Updates on the Patient Protection and Affordable Care Act
Updates on the Patient Protection and Affordable Care Act
Although some think it will happen, the possibility of National Medical Liability Reform is still active. The HEALTH Act (Help Efficient, Accessible, Low-Cost, Timely Healthcare Act of 2011) is, in essence, National Tort Reform or Medical Liability Reform that is based on liability reforms adopted by Texas and California. It places caps of $250,000 on non-economic damages (pain and suffering) and caps punitive damages at $250,000 or twice the amount of economic damages. The provision also considers each party’s liability in direct portion to responsibility, limits attorney contingency fees, and sets the statute of limitations at three years after the date of injury manifestation or one year after the injury is discovered. The bill was sponsored by Rep. Phil Gingrey, MD, (R, Ga.). Two House committees have approved the bill; up next is a vote by the full House. However, President Obama has said he will not approve capping damage awards.
The goal of ACOs is to create a hospital and provider network that would provide care with quality and cost saving initiatives, and CMS and the providers would share the cost savings. The goal is to provide high quality care with reduced cost using a more integrated delivery approach and more aggressive quality monitoring.
ACOs may have some conflict with the traditional practice of emergency medicine in several ways. First, physicians will become employees of ACOs. Traditional emergency medicine doctors have the choice in some states to work as independent contractors. Being an independent contractor allows them to provide access to care without a conflict of interest and without outside influence.
ACOs may also conflict with laws in some states that prohibit the corporate practice of medicine. CMP laws are designed to protect the physician patient relationship from conflict of interest, allowing doctors to do what is best for the patient without undue influence.
Overall, many changes have already been implemented and more changes are to come.
What is Still in the Works?
Medical Liability Reform
Although some think it will happen, the possibility of National Medical Liability Reform is still active. The HEALTH Act (Help Efficient, Accessible, Low-Cost, Timely Healthcare Act of 2011) is, in essence, National Tort Reform or Medical Liability Reform that is based on liability reforms adopted by Texas and California. It places caps of $250,000 on non-economic damages (pain and suffering) and caps punitive damages at $250,000 or twice the amount of economic damages. The provision also considers each party’s liability in direct portion to responsibility, limits attorney contingency fees, and sets the statute of limitations at three years after the date of injury manifestation or one year after the injury is discovered. The bill was sponsored by Rep. Phil Gingrey, MD, (R, Ga.). Two House committees have approved the bill; up next is a vote by the full House. However, President Obama has said he will not approve capping damage awards.
Accountable Care Organizations (ACO)
The goal of ACOs is to create a hospital and provider network that would provide care with quality and cost saving initiatives, and CMS and the providers would share the cost savings. The goal is to provide high quality care with reduced cost using a more integrated delivery approach and more aggressive quality monitoring.
ACOs may have some conflict with the traditional practice of emergency medicine in several ways. First, physicians will become employees of ACOs. Traditional emergency medicine doctors have the choice in some states to work as independent contractors. Being an independent contractor allows them to provide access to care without a conflict of interest and without outside influence.
ACOs may also conflict with laws in some states that prohibit the corporate practice of medicine. CMP laws are designed to protect the physician patient relationship from conflict of interest, allowing doctors to do what is best for the patient without undue influence.
Overall, many changes have already been implemented and more changes are to come.
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