This is a very long post, but it needs to be read to understand exactly what is in this horrible bill.
For anyone with two or three days to waste you can download it in PDF format here.
I have now read this outrageous piece of garbage four times. In my opinion a class of ninth graders could have done a better job. Pelosi was pushing these congress critters to put together something, who cares what is in it after all none of them will read it, they will just pass itr
Health Care Bill
Mr. DINGELL (for himself, Mr. RANGEL, Mr. WAXMAN, Mr. GEORGE MILLER of California, Mr. STARK, Mr. PALLONE, and Mr. ANDREWS)
introduced the following bill
(My opinion is that the above named politicians are criminals and should be treated as such. I can not wait for Nov. 2010. This bill coming from this group, does not surprise me in the least.)
To download the complete piece of crap go to Health Care Bill You can read another’s dissection of this piece of crap by visiting The Angry White Guy, a great site!!! I have read this thing line by line four times, I need to go take something for this headache.
Sarah Palin was vilified for saying that this bill contains a “Death Panel” which would decide what coverage and treatment would be allowed for our elderly or injured family members or disabled, (Like Trig her son). Turns out she was exactly right she, unlike members of Congress and Prez Zero, has read the bill. It starts on PG 424 and ends on PG 430. Members of congress claim this has been removed, strange since congress criters and Zero claimed it was not in there. Liar,Liar, Pants on fire.
This is a very dangerous bill and will destroy this country along with Cap N Trade, we must take back our country. These Washington politicians have forgotten who they work for. If it takes pitchforks and torches in the halls of Congress, So Be It.
Congressional Health Coverage
It would be nice if us peons were offered this same plan, it would be something to welcome …No such luck, after all we are just the ones who pay these dipwads salaries and pay for their health plans.
Membership Has Its Privileges
[Congress has] a choice of 10 healthcare plans that provide access to a national network of doctors, as well as several HMOs that serve each member’s home state. By contrast, 85% of private companies offering health coverage provide their employees one type of plan — take it or leave it.
Lawmakers also get special treatment at Washington’s federal medical facilities and, for a few hundred dollars a month, access to their own pharmacy and doctors, nurses and medical technicians standing by in an office conveniently located between the House and Senate chambers…
Why can’t everyone enjoy the same benefits as members of Congress? The answer: The country probably couldn’t afford it …
The plan most favored by federal workers is Blue Cross Blue Shield, which covers a family for about $1,030 a month. Taxpayers kick in $700, and employees pay the rest. ($330/mo for a family) Seeing a doctor costs $20. Generic prescriptions cost $10. Immunizations are free. There is no coverage limit…
There is no such thing as a preexisting condition…
Pg 16
SEC. 102. PROTECTING THE CHOICE TO KEEP CURRENT COVERAGE.
(a) GRANDFATHERED HEALTH INSURANCE COVERAGE DEFINED.—Subject to the succeeding provisions of this section, for purposes of establishing acceptable coverage under this division, the term ‘‘grandfathered health insurance coverage’’ means individual health insurance coverage that is offered and in force and effect before the first day of Y1 if the following conditions are met: (1) LIMITATION ON NEW ENROLLMENT.— (A) IN GENERAL.—Except as provided in this paragraph, the individual health insurance issuer offering such coverage does not enroll any individual in such coverage if the first ef1fective date of coverage is on or after the first day of Y1.
Meaning if you attempt to change your policy – for any reason – you can’t This is a phase in of a single payer system.
Pg 22
of the HC Bill mandates the Government will audit books of all employers that self insure. Can you imagine what that will do to small businesses? Many will go out of business because of all the penalties and Taxes involved with this plan.
Page 29
lines 4-16 in the HC bill –
Rationed healthcare is coming to your door! Canada and Britain anyone?
(A) ANNUAL LIMITATION.—
The cost-sharing incurred under the essential benefits package with respect to an individual (or family) for a year does not exceed the applicable level specified in subparagraph (B).
(B) APPLICABLE LEVEL.—The applicable level specified in this subparagraph for Y1 is $5,000 for an individual and $10,000 for a family. Such levels shall be increased (rounded) to the nearest $100) for each subsequent year by the annual percentage increase in the Consumer Price Index (United States city average) applicable to such year.
Yes Martha, this is the double blind trap. The providers who don’t cave after the first shot, will not be able to add any new employees to their health plan. They would automagically be enrolled in ObamaCare. Most companies, including the one my wife works for, (who provides our health coverage and has saved my life) has stated that if this piece of crap passes, they will drop the coverage. Which means, that I will die. I am at that age where the plan of Pres Zero would declare me expendable.
Pg 30
Sec 123 of HC bill – a Government committee will decide what treatments a person may receive.
SEC. 123. HEALTH BENEFITS ADVISORY COMMITTEE.
(a) ESTABLISHMENT.—
(1) IN GENERAL.—There is established a private-public advisory committee which shall be a panel of medical and other experts to be known as the Health Benefits Advisory Committee to recommend covered benefits and essential, enhanced, and premium plans.
