DJP Update 6-29-2011 North Carolina Governor vetoes medical liability law with cap on non-economic damages & Sixth Circuit Appeals Court on PPACA; LAGNIAPPE
Elections count at all levels. The plaintiff trial attorneys know this fact. They really have two issues: stop cap on damages and preserve contingency fees.
Wish I had better news for you tonight. Also, here is the rest of the disappointing news. But keep the faith and remember the Huey Long quote during the tough times re PPACA.
Also, this encouraging quote shows the fight is not over in North Carolina: “The governor does not get the last word on medical liability reform,” N.C. Medical Society chief executive Bob Seligson said, adding the “General Assembly developed a strong bipartisan bill that will reduce health care costs, protect patients and encourage job growth.”
RALEIGH, N.C. — Democratic Gov. Beverly Perdue vetoed another bill Friday pushed by the Republican majority at the legislature, this time changes to rules governing medical malpractice cases that would have capped certain monetary awards for negligence victims.
Perdue blocked a bill from taking effect that would have limited awards for malpractice victims to $500,000 for non-economic damages. Those damages cover pain, suffering and emotional distress, but they also cover catastrophic injuries like death or brain damage in patients who can’t seek compensation for lost earnings, like children and the elderly.
Perdue suggested in her veto message that she would sign into law an amended package if lawmakers developed one when they convene next month.
Perdue spokesman Mark Johnson said separately the governor had problems with the cap in the current bill.
“I commend the legislature for addressing this important issue but, in its current form, the bill is unbalanced,” Perdue said in a statement. “I urge legislators to modify the bill when the General Assembly returns in July to protect those who are catastrophically injured.”
The veto is a victory for the state’s trial lawyers and patients who opposed vigorously any cap on what’s called “non-economic” damages – those unrelated to medical bills and compensation for lost wages or income – and a setback for the state’s business community and doctors. For years, they have been seeking limits they say would curtail out-of-control malpractice insurance premiums.
Such a cap had been avoided by Democrats when they were in control of the General Assembly in part because the state trial lawyers’ association opposed the idea. Leaders of the North Carolina Advocates for Justice have been historically aligned with Democratic interests.
“We applaud the governor for vetoing this bill,” said Dick Taylor, the chief executive officer for N.C. Advocates for Justice.
The climate changed when the GOP took charge of both legislative chambers for the first time in 140 years last November. Republican leaders also saw the measure as an economic development tool by attracting doctors to set up shop in North Carolina because of favorable liability laws.
The future of an override vote on this bill is unclear when the legislature begins work again July 13.
“In countless frivolous lawsuits, trial lawyers win big and drive up health care costs for everyone. Yet Gov. Perdue chose to cater to special interests instead of reducing medical costs and improving access to care for all North Carolinians,” Senate President Pro Tem Phil Berger said in a statement. “No matter how she spins it, a veto is a veto, and this one deals a severe blow to the state’s medical community and every citizen struggling to cope with the skyrocketing cost of health care.”
The Senate passed the bill by a wide margin, but the House passed the measure by a vote of 62-44, short of the majority that would signal the chamber’s ability to cancel Perdue’s veto. The House vote wasn’t exclusively partisan – 11 Democrats and 11 Republicans voted contrary to the majority in their respective parties on the final compromise.
The North Carolina Medical Society and North Carolina Hospital Association said in a joint statement they want lawmakers to override Perdue’s veto, saying the bill already was a careful compromise.
“The governor does not get the last word on medical liability reform,” N.C. Medical Society chief executive Bob Seligson said, adding the “General Assembly developed a strong bipartisan bill that will reduce health care costs, protect patients and encourage job growth.”
Perdue signs other bills
The governor signed 24 other bills on Friday, including changes to the state’s workers compensation program and tort reform. She called both measures “good, balanced laws.”
The tort reform bill would “protect those injured and also prevent undue or disproportionate penalties from being imposed upon our companies,” she said. Meanwhile, the workers compensation changes “extend protections to injured people and also provide guidelines and protections for employers.”
