Supreme Court Start Hearings on PPACA
Beginning March 26, the U.S. Supreme Court will hear six hours of oral arguments spread out over three days regarding the constitutionality of the Patient Protection and Affordable Care Act (PPACA) and its provisions.
In November, the court agreed to hear the lawsuit brought forth by 26 states, the National Federation of Independent Business (NFIB) and two individuals. The main issue at hand and the subject of the lawsuit is the claim that Congress exceeded its constitutional power by instituting the “individual mandate,” sometimes called the “minimum coverage provision,” which requires that most Americans buy health insurance starting in 2014 or face a fiscal penalty.
EHR Incentives Still Out of Reach of Anesthesia & Pain Providers
The EHR incentive program is targeted at office-based practices. Indeed, the original version of the program would have excluded anesthesiologists explicitly. The July 28, 2010 final rule however, restricted the definition of “hospital-based” so that it only covered physicians who provide 90 percent or more of their services on an inpatient basis or in the emergency department. Most anesthesiologists do more than 10 percent of their cases on an outpatient basis, so they are not disqualified on the grounds that they are hospital-based. Nevertheless, they will be ineligible for the bonus because fewer than 50 percent of their Medicare allowables will be generated in facilities with certified EHR systems and/or because fewer than 80 percent of their patients will have records in a certified EHR system.
Then there are the meaningful use standards. Stage 1 requires the eligible professional to meet or qualify for an exclusion from each of 15 core objective functionalities (e.g., drug interaction checks) plus five out of a possible ten “menu set” measures. The EHR must allow the eligible professional to report at least six clinical quality measures, three of which are mandatory and three of which must be selected from a group of 38 measures. The majority of these objectives and clinical quality measures do not apply to anesthesiology or pain medicine practice. So the chances of quailifying for the EHR incentives are slim for anesthesia and pain professional, as the law is currently written.