Pg 42
of HC Bill – The Health Choices Commissioner will choose your HC Benefits for you. No choice!
SEC. 142. DUTIES AND AUTHORITY OF COMMISSIONER.
(a) DUTIES.—The Commissioner is responsible for carrying out the following functions under this division:
(1) QUALIFIED PLAN STANDARDS.—The establishment of qualified health benefits plan standards under this title, including the enforcement of such standards in coordination with State insurance regulators and the Secretaries of Labor and the Treasury.
PG 50
Section 152 in HC bill – HC will be provided to ALL non US citizens,i
SEC. 152. PROHIBITING DISCRIMINATION IN HEALTH CARE.
(a) IN GENERAL.—Except as otherwise explicitly permitted by this Act and by subsequent regulations consistent with this Act, all health care and related services (including insurance coverage and public health activities)1 covered by this Act shall be provided without regard to personal characteristics extraneous to the provision of high quality health care or related services.
Pg 58
HC Bill – Mandates government access to individual’s finances and
A National ID Healthcard will be issued!
‘‘(D) enable the real-time (or near real time) determination of an individual’s financial responsibility at the point of service and, to the extent possible, prior to service, including whether the individual is eligible for a specific service with a specific physician at a specific facility, which may include utilization of a machine-readable health plan beneficiary identification card;
‘‘(E) enable, where feasible, near real-time adjudication of claims;
‘‘(F) provide for timely acknowledgment, response, and status reporting applicable to any electronic transaction deemed appropriate by the Secretary;
Pg 59
HC Bill lines 21-24
This one speaks for itself, I don’t want the gummit treating my account like an ATM.
‘‘(C) enable electronic funds transfers, in order to allow automated reconciliation with the related health care payment and remittance advice;
Pg 65-69
Sec 164 is a payoff subsidized plan for retirees and their families in Unions & community organizations.
SEC. 164. REINSURANCE PROGRAM FOR RETIREES.
(a) ESTABLISHMENT.—
IN GENERAL.
Not later than 90 days after the date of the enactment of this Act, the Secretaryof Health and Human Services shall establish a temporary reinsurance program (in this section referred to as the ‘‘reinsurance program’’) to provide reimbursement to assist participating employment-based plans with the cost of providing health benefits to retirees and to eligible spouses, surviving spouses and dependents of such retirees.
DEFINITIONS.—For purposes of this section:VerDate Nov 24 2008 12:51 Jul 14, 2009 Jkt 000000 PO 00000 Frm 00065 Fmt 6652 Sfmt 6201 P\AAHCA0~1.XML HOLCPC
(A) The term ‘‘eligible employment-based plan’’ means a group health benefits plan that is maintained by one or more employers, former employers or employee associations, or a voluntary employees’ beneficiary association, or a committee or board of individuals appointed to administer such plan, and provides health benefits to retirees.
(B) The term ‘‘health benefits’’ means medical, surgical, hospital, prescription drug,and such other benefits as shall be determined by the Secretary, whether self-funded or delivered through the purchase of insurance or otherwise.
(C) The term ‘‘participating employment based plan’’ means an eligible employment based plan that is participating in the reinsurance program.
(D) The term ‘‘retiree’’ means, with respect to a participating employment-benefit plan, an individual who—is 55 years of age or older; is not eligible for coverage under title XVIII of the Social Security Act; and is not an active employee of an employer maintaining the plan or of any employer that makes or has made substantial contributions to fund such plan.
(E) The term ‘‘Secretary’’ means Secretary of Health and Human Services.
PARTICIPATION.—To be eligible to participate in the reinsurance program, an eligible employment-based plan shall submit to the Secretary an application for participation in the program, at such time, in such manner, and containing such information as the Secretary shall require.
PAYMENT.—
SUBMISSION OF CLAIMS.—
IN GENERAL.—
(A) Under the reinsurance program, a participating employment-based plan shall submit claims for reimbursement to the Secretary which shall contain documentation of the actual costs of the items and services for which each claim is being submitted.
(B)BASIS FOR CLAIMS.—
Each claim submitted under subparagraph (A) shall be based on the actual amount expended by the participating employment-based plan involved within the plan year for the appropriate employment
based health benefits provided to a retiree or to the spouse, surviving spouse, or dependent of a retiree. In determining the amount of any claim for purposes of this subsection, the participating employment-based plan shall take into account any negotiated price concessions (such as discounts, direct or indirect subsidies, rebates, and direct or indirect remunerations) obtained by such plan with respect to such health benefits. For purposes of calculating the amount of any claim, the costs paid by the retiree or by the spouse, surviving spouse, or dependent of the retiree in the form of deductibles, co-payments, and co-insurance shall be included along with the amounts paid by the participating employment-based plan.