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DJP Update 6-28-2011 – Another bad idea bites the dust: “Mystery Shoppers” & some recent tweets including the Mystery Shopper issue
(I predict IPAB will be next to disappear!)
Breaking News from Politico:
Subject: Health Care Breaking News
The Obama administration has abandoned a controversial plan to have “secret shoppers” pose as patients looking for doctors, saying that “now is not the time to move forward with this research project.”
The Obama administration has decided to pull the plug on the so-called mystery shoppers who were going to covertly phone doctors across the country in an effort to gauge shortages in primary care physicians that critics say are linked to the president’s health care law.
The proposed study was still in the planning stages, but was intended to address what the administration called a “critical public policy problem.” First revealed to the public Monday by the New York Times, the mystery shoppers were to call medical practices posing as a patient, then ask about accepted insurance providers and wait times to see a doctor.
As the news came out, the White House was attacked by doctors and critics as being “creepy” and imploring Big Brother tactics.
“After reviewing feedback received during the public comment period,” a Health and Human Services official told Fox News, “we have determined that now is not the time to move forward with this research project. Instead, we will pursue other initiatives that build on our efforts to increase access to health care providers nationwide.”
Fox News White House correspondent Mike Emanuel contributed to this report.
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TWEETS are below. And don’t fail to read the U.S. Supreme Court case Bond v. United States. The Wall Street Journal has an article on it today.
The Supreme Court’s most important ruling this year may have been its unanimous decision in Bond v. United States, which held that individual citizens can challenge federal statutes when they encroach on authority the Constitution reserves to the states. The decision, authored by Justice Anthony Kennedy, has far-reaching implications—especially for the government’s efforts to defend ObamaCare.
The Supreme Court disagreed. With an unusual unanimity, the court held squarely that individual citizens have every right to challenge federal laws on the ground that they exceed the limited and enumerated powers vested in Congress by the Constitution. The court stated without equivocation that “[b]y denying any one government complete jurisdiction over all the concerns of public life, federalism protects the liberty of the individual from arbitrary power. When the government acts in excess of its lawful powers, that liberty is at stake.”
NOTE this: KENNEDY, J., delivered the opinion for a unanimous Court. GINSBURG, J., filed a concurring opinion, in which BREYER, J., joined.
AND NOTE THIS EXCERPT:
(1) Federalism has more than one dynamic. In allocating powers between the States and National Government, federalism “ ‘secures to citizens the liberties that derive from the diffusion of sovereign power,’ ” New York v. United States, 505 U. S. 144, 181. It enables States to enact positive law in response to the initiative of those who seek a voice in shaping the destiny of their own times, and it protects the liberty of all persons within a State by ensuring that law enacted in excess of delegated governmental power cannot direct or control their actions.
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As I said previously, I believe the U.S. Supreme Court will rule PPACA unconstitutional and that Justice Kennedy will be the swing vote against the individual mandate. This case of Bond v. United States reinforces my view.
Regardless of whether I am right or wrong in my view, prudent individuals and organizations would utilize my “Big A” in my Big A and 25 C’s risk management lecture on the Intrepid Website.
In effect, it says, the Big A says: “ANTICIPATE what could go wrong and be prepared.”
Thus, what advice do the medical organizations have for all of those doctors who are rearranging their practices, closing private practices, and joining hospitals, etc. IF the law is declared unconstitutional. Best to be prepared for Hurricanes and other major events AND dramatic court decisions that reverse the rush to join an unproven experiment.
Economics In One Lesson MT @aapsonline: @benrushsocietyPrice ceilings cause shortages. Always. It will be harder to get appt. Less Dr time
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Stay well!
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This DJP Update goes to 2318 leaders in Medicine representing all of the State Medical Associations and over 100 Specialty Societies plus some other friends.
