Independent physicians plan to battle #coronavirus #COVID19, tackle Homeland security and ensure patient freedom and choice

By Craig M. Wax DO

CORONA VIRUS COVID19 – INDEPENDENT & EMPLOYED PHYSICIANS NEED:

Click here for printable PDF you can send to your Members of Congress.

Independent testing sites and protocols with universal precautions

Guidelines for Medicare and insurance companies to pay for telemedicine (Audio and Video) to screen patients from their homes (Full fee schedule)

1. Temporary regs x 6 months and return to in-person standard of care

  • Eliminate insurance red tape: prior authorizations (Rx) and precertification (procedures)
  • Eliminate insurance networks to allow all physician to aid all patients
  • Support for independent physician practices to remain viable
  • Running a highly regulated business with employed staff in an epidemic
  • Regulatory, legal, contractual, taxes, overhead, need to pay staff despite changing model from in person medicine to audio and video telemedicine
  • Safety for physicians and staff to continue to provide medical care
  • Issue all physicians all protective gear if they are to see patients in their offices
  • Physician direct Rx dispense (only legal in certain states, not NJ, NY,MA, TX…)
  • Eliminating mandatory eRX as it limits physician and patient options.
  • Suspend federal law to allow Medicaid non-par physician to Rx and order tests
  • Suspend MACRA MIPS and all “quality measures”
  • Suspend or eliminate MOC (maintenance of certification) and OCC (Osteopathic Certification) mandates imposed by hospital and insurance companies (currently blocks patient access)
  • Any available physician who completed MD and DO school and two steps of USMLE or NBOME should be eligible to practice.  There’s a population of trained physicians who can’t secure a residency slot due to inadequate number of US slots (Missouri state model). They have more training and experience than NPs and PAs.

HOMELAND SECURITY AND CORONAVIRUS COVID 19

  1. Chinese Government Endangered the World1
  2. COVID 19 cases began November but covered up through end of December
  3. China Rx – China is contractor and subcontractor for most pharmaceuticals,2,3,4

World pharmaceutical, protective equipment and technology supply chain compromised.

             D.  Critical Rx and Supply Shortages 2

              F.  COVID19 potential treatments:  Chloroquine and hydrocycholoquine (Plaquenil)5

                        1. generic and inexpensive

                        2. not FDA approved for COVID19 virus treatment

                        3. no complete controlled studies, beginning use abroad and domestic

                        4. Dosage and indications unclear to get benefit and avoid toxicity

CORONA VIRUS – COVID 19

1https://foreignpolicy.com/2020/02/15/coronavirus-xi-jinping-chinas-incompetence-endangered-the-world/
2,https://thehill.com/policy/healthcare/484276-coronavirus-outbreak-could-cause-shortages-of-150-drugs-report

3China Rx, Gibson, Rosemary

5 https://www.moaa.org/Content/Publications-and-Media/News-Articles/2019-News-Articles/Made-in-China–How-U-S–Dependence-on-Chinese-Medicines-and-Components-Could-Pose-a-Security-Threat

5https://wattsupwiththat.com/2020/03/17/an-effective-treatment-for-coronavirus-covid-19-has-been-found-in-a-common-anti-malarial-drug/

How to Increase Access to Medical Care and Lower the Cost

Through Competition and Choice

A.   Unleash the Power of the Free Market in the Healthcare Sector

  • Expand patients’ freedom and choice in the use of health savings account dollars, especially as payment for direct primary care and other models of coverage, such as periodic-fee, membership subscription services.[1] [2]
  • Codify the use of Association Health Plans (AHPs) and Short-Term Limited Duration Insurance (STLDI) as affordable, portable alternatives to current models of coverage.[3]
  • Allow Medicaid patients to use provided monies as a voucher to purchase periodic fee services.
  • Repeal the “Safe Harbor” protections of 42 U.S.C. 1320a-7b(b)(3)(C) for kickbacks to PBMs and GPOs. [4]
  • Repeal the ACA’s prohibition of physician-owned hospitals.[5]
  • Solve “surprise billing” via the arbitration model already working in New York and Texas. Benchmark rate-setting is tantamount to price controls, an anti-free market mechanism with an abysmal track record.

B.   Repeal Onerous, Unnecessary Mandates

  • Remove Electronic Health Record (EHR) and Merit-Based Incentive Payment System (MIPS) mandates for practices having fewer than 50 physicians.
  • Streamline and reform the prior-authorization requirement in Medicare Advantage and other third-party markets.[6]

C.    Mandate Transparency 

  • Codify the measures in the Administration’s two executive orders on transparency.[7] [8]
  • Direct a study by the GAO of the accounting of PBMs ( already a bill), and eventually the GPOs.[9]
  • Mandate transparency regarding the training of all levels of medical practitioner.[10]
  • Make fully transparent the funding that flows FROM pharmacy “channel companies” (such as PBMs, GPOs, and distributors) TO advocacy groups, physicians, and think tanks. This transparency should be retroactive, so as to establish histories of possible conflicts of interest, as called for on page 33 of the white paper referenced in footnote 4.

Bridge to better healthcare:

Reducing Cost and Waste in American Medicine: A physician-led roadmap

IDEAL HEALTHCARE – Freemarket competition to improve quality, decrease price and provide choice for patients

CBO report shows full Obamacare repeal is better than partial, The Hill

https://thehill.com/blogs/pundits-blog/healthcare/317269-obamacare-cbo-report-shows-full-repeal-is-better-than-partial

We should replace Obamacare with a universal tax credit – Forbes, John Goodman

https://www.forbes.com/sites/johngoodman/2015/04/01/why-we-should-replace-obamacare-with-a-universal-health-tax-credit/#735c226529b5

IP4PI Principles for Individual Choice in Healthcare – Independent Physicians for Patient Independence

https://ip4pi.wordpress.com/2017/01/08/mr-trump-here-are-14-solutions-for-ultimate-citizen-consumer-healthcare-choice/


[1] Rep. Roy’s bill: https://www.congress.gov/bill/116th-congress/house-bill/5596?s=1&r=1

[2] Sen. Cruz’s bill: https://www.congress.gov/bill/116th-congress/senate-bill/3112?s=1&r=5

[3] https://www.whitehouse.gov/presidential-actions/presidential-executive-order-promoting-healthcare-choice-competition-across-united-states/

[4] See Appendix B in the white paper: Reducing Cost and Waste: A Physician-Led Roadmap to Patient-Centered Medical Care for a legislative proposal yet to be introduced.

[5] Sen. Lankford’s bill: “Patient Access to Higher Quality Health Care Act of 2019

[6] Rep. DelBene’s bill: https://www.congress.gov/bill/116th-congress/house-bill/3107

[7] https://www.whitehouse.gov/presidential-actions/executive-order-improving-price-quality-transparency-american-healthcare-put-patients-first/

[8] https://www.hhs.gov/about/news/2019/11/15/trump-administration-announces-historic-price-transparency-and-lower-healthcare-costs-for-all-americans.html

[9] Rep. Marshall’s bill: https://www.congress.gov/bill/116th-congress/house-bill/3223?q=%7B%22search%22%3A%5B%22hr3223%22%5D%7D&s=1&r=1

[10] Rep. Bucshon’s bill https://www.congress.gov/bill/115th-congress/house-bill/3928/all-info

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