services work to contain costs in a post-ACA world.  Dig in, learn from the cadre of health care bloggers represented there, and join the conversation.  David HarlowThe Harlow Group LLCHealth Care Law and Consulting   (Source: HealthBlawg :: David Harlow's Health Care Law Blog) HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4233266 Mon, 06 Dec 2010 14:59:00 +0100 4233266 http://www.medworm.com/index.php?rid=4200623&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FpWWfBHMiss0%2Fengage-with-grace.html As patients, as family members, as friends, as health care providers, we have all faced end-of-life issues at one time or another, and we will face them again.  And again.  This weekend, the "Engage With Grace" message is being broadcast virally, through a "blog rally," at a time when many people are with family and friends over the long weekend.  The point is: we all need to have the potentially uncomfortable conversation with people close to us about what kind of treatment we would want, and they would want, if incapable of making or communicating health care decisions.  CNN ran a story on Engage With Grace yesterday. End-of-life decision-making has long been an issue of great personal and professional interest to me, and I am proud to have played a role in having out-of-hospital D... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4200623 Wed, 24 Nov 2010 21:00:00 +0100 4200623 http://www.medworm.com/index.php?rid=4190287&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2Fes001VGqoHg%2Fhealth-care-reform-what-price-progress-1.html There's a lot of breast-beating going on out there regarding recent "shocking" behavior by many health care provider organizations.  Believe it or not, all across the nation, health care providers are seeking to affiliate/acquire/be acquired in the hopes of creating more efficient, more comprehensive provider networks, which can survive and flourish under new reimbursement regimes designed to squeeze inefficiencies out of the system in an effort to achieve the much-vaunted triple aim of providing high quality health care to ensure population health at a reasonable cost.  This thread was picked up in Robert Pear's Sunday New York Times piece, Consumer Risks Feared as Health Law Spurs Mergers, which focuses on concerns that prices will go up as health care providers consolidate and gain g... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4190287 Mon, 22 Nov 2010 17:50:04 +0100 4190287 http://www.medworm.com/index.php?rid=4183385&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2F5yuEUj5711I%2Fdavid-harlow-keynotes-on-health-care-social-media-and-the-law-at-annual-healthcare-and-the-internet-.html I attended the 14th Annual Healthcare and the Internet Conference in Las Vegas this week, and gave a keynote presentation entitled: "Health Care Social Media - The Lawyers Don't Always Say No" in which I discussed the reasons for health care providers to engage with their constituencies via social media -- both from a business perspective and from a regulatory perspective (ACO rules and future phases of Meaningful Use rules effectively demand a response from providers involving social media), and how to do it without getting into trouble (there are a variety of HIPAA, other privacy, liability, anti-kickback and fraud and abuse issues to keep in mind when planning for patient engagement through social media). Here are the slides from my talk: Health Care Social Media - The Lawyers Don't Al... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4183385 Fri, 19 Nov 2010 16:53:27 +0100 4183385 http://www.medworm.com/index.php?rid=4159329&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FY64Cv7CsCEw%2F2011-mpfs-and-2011-hopps-asc-fee-schedules-finalized-by-cms.html The final Medicare physician fee schedule, Hospital Outpatient PPS and Ambulatory Surgery Center fee schedules for 2011 were released by CMS last week.  They will be formally published in the Federal Register later this month. As usual, the fee schedules include a fair number of regulatory amendments that are not, strictly speaking, fee schedules, which you can read about at the links above.  A number of the changes are driven by the ACA -- e.g., elimination of out-of-pocket costs for most preventive care. Top of mind on the physician side is the SGR formula-driven pay cut, included in the 2011 MPFS regulation: about a 25% cut for physician reimbursement is now on its glide path to being effective December 1, with a slight additional cut to be effective January 1.  As I wrote last wee... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4159329 Thu, 11 Nov 2010 17:54:58 +0100 4159329 http://www.medworm.com/index.php?rid=4155290&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FuocO2vqi--M%2Fsocial-media-policy-adopted-by-the-american-medical-association.html Earlier this month, the AMA announced that it has adopted a social media policy at its mid-year meeting. It will soon be posted on the AMA website; the full text, provided to HealthBlawg by AMA staff, is set forth at the end of this post.The key to understanding the AMA perspective lies in the title of the policy: Professionalism in the use of social media. The front matter recognizes the utility of social media and focuses on the key issue of concern for the Association: Social media "create new challenges to the patient-physician relationship."Most elements of the policy are commonsensical, and represent the extension of existing norms into the social media space: Don't post identifiable patient information online.Safeguard physician personal privacy online, understanding that anything ... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4155290 Wed, 10 Nov 2010 20:30:21 +0100 4155290 http://www.medworm.com/index.php?rid=4151733&cid=t_149015_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F11%2F08%2Fcomparing-treatments-judging-health-reform-top-ha-blog-most-read-list%2F A look at Health Affairs‘ October issue on comparative effectiveness research tops the list of most-read Health Affairs Blog posts for last month. Next on the list is Tim Jost’s look at the debate over the Affordable Care Act’s constitutionality, followed by John Goodman’s analysis of whether the new legislation will ”bend the cost curve.” Here’s the entire [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4151733 Mon, 08 Nov 2010 17:00:02 +0100 4151733 http://www.medworm.com/index.php?rid=4151980&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2F33NVHEUOWTA%2Foig-issues-roadmap-for-new-physicians-a-guide-to-avoiding-fraud-and-abuse.html In October, the Office of Inspector General issued a report on Fraud and Abuse Training in Medical Education, finding that 44% of medical schools reported giving some instruction in the anti-kickback statute and related laws, even though they weren't legally required to do so. (As an aside, do we really live in such a nanny state? Over half of all medical schools don't teach their students anything about this issue -- because nobody's making them -- even though it is an issue that looms large in the practice of medicine.)  On a more positive note, about 2/3 of institutions with residency programs instruct participants on the law, and 90% of all medical schools and training programs expressed an interest in having dsome instructional materials on the subject of the anti-kickback statute, p... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4151980 Mon, 08 Nov 2010 14:33:16 +0100 4151980 http://www.medworm.com/index.php?rid=4133945&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FQa8wXU-aVSA%2Fswing-to-the-right-the-election-and-its-effects-on-health-reform.html Like Tom Friedman, who lampooned some of this year's unreasonable campaign rhetoric in a recent column, I too would be in favor of reality-based political campaigns ... but that seemed to be too much to ask for this year.  Instead of truth, we now have truthiness.  The joke news shows (and their joke political rallies) seemed to be more popular than the evening news.  (I wish Jon Stewart and his 200,000 fans on the Washington Mall last weekend had stayed home, canvassing for their candidates of choice.)  Fact-checkers told us that many political ads this season were in the "barely true" or "pants on fire" zones according to the Truth-O-Meter.  But in the end, the buzzwords seem to have worked their magic, and many "insiders" are out, and "outsiders" are in.  The angry and the impatie... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4133945 Wed, 03 Nov 2010 05:07:10 +0100 4133945 http://www.medworm.com/index.php?rid=4119222&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FGlM8uPW2xxE%2Fdavid-harlow-will-be-a-keynote-speaker-at-the-14th-healthcare-internet-conference-november-15-17-in-.html I will be speaking on the legal issues surrounding health care social media at the upcoming 14th Annual Healthcare Internet Conference.  Some health care executives are concerned that involvement with social media on behalf of their organizations can lead only to ruin: HIPAA and malpractice liability, employment issues and other concerns lead many providers to ignore social media entirely.  Well, as I'll be explaining at the conference, the lawyers don't always say no, and there are a number of good reasons to get involved.  Health care providers that do not have a social media presence (yet) should all begin to monitor online channels, including social media channels, to learn what is being said about them -- so that they can begin to respond in real life (IRL).  Before jumping into ... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4119222 Fri, 29 Oct 2010 15:02:46 +0100 4119222 http://www.medworm.com/index.php?rid=4119223&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2F5FrhNybTxqs%2Fhealth-and-hospital-law-mcle-basics-plus.html On November 9 and 10, Massachusetts Continuing Legal Education presents its annual two-day health and hospital law extravaganza, featuring an all-star faculty.  