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DJP Update 6-18-2011 AMA Annual Meeting & media alert
AMA Annual Meeting in Chicago started today. See my updates today at AMA in tweets at: www.twitter.com/DJPNEWS
Also follow tweets from all, delegates and reporters, who place #AMAmtg in tweets. Use search engine in your Twitter software and put in #AMAmtg and all tweets will show up.
Media Alert
Will be on national Fox and Friends in morning, Sunday, at 6:45 a.m. Central (7:45 a.m. Eastern) and again on Monday at 6:15 a.m. Central (7:15 a.m. Eastern)
Will be live beamed by satellite to New York from Chicago Fox studio.
Stay well.
Donald
P.S. Stop by http://twitter.com/DJPNEWS and sign up for DJPNEWS to get tweet alerts that may not make it into DJP Updates. Twitter is free and takes minutes to join. Put email in and pick password. Great source of breaking news and you don’t flood your email with it. You can get free app for BlackBerry or IPhone etc and you check on tweets when you want. With newer operating systems, such as SNOW LEOPARD on Mac, you can put Twitter apps on your notebook or desktop.
This DJP Update goes to 2334 leaders in Medicine representing all of the State Medical Associations and over 100 Specialty Societies plus some other friends.
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DJP Update 6-12-2011 AMA Annual Meeting; George Will article re PPACA & IPAB; Oral arguments Appeals Ct Florida v. HHS June 8, 2011
OSMAP (state med society presidents past, present, and president-elect) meeting is on June 17 and AMA Annual Meeting June 18-22. Both at Hyatt on Wacker in Chicago.
For those not attending the meeting in Chicago, watch for tweets that give updates. I believe the tweet hash mark will be #AMAmtg
So if you put into the “Find” search of your Twitter program, you will get any tweet that contains #AMAmtg as soon as tweeted by someone. Twitter is an amazing way to stay current on news. And tweets are limited to 140 characters.
When I was a young boy, I was sent to St. Paul’s College boarding school in Covington, La. across Lake Pontchartrain because we lived a couple of blocks from a public housing project and gang activity was beginning. The gang was trying to recruit young kids. That began my transfer to a boarding school despite the school not having the grade I was scheduled to enter, the 3rd grade. Dad convinced the principal to put me in 4th grade!
My point in telling that story is to relate that there was a nearby park that bordered on the Bogue Falaya River. The first time I was allowed to visit the park, I was impressed with the sign at the entrance:
Let it not be said and to your shame, that all was beauty here before you came.
I have reflected on that statement many times since the 4th grade. I do believe it is appropriate for us in Medicine now as we reflect on medical care in America, the best medical care the world has ever seen. I am concerned that the wrong approach to fixing the problems in medical care financing will cause us to reflect later that the beauty of the great medical advances here was destroyed by central control of medicine by government. We will deserve the shame heaped upon our generation if we did not do our homework, if we do not have courage, and if we give up too soon. I am afraid PPACA, IPAB, and all of the other choking tentacles of PPACA will lead us to a medical system of rationing and destruction of the patients’ right to make their own decisions with the advice of the trusted personal physician.
So let’s have the final debate on this onerous law at this AMA meeting. On the items we all (almost all) can agree on, such as removing IPAB, let’s us send a strong message that it must be eliminated. Then let’s get to the individual mandate and the rest of PPACA. Let’s have a game plan to get the right to balance-bill in Medicare, strong AMA policy, into the law.
Failure to do this will be an admission that our meeting is only a debating society, interesting for some, but devoid of any practical significance. And yes, a strong stand on the principles that made Medicine great might well stop the bleeding of membership which is on a dangerous downhill slope.
Restore Liberty! I have been the spokesperson regarding Medicine in America over the years for many groups, but my message always has been the same: Get government out of Medicine; avoid coercion, and learn from the failures of socialized medicine world-wide. I just reviewed my testimony to the health subcommittee of U.S. Congress Ways and Means Committee in 1976. The hearing was on “National Health Insurance.” I said then, on behalf of the Orleans Parish Medical Society,
EXCERPT:
“We are opposed to any national health insurance scheme. So that my message may be clear, I repeat, we are opposed to any form of socialized medicine. National health insurance results in rationed care of a lower quality. National health insurance costs more. Remember you get nothing for nothing. The public always pays in the form of increased taxes. The trusted doctor-patient relationship can only exist in a system where patients and doctors can have freedom of choice through the selection of each other.”