PROGRAM PAYMENTS AND LIMIT.—If the Secretary determines that a participating employment-based plan has submitted a valid claim under paragraph (1), the Secretary shall reimburse such plan for 80 percent of that portion of the costs attributable to such claim that exceeds $15,000, but is less than $90,000. Such amounts shall be adjusted each year based on the percentage increase in the medical care component of the Consumer Price Index (rounded to the nearest multiple of $1,000)for the year involved
USE OF PAYMENTS.—
Amounts paid to a participating employment-based plan under this sub-section shall be used to lower the costs borne directly by the participants and beneficiaries for health benefits provided under such plan in the form of premiums, co-payments, deductibles, co-insurance, or other out-of-pocket costs. Such payments shall not be used to reduce the costs of an employer maintaining the participating employment-based plan. The Secretary shall develop a mechanism to monitor the appropriate use of such payments by such plans.
Pg 72
Lines 8-14
Government will bring private HC plans under Government control.
(a) ESTABLISHMENT.—There is established within the Health Choices Administration and under the direction of the Commissioner a Health Insurance Exchange in order to facilitate access of individuals and employers, through a transparent process, to a variety of choices of affordable, quality health insurance coverage, including a public health insurance option.
This section contradicts PG 16 Sec 102(a) “the individual health insurance issuer offering such coverage does not enroll any individual in such coverage if the first effective date of coverage is on or after the first day” of the year the legislation becomes law”
PG 84
Sec 203 HC bill –
Government mandates ALL benefits for private HC plans in the Exchange.
SEC. 203. BENEFITS PACKAGE LEVELS.
(a) IN GENERAL.—The Commissioner shall specify the benefits to be made available under Exchange-participating health benefits plans during each plan year, consistent with subtitle C of title I and this section.
PG 85
Line 7 HC Bill – The Government will ration your Healthcare!
(c) SPECIFICATION OF BENEFIT LEVELS FOR PLANS.— (1) IN GENERAL.—The Commissioner shall establish the following standards consistent with this subsection and title I:
PG 91
Lines 4-7 HC Bill – Government mandates linguistic appropriate services. Example – Sounds like a sweetheart deal for illegal aliens.
(7) CULTURALLY AND LINGUISTICALLY APPROPRIATE SERVICES AND COMMUNICATIONS.—The entity shall provide for culturally and linguistically appropriate communication and health services.
Pg 95
HC Bill Lines 8-18 The Government will use groups, i.e. ACORN & Americorps, to sign up individuals for Government HC plan.
*** NOTE: What The Hell in order to sort through this garbage you have to scroll dozens of pages forward and backwards to try to figure out what Sec 202 says, so you go to Sec 202 then you need to go to Sec 104 (c)A and then turn to 409 etc etc.. I swear a bunch of school kids wrote this say turn to this page now this one now this one etc etc…
-PG 102
Lines 12-18 HC Bill – Medicaid Eligible Individuals will be automatically enrolled in Medicaid. No choice., that would be me.
AUTOMATIC ENROLLMENT OF MEDICAID ELIGIBLE INDIVIDUALS INTO MEDICAID.—The Commissioner shall provide for a process under which an individual who is described in section 202(d)(3) and has not elected to enroll in an Exchange-participating health benefits plan is automatically enrolled under Medicaid.
pg 124
lines 24-25 HC No company can sue Government on price fixing. No “judicial review”.
LIMITATIONS ON REVIEW.—There shall be no administrative or judicial review of a payment rate or methodology established under this section or under section
Price fixing with no administrative or judicial review
pg 127
Lines 1-24 HC Bill – Doctors will b e told what they can earn..
(1) PHYSICIANS.—The Secretary shall provide for the annual participation of physicians under the public health insurance option, for which payment may be made for services furnished during the year, in one of 2 classes:
(A) PREFERRED PHYSICIANS.—Those physicians who agree to accept the payment rate established under section 223 (without regard to cost-sharing) as the payment in full.
(B) PARTICIPATING, NON-PREFERRED PHYSICIANS.—Those physicians who agree not to impose charges (in relation to the payment rate described in section 223 for such physicians) that exceed the ratio permitted under section 1848(g)(2)(C) of the Social Security Act.
(2) OTHER PROVIDERS.—The Secretary shall provide for the participation (on an annual or other basis specified by the Secretary) of health care providers (other than physicians) under the public health insurance option under which payment shall only be available if the provider agrees to accept the payment rate established under section 223 (without regard to cost-sharing) as the payment in full.
Pg 145
Line 15-17 An Employer must auto enroll new employees into public option plan. no opt-out.
(4) AUTO ENROLLMENT OF EMPLOYEES.—The employer provides for auto enrollment of the employee in accordance with subsection (c).
Pg 146
Lines 22-25 Employers must pay for HC for part time employees and families.
(3) MINIMUM EMPLOYER CONTRIBUTION FOR EMPLOYEESOTHER THAN FULL-TIME EMPLOYEES.—In the case of coverage for an employee who is not a full-time employee, the amount of the minimum employer contribution under this subsection shall be a proportion
Pg 149
Lines 16-24 ANY Employer with payroll $400k & above who does not provide public option pays 8% tax on all payroll.
