Winter 2014 Newsletter

Winter 2014
Inside This Issue
ObamaCare Update
ObamaCare UpdateIn the March 8-9, 2014 weekend section of the Wall Street Journal, there was a very interesting article entitled, “The Making of ObamaCare.” It was particularly interesting because it was penned by Dr. Ezekiel Emanuel, Rahm Emanuel’s brother, who also happens to be a physician and special advisor to our President on health policy. The article concentrates on three major policy points that relate to ObamaCare which merit our consideration, and we will discuss each, as follows: firstly, the change of policy as to how doctor’s bill insurance companies for services rendered to their insured patients.

Currently, the vast majority of doctors charge individual fees for services rendered. The new approach would be for doctors to bundle payments rather than charge for individual fees for services. This means that a doctor would bill for a medical “episode of care” rather than for each individual service rendered. There appears to be concern that doctors-and hospitals-bill for procedures unnecessarily just to make money, a practice I have not seen with any of my doctors, personally. With hospitals, it is impossible for me, or any consumer, to tell. Hospital bills, when the patient receives them at all, are indecipherable to the layman.

So there is a push to change this. The White House is excited about this change because policy makers believe the change will control costs, and, hopefully, will improve patient care. It is undisputed that any efforts to avoid or discourage fraud are preferable and prudent. While it was not adopted across the board, ten test projects have been implemented to see how this new approach works.

Secondly, The President, along with the support of the American Medical Association, has begun consideration of major medical malpractice reform at the federal level. This will be challenging because, ordinarily, the area of medical malpractice is controlled by local governments, but an attempt to reign in the current climate of the institution of massive malpractice claims is a positive thing. Finally, in 2018, a “Cadillac Tax” will be levied on the purchasers of expensive medical insurance plans as a source of revenue to cover the costs of ObamaCare. All of the foregoing is extremely interesting, and we will be tracking progress for our readers.

In a related area, the impact of ObamaCare on Medicaid in New York has proven to be remarkably positive. Twenty-five percent of New York City residents already receive Medicaid benefits of one sort or another. There is an effort to combine Medicaid and the ObamaCare-New York Exchanges under the umbrella of the New York State Department of Health, where Medicaid already resides. It is envisioned that the consolidation will enable the New York Exchange’s counselors to assist applicants and provide appropriate services in a more comprehensive, straight forward and simple manner, with the bonus of excellent consumer outreach. This places New York in the unique position of already being in the foreground of medical insurance reform!

We are still greatly concerned about the lack of protection to an applicant’s personal information when he or she is shopping for medical insurance in New York, or anywhere else, for that matter. We hope that New York State secures the website soon, so that applicants can take advantage of what appears to be some excellent options without fear of identity theft. We will keep you posted as to any developments in that regard.

The above list is for general information purposes only. It is not intended to constitute individual legal advice or a specific recommendation to any particular client.


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