Shortly after that portion of the testimony, I quoted Dr. Robert Sade, who in recent years became the Chair of the AMA Council on Ethical and Judicial Affairs (CEJA):
Under the leadership of such men as Thomas Paine and Thomas Jefferson, the concept of man as being sovereign unto himself, rather than a subdivision of the sovereignty of a king, emperor, or state, was incorporated into the formal structure of government for the first time. Protection of the lives and property of individual citizens was the salient characteristic of the Constitution of 1787.”
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As always, coercion has no place in America. We are a nation built on liberty and freedom.
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For those who skip the tweets or who are confused by format, don’t fail to go to these two links:
Oral arguments in mp3 audio format re PPACA Florida et al suit on appeal: dld.bz/aaYvA
If link doesn’t work, go to these two links for
Arguments to dismiss:
Arguments on the merits:
Florida v. HHS: Oral Arguments on Appeal (June 8, 2011). Counsel from both sides present oral arguments to a three-judge panel in the U.S. Court of Appeals for the 11th Circuit, consisting of Judges Joel Dubina, Frank Hull, and Stanley Marcus. [Arguments for motion to dismiss: 91 mins, MP3 | Arguments on the merits: 55 mins, MP3]
Retweeted by DJPNEWS – Great references re PPACA plus the ORAL ARGUMENTS. Listen to them yourself; don’t rely on talking heads on TV or radio; link: dld.bz/aaYvA
“The legislative cannot transfer the power of making laws to any other hands. … The power of the legislative, being derived from the people … (is) only to make laws, and not to make legislators.”
— John Locke
“Second Treatise of Government”
WASHINGTON — Here, however, is a paradox of sovereignty: The sovereign people, possessing the right to be governed as they choose, might find the exercise of that right tiresome, and so might choose to be governed in perpetuity by a despot they cannot subsequently remove. Congress did something like that in passing the Patient Protection and Affordable Care Act, aka Obamacare.
The point of PPACA is cost containment. This supposedly depends on the Independent Payment Advisory Board. The IPAB, which is a perfect expression of the progressive mind, is to be composed of 15 presidential appointees empowered to reduce Medicare spending — which is 13 percent of federal spending — to certain stipulated targets. IPAB is to do this by making “proposals” or “recommendations” to limit costs by limiting reimbursements to doctors. This, inevitably, will limit available treatments — and access to care when physicians leave the Medicare system.
The PPACA repeatedly refers to any IPAB proposal as a “legislative proposal,” and speaks of “the legislation introduced” by the IPAB. Each proposal automatically becomes law unless Congress passes — with a three-fifths supermajority required in the Senate — a measure cutting medical spending as much as the IPAB proposal would.
This is a travesty of constitutional lawmaking: An executive branch agency makes laws unless Congress enacts legislation to achieve the executive agency’s aim.
And it gets worse. Any resolution to abolish the IPAB must pass both houses of Congress. And no such resolution can be introduced before 2017 or after Feb. 1, 2017, and must be enacted by Aug. 15 of that year. And if passed, it cannot take effect until 2020. Defenders of all this audaciously call it a “fast track” process for considering termination of IPAB. It is, however, transparently designed to permanently entrench IPAB — never mind the principle that one Congress cannot by statute bind another Congress from altering that statute.
That principle may cause courts to dismiss the challenge by the Phoenix-based Goldwater Institute to Congress’ delegation of its powers, because courts may say Congress can just change its mind. Hence the court may spurn the institute’s argument on behalf of two Arizona congressmen, Jeff Flake and Trent Franks, that the entrenchment of the IPAB seriously burdens the legislators’ First Amendment rights.