SEC. 313. EMPLOYER CONTRIBUTIONS IN LIEU OF COVERAGE
.(a) IN GENERAL.—A contribution is made in accordance with this section with respect to an employee if such contribution is equal to an amount equal to 8 percent of the average wages paid by the employer during the period of enrollment
pg 150
Lines 9-13 Businesses with payroll between $251k & $400k who don’t provide public option pay 2-6% tax on all payroll.
(b) SPECIAL RULES FOR SMALL EMPLOYERS.— (1) IN GENERAL.—In the case of any employer who is a small employer for any calendar year, subsection (a) shall be applied by substituting the applicable percentage determined in accordance with the following table for ‘‘8 percent’’: If the annual payroll of such employer for the preceding calendar year:
The applicable percentage is:
Does not exceed $250,000 ………………………………. 0 percent
Exceeds $250,000, but does not exceed $300,000 2 percent
Exceeds $300,000, but does not exceed $350,000 4 percent
Exceeds $350,000, but does not exceed $400,000 6 percent
Pg 167
Lines 18-23 Individualss who don’t have acceptable HC according to Government will be taxed 2.5% of income. Hey, get your friggin hand out of my pocket!
‘‘SEC. 59B. TAX ON INDIVIDUALS WITHOUT ACCEPTABLE HEALTH CARE COVERAGE.
‘‘(a) TAX IMPOSED.—In the case of any individual who does not meet the requirements of subsection (d) at any time during the taxable year, there is hereby imposed a tax equal to 2.5 percent of the excess of—
‘‘(1) the taxpayer’s modified adjusted gross income for the taxable year, over
‘‘(2) the amount of gross income specified in section 6012(a)(1) with respect to the taxpayer.
Pg 170
Lines 1-3 HC Bill Any nonresident Alien is exempt from individual taxes. (It will come out of our pockets)
‘‘(2) PRORATION FOR PART YEAR FAILURES.— The tax imposed under subsection (a) with respect to any taxpayer for any taxable year shall not exceed the amount which bears the same ratio to the amount of tax so imposed (determined without regard to this paragraph and after application of paragraph (1))
…[snip]…
‘‘(2) NONRESIDENT ALIENS.—Subsection (a) shall not apply to any individual who is a non-resident alien.
Pg 195
HC Bill -officers & employees of HC Admin (the GOVERNMENT) will have access to ALL Americans’ finances and personal records.
Health Choices Act of 2009, shall disclose to officers and employees of the Health Choices Administration or such State-based health insurance exchange, as the case may be, return information of any taxpayer whose income is relevant in determining any affordability credit described in subtitle C of title II of the America’s Affordable Health Choices Act of 2009. Such return information shall be limited to—
‘‘(i) taxpayer identity information with respect to such taxpayer,
‘‘(ii) the filing status of such taxpayer,
‘‘(iii) the modified adjusted gross income of such taxpayer (as defined in section 59B(e)(5)),
‘‘(iv) the number of dependents of the taxpayer,
‘‘(v) such other information as is prescribed by the Secretary by regulation as might indicate whether the taxpayer is eligible for such affordability credits (and the amount thereof), and
‘‘(vi) the taxable year with respect to which the preceding information relates or,if applicable, the fact that such information is not available.
NOTE: Pay close attention to “(v) this is a catch all that could include anything.
PG 203
Line 14-15 HC – “The tax imposed under this section shall not be treated as tax” Goblegook
‘‘(4) NOT TREATED AS TAX IMPOSED BY THIS CHAPTER FOR CERTAIN PURPOSES.—The tax imposed under this section shall not be treated as tax imposed by this chapter for purposes of determining the amount of any credit under this chapter or for purposes of section 55.’’.
*A tax that is not a tax… perhaps this is all just a bad dream?
Pg 239
Line 14-24 HC Bill Government will reduce physician services for Medicaid. Seniors, low income, say it ain’t so
(c) LIMITATION ON PHYSICIANS’ SERVICES INCLUDED IN TARGET GROWTH RATE COMPUTATION TO SERVICES COVERED UNDER PHYSICIAN FEE SCHEDULE.—Effective for services furnished on or after January 1, 2009, section 1848(f)(4)(A) of such Act is amended striking ‘‘(such as clinical’’ and all that follows through ‘‘in a physician’s office’’ and inserting ‘‘for which payment under this part is made under the fee schedule under this section, for services for practitioners described in section 1842(b)(18)(C) on a basis related to such fee schedule, or for services described in section 1861(p) (other than such services when furnished in the facility of a provider of services)’’.
Pg 241
Line 6-8 HC Bill – Doctors – doesn’t matter what specialty – will all be paid the same.
Service categories established under this paragraph shall apply without regard to the specialty of the physician furnishing the service.’’.
PG 253
Line 10-18 Government sets value of Doctor’s time, professional judgment, etc.
‘‘(ii) COMPONENTS AND ELEMENTS OF WORK.—The process described in clause (i) may include validation of work elements (such as time, mental effort and professional judgment, technical skill and physical effort, and stress due to risk) involved with furnishing a service and may include validation of the pre, post, and intra-service components of work.
