Abortion Laws on Trial

Recently, Alabama’s governor signed into law the country’s most restrictive anti-abortion bill, which could put doctors who perform abortions with life in prison. The Republican governor, Kay Ivey signed the bill following approval by the Alabama Senate. Physicians who perform abortions could face up to 99 years in prison. Even attempting an abortion will be seen as a Class C Felony, putting the physician at risk of a 10-year prison sentence.

Then another state chimed in with a new abortion law. Missouri Senate passed a bill that will prohibit abortions after eight weeks. The bill is being called the “Missouri Stands for the Unborn Act,” which bans abortions after the detection of a heartbeat. However, they aren’t as strict as Alabama is with this new law. The law will allow for the procedure to be done if the mother caring could be in harm.

Currently, the law has not taken effect yet in Alabama. So, as of right now, abortions are still very much legal, medical procedures. However, this Act will be brought to court by Planned Parenthood and ACLU.

“The ACLU of Alabama, along with the National ACLU and PPFA, will file a lawsuit to stop this unconstitutional ban and protect every woman’s right to make her own choice about her healthcare, her body, and her future.”

“PLEASE REMEMBER: This bill will not take effect anytime in the near future, and abortion will remain a safe, legal, medical procedure at all clinics in Alabama.” The ACLU took to Twitter to state these, and it seems like this Act could have some powerful foes to get through before it even falls into place.

Another state that also dipped its feet into the new strict abortion laws is Georgia. Governor Brian Kelly signed a law on May 7th that would ban abortions as soon as a heartbeat was detected. The law does allow for women to abort against incest or rape, but the victim would have to report it to the police, and the abortion can’t be done after 20 weeks.

With these states being so close to Florida, it could affect patients coming here to try and get abortions. However, with these acts going to trail in most cases with Planned Parenthood, we could see this as a huge mishap and waste of time.

A Look at Types of Universal Healthcare

Americans all around the nation are giving their support for Medicare for all. On March 29 of this year, we wrote a blog called “Is Medicare For All the Solution?” In case you don’t know what Medicare For All is,

“Medicare For All is a universal health care plan that was developed by Vermont Senator, Bernie Sanders. This would be built off what former President Barack Obama had with the Affordable Care Act (ACA), also known as Obamacare. Medicare For All is a solution that would help give health insurance at affordable rates, covering primary and specialty healthcare, vision, hearing, dental, mental health, addiction services, and many other essential health care solutions.”

Niran S. Al-Agba, MD, explains universal health care through the following four points:
1. Most universal health care systems are not highly centralized,
2. Most universal coverage systems offer narrow benefit packages and incorporate cost-sharing for patients.
3. Private health insurance plays a significant role in most developed countries with universal coverage.
4. Countries with universal coverage have strict immigration policies to control health care expenditures.

The Commonwealth Fund recently compared universal health care systems around the globe with the United States single-payer bills proposed in Congress. The country that most resembles the US proposal (where decision making is centralized) is France. In France, the government is responsible for 77 percent of total health expenditures. However, there is an out-of-pocket cost share for patients that is around 7 percent, annually. A few other countries that also use a highly centralized system are the Netherlands, Singapore, and Taiwan. However, these countries have populations that are more similar to that of only one state in the US.

Another type of Universal Healthcare is a “hybrid” system, where decision making and financing are shared at the federal, regional, and local government levels. This form of government is the most cost-effective system to deliver universal health care coverage to a larger population. In Australia, Denmark, the United Kingdom, and Norway, policy making and resource allocation decisions remain centralized. However, there is flexibility within a region to distribute funds in a more individualized way that is best for local needs.

There is also a “decentralized” universal health coverage system, where decision making and resource allocation is regulated at the regional or provincial level. Canada, Germany, Sweden, and Switzerland use this system. For example, in Canada, each province receives (per capita) block grants from the federal government. A block grant is a fixed amount of money the government allocates to a province in advance. Regions are usually held accountable through the establishment of broad national guidelines to ensure fairness and service uniformity.

Now that we’ve gone over a few different universal health care systems which do you think is the best? Using our comment section is a safe place to share your opinions and see what others think about the article or things we’ve talked about in the blog.

Weight-Related Cancers on the Rise

Recently, J. Leonard Lichtenfeld, the interim Chief Medical and Scientific Officer for the American Cancer Society posted some findings by the society,

“What if I told you that our children were being exposed to a known carcinogen…The carcinogen is excess weight.”

