Has your Diovan or Valsartan been recalled by the FDA? Don’t Panic.

Buy generic medications directly from the pharmacy or DPC physician with the best price and service.  Is your “coverage” or chain pharmacy getting in the way of making this urgent change? Then change insurance companies, ditch the PBMs -pharmacy benefit managers, and find an independent pharmacy or DPC physician.

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Making American Medicine Great Again in 10 Simple Steps #MAGA

1. Price transparency for all healthcare services and supplies.
2. Site neutral payments (no hospital advantages).
3. Legislation to open and eliminate closed insurance networks. Networks are the third parties strangle-hold noose on healthcare.
4. Care must not be limited by insurance red-tape “referrals,” pre-certifications of imaging tests, and prior authorizations of medicines.
5. Reconsider tax exempt status of hospitals. They should have no advantage over physician offices or other services.
6. Patients should shop for all non emergent healthcare services and supplies and keep their savings.
7. Repeal 1987 GPO PBM anti-kickback safe harbor. Enable freemarket competition.
8. Define DPC as healthcare service contract between patient and facility or physician, not insurance. Keep DPC simple, direct, third party and government free, and patient empowered.
9. HSA expanded for DPC and OTC meds.
10. Legislation to permit physicians to see charity patients in return for either tax deduction or  malpractice insurance.
Two supplementary short editorials:
To solve U.S. healthcare crisis, think small, not big
The American hospital: from volunteer charity to tax-exempt patronage pit

Less is More: take the deductions for MACRA non-compliance

Friend of IP4PI, Jane Hughes, MD writes in:

Greetings,

Read this BS sent to us by our “professional” organization whose mission is to preserve the profession, etc etc. For the love of God I cannot understand why any physician can’t see by now that this is a fool’s errand and meant to be. Our clarion call should be to all doctors: Take the deductions for non-compliance because: you will save in essence $40,000/yr in compliance costs that would take $430,000 in Medicare payments at the 9% top reward to equal your $40,000 reimbursement before you see a penny in increased payments. More importantly, you can proudly state that you are saving the government (taxpayers) money at the same time. And the best, wait for it- it would go away because no one would be doing it.

This is not to say I have given up on reform. But, to change Medicare we have to straighten out the private sector, and then, with insolvency looming, we can give Medicare ppl a choice- defined monthly contribution (i.e. check like Social Security) or continued traditional Medicare, which would also be a fast disappearing institution with the current costs to “beneficiaries.” Gee, HSAs with no networks, Medicare as catastrophic, and cash pricing versus what we have now… pipe dream worth fighting for. As you can see I almost came off the rails reading this stuff.

Warm regards,
Jane

Forget Pens, How About Banning Kickbacks?

Back in 2008 the Pharmaceutical industry ostensibly took the high road and called for a moratorium on branded items handed out to doctors. No more free pens. Then in 2010 the Physician Payment Sunshine Act cemented in place red tape impeding other gifts to physicians. No more free lunches … with out filling out a form for Uncle Sam.

Well the truth is: “We’ve got big problems in health care, and I don’t think the problem is pens,” stated Houston physician Stephen Lapin, MD, speaking what was on the mind of virtually, if not literally, every physician.

These changes didn’t accomplish much if anything but a few warm fuzzy feelings for politicians, while the folks in C-Suites likely congratulated each other with a slap on the back for yet again shifting the blame onto doctors and covering up their own corruption.

This time doctors are fighting back and asking for real change, change with the potential to save patients to the tune of $100 billion dollars. How? By axing out the Pharmaceutical industry kickbacks being used to bribe the middlemen in control of American’s pharmaceutical benefits.

Your action is needed by July 16 to help end these improper bribes that are driving up costs, creating shortages, and controlling the prescriptions covered by your plan.

Speaking out is easy and instructions can be found here: https://aapsonline.org/alert-and-special-legislative-update-pharmacy-benefits-managers/.