PG 265
Sec 1131Government mandates & controls productivity for private HC industries.
SEC. 1131. INCORPORATING PRODUCTIVITY IMPROVEMENTS INTO MARKET BASKET UPDATES THAT DO NOT ALREADY INCORPORATE SUCH IMPROVEMENTS.
PG 268
Sec 1141 Federal Government regulates rental & purchase of power driven wheelchairs.
SEC. 1141. RENTAL AND PURCHASE OF POWER-DRIVEN WHEELCHAIRS.
(a) IN GENERAL.—Section 1834(a)(7)(A)(iii) of the Social Security Act (42 U.S.C. 1395m(a)(7)(A)(iii)) is amended—
(1) in the heading, by inserting ‘‘CERTAIN COMPLEX REHABILITATIVE’’ after ‘‘OPTION FOR’’; and
(2) by striking ‘‘power-driven wheelchair’’ and inserting ‘‘complex rehabilitative power-driven wheel chair recognized by the Secretary as classified within group 3 or higher’’.
Group 3? What the hell?
PG 272
SEC. 1145. TREATMENT OF CERTAIN CANCER HOSPITALS – Cancer patients – I am one of those.
SEC. 1145. TREATMENT OF CERTAIN CANCER HOSPITALS.
Section 1833(t) of the Social Security Act (42 U.S.C. 1395l(t)) is amended by adding at the end the following new paragraph:
‘‘(18) AUTHORIZATION OF ADJUSTMENT FOR CANCER HOSPITALS.—
‘‘(A) STUDY.—The Secretary shall conduct a study to determine if, under the system under this subsection, costs incurred by hospitals described in section 1886(d)(1)(B)(v) with respect to ambulatory payment classification groups exceed those costs incurred by other hospitals furnishing services under this subsection (as determined appropriate by the Secretary).
Page 280
Sec 1151 The Government will penalize hospitals for what Government deems preventable readmission. Some lackey in Wash will decide these things?
Subtitle C—Provisions Related to Medicare Parts A and B
3 SEC. 1151. REDUCING POTENTIALLY PREVENTABLE HOSPITAL READMISSIONS.
(a) HOSPITALS.— (1) IN GENERAL.—Section 1886 of the Social Security Act (42 U.S.C. 1395ww), as amended by section 1103(a), is amended by adding at the end the following new subsection:
‘‘(p) ADJUSTMENT TO HOSPITAL PAYMENTS FOR EXCESS READMISSIONS.—
‘‘(1) IN GENERAL.—With respect to payment for discharges from an applicable hospital (as defined in paragraph (5)(C)) occurring during a fiscal year beginning on or after October 1, 2011, in order to account for excess readmissions in the hospital, the Secretary shall reduce the payments that would otherwise be made to such hospital under subsection (d) (or section 1814(b)(3), as the case may be) for such a discharge by an amount equal to the product of—
‘‘(A) the base operating DRG payment amount (as defined in paragraph (2)) for the discharge; and
‘‘(B) the adjustment factor (described in paragraph (3)(A)) for the hospital for the fiscal year.
Pg 298
Lines 9-14 Doctors who treat a patient during initial admission that results in a readmission – Government will penalize you.
(C) applying a payment reduction for physicians who treat the patient during the initial admission that results in a readmission; and
(D) methods for attributing payments or payment reductions to the appropriate physician or physicians.
Pg 299
Sec 1152 Bundling of payment to doctors. Bundle my ASS.
SEC. 1152. POST ACUTE CARE SERVICES PAYMENT REFORM PLAN AND BUNDLING PILOT PROGRAM.
(1) IN GENERAL.—The Secretary of Health and Human Services (in this section referred to as the ‘‘Secretary’’) shall develop a detailed plan to reform payment for post acute care (PAC) services under the Medicare program under title XVIII of the Social Security Act (in this section referred to as the ‘‘Medicare program)’’.
Pg 317
L 13-20 PROHIBITION on ownership/investment. Government tells Doctors what/how much they can own.
‘‘(B) PROHIBITION ON PHYSICIAN OWNERSHIP OR INVESTMENT.—The percentage of the total value of the ownership or investment interests held in the hospital, or in an entity whose assets include the hospital, by physician owners or investors in the aggregate does not exceed such percentage as of the date of enactment of this subsection.
Pg 317-318
lines 21-25,1-3 PROHIBITION on expansion – Government will dictate that hospitals cannot expand.
‘‘(C) PROHIBITION ON EXPANSION OF FACILITY CAPACITY.—Except as provided in paragraph (2), the number of operating rooms, procedure rooms, or beds of the hospital at any time on or after the date of the enactment of this subsection are no greater than the number of operating rooms, procedure rooms, or beds, respectively, as of such date.
Pg 335
L 16-25 Pg 336-339 – Government dictates establishment of outcome-based measures which forces health care rationing.