The American Cancer Society posted the report that shares the details of their findings on the medical journal Lancet Public Health. They also published another work in 2003, in the New England Journal of Medicine that shared evidence of cancer risks increase with excess body weight.

The piece published to Lancet used 12 cancers that are known to be linked with being overweight and obese, and 18 other common cancers that are provenly not related to being overweight. With 6 of the 12 those cancers showing an increase in younger people, whereas 2 of the 18 showed similar cases.

“What is even more disturbing about the new data is the observation that for the weight-related cancers, the risk is increasing among progressively younger people, mirroring an increase in overweight and obesity we’re seeing in the U.S.” The link between the two factors may be something more severe or something we should not worry about.  Do you think the connection between weight-related cancers and obesity are connected?

The authors of the report also pointed out that as of 2014 1 of 3 children and adolescents are overweight or obese, and 78.2 percent of Americans (from 22 to 74 years of age) are also in the same situation. These numbers should have us very worried about the nation’s health.

Then as we look back to work published in 2003,

“The fact is, these warnings have not exactly received a lot of traction. The irony, of course, is the association between body weight cancer gets a fraction of the attention of other, much smaller risks.” The older published work was not taken as seriously as it should have been and unfortunately, because of that, the situation hasn’t gotten better.

However, how do we make these numbers deplete?

“We can try to do something about this as individuals: We can try to eat more fruits and vegetables and less red and processed meat and other processed foods; we can try to be more active.” As a group, Americans can make better health choices, and try to avoid unhealthy alternatives. Americans need to get out more and make better life choices to make sure they can cap out on their experiences and life in a whole.

We (Emerald Coast Medical Association) have written some other papers on how to stay healthy, and we recommend that you read those too.  J. Leonard Lichtenfeld left his readers with this,

“We haven’t worked this hard to fail. We always work hard to succeed, to improve our lives. Now it is clearly the time to take on this challenge, to make a difference, and avoid what appears to be a looming catastrophe when it comes to a disease we all dread. And that disease is cancer.”

Emerald Coast Medical Association doesn’t just care for your health, but we also care for your opinion and wellbeing. Feel free to leave a comment and discuss how you feel about weight-related cancers and obesity. Also, we will always do our best to keep you informed, and you’ll always have a voice we want to hear.

Is Medicare For All the Solution?

Medicare For All is a universal health care plan that was developed by Vermont Senator, Bernie Sanders. This would be built off what former President Barack Obama had with the Affordable Care Act (ACA), also known as Obamacare. Medicare For All is a solution that would help give health insurance at affordable rates, covering primary and specialty healthcare, vision, hearing, dental, mental health,addiction services, and many other essential health care solutions.

Not much is known on where funding would come from for this new health care solution. However, it is sure to be discussed soon with the 2020 elections coming up.

The first thing that needs to be viewed is how this will pass through Congress. The current House of Representatives may be inclined to pass this Medicare For All plan, whereas, the Senate would be completely opposed. This could change come 2020, but there will still be many opposers, including Republicans and moderates, the insurance lobby, and other special interests. This new plan would require a total reboot of our current healthcare, which would cause a reworking of the tax code, rearranging of national priorities, and either cause reconstruction or abolishment of the health insurance industry.

With our current healthcare system, some like it, and some hate it. However, more people are without health care than individuals who have health care. Most people will agree that, as a nation, we need to improve health insurance coverage and make it more affordable. President Obama attempted to do so, but unfortunately, due to some flaws in the ACA, it wasn’t all that people hoped for. However, people are becoming hopeful for this Medicare For All plan because they want an expansion of Medicare. Some also support a single payer system, backed by the government, but it doesn’t have to be Medicare.

With the Medicare For All plan possibly destroying the health insurance industry we have now, some citizens are becoming irate. This would mean the abolishment of health insurance plans through employers and private health insurances that users currently have in place.

There is also the giant question in the air of, “who pays for it?” Medicare is not free, and it isn’t all that cheap depending on the individual’s circumstances, needs, and preferences. There are also still costs that Medicare doesn’t cover for some patients, creating even more issues for Medicare For All. Big-ticket items that aren’t covered by Medicare could begin to overwhelm the patient. There is also the government’s single-payer plan, which would cost somewhere in the 30 trillion dollar range over a decade, which would make US citizens pay more in taxes.

This new Medicare For All plan could be very overwhelming and could cause many issues. It could also bring in a new affordable health insurance policy that is easier to acquire.

