Legislative Priorities for 2001
With a new Congress and a new president,
our nation faces a number of legislative challenges for 2001,
and the Patients' Bill of Rights again leads the list. President
Bush has promised to enact a patients' bill of rights, and HHS
Secretary Tommy Thompson plans to draft an HMO reform bill in
the coming weeks, along with a patients' bill of rights that "protects
and serves all Americans, but recognizes that many states already
have these protections."
A number of patient protection bills are
in process, including one by Senators Frist (R-TN), Breaux (D-LA)
and Jeffords (R-VT) which presently does not address fair reimbursement
for physicians providing emergency care. Republican House members
including Representatives John Shadegg (AZ), Jim Greenwood (PA),
and Amo Houghton (NY) are working on an counterpart to the McCain/Kennedy-Ganske/Dingell
bill, titled "The Bipartisan Patient Protection Act of 2001"
(S.283/H.R. 526).
The bill provides for emergency services
"without the need for any prior authorization determination,"
so long as the health insurance policy includes emergency health
care coverage. Both groups are striving to gain Democratic cosponsors
for their bills.
A regulatory relief bill co-sponsored by
Representatives Pat Toomey (R-PA) and Shelley Berkley (D-NV) and
Senators Frank Murkowski (R-AK) and John Kerry (D-MA) is also
being considered. The Medicare Education and Regulatory Fairness
Act of 2001 ("MERFA," H.R. 868/S. 452), provides modest
reform of Medicare audit practices by guaranteeing physicians
certain due process rights and targeting Medicare education funds
for physicians and health care providers. Although MERFA does
not offer physicians total regulatory relief, I believe it will
be wise to support it because it is a step in the right direction.
Other federal legislative priorities include
graduate medical education funding; the GAO study on practice
expenses related to Medicare reimbursement issues; appropriations
for poison control and trauma centers; Medicare physician fee
schedule issues; practice expense/uncompensated care; HCFA evaluation
and management documentation guidelines; EMTALA modifications,
amendments, and implementation of new regulations; and implementation
of federal prudent layperson standards for Medicaid and Medicare.
Louisiana regains some of the power lost
when Rep. Bob Livingston resigned, as Sen. Mary Landrieu joins
the Senate Appropriations Committee and Rep. David Vitter becomes
a member of the House Appropriations Committee. Other House appointments
include Rep. Billy Tauzin, chair of the Energy and Commerce Committee;
Rep. Richard Baker, chair of a subcommittee of the Financial Services
Committee; and Rep. Jim McCrery, head of a subcommittee of the
Ways and Means Committee. In the Senate, Sen. John Breaux joins
the Rules Committee, in addition to his existing roles on the
Finance and Commerce Committees. Sen. Landrieu will continue serving
on the Senate Energy and Armed Services Committees.
Our state legislature has been busy with
issues such as teacher pay raises and the Harrah's Casino in New
Orleans. The regular session began March 26th, so state legislative
actions concerning emergency medicine are still unfolding. It
is clear that health care is back on the chopping block. The governor's
executive budget has been presented to the Joint Budget Committee,
with $11.6 million in DHH cuts, Medicaid cuts topping $170 million
and reductions of 2,000 positions within DHH and the LSU charity
hospital system.
It is my hope that each member of the medical
community will consider not just how these legislative activities
will affect their work environment, but how they can express their
opinions to their legislators to help enact positive change for
the benefit of health care providers and patients. Our voices
cannot be heard if we do not speak up!
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