‘‘(ii) ESTABLISHMENT OF OUTCOME BASED MEASURES.—By not later than for 2013 the Secretary shall implement reporting requirements for quality under this section on measures selected under clause (iii) that reflect the outcomes of care experienced by individuals enrolled in Medicare Advantage plans (in addition to measures described in clause (i)). Such measures may include—
NOTE I’m not going to post all of pages.
Pg 341
Lines 3-9 Government has authority to disqualify Medicare Adv Plans, HMOs, etc., let’s force people into the Government plan.
‘‘(iv) AUTHORITY TO DISQUALIFY CERTAIN PLANS.—In applying clauses (ii) and (iii), the Secretary may determine not to identify a Medicare Advantage plan if the Secretary has identified deficiencies in the plan’s compliance with rules for such plans under this part.
Pg 354
Sec 1177 – Government will RESTRICT enrollment of Special needs people! I guess we don’t rate the no pre-existing condition clause that Congress has.
SEC. 1177. EXTENSION OF AUTHORITY OF SPECIAL NEEDS PLANS TO RESTRICT ENROLLMENT.
(a) IN GENERAL.—Section 1859(f)(1) of the Social Security Act (42 U.S.C. 1395w–28(f)(1)) is amended by striking ‘‘January 1, 2011’’ and inserting ‘‘January 1, 2013 (or January 1, 2016, in the case of a plan described in section 1177(b)(1) of the America’s Affordable Health Choices Act of 2009)’’.
Pg 379
Sec 1191 Government creates more bureaucracy – Telehealth Advisory Committee. HC by phone.
Subtitle F—Medicare Rural Access Protections
SEC. 1191. TELEHEALTH EXPANSION AND ENHANCEMENTS.
(a) ADDITIONAL TELEHEALTH SITE.—— (1) IN GENERAL.—Paragraph (4)(C)(ii) of section 1834(m) of the Social Security Act (42 U.S.C. 1395m(m)) is amended by adding at the end the following new subclause:
Phoning in your health care, Just what I want, do it yourself surgery..
PG 424
sec 1233
Lines 4-12 Government mandates Advance Care Planning Consultations. Senior Citizens end of life coaching.
‘‘Advance Care Planning Consultation
‘‘(hhh)(1) Subject to paragraphs (3) and (4), the term ‘advance care planning consultation’ means a consultation between the individual and a practitioner described in paragraph (2) regarding advance care planning, if, subject to paragraph (3), the individual involved has not had such a consultation within the last 5 years. Such consultation shall include the following:
Pg 425
Lines 17-19 Government will instruct & consult regarding living wills, durable powers of attorney. Mandatory!
‘‘(A) An explanation by the practitioner of advance care planning, including key questions and considerations, important steps, and suggested people to talk to.
‘‘(B) An explanation by the practitioner of advance directives, including living wills and durable powers of attorney, and their uses.
‘‘(C) An explanation by the practitioner of the role and responsibilities of a health care proxy.
PG 425
Lines 22-25, 426 Lines 1-3 Government provides approved list of end of life resources. It’s your time to die.
‘‘(D) The provision by the practitioner of a list of national and State-specific resources to assist consumers and their families with advance care planning, including the national toll-free hotline, the advance care planning clearinghouses, and State legal service organizations (including those funded through the Older Americans Act of 1965).‘‘(E) An explanation by the practitioner of the continuum of end-of-life services and supports available, including palliative care and hospice, and benefits for such services and supports that are available under this title.
PG 427
Lines 15-24 Government mandates program for orders for end of life. The Government has a say in how your life ends.
‘‘(iii) A program for orders for life sustaining treatment for a States described in this clause is a program that—
‘‘(I) ensures such orders are standardized and uniquely identifiable throughout the State;
‘‘(II) distributes or makes accessible such orders to physicians and other health professionals that (acting within the scope of the professional’s authority under State law) may sign orders for life sustaining treatment;
Pg 429
Lines 1-9 An “advanced care planning consultant” will be used frequently as patients’ health deteriorates. What are you waiting for, DIE.
‘‘(B) An advance care planning consultation with respect to an individual may be conducted more frequently than provided under paragraph (1) if there is a significant change in the health condition of the individual, including diagnosis of a chronic, progressive, life-limiting disease, a life-threatening or terminal diagnosis or life-threatening injury, or upon admission to a skilled nursing facility, a long-term care facility (as defined by the Secretary), or a hospice program
PG 429
Lines 10-12 “advanced care consultation” may include an ORDER for end of life plans. AN ORDER from the Government to end a life!
‘‘(4) A consultation under this subsection may include the formulation of an order regarding life sustaining treatment or a similar order.
Pg 429
Lines 13-25 – The Government will specify which Doctors can write an end of life order.
‘‘(5)(A) For purposes of this section, the term ‘order regarding life sustaining treatment’ means, with respect to an individual, an actionable medical order relating to the treatment of that individual that—‘‘(i) is signed and dated by a physician (as defined in subsection (r)(1)) or another health care professional (as specified by the Secretary and who is acting within the scope of the professional’s authority under State law in signing such an order, including a nurse practitioner or physician assistant) and is in a form that permits it to stay with the individual and be followed by health care professionals and providers across the continuum of care;
PG 430
Lines 11-15 The Government will decide what level of treatment you will have at end of life.