One thing that isn’t overwhelming is how Emerald Coast Medical Association takes care of its physicians at all government levels. Our Board of Governors routinely take their time to advocate for patients and physicians at the local, state, and federal level. What’s your stance on this issue? Voice your opinion in the comments section below.

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A Closer Look at “Surprise Billing”

As the dilemma of “surprise billing” at hospitals around the nation gains scrutiny from the White House and Congress, many major hospital groups indicated they want a hand in shaping the conversation. In a letter sent to the Congressional leaders, from the American Hospital Association and the Federation of American Hospitals, laid out principles they want legislators to consider as they seek to address the problem. Their solutions aimed at policies for health payers and asked for protection for the patients. Notably, however, they also opposed the controversial practice of balance billing by providers.

These “surprise bills” or “balance bills” can devastate patients. Every little thing can be charged because a patient needed emergency help, but they were at an out of network hospital or received surgery from an out of network doctor. The bill can skyrocket and leave the patient in a financial crisis. This issue has created a “back and forth” in the industry over who is to blame for the surprise medical bills or the practice of charging patients for care that is more costly than the actual amount or not covered by their insurance. A group of insurance, business, and consumer groups announced in December that they would band together to push for stronger patient protections and released their principles for the conversation.

The letter from the hospital groups stated, “We are fully committed to protecting patients from “surprise bills” that result from unexpected gaps in coverage or medical emergencies.” This also included America’s Essential Hospitals, the Association of American Medical Colleges, the Catholic Health Association of the United States and the Children’s Hospital Association. They added, “We appreciate your leadership on this issue and look forward to continuing to work with you on a federal legislative solution.”

The group wants a definition of “surprise bills” agreed upon, and under this definition, call for more financial help to the patient. They also want protection for patients who are denied payment by a payer if, for example, the health plan determines the instance was not an emergency. Another massive principle pushed for is ensuring patients have access to comprehensive provider networks and accurate network information through their health plans. The “surprise bill” is something that happens one out of every five medical emergencies that take place. For the sake of the patient, it should be a priority to solve these issues and form a resolution.

Another Falsified EHR Vendor Identified

Greenway Health, A Tampa-based electronic health record (EHR) company has falsely obtained EHR certification and incentivized clients in exchange for promoting or recommending its products to prospective new customers, and because of this act, the company will be dishing out $57.25 million.

In a statement provided by the company, Richard Atkin, Greenway Health CEO, said the Department of Justice (DOJ) settlement is an admission of wrongdoing and insured that all Greenway products remain ONC-certified.

Atkin also stated, “This agreement allows us to focus on innovation while collaborating with our customers to improve the delivery of healthcare and the health of our communities.” So, to Greenway Health this deficit will help them better their future.

This settlement by the DOJ is the second time federal prosecutors have taken legal action against an EHR vendor for falsifying Meaningful Use certification. Not even two years prior, in May of 2017, a Massachusetts-based company, eClinicalWorks agreed to pay $155 million to settle allegations that they violated the False Claims Act by falsely claiming their software met Meaningful Use requirements. The Meaningful Use Program was put into play to encourage healthcare providers to show “meaningful use” of certified EHR. The U.S. Department of Health and Human Services made incentive payments available to eligible healthcare providers that adopted certified EHR technology and met the requirements relating to their use of the technology.

“Many people saw the eClinicalWorks settlement as a wake-up call,” said Matt Fisher, a partner with Boston-based law firm Mirick O’Connell and chair of the firm’s health law group, also stating that this second DOJ settlement could lead to more findings of false claims.

Just like the complaint toward eClinicalWorks, the complaint filed against Greenway Health by the DOJ under the False Claims Act alleges that the company made its users submit false claims to the government by misrepresenting the capabilities of their EHR product, Prime Suit. This resulted in overpaying or improper payments to healthcare providers under the Meaningful Use Program. Greenway Health also violated the Anti-Kickback Statute by paying its clients or providing other incentives for them to recommend their product.

With these two settlements taking place, Christina E. Nolan, an United States Attorney for the District of Vermont, said that EHR companies should consider themselves “on notice.” EHR companies are now on watch by the US government and should make sure that what they are doing is legitimate.

Nolan also stated, “In the last two years, my office has resolved two matters against leading EHR developers where we alleged significant fraudulent conduct. These are the two largest recoveries in the history of this District and represent the return of over $212 million of fraudulently-obtained taxpayer monies. These cases are important, not only to prevent theft of taxpayer dollars but to ensure that the promise of health technology is realized in the form of improved patient safety and efficient healthcare information flow.”