Diane Cohen, the institute’s senior attorney, demonstrates that the IPAB is doubly anti-constitutional. It derogates the powers of Congress. And it ignores the principle of separation of powers: It is an executive agency, its members appointed by the president, exercising legislative powers over which neither Congress nor the judiciary can exercise proper control.
Unfortunately, the IPAB may not be unconstitutional. This is because the Supreme Court, having slight interest in policing Congress’ incontinent desire to give to others the power to make difficult decisions, has become excessively permissive about delegation. Cohen notes this from Justice Antonin Scalia’s dissent in a 1989 case wherein the Supreme Court affirmed the power of the U.S. Sentencing Commission to set “guidelines” that, being binding, have the effect of statutes:
“I anticipate that Congress will find delegation of its lawmaking powers much more attractive in the future. … I foresee all manner of ‘expert’ bodies, insulated from the political process, to which Congress will delegate various portions of its lawmaking responsibility. How tempting to create an expert Medical Commission … to dispose of such thorny, ‘no-win’ political issues as the withholding of life-support systems in federally funded hospitals.”
The Supreme Court said the legislative power of Congress does not include the power to delegate legislative authority to an executive agency without “intelligible principles” to constrain such authority. The only principle — if such it can be called — constraining the IPAB is that its mission is to cut medical costs as it sees fit.
The Goldwater Institute’s challenge to the IPAB serves the high purpose of highlighting some of Obamacare’s most grotesque provisions, which radiate distrust of the public and its elected representatives. The essence of progressivism, and of the administrative state that is progressivism’s project, is this doctrine: Modern society is too complex for popular sovereignty, so government of, by and for supposedly disinterested experts must not perish from the earth.
George Will’s email address
is georgewill@washpost.com.
WASHINGTON POST WRITERS GROUP
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Stay well and travel with care.
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This DJP Update goes to 2318 leaders in Medicine representing all of the State Medical Associations and over 100 Specialty Societies plus some other friends.
You can share it with your members and it has the potential to reach 800,000 physicians.
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DJP Update 6-8-2011 Media alert radio interview in morning re PPACA challenge Fed 11th Circuit & other recent tweets including R.I.P. Bud Lomell D-Day Ranger hero
KTRH radio 740 Houston in morn 6:20 a.m. Central with Lana & JP re #PPACA#hcr challenge Fed 11th Circuit http://www.ktrh.com
And a sad note about the death of Pointe du Hoc hero Leonard “Bud” Lomell. Plus other D-Day info. See tweets.
P.S. Stop by http://twitter.com/DJPNEWS and sign up for DJPNEWS to get tweet alerts that may not make it into DJP Updates. Twitter is free and takes minutes to join. Put email in and pick password. Great source of breaking news and you don’t flood your email with it. You can get free app for BlackBerry or IPhone etc and you check on tweets when you want. With newer operating systems, such as SNOW LEOPARD on Mac, you can put Twitter apps on your notebook or desktop.
This DJP Update goes to 2318 leaders in Medicine representing all of the State Medical Associations and over 100 Specialty Societies plus some other friends.
You can share it with your members and it has the potential to reach 800,000 physicians.
To join the list, send me an email stating “Join DJP Update”
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Former American Medical Assocation president Donald Palmisano, M.D., knows a thing or two about leadership, and the updated and amplified version of his book could not be more appropriate for our times. On Leadership: Essential Principles for Business, Political and Personal Success serves as an indispensible guide with lessons from successful leaders whose decisions have a sweeping impact on nations and from those whose decisions save a single life.
The book is a mixture of true stories, including some of the author’s own, that exemplify the essential characteristics of a leader: courage, persistence, decisiveness, communication, creativity, and doing your homework.
We can only conclude that the outcome of Obamacare would have been very different had Dr. Palmisano still been in charge of the AMA when it gave its support to that legislation at a crucial time in return for . . . nothing, really.
This law will be terrible for physicians and worse for patients. Sixty percent of physicians said the new law will force them to stop serving or restrict services to certain categories of patients, especially in Medicare and Medicaid, and an alarming number of doctors are planning to leave the practice of medicine as soon as they can.