‘‘(B) The level of treatment indicated under subparagraph (A)(ii) may range from an indication for full treatment to an indication to limit some or all or specified interventions. Such indicated levels of treatment may include indications respecting, among other items
‘(i) the intensity of medical intervention if the patient is pulse less, apneic, or has serious cardiac or pulmonary problems; ‘‘(ii) the individual’s desire regarding transfer to a hospital or remaining at the current care setting; ‘‘(iii) the use of antibiotics; and ‘‘(iv) the use of artificially administered nutrition and hydration.’’.
Pg 469
Community Based Home Medical Services/Non profit orgs.
‘‘(B) COMMUNITY-BASED MEDICAL HOME DEFINED.—In this section, the term ‘community-based medical home’ means a nonprofit community-based or State-based organization that is certified under paragraph (2) as meeting the following requirements:
‘‘(i) The organization provides beneficiaries with medical home services.
Page 472
Lines 14-17 PAYMENT TO COMMUNITY-BASED ORGANIZATION. One monthly payment to a community-based organization.
(What are community based organizations? Are we talkin’ acorn?)
In regards to SEC. 1302. MEDICAL HOME PILOT PROGRAM.
‘‘(i) PAYMENT TO COMMUNITY-BASED ORGANIZATION.—One monthly payment to a community-based or State-based organization.
PG 489
Sec 1308 The Government will cover Marriage & Family therapy. I don’t want Government in my marriage.
SEC. 1308. COVERAGE OF MARRIAGE AND FAMILY THERAPIST SERVICES AND MENTAL HEALTH COUNSELOR SERVICES.
(a) COVERAGE OF MARRIAGE AND FAMILY THERAPIST SERVICES.—
(1) COVERAGE OF SERVICES.—Section 1861(s)(2) of the Social Security Act (42 U.S.C.1395x(s)(2)), as amended by section 1235, is amended— (A) in subparagraph (EE), by striking ‘‘and’’ at the end; (B) in subparagraph (FF), by adding ‘‘and’’ at the end; and (C) by adding at the end the following new subparagraph:
‘‘(GG) marriage and family therapist services (as defined in subsection (jjj));’’.
Pg 494-498
Government will cover Mental Health Services including defining, creating, rationing those services.
You can look up those pages I’m not going to post it all…It is scary stuff if you are not an illegal.
SEC. 1222. DEMONSTRATION TO PROMOTE ACCESS FOR MEDICARE BENEFICIARIES WITH LIMITED ENGLISH PROFICIENCY BY PROVIDING REIMBURSEMENT FOR CULTURALLY AND LINGUISTICALLY APPROPRIATE SERVICES.
(a) IN GENERAL.-Not later than 6 months after the date of the completion of the study described in section 1221(a), the Secretary, acting through the Centers for Medicare & Medicaid Services, shall carry out a demonstration program under which the Secretary shall award not fewer than 24 3-year grants to eligible Medicare service providers (as described in subsection (b)(1)) to improve effective communication between such providers and Medicare beneficiaries who are living in communities where racial and ethnic minorities, including populations that face language barriers, are underserved with respect to such services.
The section goes on to specify the amount ($500,000) and other factors regarding these grants. :
(B) FOR COMMUNITY ORGANIZATIONS.- The Secretary shall give priority to applicants that have developed partnerships with community organizations or with agencies with experience in language access.
Pg 839
Sec 1904 The Government tells you how to raise your children. Now this is said to be voluntary so how long does it take for something to go from voluntary to mandatory? .
SEC. 1904. GRANTS TO STATES FOR QUALITY HOME VISITATION PROGRAMS FOR FAMILIES WITH YOUNG CHILDREN AND FAMILIES EXPECTING CHILDREN. Part B of title IV of the Social Security Act (42 U.S.C. 621–629i) is amended by adding at the end the following: ‘‘Subpart 3—Support for Quality Home Visitation Programs
‘‘SEC. 440. HOME VISITATION PROGRAMS FOR FAMILIES WITH YOUNG CHILDREN AND FAMILIES EXPECTING CHILDREN.
‘‘(a) PURPOSE.—The purpose of this section is to improve the well-being, health, and development of children by enabling the establishment and expansion of high quality programs providing voluntary home visitation for families with young children and families expecting children.
‘‘(b) GRANT APPLICATION.—A State that desires to receive a grant under this section shall submit to the Secretary for approval, at such time and in such manner as the Secretary may require, an application for the grant that includes the following:
‘‘(1) DESCRIPTION OF HOME VISITATION PROGRAMS.—A description of the high quality programs of home visitation for families with young children and families expecting children that will be supported by a grant made to the State under this section, the outcomes the programs are intended to achieve, and the evidence supporting the effectiveness of the programs.
From page 839 to 852 Line 12 is a bunch of scary stuff. It sounds like CPS will be visiting all of our homes to make sure we are not hiding kids in the closet.