I am honored to be part of this august group once again. If you are in the Boston area and are interested in attending this program, I am giving away one free pass to the seventh person who provides the correct answer to the following question, by tweeting it to me -- @healthblawg:  Who is the Administrator of the Centers for Medicare and Medicaid Services and what is the pithy catchphrase he uses to refer to his vision for reforming the U.S. health care system? David HarlowThe Harlow Group LLCHealth Care Law and Consulting   (Source: HealthBlawg :: David Harlow's Health Care Law Blog) HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4119223 Thu, 28 Oct 2010 02:39:15 +0100 4119223 http://www.medworm.com/index.php?rid=4105816&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FoWmt5JQ5BeI%2Fconnected-health-symposium-2010.html I attended the Connected Health Symposium last week in Boston. I enjoyed many of the sessions (sometimes wished I could have attended two simultaneously, though the livetweeting helped on that front), and as usual enjoyed the hallway and exhibit floor conversations too.  As is often the case at conferences these days, I had the opportunity to meet several on-line connections in real life for the first time.  (I will not attempt to give a comprehensive report of the symposium here; please see the livetweeting archive linked to above and other reports to get a sense of the rest of the event.) This year's exhibit floor included a diverse mix of distance health tools.  Most striking from my perspective was the fact that most of these tools do one of two things: Enable patient-clinician vi... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4105816 Mon, 25 Oct 2010 16:41:01 +0100 4105816 http://www.medworm.com/index.php?rid=4065461&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Fhealthblawg.typepad.com%2Ffiles%2Fhealthblawg-ruth-balser-interview-100410.mp3 The Massachusetts health reform experience is often cited as a model for key aspects of the federal health reform law - the Affordable Care Act.  To gain some insight into the origins of the Massachusetts health reform law, and to explore current experience with implementation, I spoke with Rep. Ruth Balser, a legislative leader and supporter of the health reform laws in Massachusetts.   The audio file of my interview with Rep. Ruth Balser (about 25 minutes long) is available for listening or download.  A full transcript is at the end of this post (and in the linked Massachusetts State Rep. Ruth Balser interview transcript). David HarlowThe Harlow Group LLCHealth Care Law and Consulting HealthBlawg :: David Harlow’s Health Care Law BlogInterview of Massachusetts State Repr... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4065461 Wed, 13 Oct 2010 05:50:48 +0100 4065461 http://www.medworm.com/index.php?rid=4045064&cid=t_149015_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F10%2F08%2Fa-victory-for-health-reform-and-good-law%2F Editor’s Note: Yesterday, a federal District Court judge in Michigan rejected a constitutional challenge to the Affordable Care Act. Below, Timothy Jost of the Washington and Lee University School of Law discusses the court’s decision. In the June issue of Health Affairs, Jost and Ilya Shapiro of the Cato Institute offered “pro and con” perspectives on the constitutionality [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4045064 Fri, 08 Oct 2010 13:47:54 +0100 4045064 http://www.medworm.com/index.php?rid=4040540&cid=t_149015_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F10%2F07%2Fbreach-notice-the-struggle-for-medical-records-security-continues%2F On July 28 the Obama Administration surprised many in the health sector by withdrawing a pending Department of Health and Human Services (HHS) final “breach notification” rule governing when consumers must be informed of illicit access or use of their medical records. With this exceptional action, the Administration now has a critical opportunity to correct [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4040540 Thu, 07 Oct 2010 14:52:49 +0100 4040540 http://www.medworm.com/index.php?rid=4036772&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FmSY0Ec6RZEE%2Faco-workshop-the-feds-commit-to-making-accountable-care-organizations-work-with-safe-harbors-waivers.html Don Berwick kicked off the day-long Accountable Care Organization (ACO) Workshop and Listening Session, co-hosted by the FTC, CMS and the OIG, with a short, stirring speech that touched on his Triple Aim for health care: better care for individuals, better health for populations and reduced per-capita costs.  He committed the government to interpreting applicable statutes "wisely, so as not to impede the development of ACOs."  That sums up the reason this workshop was so eagerly anticipated.  Health care providers are extremely eager to become ACOs - though the term has yet to be fully defined - yet are extremely concerned about the potential to have specific ACO arrangements identified as illegal by the FTC, the OIG or CMS because the arrangements violate antitrust law, Stark, anti-kic... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4036772 Wed, 06 Oct 2010 04:16:06 +0100 4036772 http://www.medworm.com/index.php?rid=4027241&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FK2wx9VttOGM%2Fmhealth-markets-and-cold-hard-cash.html Last month, PricewaterhouseCoopers issued a report, Healthcare Unwired, examining the market for mobile health monitoring devices, reminder services, etc. among both health care providers and the general public.  One of the big take-away points seems to be that 40% of the general public would be willing to pay for mobile health, or mHealth, devices or services ranging from reminders to data uploads; and the reaction by insiders is either joy (40% is good) or dismay (40% is not enough).  PwC estimated the mHealth market to be worth somewhere between $7.7 billion and $43 billion per year, based on consumers' expressed willingness to pay. Deloitte recently issued a report on mPHRs, as well -- and there is tremendous interest in this space, as discussed in John Moore's recent post over at Ch... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4027241 Sun, 03 Oct 2010 15:46:27 +0100 4027241 http://www.medworm.com/index.php?rid=4013321&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2Fulbc5SYkKHI%2Fself-referral-disclosure-protocol-redux-if-it-aint-broke-dont-fix-it.html The OIG scrapped its old self-referral voluntary disclosure program in 2009 (it dated back to 1998, and was revisited in 2008), and the PPACA mandated that it be replaced.  Just like clockwork, on the deadline for its promulgation, the OIG obliged, and the new Self-Referral Disclosure Protocol is now posted and effective. The new protocol could be clearer, and could offer more comfort -- but it doesn't.  Makes one pine for the old policy's clarity: in the old days, voluntary disclosure bought you a discounted fine for Stark violations -- not like the new protocol's wishy-washy maybe-we'll give-you-a-discount language.  The new protocol also fails to help a provider seeking to disclose past wrongs voluntarily in dealing with the Federales on a number of fronts simultaneously (e.g., for ... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4013321 Tue, 28 Sep 2010 14:02:00 +0100 4013321 http://www.medworm.com/index.php?rid=4003327&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2Fw4GyXWLGGW0%2Fmassachusetts-health-care-payment-plan-gets-renewed-attention-global-payments-to-replace-fee-for-ser.html Federal health reform and Massachusetts health reform may find a point of convergence in the development of ACOs (accountable care organizations) and the payment mechanisms that will make them tick (or hum, or do whatever it is that we want them to do).  The Federales will be holding a listening session next week on the issues raised by ACOs across the HHS and FTC landscapes.  Meanwhile, back in Boston, the inner circle of health care regulators and the regulated community are busy hashing out an approach to global payments that could be ready for prime time by January 1. The need for payment reform in Massachusetts has been well-documented -- see the health care market report from the AG's office, as well as an earlier report on the imperative to keep insurance risk on insurers and pla... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4003327 Mon, 27 Sep 2010 21:24:22 +0100 4003327 http://www.medworm.com/index.php?rid=3994085&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FkiWCGPxo8B0%2Fdavid-harlow-honored-with-rx-for-excellence-award-from-massachusetts-medical-law-report.html Massachusetts Medical Law Report is honoring me this week with an Rx for Excellence award, as one of its "Heroes From the Field."  I am, indeed, honored by the recognition, and honored to be in the company of my fellow award recipients.  Please check out the list at the link above, and follow the good work that all of these fine folks have been doing around the Commonwealth. David HarlowThe Harlow Group LLCHealth Care Law and Consulting (Source: HealthBlawg :: David Harlow's Health Care Law Blog) HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3994085 Wed, 22 Sep 2010 15:11:04 +0100 3994085 http://www.medworm.com/index.php?rid=3980903&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FwWLX0hXxlII%2Fdavid-harlow-named-to-advisory-board-for-the-mayo-clinic-center-for-health-care-social-media-crowdso.html At the invitation of Lee Aase, I have joined the advisory board for his new initiative, the Mayo Clinic Center for Health Care Social Media.  I am honored -- and delighted -- to be part of the dynamic group of leading thinkers and practitioners of this art and science that Lee has assembled.  I encourage you to follow the links to their twitterfeeds and blogs via the advisory board link above.  You will be well-rewarded for your investment of time.  Lee is crowdsourcing nominations for the remaining seats on the advisory board.  Please help us out -- let us hear from you. David HarlowThe Harlow Group LLCHealth Care Law and Consulting (Source: HealthBlawg :: David Harlow's Health Care Law Blog) HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3980903 Fri, 17 Sep 2010 15:43:13 +0100 3980903 http://www.medworm.com/index.php?rid=3942881&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FkWg4LfO-GBo%2Foig-imaging-preauthorization-may-be-handled-by-hospital-for-referring-docs-and-patients.html The OIG released an advisory opinion at the end of last month OK'ing a hospital's proposal to provide insurance pre-authorization srevices free of charge to patients and physicians.  This is an issue that has long vexed folks in the imaging world.  