FYI - New Health Care Bill

[Guest guest]

The addition to existing law of five words, and a comma, may cause a world

of hurt to state governments.

Tucked away on page 466 of President Obama’s 2,704-page health-care

bill<http://democrats.senate.gov/reform/patient-protection-affordable-care-act.p\

df>is

a provision that changes the definition of “medical assistance,” the

term

describing what states are required to provide to Medicaid recipients.

States have in the past been required to provide payment for services to

physicians. Now, under the new definition, states will be liable for

ensuring provision of “the care and services themselves.”

In other words, states are legally on the hook not only to ensure that

Medicaid recipients are paid for, but that they’re seen by a doctor.

Medicaid recipients have found it increasingly difficult to be seen by

doctors, as states in extreme economic duress have cut payment rates.

The new law seeks to solve the problem, but may cost states even more money

at a time when most are in some of the worst economic

straits<http://dailycaller.com/2010/04/01/new-yorks-9-billion-deficit-no-april-f\

ools-joke-but-rather-a-harbinger-of-other-states-budget-shortfalls/>since

the Great Depression.

“With the expanded definition, it leaves every state vulnerable to a new

wave of lawsuits any time someone cannot access a service, even if that

service is limited by virtue of the rates we pay,” said Alan Levine,

Louisiana’s secretary of health and hospitals, in a recent memo prepared for

fellow state government officials.

Levine wrote: “DHH cannot estimate the cost of this, but it is not even

worth estimating. It will be substantial.”

Ann Kohler, director of health policy at the nonpartisan American Public

Human Services Association, said she was aware of the concern and was

“looking at the legislative language,” but had not yet reached a

determination.

“I have my lawyers looking at it right now,” she said.

Republicans on the House Energy and Commerce Committee said they agreed that

the provision could open the floodgates to lawsuits.

“Section 2304 changes the definition of Medical Assistance, and potentially,

wipes clean years of court precedent that has kept states from losing very

expensive lawsuits,” a GOP staffer said. “The states and the Medicaid

directors are very worried about this provision.”

A spokeswoman for House Energy and Commerce Committee Chairman Henry Waxman,

California Democrat, did not respond to a request for comment on the

provision.

Victor Schwartz, a tort law expert at Shook, Hardy and Bacon in D.C., said

that Waxman sees trial lawyers as positive agents of change.

“He sees tort law as a regulatory engine that’s needed just beyond

legislation. He sees trial lawyers as heroic who are there to help the

ordinary people,” Schwartz said.

“That may have been true 30 years ago when Mr. Waxman was a lawyer, but now

it’s big business as much as Exxon,” Schwartz said. “The hero with a

slingshot isn’t around too much any more.”

Not all state Medicaid directors said they were concerned about the change

to the law.

“There’s been some chatter on this issue among state Medicaid directors.

Some say the sky is falling, others say it makes little difference, still

others say they are unaware of the ‘change,’” said Doug Porter, an assistant

secretary of social and health services in Washington state.

“I’m in the ‘makes little difference’ camp,” Porter said by e-mail. “We here

in the 9th Circuit are used to getting sued.”

Other states said they were still trying to determine the impact of the

change.

Read more:

http://dailycaller.com/2010/04/02/states-fear-that-five-words-in-obama-health-la\

w-will-open-door-to-lawsuits/#ixzz0jwNHOJhO

--

Ortiz, MS, RD

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