The experienced and invaluable leadership in the medical profession will be lost as physicians are forced to turn over more and more of their authority to government officials dictating the practice of medicine. Most say they will leave medicine rather than subject their patients to medical decisions made by bureaucrats rather than physicians.
Dr. Palmisano, a practicing physician in New Orleans, gives an example of why medical care in America has been the best in the world, and why we want experienced and decisive doctors in charge.
In his chapter on persistence, he quotes Winston Churchill from the dark days of World War II saying, “Never give in — never, never, never, in nothing great or small, large or petty, give in.”
Dr. Palmisano reports on working with another surgeon to try to save a 23-year-old man badly injured in an automobile accident. After significant ER intervention, the patient’s heart stopped beating. Let him tell the story:
External cardiac compression was done, but it did not restore the heartbeat. The anesthesiologist shook his head and said, “There is nothing more we can do. We must pronounce him dead.”
At that moment, I refused to believe that this young man was dead. Everything that was supposed to be done was done. I pulled back the drapes covering the patient’s chest, splashed antiseptic on his chest and cut it open. I reached for his lifeless heart and began to squeeze it between my hands. I told the anesthesiologist to keep squeezing the breathing bag filled with oxygen. I could not leave the room without saying to myself that EVERYTHING possible had been done. Suddenly, between squeezes on the heart, I felt it start beating!
The patient recovered and went on to become an accomplished engineer, sending post cards to Dr. Palmisano from all over the world.
Persistence pays off.
Dr. Palmisano and the many stories he reports will inspire you and give you hope for America, from courageous and persistent politicians like Rep. Paul Ryan and Sen. Marco Rubio to examples of failures in leadership by “Brownie” during Hurricane Katrina. The book is a wealth of life lessons from Dr. Palmisano’s extensive experience — from public speaking and debate prep to his love of technology and how it can extend our expertise.
Each chapter ends with lessons learned. The lessons in the concluding chapter about “Emerging leaders in a time of crisis” seem most relevant: “It’s time for a new generation of leaders,” he declares, and he believes that the American people are ready.
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LAGNIAPPE: Congratulations to Texas for passing Loser Pays legislation that started as HB 274. Read the text of the law at:
Note reasonable attorney fees. Also note that it applies only to claims that do not exceed $100,000 in damages.
This is an important bill, but keep in mind that a plaintiff can claim the damages are more than $100,000 by saying the “pain and suffering” non-economic damages alone are more than $100,000.
Will be interesting to see how the plaintiff bar tries to get around the law.
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Stay well and have a great weekend.
Donald
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This DJP Update goes to 2330 leaders in Medicine representing all of the State Medical Associations and over 100 Specialty Societies plus some other friends.
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DJP Update 6-2-2011 evening edition: AMA Annual Meeting and resolutions – Keep your eyes on PPACA and individual mandate; consider definition of Liberty.
Government wants to pay for quality and not quantity, according to the advocates for PPACA. But the question I would like an answer to is: Who determines the quality? Will it be the patient armed with transparency and scientific information from readily accessible scientific experts and selecting the doctor the patient wants? Or will it be some panel appointed by the Executive Branch or Congress? Consider this for a moment. You have heard of the Medicare money penalty for readmissions to the hospital in the latest government plans. But how does that measure quality? With a monetary incentive not to admit the patient, who will track the patients who die because of failure to admit back into the hospital? Where is that monitored? Will there be lots of unintended consequences of the new law? I believe so.
Below is an article about the view of the MGMA regarding ACOs. ACOs are just one part of PPACA. The more the regulations come forth, the more are the problems. And wait until the world sees IPAB in action. I don’t think the history books will determine it to be just advisory. All of these issues are government central planning at its best.