Clearly, this is a free service provided to referral sources (to the extent they are obligated by contract with third party payors to obtain the pre-authorization before referring a patient for an MRI, for example), so why is the OIG OK with it?  In the opinion, the OIG blesses the arrangement for four reasons: The arrangement doesn't target specific referring docs, so the pre-authorization service will be provided for patients of docs who are contractually bound to handle it themselves, as well as for patients of those who aren't, and t... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3942881 Tue, 07 Sep 2010 18:17:13 +0100 3942881 http://www.medworm.com/index.php?rid=3865339&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2F0WzQCo-80LM%2Fprivacy-and-security-of-patient-records-the-lesson-of-the-weakest-link.html The Queen of Soul famously wailed about being a link in a chain of fools.  Today's lead story in the Boston Globe tells us about another sort of link in the chain -- the weakest link in the chain of custody of patient records.  In brief, a pathology billing service bought out by another service apparently dumped all records more that a year old in a town dump; a Globe photographer taking out his own trash noticed that the paper records (which he was looking at because he thought they ought to be recycled rather than dumped) had identifiable patient data and represented at least four hospitals from across Eastern Massachusetts.  Clearly, these records ought to have been shredded or otherwise destroyed before disposal.  Assuming they had some airtight contracts in place, the hospitals in... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3865339 Fri, 13 Aug 2010 16:49:13 +0100 3865339 http://www.medworm.com/index.php?rid=3854492&cid=t_149015_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F08%2F10%2Fhealth-policy-brief-pre-existing-condition-coverage%2F The latest Health Policy Brief from Health Affairs and the Robert Wood Johnson Foundation (RWJF) explores challenges facing the new Pre-Existing Condition Insurance Plan, a program designed to help those with illnesses who have had difficulty obtaining affordable health insurance. The brief reviews decisions that may need to be made by the administration and Congress [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3854492 Tue, 10 Aug 2010 20:00:29 +0100 3854492 http://www.medworm.com/index.php?rid=3812939&cid=t_149015_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F08%2F02%2Fjulys-most-read-health-affairs-blog-posts%2F Topping July’s list of most-read Health Affairs Blog posts is Uwe Reinhardt’s essay arguing that increasing the number of health insurers is not likely to contribute to controlling health care cost growth. Also on the list: a look at Health Affairs‘ July issue on health reform; John Goodman on likely trends in emergency department traffic; John Halamka on the final “meaningful use” standards for electronic health records; Carol Levine, [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3812939 Mon, 02 Aug 2010 17:49:36 +0100 3812939 http://www.medworm.com/index.php?rid=3805791&cid=t_149015_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F07%2F30%2Fimplementing-health-reform-pre-existing-condition-coverage%2F Editor’s Note: Earlier posts by Timothy Jost provide analyses of regulations implementing provisions of the new health reform legislation governing appeals of coverage denials, coverage for preventive services, a patient bill of rights, grandfathered plans, tax exempt hospitals, the small employer tax credit, the Web portal, reinsurance for early retirees, and young adult coverage. As of January 1, 2014, [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3805791 Fri, 30 Jul 2010 19:07:36 +0100 3805791 http://www.medworm.com/index.php?rid=3805792&cid=t_149015_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F07%2F30%2Fchanging-the-name-but-not-the-political-game%2F Editor’s Note: Yesterday, the Obama administration announced interim final regulations governing the temporary Pre-Existing Condition Insurance Plan created by the Patient Protection and Affordable Care Act. Below, Thomas Miller and James Capretta criticize this portion of the Act and the design of the temporary health insurance pools for high-risk individuals that it creates. For more on [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3805792 Fri, 30 Jul 2010 12:59:21 +0100 3805792 http://www.medworm.com/index.php?rid=3794741&cid=t_149015_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F07%2F27%2Fhealth-policy-brief-accountable-care-organizations%2F Americans will soon be hearing more about a new type of entity: accountable care organizations. That’s because the health care reform legislation enacted earlier this year authorizes Medicare to contract with accountable care organizations, or ACOs, to provide care for enrollees. Accountable care organizations are designed to focus on delivering care to a particular population [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3794741 Tue, 27 Jul 2010 19:54:59 +0100 3794741 http://www.medworm.com/index.php?rid=3786981&cid=t_149015_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F07%2F25%2Fimplementing-health-reform-the-appeals-process%2F Editor’s Note: Earlier posts by Timothy Jost provide analyses of regulations implementing provisions of the new health reform legislation governing coverage for preventive services, a patient bill of rights, grandfathered plans, tax exempt hospitals, the small employer tax credit, the Web portal, reinsurance for early retirees, and young adult coverage.  On July 22, 2010, the Departments of Health [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3786981 Sun, 25 Jul 2010 12:12:39 +0100 3786981 http://www.medworm.com/index.php?rid=3753923&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FVcpI21OUncI%2Fmeaningful-use-the-final-rule.html Meaningful use was given its final definition yesterday, in the meaningful use final rule released by HHS.  Secretary Sebelius, CMS Adminsitrator Berwick, ONC chief Blumenthal and the two Reginas spoke -- U.S. Surgeon General Regina Benjamin, and Regina Holliday, whose late husband's last days were complicated by the failure of health care facilities to release and share health records.  Berwick, in his first full day on the job as CMS Adminstrator, waxed rhapsodic about the pleasures of practicing as a pediatrician at Harvard Community Health Plan using its pioneering electronic health record system.  (Years later, I am still a patient at Harvard Vanguard Medical Associates, which used to be part of HCHP, and I am still spoiled by the EHR system there.)  Blumenthal and Benjamin also s... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3753923 Wed, 14 Jul 2010 19:27:14 +0100 3753923 http://www.medworm.com/index.php?rid=3740563&cid=t_149015_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F07%2F09%2Fcourt-voids-federal-rejection-of-health-benefits-for-same-sex-spouses%2F Portions of the federal Defense of Marriage Act (DOMA), which bars the federal government from recognizing same-sex marriages, are unconstitutional, Judge Joseph Tauro of the United States District Court in Boston ruled in two cases yesterday. The cases arose in Massachusetts, which recognizes same-sex marriages, and they revolved around the obstacle DOMA creates when members of [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3740563 Fri, 09 Jul 2010 20:50:51 +0100 3740563 http://www.medworm.com/index.php?rid=3737119&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2F8KU7LFg7rGg%2Fonc-announces-hitech-amendments-to-hipaa-privacy-security-and-enforcement-rules.html The federales announced a new set of HIPAA regulations today (to be published in the Federal Register on July 14) in a press conference featuring Kathleen Sebelius (HHS Secretary), Georgina Verdugo (HHS OCR Director) and David Blumenthal (ONC Director).  The HIPAA changes are essentially mandated by the HITECH Act.  From the HHS presser:The proposed rule announced today would strengthen and expand enforcement of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy, Security, and Enforcement Rules by:expanding individuals’ rights to access their information and to restrict certain types of disclosures of protected health information to health plans; requiring business associates of HIPAA-covered entities to be under most of the same rules as the covered ... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3737119 Fri, 09 Jul 2010 03:31:57 +0100 3737119 http://www.medworm.com/index.php?rid=3699584&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FFaUUWbRT4o4%2Fhealthblawg-nominated-to-lexisnexis-top-50-blogs-in-their-insurance-law-community.html Thanks, LexisNexis, for this honor.  Everybody else, head over to the Top 50 Blogs post, register, and post a comment endorsing HealthBlawg.  While you're there, check out the other nominees, including the blogs of fellow Health Wonks Hank Stern and Joe Paduda. David HarlowThe Harlow Group LLCHealth Care Law and Consulting (Source: HealthBlawg :: David Harlow's Health Care Law Blog) HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3699584 Fri, 25 Jun 2010 21:06:56 +0100 3699584 http://www.medworm.com/index.php?rid=3690803&cid=t_149015_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F06%2F23%2Fimplementing-health-reform-a-patient-bill-of-rights%2F Editor’s Note: Earlier posts by Timothy Jost provide analyses of regulations implementing provisions of the new health reform legislation governing grandfathered plans, tax exempt hospitals, the small employer tax credit, the Web portal, reinsurance for early retirees, and young adult coverage.  On June 22, the Departments of Health and Human Services, Labor, and Treasury released interim final regulations implementing five of the insurance enrollee protections of the Patient Protection and Affordable Care Act: the prohibition against preexisting condition exclusions, the prohibition against lifetime health insurance coverage limits, the restriction of annual coverage limits, the limitation on rescissions, and the provisions guaranteeing direct access to certain types of providers a... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3690803 Wed, 23 Jun 2010 17:09:23 +0100 3690803 http://www.medworm.com/index.php?rid=3679828&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Fhealthblawg.typepad.com%2Ffiles%2Fmike-barber-interview-w-david-harlow-on-healthblawg-062010.mp3 What if you could improve health care across the three intransigent parameters of cost, access and quality by 15%?  That's the challenge GE has set out for itself in the form of its current five-year Healthymagination campaign, and it's investing $6 billion in the effort.  I caught up with GE's VP for Healthymagination, Mike Barber, recently, and I invite you to listen in on our conversation about GE's efforts in the US and globally, within GE's health care business unit and beyond, to roll out this major investment -- which, obviously, GE expects to yield a return in the future.The audio file of my interview with Mike Barber (about 20 minutes long) is available for listening or download:  A full transcript is at the end of this post (and in the linked Mike Barber, VP, Healt... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3679828 Mon, 21 Jun 2010 03:07:01 +0100 3679828 http://www.medworm.com/index.php?rid=3676757&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FyRMSYqtyZV8%2Ffinal-ehr-certification-rule-announced-by-onc.html A surgeon can’t operate without the proper equipment. A clinician can’t achieve meaningful use of electronic health records without an EHR that is designed to improve patient care and practice efficiency. -- David BlumenthalToday, David Blumenthal, Steve Posnack and Carol Bean of the ONC announced the publication of the final (albeit temporary) EHR certification rule.  The actual publication date in the Federal Register will be June 24. (Here is the display copy of the EHR Certification Rule; a permanent rule will be forthcoming later this year.)The technical standards were glossed over on a conference call with ONC this afternoon; the focus, instead, was on getting testing and certification rolling.  Organizations or consortia may apply for recognition as testing and/or certific... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3676757 Fri, 18 Jun 2010 19:59:14 +0100 3676757 http://www.medworm.com/index.php?rid=3665934&cid=t_149015_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F06%2F15%2Fimplementing-health-reform-grandfathered-plans%2F Editor’s Note: Earlier posts by Timothy Jost provide analyses of regulations implementing provisions of the new health reform legislation governing tax exempt hospitals, the small employer tax credit, the Web portal, reinsurance for early retirees, and young adult coverage.  From the beginning of his push for health care reform, President Obama promised “If you like your insurance plan, your doctor, or both, you will be able to keep them.” He never meant to say by this, however, “if you don’t like the plan you have, you will be stuck with it forever,” or, for that matter, “if your insurance plan changes dramatically to your disadvantage, you will not be able to escape it.”  Balancing the desire to let individuals and employers maintain relatively inexpensive pre-r... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3665934 Tue, 15 Jun 2010 21:01:45 +0100 3665934 http://www.medworm.com/index.php?rid=3659039&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FXMnHSRgDRI4%2Fblawg-review-268.html "In my many years I have come to a conclusion that one useless man is a shame, two is a law firm, and three or more is a congress." -- John Adams*Welcome to the Flag Day 2010 edition of Blawg Review, the weekly law blog carnival.  If you need to get your bearings, feel free to peruse previous HealthBlawg-hosted editions of Blawg Review: #88, #129, #154 and #211.John Adams is a person of interest for this edition, because he made his home in Quincy, MA.Quincy is a point of interest because not only did Adams give it to his son as a middle name, it also happens to be the home of the longest-running Flag Day parade and celebration in these United States.  (It was rained out this year, but check out the, um, boring video of last year's parade.)Quincy is also the home of the granite quarrie... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3659039 Mon, 14 Jun 2010 04:50:53 +0100 3659039 http://www.medworm.com/index.php?rid=3659040&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FrXsauD6Khtw%2Fspring-into-summer.html My apologies to regular readers of HealthBlawg for sporadic posting as of late.  Things should pick up this week with an edition of Blawg Review and a podcast interview at the very least.  If you aren't already following me on Twitter, then I heartily recommend you give it a try; when I don't blog, at least I tweet.  (If you aren't ready to commit, you could add a feed of my tweets to your RSS reader here.)  I've been spending some time over the past month or so preparing for, and now teaching, a course in Health Law and Business Ethics at The Heller School for Social Policy and Management at Brandeis University, as part of the MD/MBA dual degree program offered jointly with the Tufts University School of Medicine.  This has - somehow - eaten into blogging time.  Most gratify... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3659040 Sun, 13 Jun 2010 07:12:33 +0100 3659040 http://www.medworm.com/index.php?rid=3652378&cid=t_149015_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F06%2F10%2Ffleshing-out-the-concept-of-insurance-exchanges%2F The idea of a health insurance exchange is broad enough to encompass many interpretations, and that can be both a good thing and a bad thing, Jon Kingsdale said Tuesday. He spoke at a Health Affairs briefing on implementing health reform, which was keynoted by Nancy-Ann DeParle, director of the White House Office of Health Reform. The briefing marked the release of the journal’s June issue, “Moving Forward On Health Reform,” published with the support of the Robert Wood Johnson Foundation. “One of the political assets of [the term exchange] is that the concept is so mutable,” said Kingsdale, an independent consultant who until recently was the executive director of the Commonwealth Health Insurance Connector Authority in Massachusetts, the nation’s highest profile insurance ex... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3652378 Thu, 10 Jun 2010 19:46:41 +0100 3652378 http://www.medworm.com/index.php?rid=3652513&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2F7m7W28qpGY8%2Fblog-carnival-trifecta.html It's a Health Wonk Review week -- the latest, "killer," edition of the biweekly blog carnival for health wonks is up, courtesy of Tinker Ready at Boston Health News.  The weekly carnivals are worth a read, too, of course: the lawyers' Blawg Review at Spam Notes and the medbloggers'  Grand Rounds at MDiTV.Tune in again next Monday, when Blawg Review returns to HealthBlawg - the home of hipness. David HarlowThe Harlow Group LLCHealth Care Law and Consulting (Source: HealthBlawg :: David Harlow's Health Care Law Blog) HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3652513 Thu, 10 Jun 2010 19:17:35 +0100 3652513 http://www.medworm.com/index.php?rid=3640983&cid=t_149015_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F06%2F08%2Fnew-health-affairs-issue-implementing-health-reform%2F State and federal officials, insurers, and health care providers face thousands of important decisions in implementing the Patient Protection and Affordable Care Act of 2010, according to the June issue of Health Affairs. In this issue, some of the nation’s leading experts weigh in on the nuts and bolts of what’s needed to achieve the key goals of health reform: expanding health coverage, improving quality, and controlling costs. The issue will be distributed this morning at a Washington D.C. briefing. Health Affairs will offer live Twitter updates from the event at #HAreform. Putting in place the provisions of the new law entails many daunting tasks: establishing new rules for insurers; setting up insurance exchanges; getting states ready for Medicaid expansion and other new roles; an... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3640983 Tue, 08 Jun 2010 11:05:15 +0100 3640983 http://www.medworm.com/index.php?rid=3607633&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FqzpOgmWV1IU%2Fsocial-media-summit-2010-june-3-sponsored-by-mass-tlc-at-microsoft-nerd.html I'll be facilitating one of the breakout sessions at the Massachusetts Technology Leadership Council's Social Media Summit 2010 next Thursday - and the rest of the program looks pretty darn good, too.  Check out the agenda, and I hope to see you there.  If you can't make it in person, follow along on Twitter. David HarlowThe Harlow Group LLCHealth Care Law and Consulting (Source: HealthBlawg :: David Harlow's Health Care Law Blog) HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3607633 Fri, 28 May 2010 04:16:18 +0100 3607633 http://www.medworm.com/index.php?rid=3599336&cid=t_149015_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F05%2F26%2Fsherry-glied-on-mental-health-and-mandates%2F The Senate Finance Committee is scheduled to vote today on the nomination of Sherry Glied to be the Assistant Secretary for Planning and Evaluation at the Department of Health and Human Services. The President nominated Glied, a professor and chair of the department of Health Policy and Management at Columbia University’s Mailman School of Public Health, on May 21, 2009. Glied served as a senior economist for healthcare and labor market policy to the President’s Council of Economic Advisers under both President George H.W. Bush and President Clinton. She was a participant in President Clinton’s Health Care Task Force and headed working groups on global budgets and the economic impacts of Clinton’s reform plan. The Well-Being Of People With Mental Illness. Glied coauthored ... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3599336 Wed, 26 May 2010 14:20:05 +0100 3599336 http://www.medworm.com/index.php?rid=3577366&cid=t_149015_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F05%2F05%2Fimplementing-health-reform-web-portals-and-retiree-reinsurance%2F Editor’s Note: Other posts by Timothy Jost analyze regulations implementing provisions of the recently passed health reform legislation governing young adult coverage and the small employer tax credit. Although the dust has hardly settled from the enactment of landmark health care reform legislation in late March, and dark mutterings of repeal or defunding continue, implementation of the legislation has already begun.  