The Civil Division’s Commercial Litigation Branch, Northern Districts of Georgia and the HHS Office of Inspector General, and the U.S. Attorney’s Offices for the District of Vermont conducted this investigation.

Join Emerald Coast Medical Association today to stay on top of the latest news and claim numerous benefits available for members, including a discounted group health plan. Click below to join!

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Big Hospitals Sue HHS

Hospitals are beginning to follow in the footsteps of the American Hospital Association and are suing the Trump Administration for its decision to institute site-neutral payments.

The change, which is part of the Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System rule-making for 2019, would lower reimbursements for hospital outpatient department services to match rates set by the physician fee schedule for clinic visits. This would mean lower costs for a patient’s insurance. However, hospitals would lose about $380 million in 2019 alone and possibly up to $760 million in 2020.  The colossal loss of money is causing an uproar with (as of right now) 38 hospitals signing the lawsuit.

This isn’t even helping the patient from what CMS Administrator Seema Verma says, “It doesn’t make sense for taxpayers, and it certainly doesn’t make sense for patients because they end up having to pay more depending on the site of service.”

However, this can be looked at as taking down the money hungry hospitals. University of Michigan health law professor Nicholas Bagley was among the observers who praised the Trump administration for the proposal, saying CMS is “picking a fight with powerful hospitals because it’s the right thing to do.” The site-neutral payments would mean, hospitals would have to offer the same care at lower prices.

The previous system had Medicare paying higher rates for services provided at the hospitals outpatient facilities. The Centers for Medicare & Medicaid Services projects the policy change will save the beneficiaries $150 million in co-payments annually; dropping the average copay from $23 to $9.

“The different payment rates also pushed hospitals to purchase independent practices to increase their reach and take advantage of the higher reimbursement rates,” Verma said. “Neutralizing payments would increase provider competition.” Competition could potentially turn into one hospital bettering the others, just because they have more resources and more funding.

However, Farzad Mostashari, MD, co-founder, and CEO of Aledade, said in a series of tweets that hospitals will fight the OPPS rule “bitterly” but that there could be a long-term benefit for them in it.

“The truth is that this proposal could help hospitals be more competitive in value-based contracts/ alternative payment models, and they should embrace the changes,” Mostashari wrote. “If rural hospitals or AMCs need subsidies, then we should do it directly, not through distorting payment policies.”

Here at Emerald Coast Medical Association, we care about your health too. Since 1981, over 50 local physicians banded together to create a Physician’s Security and Benefit plan.

The primary goals are:

  • Provide affordable health insurance to employees, physicians, and their families
  • Upon the death of a physician, provide insurance for the spouse and children of the physician
  • Use each others’ premium dollars to pay claims for those physicians and their family members who had serious medical conditions
  • To provide a premium-rating schedule that did not discriminate against those physicians and their employees who had incurred large medical claims
  • Avoid implementing “gatekeeper” type “managed care” features
  • Promote access to virtually all providers in and out of the state
  • Establish a stable alternative to those carriers who often abandon the insurance marketplace

You can get all this and more for being an Emerald Coast Medical Association Member.

No reason to wait, sign up today. We want to help you and your practice stay healthy and up to date on relevant information.

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Walgreens Becoming the New Leader in the Consumer Health Market

Walgreens and Microsoft are teaming up to become the most efficient consumer health market available. The two powerhouse companies are going to bring new technology and retail innovations to alter the healthcare delivery space. This multi-year agreement is being aimed to lower the costs of medical supplies and improve patients’ wellbeing. Walgreens has been making impressive partnerships with companies over the last few months to bring their customers the best experience possible. Walgreens has also made agreements with Silicon Valley, Verily, Alphabet Inc. and LabCorp to bring both new technology and more effective healthcare resources to consumers.

“Our strategic partnership with Microsoft demonstrates our strong commitment to creating integrated, next-generation, digitally enabled healthcare delivery solutions for our customers, transforming our stores into modern neighborhood health destinations and expanding customer offerings,” Stefano Pessina, executive vice chairman and chief executive officer of Walgreens had this to say about Microsoft partnering with Walgreens.

This partnership could mean quicker, better, and more stress-free care for their consumers, which will also solidify that customers are getting the necessary supplies to keep their health. If the medicine they get is not working, they can notify their local Walgreens to get the required supplies. One of the first issues Walgreens wishes to fix is their ability to connect with consumers through their digital devices. The goal is to make the customer feel more like an individual who truly matters to the company.

