Today’s article about HHS cybersecurity planning, published in Becker’s Hospital Review, reports on a yet another policy failure courtesy of the bloated bureaucracy in DC. The federal government is so big that it doesn’t know what departments it has or how it’s spent our money.
In April 2017 HHS announced the planned formation of a Healthcare Cybersecurity and Communications Integration Center (HCCIC). 14 months later, you’d expect that the HCCIC would be off an running, especially given the massive patient data breeches and ransomware attacks that have become all too common. Wrong. Instead massive confusion surrounds the status on the HCCIC. Congress is looking for answers and HHS seems to have few answers.
One telling quote from Becker’s:
Stakeholders have informed our staffs that they no longer understand whether the HCCIC still exists, who is running it or what capabilities and responsibilities it has,” the lawmakers wrote, noting HHS has provided only vague responses to requests for clarification on these issues.
Dr. Walter Wood writes:
I board certified prior to 1991 and have “lifetime” certification equivalent to an academic degree. I can attest that my younger colleagues and their patients are being harmed by costly and time consuming “requirements” to participate in “re-certification” and “maintenance” of certification, soon to be renamed “Continuing Board Certification,” which is not needed and not only does not help patients but harms them. Patients in need are harmed when a doctor is not taking care of patients because the doctor is busy preparing for or repeatedly jumping through hoops such as what lawyers experience once in a lifetime with their bar exam. I was somewhat stunned that an anti-trust judge thought it was necessary to demonstrate “harm to consumers” as a result of the egregious behavior of the ABMS and its colluding member boards. That judge needs to be asked whether s/he repeats the bar exam every ten years.
Walter Wood, MD, FAAD
P.S. I have posted these comments at certificationharm.org.
The Direct Primary Care Alliance launched on January 1, 2018 as a physician-led organization exclusively focused on growing the Direct Primary Care (DPC) movement. The Alliance was born from a grassroots network of practicing DPC physicians looking to provide a unified voice and resources for fellow DPC physicians. The motivations for launching the Alliance can be found in remarks from our inaugural president, W. Ryan Neuhofel, DO, MPH:
We now realize the transformative potential of the DPC model and are at the advent of moving beyond novelty. But, many hurdles exist for us to achieve that vision. The challenges ahead of us are immense. Yet I can think of no better group of people to overcome these odds.
Haseeb Ahmed, MD | Staci Benson, DO | Kissi Blackwell, MD | Michael Ciampi, MD | Wendy Cohen, MD| William Crouch, MD | Jeffrey Davenport, MD | Lisa Davidson, DO | Jessica Davis, MD | Marguerite Duane, MD, MHA | Allison Edwards, MD | Phil Eskew, DO | Douglas Farrago, MD | Jack Forbush, DO | Michael Garrett, MD | Jeffrey Gold, MD | Bridget Gruender, MD | Julie Gunther, MD | Jennifer Harader, MD | Ricky Haug, MD | Delicia Haynes, MD | Jonathon Izbicki, DO | Eric Kropp, MD | Rob Lamberts, MD | Brian Lanier, MD | Vance Lassey, MD | Kimberly Legg-Corba, DO | Peter Lehmann, MD | Gordon Luan, MD | Carmela Mancini, DO, MPH | Matthew McCarthy, DO | Maura McLaughlin, MD | Kimberly Nalda, MD | Robert Nelson, MD | Ryan Neuhofel, DO, MPH | James Pickney , MD | Shane Purcell, MD | Rob Rosborough, MD | Molly Rutherford, MD, MPH | Emilie Scott, MD | Paul Thomas , MD | Nicholas Tomsen, MD | Josh Umbehr, MD| Luke Van Kirk, DO | Kylie Vannaman, MD | Amy Walsh, MD | Thomas White, MD
From our friends at D4PC:
The Trump administration, encouraged by Senator Rand Paul, circumvented Congress with Executive Order 13813 to create rules through the Department of Labor that allow approximately 44 million Americans to create and/or join Association Health Plans (AHP).
These AHP are exempt from many of the ObamaCare mandates that have been cost drivers for the insurance policies offered to self-employed and small businesses that often doubled rates.
“The proposed rule is designed to make it easier for groups of individuals and small businesses to band together and buy the kind of insurance that large companies offer their workers. That kind of insurance is regulated under federal labor law and isn’t subject to all the requirements and consumer protections that apply to individual and small business insurance under ObamaCare.” -NYtimes.com
The sweeping new rules have been published for public comment for 60 days before they are implemented with the force of law.
Click here to read more.
Others’ eyes are finally opening to what physicians have been seeing for years: EHR billing and compliance IT only adds to healthcare costs not quality, economy or patient satisfaction.
In 2016 Forbes reported that “U.S physician costs to keep up [with HIT] have reached more than $32,000 per doctor annually.”
IP4PI founder, Craig M. Wax, D.O., has been writing and speaking on this for the better part of this decade. Here are just a few of his talks about EHR’s attack on patient care:
EHR privacy and security: mission impossible (patient town hall version 2012)
EHR privacy and security: mission impossible (physician version 2012)
EHR the Trojan horse (2014)
EHR remote control (2014)
DPC physicians and patients take note!
An aspect of Alexander-Murray will exacerbate an under-appreciated flaw in ACA requirements for plans considered “catastrophic plans.”
Alexander-Murray will allow anyone to have a “catastrophic plan” as such plan is defined by ACA. ACA limits enrollment in these plans to enrollees under 30 years of age or enrollees who have a waiver. Alexander-Murray would do away with these limitations. So far so good.
Another ACA limitation on these plans — found in ACA section 1302(e) — is that the plans will provide no benefits until the enrollee’s annual out of pocket limit has been reached, except that the plan must cover “at least 3 primary care visits.”
This will harmful to patients of DPC practices and is bad policy. It essentially forces primary care to be handled in-network — great for the insurance companies but not for the patients orthe doctors.
Ideally the requirement should be struck from ACA. Alternately, a small change along the lines of this or something similar [in brackets] might help fix this problem:
(B)the plan provides—
(ii)coverage for at least three primary care visits, [unless the enrollee is separately contracted with a direct primary care physician, in which case the plan will refund to the enrollee an amount equal to the value of such coverage.]
CMS ACA MACRA MIPS and APMs discriminate against independent solo and small primary care practices, while unfairly advantaging hospital health systems who employ doctors. Please exempt solo and small physician practices of 9 or fewer doctors or less than 999 Medicare patients. CMS ACA MACRA MIPS and APMs will put small independent practices out of business and will deprive patients of their physician, jeopardizing their health.
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