Although the most revolutionary provisions of the Patient Protection and Affordable Care Act (PPACA) do not go into effect until 2014, some provisions are effective immediately, others will go into effect for the first insurance plan year after September 23 (the six month anniversary of enactment), and yet others will roll out over the next several years. HHS has m... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3577366 Thu, 06 May 2010 03:45:46 +0100 3577366 http://www.medworm.com/index.php?rid=3538053&cid=t_149015_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F05%2F05%2Fimplementing-health-reform-web-portals-and-retiree-reinsurance%2F Although the dust has hardly settled from the enactment of landmark health care reform legislation in late March, and dark mutterings of repeal or defunding continue, implementation of the legislation has already begun.  Although the most revolutionary provisions of the Patient Protection and Affordable Care Act (PPACA) do not go into effect until 2014, some provisions are effective immediately, others will go into effect for the first insurance plan year after September 23 (the six month anniversary of enactment), and yet others will roll out over the next several years. HHS has moved quickly to staff up for implementation, creating a new Office of Consumer Information and Insurance Oversight (OCIIO), headed by Jay Angoff, the former insurance commissioner of Missouri and deputy insuranc... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3538053 Thu, 06 May 2010 03:45:46 +0100 3538053 http://www.medworm.com/index.php?rid=3538253&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FJsTiCYleTIA%2Fhit-incentives-in-massachusetts-less-carrot-more-stick.html Health care providers all over the country are all worked up because they say that the federales' regulations on meaningful use of certified EHRs go too far, too fast.  They should be glad they're not in Massachusetts, where EHR use will soon be required as a condition of licensure of physicians, hospitals and community health centers.  The word got out, thanks to Secretary of Health and Human Services JudyAnn Bigby, who spoke at last week's HIT conference hosted by Governor Deval Patrick and the MA Health Data Consortium.  This seemed to be news to some folks out there, but these requirements are deep in the heart of Part II of the Massachusetts health reform law (Chapter 305 of the Acts of 2008).  Much of the coverage in August 2008 didn't mention the EHR-for-licensure provisions, bu... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3538253 Thu, 06 May 2010 00:54:04 +0100 3538253 http://www.medworm.com/index.php?rid=3526840&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Fhealthblawg.typepad.com%2Ffiles%2Fgeorge-pantos-hpm-institute-healthblawg-interview-with-david-harlow-042110.mp3 Health care costs are a perennial issue for employers and employees.  There are a variety of approaches out there designed to improve health status and health outcomes and reduce costs at the same time.  Proponents of a variety of approaches have been featured here on HealthBlawg in the past.  I recently had the opportunity to speak with George Pantos, of the Healthcare Performance Management Institute, a brand-new organization on the scene, founded by a group of folks who have developed tools for managing these costs. The audio file of my interview with George Pantos (about 20 minutes long) is available for download/podcast.  A full transcript is at the end of this post (and in the linked George Pantos, Executive Director, Healthcare Performance Management Institute, HealthBlaw... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3526840 Mon, 03 May 2010 03:16:33 +0100 3526840 http://www.medworm.com/index.php?rid=3511509&cid=t_149015_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F04%2F28%2Fcredit-scores-juicing-up-the-mandate%2F Americans carry large amounts of consumer debt.  They are directly affected by credit scores, because the scores affect the interest rates they pay, and the amount of credit they are offered.  One late payment of a bill:  a 60- to 110-point score reduction.  Simply hitting the limit on a credit card:  a 10- to 45-point reduction.  A foreclosure:  an 85 to 160 point reduction.  And the grand finale, a medical bankruptcy: a 130- to 240- point reduction.  When new coverage standards are implemented under the Patient Protection and Affordable Care Act (PPACA), the resulting “creditable” coverage will place caps on consumer cost sharing.  This can dramatically reduce medical bankruptcies, helping both consumers and their lenders.  Because of this, credit scores can poten... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3511509 Wed, 28 Apr 2010 12:41:58 +0100 3511509 http://www.medworm.com/index.php?rid=3504996&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FDN-L1oh3I1U%2Ffake-facebook-profiles-and-other-portents-of-the-end-times.html One issue up for discussion in this evening's free-form health care social media tweetchat was the fake Facebook page of eSara Baker, posted as a form of marketing for a company providing online health-related services (which sound like typical patient portal stuff like scheduling appointments and accessing test results).  The page prominently states: "If you haven't uncovered our secret yet, here it is: Sara isn't a real person." The identity of the company and the services provided are not at issue here.  The issue discussed in the #hcsm tweetchat was whether using social media to market a health care service through the use of a fabricated profile was unethical and/or harmful to authentic uses of social media for health care. I disagree with some of my #hcsm cohorts who twee... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3504996 Mon, 26 Apr 2010 03:04:59 +0100 3504996 http://www.medworm.com/index.php?rid=3499164&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2Fz9pni8O1CPk%2Fhealth-care-social-media-comes-to-the-massachusetts-hospital-association.html The Massachusetts Hospital Association presented a health care social media program today featuring two leading evangelists and strategists -- who also happen to be compelling speakers: Larry Weber and Lee Aase.  The MHA is getting its own social media presence off the ground, and the hospitals represented at the meeting are at various stages of social media adoption and use. The show-and-tell and war stories resonated with the audience, and a number of attendees were resolved to pick up flip cameras and integrate video into their social media offerings.  As the token lawyer in the room, I was asked if stand-up video interviews could be posted by virtue of getting electronic releases; since a digital signature is a signature these days under the law, I said yes.  The truth is, digiti... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3499164 Fri, 23 Apr 2010 11:41:02 +0100 3499164 http://www.medworm.com/index.php?rid=3490728&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FN0rw9xKpgWg%2Ffda-radiation-therapy-emitting-equipment-regulation-ehr-device.html Earlier this month, the FDA released a letter announcing a new focus on radiation-emitting products.  Here's the core of the letter:In order to reduce the number of under-doses, over-doses, and misaligned exposures from therapeutic radiation the FDA is taking several steps to improve the safety and safe use of certain radiation therapy devices. Analyses of Medical Device Reports (MDRs) revealed device problems that appear to be the result of faulty design or use error that could be mitigated by the incorporation of additional safeguards. Between December 31, 1999, and February 18, 2010, FDA received 1,182 MDRs associated with the use of radiation therapy devices. Of these MDRs, linear accelerators accounted for 74%, radiation therapy treatment planning systems (RTP) accounted for 19%, and... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3490728 Wed, 21 Apr 2010 13:59:06 +0100 3490728 http://www.medworm.com/index.php?rid=3487195&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FqwfebZK_bx0%2F2011-ipps-draft-rule-released-by-cms-good-news-bad-news.html The good news is that the acute hospital market basket update in Medicare payment proposed in the 2011 IPPS draft rule released by CMS on April 19 (to be published in the Federal Register on May 4) is 2.4% (subject to revision based on data clarifications in the final rule).  The bad news comes in two parts.  First, the 2.4% includes 2% for RHQDAPU compliance, and there are a number of new measures to report.  Second, and even worse, is that the rule also includes a -2.9% adjustment (yes, Virginia, a net cut of 0.5%) to account for part of the anticipated overpayment resulting from zealous documentation of claims under the relatively new MS-DRG system.  CMS gave hospitals a bye last year, when this adjustment was supposed to start.  Part 2 of the adjustment is supposed to be... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3487195 Tue, 20 Apr 2010 00:27:52 +0100 3487195 http://www.medworm.com/index.php?rid=3482949&cid=t_149015_109_f&fid=36089&url=http%3A%2F%2Fthesituationist.wordpress.com%2F2010%2F04%2F19%2Fde-capturing-the-fda%2F Harvard Law Student, Jason Iuliano, recently posted his forthcoming article, “Killing Us Sweetly: How to Take Industry Out of the FDA” (forthcoming Journal of Food Law and Policy) on SSRN.  Here’s the abstract. * * * For more than a century, the Food and Drug Administration has purported to protect the public health. During that time, it has actually been placing corporate profits above consumer safety. Nowhere is this corruption more evident than in the approval of artificial sweeteners. FDA leaders’ close ties to the very industry they were supposed to be regulating present a startling picture. Ignoring warnings from both independent scientists and their own review panels, FDA decision makers let greed guide their actions. They approved carcinogenic sweeteners such ... The Situationist blogs http://www.medworm.com/rss/comments.php?id=3482949 Mon, 19 Apr 2010 04:01:50 +0100 3482949 http://www.medworm.com/index.php?rid=3471893&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FV8chGkdkGmo%2Fhealth-wonk-review.html I'm not a superstitious man, but April 15th is fraught with doom, linked as it is to death and taxes ... among other themes, as we will explore in this edition of Health Wonk Review.  