 

AT RISK: Bill to Let Patients Use HSAs for DPC

Earlier this week we heard the good news that H.R. 365 was finally going to be considered by the House Committee on Ways and Means, bringing the use of Health Savings Accounts (HSAs) for Direct Patient Care (DPC) one step closer to reality.

Then we learned “a few small changes” had been made to the bill. Unfortunately the “few small changes” have greatly damaged the legislation.

You can read a copy of the latest bill here: https://goo.gl/B6imgQ.

Under the new language, DPC practices would have to comply with several federal requirements in order to become HSA-eligible. One provision limits the care provided under the agreement to specific CPT codes.  Another would prohibit DPC arrangements priced over a certain threshold from being HSA-eligible. Others further limit how the pricing can be structured and what care can and cannot be included. Specialists would be blocked from offering innovative HSA-eligible monthly membership payment arrangements.

To us, these changes are unacceptable and might be worse than no bill at all. If the bill passes in this form it would put practices that don’t comply with the federal rules at a competitive disadvantage to practices that align their model to satisfy DC instead of their patients.

One more problem:  these changes were tucked in at the last second barely a day ahead of Wednesday’s mark up session of the Bill in House Ways and Means.  That’s right, the new bill is headed to be pushed through committee with little chance for public input.

Today, AAPS sent a letter to every Ways and Means Committee member, and the committee staff, expressing our concerns about this bill and a few other bills the committee will consider on Wednesday, July 11.  Overall, we like a number of the bills under review, because they do expand HSA flexibility. But there are several key problems that tilt the playing field to the advantage of corporate medicine. Read more in our letter here: https://goo.gl/XYutr5.

What can you do?  Please send the committee a message ASAP before Wednesday at 2pm Eastern.  Here are the steps:

1) Copy the following text:

Dear Chairman Brady, Ranking Member Neal, and Members of the House Committee on Ways and Means,

Tomorrow you will be considering replacement language to H.R. 365, the Primary Care Enhancement Act. The addition of improper requirements means the new bill will not accomplish the goal of allowing patients to use their Health Savings Accounts to see the Direct Patient Care physicians of their choice.  I encourage the committee to consider adopting H.R. 365 as written, while rejecting the recent changes. In addition I encourage you to please consider AAPS recommendations about this bill and others you are considering today. The AAPS letter to the committee is available at https://goo.gl/XYutr5.

2) Visit https://waysandmeans.house.gov/contact/ and paste the comment in to the appropriate field and modify as desired.

2a) You can also fax your comment to the committee: (202) 225-2610

3) If your representative is on the Ways and Means Committee, email the note to the Health Legislative Assistant for your Member of Congress. A list of committee members and their health staff contact information, sorted by state, is available here: https://goo.gl/8iqw3u.

Thank you for speaking out!

Permission Denied

Friend of IP4PI Gene Uzawa Dorio, M.D. writes in:

I received a phone call from a hospital case manager that my patient did not meet criteria for further admission and should be discharged. Unfortunately, the patient was just removed from a breathing machine, and was still in the ICU for sepsis.

There are several criteria used by hospitals guiding whether a patient should be admitted or discharged. Who establishes these criteria? Hospitals of course, with evidence-based bias to divert money into their pockets.

This conspiracy by business people has been detrimental to the quality of healthcare the American people receive when hospitalization is required.

With almost 40 years of practice and experience, I remain up to date on how to provide scientific evidence-based care to patients. Unfortunately, I now have to ask permission for a patient to be admitted, have certain testing and procedures, and remain in the hospital setting.

Asking for permission from those in authority who ultimately benefit from denial is not only intuitively wrong, but crosses the boundary of moral and ethical sense.

It also violates the Hippocratic Oath I have taken, and reminds me they have only taken an oath to benefit themselves.

Comments: http://scvphysicianreport.com/2018/07/01/doctors-diary-july-1-2018-permission-denied/ Hit “Home” for past snippets.