The Washington Post reports that 2.1 million people have signed up for health-insurance policies, about half through the federal exchange and about half through the state exchanges. Federal officials are also confident the 2.1 million figure means more Americans, rather than fewer, now have health-care coverage starting Wednesday since it 'certainly outpaces anyone who may have lost a plan' this year," The Post further reports.
FierceEMR reports that consolidation and new business relationships between healthcare providers will create issues regarding patient privacy and electronic health records, according to two healthcare attorneys interviewed by the blog.
Health law attorneys Michael Kline and Elizabeth Litten with Fox Rothschild in Princeton, N.J., told FierceEMR that the issues could include:
a. the expansion of health care entities "increases the risk of breach of the data as the octupus grows";
b. fights over who gets the patient, including if it means that the entity that controls the health care records is in control of the patient.
The Wall Street Journal reports that research by the U.S. Senate Commerce Committee found that data brokers are maintaining health records as part of their massive data collection: "Marketers maintain databases that purport to track and sell the names of people who have diabetes, depression, and osteoporosis, as well as how often women visit a gynecologist."
There is little oversight of data brokers, including from the subjects of the data collection; we don't have the right to find out what type of data is collected about us or who buys the information about us.
"An industry which began in the 1970s collecting data from public records to help marketers send direct mail has become an engine of a global $120 billion digital-advertising industry, helping marketers deliver increasingly targeted ads across the web and on mobile phones," The Journal also reports.
An audit by the Department of the Health and Human Services' Office of Inspector General found that most hospitals don't have policies about copying and pasting health information in electronic health records, iHealthBeat reports. That could lead to health care fraud and abuse such as fraudulent billing and incorrect information being entered into patient records. Only 24% of hospitals had a policy regarding the "improper use of copy-and-paste functions within EHR systems," iHealthBeat further reports.
Separately, Government Health IT reports that earlier this month the Centers for Medicare & Medicaid Services decided to propose a delay in the next two stages of its program to incentivize healthcare providers to adopt "meaningful use" of electronic health records in exchange for governmental incentives.
Advocates say that some plans offered through the Obamacare online insurance exchanges are offering skimpy drug coverage for expensive conditions like AIDS, cancer and other chronic conditions, The Washington Post reports. One advocate, John Peller, vice president of policy for the AIDS Foundation of Chicago, told The Post: '“The fear is that they are putting discriminatory plan designs into place to try to deter certain people from enrolling by not covering the medications they need, or putting policies in place that make them jump through hoops to get care.'"
The issues are, advocates told The Post, that: "The plans are curbing their lists of covered drugs and limiting quantities, requiring prior authorizations and insisting on 'fail first' or 'step therapy' protocols that compel doctors to prescribe a certain drug first before moving on to another — even if it’s not the physician’s and patient’s drug of choice."
NPR's Michelle Andrews did an interview with Jennifer Mathis of Judge David L. Bazelon Center for Mental Health Law on the final rule from the federal government to enforce parity in health insurance coverage between physical health and mental health.
A couple interesting nuggets:
One- Since interim parity regulations came out, only a small percentage of plans have dropped mental health or substance use coverage.
Two- The final rules make clear in a way that the interim rules didn't that "intermediate-level mental health services, including residential treatment and intensive outpatient services," have to be covered in parity.
America's new health law is beating projections on how much it will cost, The New York Times reports, "with both the Medicaid expansion and the subsidies for private insurance plans ending up less expensive than anticipated." The main reason is the slow economy as well as deductibles and copays that discourage consumers from undertaking some health care.
The Concord Monitor reports that the "federal stimulus bill passed in 2008 contained billions of dollars in funding for medical providers to adopt electronic health records." The carrot: the financial incentives to adopt electronic health records. The stick: if healthcare providers do not achieve "meaningful use" in their electronic records, they face deductions from their Medicare payments.
However, some independent physician practices that do not have a lot of Medicare payments find "the incentives haven’t been big enough to justify the costs of meeting the high standards," The Monitor further reports.
Doctors find some benefits from electronic records but they also find the records to be "cumbersome, time-consuming and annoying" than old-fashioned paper charting, The Monitor further reports.
The value of electronic health records will likely improve if healthcare providers become more agile in using them and if the systems also are redesigned and updated to reflect the deficits many users find in them.
President Obama's administration is still reeling from the failure to have the federal health-insurance exchange up and running for consumers to shop for health insurance (ahead of the deadline for when the insurance mandate kicks in). There could be further repurcussions if the Internal Revenue Service is not ready to enforce the requirement that all Americans secure health insurance, The Washington Post reports.
The issues include, The Post reports, that: "Besides lacking coverage information that would help the agency enforce the 'individual mandate,' the IRS also is hamstrung in penalizing those who do not sign up. The lawmakers who drafted the health-care law intentionally barred the IRS from using its customary tools for collecting penalties — liens, foreclosures and criminal prosecution. The only means of collecting the fine is to essentially garnish tax refunds for people who overpaid their taxes."
Legislation introduced in the U.S. Senate (and which mirrors legislation introduced in the House of Representatives) would expand the federal incentives for the adoption of electronic health records to "psychiatric hospitals, substance abuse facilities and psychologists," according to FierceEMR. Senator Rob Portman, R-Ohio's bill also would ensure that electronic health records are not medical devices to be regulated under the Food, Drugs and Cosmetics Act and limit electronic discovery of electronic health records, the web site also reported.
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