For that reason, and due to the happy accident that this edition is the fifth that I have hosted (Joe Paduda thought it was the umpteenth; I know, I know, we lawyers have a way with words ... but there have only been 1, 2, 3, 4 others), I'm opening this post under the protective auspices of a khamsa, a five-fingered good luck talisman, or amulet, designed to ward off the evil eye. Will Rogers once said: "The income tax has made liars out of more Americans than golf."  Honesty is, they say, the best policy.  On the flipside, though, last week Roy Poses questioned the de-linking of ethics from pecu... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3471893 Thu, 15 Apr 2010 09:16:39 +0100 3471893 http://www.medworm.com/index.php?rid=3453866&cid=t_149015_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F04%2F08%2Fmedicare-part-d-drug-pricing%2F Last month, Rep. Peter Welch (D-VT) introduced a bill (H.R. 4752) to overturn the 2003 ban on government-led price negotiations for Medicare Part D drug plans.  The bill has 67 co-sponsors so far.  While perhaps well intentioned, this bill will do little to reduce Part D drug prices. Giving the government the power to negotiate drug prices can work only if we have credible alternatives to the drug on the table.  Plans need: (1) generics or similar drugs in the therapeutic class; and (2) formulary flexibility to drive market share in exchange for price concessions. First, many complex specialty drugs are biological and don’t have generic equivalents.  Proposals debated in this Congress would establish a regulatory pathway for bio-similars, but the current language mandates a long excl... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3453866 Thu, 08 Apr 2010 18:55:04 +0100 3453866 http://www.medworm.com/index.php?rid=3443808&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Fhealthblawg.typepad.com%2Ffiles%2Fhealthblawg-interview-earl-jones-svp-ge-healthcare-it-ehealth-040110-1.mp3 GE Healthcare IT has been working in the years leading up to the HITECH Act on a number of initiatives to enable meaningful use of health care IT -- or as Senior VP and General Manager of eHealth Earl Jones puts it, building the "connected health care ecosystem."In what may be seen as either a pragmatic move or a revolutionary one, GE is developing tools that allow for communication across health care IT systems -- not just connecting one GE Centricity installation with another -- but acting as a technology-agnostic bridge for information across health care IT systems and across health systems.  While Jones notes that we're in the early stages of linking isolated lily pads across the surface of a pond, GE is developing tools that not only facilitate interoperability, but also facilitate t... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3443808 Wed, 07 Apr 2010 02:53:32 +0100 3443808 http://www.medworm.com/index.php?rid=3437768&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FpQ7ENGfaD6U%2Fhealth-reform-enacted-healthblawger-punked-by-potus.html As regular readers of HealthBlawg are well aware, I had my doubts that el Presidente could pull it off once the Dems lost Kennedy's Senate seat, but he did manage to rally the troops and get the sausage version of health insurance reform enacted.  Nothing to sneeze at, but it's only a first step -- health insurance reform, not a full health reform package as promised during the campaign.  Nevertheless, the steps to be taken towards implementation of health reform remain the same -- even though we do have legislation in place, and a nominee (finally) -- Don Berwick -- to head CMS.  (See more on the pros and cons of Berwick's nomination, and a podcast interview with Berwick here on HealthBlawg from about 18 months ago.)  In brief, with or without the legislation -- and many, many... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3437768 Sun, 04 Apr 2010 20:39:29 +0100 3437768 http://www.medworm.com/index.php?rid=3429272&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FvaxHwF57DRs%2Fblog-carnivals-next-health-wonk-review-right-here-on-april-15.html This week, health reform looms large in the minds of blog carnival hosts.  Evan Falchuk's health reform edition of Grand Rounds is up at his See First blog.  Rich Elmore hosts the current Health Wonk Review at his Healthcare Technology News (check out the flying pigs photos and more; cf. the HealthBlawger's "First Hundred Days" edition of Blawg Review for another reference to flying pigs). The next edition of Health Wonk Review will be hosted right here on April 15th.  The themes we will be exploring in that biweekly exegesis of health wonkery include the following: Metaphors Lying Song (esp. the blues) Art (esp. painting, drawing) Inventors and their contraptions Fast food Liberation Cosmetic surgery/medical spas Impressionist 19th century novels Immenseness Mortality Rac... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3429272 Thu, 01 Apr 2010 15:08:58 +0100 3429272 http://www.medworm.com/index.php?rid=3390735&cid=t_149015_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F03%2F21%2Fabortion-agreement-clears-way-for-health-reform%2F The passage of health reform legislation, which once seemed inevitable, then seemed far less likely with the election of Scott Brown in Massachusetts, now seems close to inevitable again. By agreeing to issue an executive order continuing current policy against the use of public funds for abortion, the White House won the support of Rep. Bart Stupak (D-MI) and several other members of Congress who had objected that the Senate-passed health reform legislation did not sufficiently guard against public funding for abortion. “While the legislation as written maintains current law, the executive order provides additional safeguards to ensure that the status quo is upheld and enforced, and that the health care legislation’s restrictions against the public funding of abortions cannot ... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3390735 Sun, 21 Mar 2010 20:51:58 +0100 3390735 http://www.medworm.com/index.php?rid=3386875&cid=t_149015_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F03%2F19%2Fthe-health-care-reform-reconciliation-bill%2F **An update added the afternoon of March 20 at the end of this post provides a brief summation of the manager’s amendment to the health reform reconciliation bill being considered by the House.** The House began its last step in the health reform legislative process early in the afternoon of Thursday, March 18, when it released HR 4872, the Health Care and Education Affordability Reconciliation Act of 2010. As this year’s health reform legislation has gone, this is a slender bill, weighing in at 153 pages, of which 35 are dedicated to student loans and 32 to revenue enhancements. Nonetheless, the reconciliation bill makes significant changes in the Senate bill, moving it closer to the House’s earlier legislation. First, a quick recap for anyone who happens to have slept through t... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3386875 Fri, 19 Mar 2010 18:11:47 +0100 3386875 http://www.medworm.com/index.php?rid=3385328&cid=t_149015_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F03%2F19%2Fthe-health-care-reform-reconciliation-bill%2F The House began its last step in the health reform legislative process early in the afternoon of Thursday, March 18, when it released HR 4872, the Health Care and Education Affordability Reconciliation Act of 2010. As this year’s health reform legislation has gone, this is a slender bill, weighing in at 153 pages, of which 35 are dedicated to student loans and 32 to revenue enhancements. Nonetheless, the reconciliation bill makes significant changes in the Senate bill, moving it closer to the House’s earlier legislation. First, a quick recap for anyone who happens to have slept through the past few months. On November 7, the House passed its health reform bill, HR 3962, by a vote of 220 to 215. After more than a month of deliberation, the Senate finally cut off a filibuster and passed ... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3385328 Fri, 19 Mar 2010 18:11:47 +0100 3385328 http://www.medworm.com/index.php?rid=3382922&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Fhealthblawg.typepad.com%2Ffiles%2Fpeter-neumann-healthblawg-interview-david-harlow-031610.mp3 The national debate on health care reform is currently focused on health insurance reform -- coverage, one of the proverbial three legs of the health care reform stool: coverage, cost and quality.  In order to bend the cost curve -- no matter what the approach to health care reform: be it federal legislation, state initiatives, federal pilots and demonstration projects, and/or private sector initiatives -- most would agree that we need a rational approach to cost-effectiveness research, or comparative effectiveness research that we can all rely upon.  Anyone who embarks on a search for such an approach will soon find Peter Neumann's Center for the Evaluation of Value and Risk in Health at the Tufts University Medical Center and the CEVR's Cost-Effectiveness Analysis Registry.  I spoke w... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3382922 Fri, 19 Mar 2010 13:05:29 +0100 3382922 http://www.medworm.com/index.php?rid=3374222&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FCfqn1wiNksk%2Fmassachusetts-health-care-cost-trends-hearings-yield-data-stir-heated-debate-.html   The Massachusetts Division of Health Care Finance and Policy and the Attorney General's Office are holding three days of hearings this week on health care cost trends.  You may wish to get up to speed by taking a look at the HealthBlawger's earlier review of preliminary reports on Massachusetts health care cost trends and positioning by key participants.  There is a comprehensive collection of preliminary reports and testimony on the Commonwealth's website. Tuesday's Boston Globe reported that Harvard Pilgrim Health Care (one of the Big Three not-for-profit insurers here) released hospital payment data confirming what the AG's office had previously reported (and what has been widely surmised or known for years) -- namely, that certain hospitals get paid substantially more for the s... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3374222 Wed, 17 Mar 2010 17:02:45 +0100 3374222 http://www.medworm.com/index.php?rid=3374223&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FGoZmGo7u-GA%2Fdavid-harlow-quoted-on-electronic-health-records-implementation-and-incentives-in-mass-medical-law-r.html Just a few days before the comment period closed on the draft regulations defining meaningful use (see all meaningful use comments), the Massachusetts Medical Law Report ran a piece on the HITECH Act incentives for implementation of electronic health records systems, quoting me and a couple other usual suspects.  I highlighted some shortcomings in the proposed rule, and also noted that health care providers need to be implementing EHRs not just for the stimulus kicker ... that alone is not worth it:[T]he regulation calls for all physicians to use e-prescribing 75 percent of the time by 2012.David Harlow, a Newton-based lawyer and health care consultant, said that this won’t be an easy task, noting that Massachusetts is considered a leader in e-prescribing even though only 10 percent of ... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3374223 Wed, 17 Mar 2010 00:46:42 +0100 3374223 http://www.medworm.com/index.php?rid=3354434&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2F540ouT9hVd4%2Fpatient-safety-not-taught-in-medical-school-lucian-leape-institute-releases-teaching-safe-patient-care.html This report is the first of a planned series of such reports on issues that the Lucian Leape Institute has identified as top priorities in ongoing efforts to improve patient safety. “We are very excited about this initial report of the Lucian Leape Institute,” said Diane C. Pinakiewicz, MBA, President of the Lucian Leape Institute and the National Patient Safety Foundation, “but we recognize that this is just the beginning of a major collaborative effort to see the report’s recommendations through to their full implementation.”Subsequent Institute initiatives will address integration of care across health care organizations and delivery systems; restoration of pride, meaning and joy in professional work; active consumer engagement in patient care; and provision of fully transpare... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3354434 Thu, 11 Mar 2010 05:01:06 +0100 3354434 http://www.medworm.com/index.php?rid=3346554&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Fhealthblawg.typepad.com%2Ffiles%2Fjohn-glaser-partners-cio-podcast-interview-healthblawg-david-harlow-030310.mp3 What does a large health system CIO worry about if his system is already fully up to speed in the day-to-day use of EHRs?  Using them in ways that improve communication of information across a diverse group of clinicians, and that enable the integration of additional interesting and useful data as time goes on -- such as the integration of genetic testing data into the diagnostic and treatment logic built into the EHR.John Glaser explains how Partners uses its EHR system to leverage knowledge for the benefit of patients, and describes some of the ways in which decision support systems are being used today and may be used in the future.  Tools in place at Partners now:[T]here is for example a monthly report put out on dozens and dozens of quality measures and they are coded red, yellow... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3346554 Tue, 09 Mar 2010 12:46:44 +0100 3346554 http://www.medworm.com/index.php?rid=3327080&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2FswUaX-REUa0%2Fhimss-in-atlanta-and-online-better-health.html The HIMSS annual convention going on this week in Atlanta is a 30,000-person blowout of epic proportions (and, yes, there was snow there but not in Boston), with many industry announcements, product launches, and meetings and sessions large and small.  There were a ton of blog posts (even a couple of blogger panels - sorry I couldn't participate remotely), and a blizzard of tweets at #HIMSS10.  For some up-close-and-personal looks at products and services brought to the conference, look no further than the Better Health livestreamed video interviews from HIMSS.  @DrVal (Val Jones),  @DoctorAnonymous (Mike Sevilla) and @Blogborygmi (Nick Genes) have been doing a bang-up job broadcasting to those interested well beyond the exhibit halls, and have been taking questions online for the ... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3327080 Wed, 03 Mar 2010 02:19:44 +0100 3327080 http://www.medworm.com/index.php?rid=3318493&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2Fwl7iaC-u-VA%2Frac-david-harlow-quoted-part-b-insider.html The OIG recently reviewed RAC performance to date in identifying fraud (vs. overpayment) and found the RACs wanting.  To be fair, the RACs haven't been trained in identifying Medicare fraud. Part B Insider asked me how providers should prepare for an encounter with a RAC (a "RAC attack"?) and my answer is consistent with what I advise providers on a regular basis:  Be prepared.  Be proactive.  “From my perspective, it is always better to conduct regular internal reviews as part of robust standing compliance and internal audit programs,” Harlow says. “If these compliance reviews and audits are carried out thoroughly, the results may be used in challenging or appealing RAC reviews.” When applicable, providers should initiate self-disclosure of fraudulent billing uncovered by ... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3318493 Mon, 01 Mar 2010 03:58:49 +0100 3318493 http://www.medworm.com/index.php?rid=3318495&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Fhealthblawg.typepad.com%2FDave%2520Fischer%2520MITA%2520HealthBlawg%2520Interview%2520with%2520David%2520Harlow%2520022510.mp3 MITA Executive Director Dave Fischer spoke with HealthBlawg last week about industry efforts to control radiation dose in diagnostic radiology modalities such as CT.  A congressional hearing on radiation dose control took place the day after we spoke, and the FDA will be holding a hearing on diagnostic radiology issues in late March.  Earlier last week, timed in part perhaps because of the upcomng congressional committee hearing, MITA kicked off the dose check initiative, a tool for manufacturers and providers to use in better regulating diagnostic imaging radiation dose, which Dave Fischer describes in our interview.  He also referred to the CMS demonstration project on appropriateness of imaging services now underway, authorized by MIPPA.   It now seems surprising that there ... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3318495 Sun, 28 Feb 2010 22:39:57 +0100 3318495 http://www.medworm.com/index.php?rid=3314705&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthBlawg%2F%7E3%2Frt9vLsiqvjw%2Fmpfs-in-crisis-holding-of-claims-for-services-paid-under-the-2010-medicare-physician-fee-schedule.html Days of Future Passed (or: deja vu all over again).  Late Friday, after business hours, CMS pushed the following announcement via its physician information listserv: The Centers for Medicare & Medicaid Services (CMS) is working with Congress, health care providers, and the beneficiary community to avoid disruption in the delivery of health care services and payment of claims for physicians, non-physician practitioners, and other providers of services paid under the Medicare physician fee schedule. As you are aware, the Department of Defense Appropriations Act of 2010 provided a zero percent (0%) update to the 2010 MPFS effective for dates of service January 1, 2010, through February 28, 2010.  We believe Congress is working to avoid the negative update that will take effec... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3314705 Sat, 27 Feb 2010 01:49:03 +0100 3314705 http://www.medworm.com/index.php?rid=3311641&cid=t_149015_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F02%2F25%2Fhealth-care-summit-half-time-report%2F Editor’s Note: This is the first of 2 posts from Tim Jost on the summit. Part 2 looks at budget deficit, Medicare, malpractice, and possible areas of agreement. The health care summit has now been underway for almost 3 hours.  President Obama established in his opening statement what he hoped would come of the summit, which was to reach agreement on areas of commonality in the need for health care reform.  The President, as well as a number of the Democratic speakers, has stressed these commonalities.  The message is, of course, we both have the same goals and our bill meets these goals, so what is the problem?  The Republicans are having none of it.  They showed up to reject the Democratic bill and present their own alternatives.  They came heavily armed with facts and figures... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3311641 Thu, 25 Feb 2010 19:26:14 +0100 3311641 http://www.medworm.com/index.php?rid=3298283&cid=t_149015_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F02%2F22%2Fthe-presidents-health-reform-proposal-other-provisions%2F Editor’s Note: Timothy Jost, the author of the post below, analyzed the insurance and revenue provisions of the President’s Proposal for Health Care Reform in an earlier post. Public debate concerning the pending congressional health reform legislation has largely focused on insurance reforms, which were discussed in my first post on the president’s latest reform proposal.  But the health insurance reform provisions make up only one title and one-fifth of the 2,400-page Senate bill on which the final reform will undoubtedly be based, if reform happens at all.  The remaining provisions of the legislation address a wide range of health reform issues—indeed, most of the topics that health reform must deal with to be comprehensive (and perhaps some that could better have b... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3298283 Mon, 22 Feb 2010 22:10:05 +0100 3298283 http://www.medworm.com/index.php?rid=3298284&cid=t_149015_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F02%2F22%2Fthe-presidents-health-reform-proposal-insurance-and-revenue-provisions%2F Editor’s Note: Timothy Jost analyzes the insurance and revenue provisions of the President’s Proposal for Health Care Reform in the post below. In a second post, Jost analyzes the other provisions of the proposal. On Monday, February 22, the White House posted the President’s Proposal for Health Care Reform.  