The AMA Annual Meeting is coming up this month in Chicago. Regardless of decreasing AMA membership, perhaps less than 20% of practicing physicians, (I will be interested in the final tally) the fact remains that all of the state medical associations and the specialties are represented in the AMA House of Delegates. Make no mistake, the big debate will be on the new health care law, PPACA. There are competing resolutions for and against. The individual mandate is another subset that will be debated with great emotion. Visit the AMA Website if you are a member of AMA and review these resolutions. Be sure to read resolutions 109 advocating “Rescind” individual mandate, as well as others supporting the individual mandate, Res 114 and Res 102. There are others for you to review that give different views on the issue.
Don’t fail to read CMS Report 9 in Reference Committee A entitled “Covering the Uninsured and Individual Responsibility”
I find it interesting that the report states the individual responsibility requirement (DJP comment: of course this means individual mandate) “preserves individual liberty”.
EXCERPT from page 8 of CMS Report 9
DJP Comment: I disagree that the individual mandate preserves individual liberty.
As you have heard me say, at the microphone and in my writings, LIBERTY, by definition, is the absence of coercion.
If one uses incorrect definitions, it is possible to justify anything.
One reference re Liberty:
In his monumental work The Constitution of Liberty, F.A. Hayek and the discussion of “individual liberty” he says: “defining freedom as the absence of coercion…”
Of course we all know, the Supreme Court will make the final decision as to the constitutionality of the individual mandate. But in the meantime, we need to follow our AMA policy from the policy-making body of AMA, the House of Delegates. And when AMA makes policy, that on reflection, is not sound, or strays from policy, as some in the House of Delegates believe has happened with PPACA considered as a whole, then we need to fix it in the House of Delegates. We will have that opportunity to revisit current AMA policy, the individual mandate H-165.848, and decide if we wish to remove it. Mistakes can be made. It is wonderful to recognize mistakes and correct them. Even if the Supreme Court declares PPACA unconstitutional because of the individual mandate, we still will have our AMA policy unless we change it. If the policy cannot be implemented because the Court has said it is not allowed to mandate people in that manner, then the policy is no longer viable as a possible advocacy issue.
MGMA: ACO costs outweigh benefits under proposed CMS rule
By Andis Robeznieks
Posted: June 1, 2011 – 3:00 pm ET
Tags: Accountable Care Organizations, Costs, Medical Group Management Association (MGMA), Physicians
The CMS’ proposed rule (PDF) on accountable care organizations carries “excessively high” startup and operation costs relative to its “small and uncertain financial benefits” as well as “substantial regulatory risks” from the CMS inspector general’s office, the U.S. Federal Trade Commission and the U.S. Justice Department, according to formal comments filed by the Medical Group Management Association.
The Englewood, Colo.-based association’s comments also criticize the proposed rule’s attempts to link ACO implementation with federal programs promoting health information technology adoption.
“Medical groups already face a number of incentives or penalties associated with decisions to deploy or not to deploy healthcare information technology,” according to the association. “MGMA has urged the government in multiple forums to be realistic about the pace of (electronic health-record system) deployment, given the significant upfront and ongoing costs of those systems and the very real risks of ‘false starts’ with technology that may not be sustainable because of rapid product innovation and market dynamics.”
In addition to its eight-page comment letter to CMS Administrator Dr. Donald Berwick, the MGMA sent separate letters to the office of CMS Inspector General Daniel Levinson and FTC Secretary Donald Clark calling on the FTC and the Justice Department to “find a more streamlined method to screen proposed (ACO) collaborations so that the very process of seeking approval does not deter applicants.”
The MGMA has 22,500 members who manage some 13,600 medical organizations in which approximately 280,000 physicians practice.
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This DJP Update goes to 2331 leaders in Medicine representing all of the State Medical Associations and over 100 Specialty Societies plus some other friends.
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DJP Update 6-2-2011 AMA’s New EVP/CEO – starts Job July 1
See AMA press release below.
