A Tool for Patients to Bypass MACRA Rationing and Privacy Intrusion?

Could the below HHS regulation be a potential tool to help patients do an end run around MACRA privacy intrusions and rationing guidelinesMedicare patients CAN refuse to authorize the filing of a Medicare claim and pay cash as outlined below.
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In 2013 HHS updated HIPAA regulations giving cash-paying patients greater ability to restrict the disclosure of health information.  Here’s what the final rule states about Medicarepatients’ ability to assert this right:

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MACRA violates sound economic principles.

Holly Fritch, MD points out:

MACRA violates sound economic principles. It is a false premise (repeatedly stated) that MACRA decreases healthcare costs. Nobel prize winner Coase’s Transaction Cost Theorem states that transaction costs of time, money, and effort, which increase the effort to provide care, result in higher monetary costs.

Get you comments in opposition to MACRA in TODAY!  Deadline: June 27 11:59pm Eastern. Comment at: http://bit.ly/macracomment

Just as we warned in 2009, the news is not good: Beware ObamaCare II, aka MACRA.

Jane Hughes, MD writes in:

After wasting billion of dollars on failed ObamaCare exchanges and forcing many Americans off their insurance plans, Washington directed it’s attention to fixing Medicare. Unfortunately, the same people who orchestrated ObamaCare authored the MACRA Law, referred to as the “Doc Fix”.

Nine hundred and sixty-two pages of CMS rules were just released, and groups of physicians from across the country have now had a chance to see what’s in it. Just as we warned in 2009, the news is not good. It shifts money for patient care to data mining patient records, destroying privacy and dignity of patients, forcing doctors through payment manipulations to violate their Hippocratic Oath, and paves the way to a bureaucrat rather than your physician deciding your healthcare options. Of course all this is sold as cost control and quality enhancement. If only. MACRA implementation would be astronomically expensive, ever changing and convoluted, and would destroy individual and small group practices as we watch it implode after billions more wasted healthcare dollars.

There’s still time to stop it.

Register your protest. Visit https://www.regulations.gov/#!docketDetail;D=CMS-2016-0060 and scroll down to “Comment Now” button.

Let your Representative and Senator know MACRA must be stopped. Sometimes it’s better to cut your losses.

Taming the MACRA Beast of Quantitated Madness

Guest Post from Barbara Duck: http://ducknetweb.blogspot.com/

The Rise of the Quants, Again! This Time In US Healthcare- Taming the MACRA Beast of Quantitated Madness For A Lot of Things That Are Probably Just Not True

I’ve been watching this for years with the way healthcare is changing in the US today and we certainly need and do use constructive and good measurements in what the industry does, but just like in the financial world, we’re starting to cross some borders here into madness where mathematical models with “no” proof of concept even are producing numbers that don’t compute and host environments that are hostile to the future of providing good care.  In other words, it’s time to take to take a step back and look at where we are and it’s not pretty nor productive in a lot of business areas today. Continue reading

MACRA is what you get when United Healthcare runs CMS

Barbara Duck, @MedicalQuack writes in:

This is what happens when you have a Quant, formerly a Quant/CEO from United Healthcare running CMS. Slavitt had not changed his spots at all and over the years United has been mentoring CMS and HHS on their models anyway, where he was in fact involved.

I’ve beat my brains out trying to bring this awareness around for years with math modeling and evil algorithms being the vehicles that drive this. Again, I can’t wait until he’s out of that office as I do well trolling him on TwitterJ That’s for real too as having my former background as an EMR programmer, I can dive right in there. The relationship with HHS and United Healthcare is so scary and has been for years and it all developed right in plane site as nobody seemed to want to even blink an eye.

So how many MDs will be driven out of private practice now and end up working at one of the over 300 MedExpress (United Healthcare owned) urgent care centers? I don’t want to see that of course, but mention it as a “part of the plan” with CMS and HHS restructuring.

This is like the Ingenix Phoenix bird resurrecting from the ashes if you will, as it’s the same math modeling that Slavitt learned at both Goldman and McKinsey corporation as that’s what they do there and look how many McKinsey consultants have gone to jail or gotten in trouble with the law, Valeant CEO is the most recent that comes to mind.

New Medicare MACRA/MIPS Penalty Hits Solo & Small Groups Hardest – Open Letter to AOA and AMA

Dear AOA and AMA leadership,
Has anyone at AOA and AMA that enthusiastically supported MACRA actually taken the time to read it this week(links below)? It is a statisticians nightmare. When applied to the practice of medicine, it is a plague. It is more onerous than meaningful use and the sustainable growth rate that it replaces. Not only does it penalize solo and small practice physicians, but controls the practice of medicine through reimbursement and procedure micromanagement based on government MIPS data. 
We practicing physicians knew this when the AOA and AMA were busy jumping on the government bandwagon for change at any price. We are out of the frying pan and into the fire, ladies and gentlemen.
What will the AOA and AMA do to champion the cause of solo and small practice private medicine in the face of ACA, ACO and MACRA disaster? Try DPC-Direct primary care unhindered by government and third parties.
Everyone at AOA and AMA should attempt to read it as we concerned physicians are this week.
Commentary:
Whole MACRA here:
Best wishes for good health,

Craig M. Wax, DO
Family Physician
Host of Your Health Matters
Rowan Radio 89.7 WGLS FM
Twitter @drcraigwax

Physicians must take back control over definition of quality in medicine

Guest Post by Cynthia Marcotte Stamer, Esq.

Balanced billing is an important element, but only works if physicians recapture control over the quality question.   That’s why in addition to anything else physicians do, physicians must work to take back control over the right to define quality in medicine by controlling or beating back payer driven, cost motivated PQRS and other quality rankings that demonize physicians for practicing better medicine than what payers want to pay for both by demanding meaningful input to the design and quality standards and processes, pushing for reform that prevents payers and the government from misaligning and punishing physicians that put patients first, and other actions that ensure that patients put their confidence and control of care in the hands of physicians not payers or the government.   CMS recently extended the comment deadline on the 2016 PRQS Quality Measure Plan to March 1.  See CMS Seeks Public Comments on Draft Quality Measure Development Plan (MDP) by March 1, 2016 (1-29-2016). See here.  I urge everyone to review and submit meaningful comments on these proposed quality measures as whether or not you use to participate, they will be used to rate you. Continue reading