Although the proposal was posted as “a prelude to the February 25 health care summit between Democrat and Republican congressional leadership and the president, it is not a mere ideas piece or discussion draft.  Rather, it is essentially the outline of a budget reconciliation bill that—in tandem with HR 3590, already enacted by the Senate—would complete the task of comprehensive health care reform when adopted by both Houses.  All of the provisions of the Pre... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3298284 Mon, 22 Feb 2010 20:06:13 +0100 3298284 http://www.medworm.com/index.php?rid=3275847&cid=t_149015_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2010%2F02%2F16%2Ffocus-on-georgias-mental-health-crisis%2F Former First Lady Rosalynn Carter will provide opening remarks for a discussion on the mental health crisis in Georgia tonight, Feb. 16, from 7-8:30 p.m. at The Carter Center. This Conversations at The Carter Center event is sold out but will be webcast live at www.cartercenter.org More than 130 patients have died under suspicious circumstances in Georgia’s public psychiatric hospitals over the past seven years, according to an exposé by the Atlanta Journal-Constitution. The Carter Center has been a leading voice for change in Georgia’s mental health system since this crisis came to light, and has worked to identify strategies to transform Georgia’s shame into a model for the nation. Carter Center Mental Health Program Director Dr. Thom Bornemann will moderate a panel of... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=3275847 Tue, 16 Feb 2010 12:57:11 +0100 3275847 http://www.medworm.com/index.php?rid=3311793&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Fhealthblawg.typepad.com%2Ffiles%2Fwayne-burton-cyndy-nayer-healthblawg-interview-part-ii-020510.mp3 Today we bring you Part II of my conversation with Wayne Burton and Cyndy Nayer of the Center for Health Innovation, where we get into some specific examples of successful programs.  The Center represents over 40 million lives, and brings together employers and providers to focus on a limited number of levers targeted at health and wellness - rather than health care.  The ROI of wellness efforts in the workplace is pegged at nearly 300% in a recent Health Affairs article by Karen Baicker et al. and accompanying Health Affairs blog post by Jaan Sidorov - one of my fellow "Health Wonks."  Clearly this is an area that demands our attention.  The audio file of Part II of my interview with Wayne Burton and Cyndy Nayer (about 20 minutes long) is available for download/podcast.  A full trans... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3311793 Wed, 10 Feb 2010 00:10:58 +0100 3311793 http://www.medworm.com/index.php?rid=3311794&cid=t_149015_114_f&fid=34648&url=http%3A%2F%2Fhealthblawg.typepad.com%2Ffiles%2Fwayne-burton-and-cyndy-naylor-healthblawg-interview-part-i-020510.mp3 I recently spoke with Wayne Burton, MD and Cyndy Nayer.  Cyndy is co-founder and President of the Center for Health Value Innovation; Wayne is a member of the Board of Strategic Advisors, and former longtime Corporate Medical Director of JP Morgan Chase.  The Center focuses on sharing evidence of improved health and economic outcomes through value-based designs.  In the current environment, this sort of private-sector focus on value-based health improvement and cost savings is critical.  Given the recent collapse of health reform inside the Beltway, now is the time for organizations such as the Center to prove themselves and their approaches, by demonstrating that they are able to "bend the cost curve" while improving health indicators, and ensure that efforts to do so yield a sign... HealthBlawg :: David Harlow's Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3311794 Tue, 09 Feb 2010 22:32:39 +0100 3311794 http://www.medworm.com/index.php?rid=3212297&cid=t_149015_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F01%2F27%2Ften-small-scale-reforms-for-pre-existing-chronic-conditions%2F Most proposals for dealing with the problems of pre-existing conditions would completely divorce health insurance premiums from expected health care costs. Yet a policy of trying to force health plans to take enrollees they do not want risks jeopardizing the quality of care they receive. Instead of suppressing the price system, I propose ten ways of dealing with this problem that make greater use of it. In a reformed health care system, the chronically ill along with their doctors, their employers and their insurers should all find lower-cost, higher-quality, more-accessible care in their economic self-interest. 1. Encourage Portable Insurance. In almost every state, employers are not allowed to buy the kind of insurance employees most want and need: Insurance they own and can take with th... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3212297 Wed, 27 Jan 2010 13:59:16 +0100 3212297 http://www.medworm.com/index.php?rid=3189115&cid=t_149015_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F01%2F19%2Fwhy-wellness-incentives-belong-in-the-workplace%2F The health care reform debate has stirred up strong sentiments on both sides of an important issue that, on its face, doesn’t seem all that complicated: Should employers that offer wellness and prevention programs offer employees monetary rewards for their participation? Should the rewards be linked to attainment of wellness goals? The Agency for Healthcare Research and Quality tells us leading employers, state Medicaid agencies and health plans recognize the potential power of financial incentives in attaining quality goals. Others are not so sure. Writing in a recent issue of the New England Journal of Medicine, Harald Schmidt and colleagues distinguish between incentives that reward “participation” versus those for “attainment.” They argue the latter might be fundamentally unf... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3189115 Wed, 20 Jan 2010 04:54:18 +0100 3189115 http://www.medworm.com/index.php?rid=3178751&cid=t_149015_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F01%2F16%2Frequiring-employers-to-contribute-to-health-coverage-for-workers%2F Almost three out of five Americans under age 65 have employment-based health insurance – but with costs rising, this coverage is under serious pressure. Congress is now finalizing plans to require more employers to contribute to coverage for their workers. The latest Health Policy Brief from Health Affairs and the Robert Wood Johnson Foundation (RWJF) examines this issue, known as the employer mandate, and explains how proposed legislation would expand job-based health insurance. Some of the issues the brief discusses: Why major employers as diverse as Walmart and the AFL-CIO have endorsed a proposed employer mandate – and why an equally diverse range of organizations have opposed it. The history of employer mandates and “pay or play” proposals. The differences bet... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3178751 Sat, 16 Jan 2010 05:58:22 +0100 3178751 http://www.medworm.com/index.php?rid=3175843&cid=t_149015_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F01%2F14%2Fnew-policy-brief-examines-individual-mandate%2F As negotiations continue to reconcile the differences between the Senate and House versions of the health reform legislation, one thing is clear: most Americans would be required to obtain health insurance and penalties would be imposed on those who failed to do so.  This provision is known as “individual responsibility” or an “individual mandate.”  An updated Health Policy Brief from Health Affairs and the Robert Wood Johnson Foundation examines the individual mandate issue.  It updates the policy brief issued by Health Affairs on September 29, 2009. Highlights include: Ways in which legal residents could comply with the provision – for example, by obtaining  coverage through an insurance exchange or, if they qualified, through a government program such... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3175843 Thu, 14 Jan 2010 19:37:02 +0100 3175843 http://www.medworm.com/index.php?rid=3171866&cid=t_149015_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F01%2F13%2Fabortion-coverage-and-health-reform-bringing-evidence-to-bear%2F Discussion:  As stated above, the median cost of first-trimester abortion care ($430) is almost twice the typical out-of-pocket health care expenses paid by young, uninsured individuals, and the median cost of second-trimester abortions ($1,260) is about four times typical out-of-pocket expenses. The cost of a first-trimester abortion represents 4 percent of income for uninsured females ages 25-34. Females and individuals who have difficulties obtaining needed health care have relatively higher out-of-pocket expenses and thus will be more affected by a lack of abortion coverage. This is particularly true for women who need second-trimester abortion because of health risks or fetal impairments or who are already paying a large portion of their income on health care. Furthermore, unins... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3171866 Wed, 13 Jan 2010 17:59:36 +0100 3171866 http://www.medworm.com/index.php?rid=3167083&cid=t_149015_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F01%2F12%2Fthe-mammograpy-guidelines-and-evidence-based-medicine%2F As someone who has spent the last several years promoting the development of a comparativeness effectiveness center that would encourage the production of more objective information about what works medically, for whom, and under what circumstances, it is hard not to feel discouraged by the reaction to the breast cancer screening guidelines recently announced by the U.S. Preventive Services Task Force.  To be sure, there are a variety of lessons that should be learned from this experience about how to present to the public information that goes against current “conventional wisdom, ” how to explain why current recommendations may differ from past recommendations or current practice, how to reach out to the media, and how to handle issues of  timing, task force composition and so fort... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3167083 Tue, 12 Jan 2010 18:45:29 +0100 3167083