Another goal is building more information based on data science and artificial intelligence to help their customers feel even more personalized. The agreement offers more things to Walgreens than better health for their customers. Microsoft will also become the cloud provider for Walgreens, and the pharmacy chain will transfer the majority of its company’s IT infrastructure onto Microsoft Azure. Microsoft is gifting Microsoft 365 to more than 380,000 employees in the process.

Emerald Coast Medical Association wants you to stay healthy and up to date on medical news. If you become a member of ECMA one of the most significant benefits we offer you is medical malpractice insurance. This means you get to spend less on medical malpractice insurance, get a discount for being a member, and receive protection from a claims team that wins 90% of its trails. However, that’s not all; you get to make your choices with settlements, free trial coverage and promised solid financial strength. This one benefit provides you with many resources to keep your practice going.

There are many more benefits that come with your ECMA Membership. Join today and make your future better.

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The Improvement of AI’s Application in Healthcare

Artificial intelligence beat out a professional looking for precancerous changes in the cervix. The National Cancer Institute designed the AI’s algorithm for low-resource areas. The machine was given around 60,000 images from a study done in the 1990s in Costa Rica. These images then helped accurately identify cervical cancer. When the AI was then tested, it overperformed from its human counterparts. This was not due to lack of skills from the professional, but just simple human error and speed. This kind of technology used in places that do not have the resources could be monumental. AI like this could also become the new norm everywhere soon. All the healthcare worker would need is a camera and the system to perform the task, which in return would bring treatment in a single visit.

AI’s use in the medical field is slowly becoming more and more effective, for both healthcare professionals and the individuals needing treatment. Roughly 2.5 billion dollars is being wasted every year on ineffective treatments. Professionals are forced to use a trial and error method whereas AI can quickly pinpoint a more precise treatment. AI is keeping patients out of the office too. A virtual assistant could be used instead of going back and forth from doctor to doctor. The assistant would also keep the patients up to date on medication, what medicine should be used and when, and keep track on whether the patient is getting worse or better.

Heavier use of AI would cut costs and time spent on patients. AI could potentially reduce costs by 50 percent simply by not having human errors and by making sure doctors have the proper information needed for a patient. This would also save doctors time and effort on patients. Instead of being stuck on one problem, AI could help assist healthcare professionals to move from one patient to the next with ease.

Government Shutdown & Healthcare

The government shutdown between President Trump’s administration and congressional Democrats regarding funding of the “border wall” leaves many with questions regarding its immediate impact on changing current healthcare systems. While the ongoing partial government shutdown leaves the majority of the federal government’s public health programs unaffected, the lack of funding to specific departments has the potential to alter some important health-related initiatives.

Due to the passing of five major appropriation bills by Congress, the funding of the Department of Health and Human Services and the Department of Veterans Affairs has remained. This funding dampens immediate large-scale negative impacts because many government healthcare programs such as Obamacare, Medicare, and Medicaid are insulated and funded through September. Additionally, two other critical unaffected departments are the Center for Disease Control and Prevention and the National Institutes of Health, allowing for the continuation of public health surveillance and significant biomedical research respectively. Unfortunately, other government agencies such as the Food and Drug Administration are greatly affected. Due to the Department of Agriculture being completely shut down, the FDA is currently only operating at 60% of regular employees leading to potential problems regarding regulations and mandatory recalls of possible harmful goods.

Another detrimental effect of the government shutdown is an impact on the Indian Health Service (IHS). The IHS receives all of its funding from the recently shut down Department of the Interior, which has had widespread consequences to Native American tribes. The only services that can continue in these areas are “immediate needs of the patients, medical staff and medical facilities” and this lack of funding has been extended to suspending grants and other IHS health programs.

Well-known departments and agencies such as the Department of Homeland Security’s Office of Health Affairs and the Environmental Protection Agency have already been displaying negative aftermath of the government shutdown with all signs pointing to large detrimental effects if this continues for an extended period. Health inspectors at the United States borders and the Countering Weapons of Mass Destruction Office have already faced setbacks causing increased concern regarding possible decreased safety of US citizens. Furthermore, even the National Park Service has ceased all restroom maintenance and trash service due to funding leading to closures of popular parks such as Yosemite and Joshua Tree National Park due to unsanitary conditions.