Federal Deficit Cutting Committee Now Goes to Work Physicians Fear Sebelius’ Health Care Budget Knife

Federal Deficit Cutting Committee Now Goes to Work

Physicians Fear Sebelius’ Health Care Budget Knife

 

The Congressional deficit reduction Super Committee charged with determining where to cut $1.3 trillion from the federal deficit over the next 10 years has begun a series of public hearings to determine how and where to trim.

 

The Committee has until November 23 to come up with answers.  It has stated that all sectors of health care are candidates for significant cuts.

 

If the Super Committee fails to win Congressional approval or if President Obama vetoes its proposed reductions, overall federal spending would be cut automatically, divided between defense spending and non-defense discretionary spending.  The cut would include 2% across the board affecting all Medicare providers.

 

Cuts to the Medicare program would be capped at 2% of total Medicare spending over the 10-year period,approximately $100 to $120 billion. 

 

Certain entitlements would be exempt from the cuts, including Social Security, veterans' benefits, civilian and military retirement funding and programs for low-income Americans, such as Medicaid and food stamps.

 

Because beneficiaries would be exempt from cuts, all savings must come from Medicare providers. Health and Human Services Secretary Kathleen Sebelius would be tasked with identifying and implementing the reductions.

 

Health care groups have started lobbying the Super Committee with appeals to protect their share of federal health care program dollars. 

 

Physicians, seeking a replacement for the Sustainable Growth Rate (SGR) formula determining physician payments under Medicare, argue that annual temporary pay “freezes” and token increases only mask and intensify a growing imbalance between SGR-determined physician reimbursement and actual costs.  A focus on frugality in government, they fear, will make that imbalance worse.

Proposed Rule Applies to Labs under CLIA Regulation Patients Would Get Direct Access to Lab Test Results

Proposed Rule Applies to Labs under CLIA Regulation

 

Patients Would Get Direct Access to Lab Test Results

 

CMS this month proposed a rule change to give patients of labs operating under CLIA regulations (as well as their authorized patient representatives) direct access to their test result reports.

 

At the present time, laboratory test patients in many states do not have direct access to their results because of a CLIA rule permitting direct release of test results only if (1) the ordering provider expressly authorizes the laboratory to do so at the time the test is ordered, or (2) state law expressly allows for it. 

 

Even though the HIPPA Privacy Rule generally permits direct release of health information to a patient or authorized representative, it defers to the CLIA regulation limitations.  There are 26 states without laws authorizing direct disclosure of test results to patients and 13 states that expressly prohibit it. Patients of CLIA regulated labs in these states cannot obtain their lab results directly.

 

The proposed rule would amend CLIA regulations to allow labs to give patients their test result reports on request.  

 

The proposed rule would eliminate the Privacy Rule exception for an individual’s access to laboratory test result reports.   The amended Privacy Rule would preempt contrary state laws governing a patient’s direct access to lab result reports.

 

CMS reimburses laboratory service providers under Medicare and other federal healthcare programs, CDC is responsible for lab regulation under the Clinical Laboratory Improvement Amendments of 1988 (CLIA), and OCR is responsible for administering the Privacy Rule that under the Health Insurance Portability and Accountability Act of 1986 (HIPAA).