EMBARGOED FOR RELEASE: 11 A.M. (CT), JUNE 2, 2011
AMA NAMES DR. JAMES MADARA NEW EVP/CEO
Accomplished academic medical center administrator and dean begins post July 1
CHICAGO – The American Medical Association (AMA) today named James L. Madara, M.D., as its new Executive Vice President and Chief Executive Officer. Dr. Madara will assume leadership of the nation’s oldest and largest physician group on July 1.
Dr. Madara, 60, is an accomplished academic medical centerphysician, medical scientist and administrator who served as Timmie Professor and Chair of Pathology and Laboratory Medicine at the Emory University School of Medicine before assuming the Thompson Distinguished Service Professorship and deanship at the University of Chicago Pritzker School of Medicine, where he was the longest serving Pritzker dean in the last 35 years. Subsequently, he added the responsibility of CEO of the University of Chicago Medical Center, bringing together the university’s biomedical research, teaching and clinical activities. As CEO, he engineered significant new affiliations with community hospitals, teaching hospital systems, community Federally Qualified Health Centers on Chicago’s South Side, as well as with national research organizations including the Janelia Campus of the Howard Hughes Medical Institute in Bethesda and the Ludwig Foundation of New York.
“The AMA is a venerable institution, and I am honored to leadit during this challenging and exciting time,” Dr. Madara said. “The AMA has been at the forefront working to improve public health, physician practice, patient care and our American health care system for the past 164 years. Today more than ever, America’s patients and physicians need a strong and vibrant AMA to tackle the many challenges facing them. I look forward to leveraging my skills and experience to help the AMA succeed and fulfill its core mission to promote the art and science of medicine and the betterment of public health.”
While at the University of Chicago from 2002-2009, Dr. Madara oversaw a significant renewal of the institution’s biomedical campus, including the Comer Children’s Hospital, the Gordon Center for Integrative Science, a new adult hospital pavilion, and the Knapp Center for Biomedical Discovery. His deanship also extended to the University’s renowned Biological Sciences Division.
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“The American Medical Association is thrilled to have a proven medical leader like Dr. Madara serve as our next EVP/CEO,” said Ardis D. Hoven, M.D., chair, AMA Board of Trustees. “Dr. Madara is a strong strategic thinker and planner who has a track record of bringing people together to accomplish significant, ambitious, health-related goals and projects. Having overseen a $1.6 billion integrated academic medical center, Dr. Madara understands many of the complex clinical, academic and business-related issues confronting medicine and health care today. His insight and perspective will be invaluable in helping the AMA tackle its agenda.”
Dr. Madara is a noted academic pathologist and an authority on epithelial cell biology and on gastrointestinal disease. He has published more than 200 original papers and chapters, making important contributions to understanding the biology of the cells that line the digestive tract. His work has garnered both national and international awards.
Dr. Madara has served as President of the American Board of Pathology, as Editor-in-Chief of the American Journal of Pathology, has received a prestigious MERIT Award from the NIH, has been elected to membership in the Association of American Physicians, and recently received the Davenport Award for lifetime achievement in gastrointestinal disease from the American Physiological Society.
Most recently, Dr. Madara served as senior advisor with Leavitt Partners, a highly innovative health care consulting firm started by former Secretary of Health and Human Services Mike Leavitt.
Dr. Madara earned his medical degree from Hahnemann Medical College in Philadelphia. He completed his internship and residency at New England Deaconess Hospital in Boston. He subsequently completed a fellowship in anatomy and cell biology at Peter Bent Brigham Hospital in Boston (now Brigham and Women’s Hospital). Following his fellowship, Dr. Madara joined the faculty of Harvard Medical School where he rose to a full tenured professor and served as director of the Harvard Digestive Diseases Center.
Dr. Madara is married to Vicki M. Madara. They have two children: Alexis and Max.
The American Medical Association helps doctors help patients by uniting physicians nationwide to work on the most important professional, public health and health policy issues. The nation’s largest physician organization plays a leading role in shaping the future of medicine. For more information on the AMA, please visit www.ama-assn.org. Follow AMA on Twitter at https://twitter.com/AmerMedicalAssn