Pg 852 to 1001 is full of congralees B.S.. (remove this coma, add a period here, in general useless stuff that need not be there if they had written it right the first time.
Pg 1001 to 1008
Subtitle C—National Medical Device Registry
SEC. 2521. NATIONAL MEDICAL DEVICE REGISTRY.
(a) REGISTRY.— (1) IN GENERAL.—Section 519 of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360i) is amended— (A) by redesignating subsection (g) as sub-section (h); and (B) by inserting after subsection (f) the following: ‘‘National Medical Device Registry ‘‘(g)(1) The Secretary shall establish a national medical device registry (in this subsection referred to as th ‘registry’) to facilitate analysis of think this safety and outcomes data on each device that—
‘‘(A) is or has been used in or on a patient; an ‘‘(B) is— ‘‘(i) a class III device; or ‘‘(ii) a class II device that is implantable, life-supporting, or life-sustaining. ‘‘(2) In developing the registry, the Secretary shall, in consultation with the Commissioner of Food and Drugs, the Administrator of the Centers for Medicare & Medicaid Services, the head of the Office of the National Coordnator for Health Information Technology, and the Secretary of Veterans Affairs, determine the best methods for— ‘‘
(A) including in the registry, in a manner consistent with subsection (f), appropriate information to identify each device described in paragraph (1) by type, model, and serial number or other unique identifier;‘‘(B) validating methods for analyzing patient safety and outcomes data from multiple sources and for linking such data with the information included in the registry as described in subparagraph
(A), including, to the extent feasible, use of—‘‘(i) data provided to the Secretary under other provisions of this chapter; and ‘‘(ii) information from public and private sources identified under paragraph (3); ‘‘
(C) integrating the activities described in this subsection with— ‘‘(i) activities under paragraph (3) of section 505(k) (relating to active post market risk identification); ‘‘(ii) activities under paragraph (4) of section 505(k) (relating to advanced analysis of drug safety data); and ‘‘(iii) other post market device surveillance activities of the Secretary authorized by this chapter; and ‘
‘(D) providing public access to the data and analysis collected or developed through the registry in a manner and form that protects patient privacy and proprietary information and is comprehensive, useful, and not misleading to patients, physicians, and scientists. ‘‘(3)(A) To facilitate analyses of post market safety and patient outcomes for devices described in paragraph (1), the Secretary shall, in collaboration with public, academic, and private entities, develop methods to— ‘‘(i) obtain access to disparate sources of patient safety and outcomes data, including— ‘‘(I) Federal health-related electronic data (such as data from the Medicare program under title XVIII of the Social Security Act or from the health systems of the Department of Veterans Affairs); ‘‘(II) private sector health-related electronic data (such as pharmaceutical purchase data and health insurance claims data); and ‘‘(III) other data as the Secretary deems necessary to permit post market assessment of device safety and effectiveness; and ‘‘(ii) link data obtained under clause (i) with information in the registry.
‘‘(B) In this paragraph, the term ‘data’ refers to information respecting a device described in paragraph (1), including claims data, patient survey data, standardized analytic files that allow for the pooling and analysis of data from disparate data environments, electronic health records, and any other data deemed appropriate by the Secretary. ‘‘(4) Not later than 36 months after the date of the enactment of this subsection, the Secretary shall promulgate regulations for establishment and operation of the registry under paragraph (1). Such regulations—
(A)(i) in the case of devices that are described in paragraph (1) and sold on or after the date of the enactment of this subsection, shall require manufacturers of such devices to submit information to the registry, including, for each such device, the type, model, and serial number or, if required under sub-section (f), other unique device identifier; and ‘‘(ii) in the case of devices that are described in paragraph (1) and sold before such date, may require manufacturers of such devices to submit such information to the registry, if deemed necessary by the Secretary to protect the public health; ‘‘(B) shall establish procedures— ‘‘(i) to permit linkage of information submitted pursuant to subparagraph
(A) with patient safety and outcomes data obtained under paragraph (3); and ‘‘(ii) to permit analyses of linked data; ‘‘(C) may require device manufacturers to submit such other information as is necessary to facilitate post market assessments of device safety and effectiveness and notification of device risks; ‘‘(D) shall establish requirements for regular and timely reports to the Secretary, which shall be included in the registry, concerning adverse event trends, adverse event patterns, incidence and prevalence of adverse events, and other information the Secretary determines appropriate, which may include data on comparative safety and outcomes trends; and ‘‘
(E) shall establish procedures to permit public access to the information in the registry in a manner and form that protects patient privacy and proprietary information and is comprehensive, useful, and not misleading to patients, physicians, and scientists. ‘‘(5) To carry out this subsection, there are authorized to be appropriated such sums as may be necessary for fiscal years 2010 and 2011.’’. (2) EFFECTIVE DATE.—The Secretary of Health and Human Services shall establish and begin implementation of the registry under section 519(g) of the Federal Food, Drug, and Cosmetic Act, as added by paragraph (1), by not later than the date that is 36 months after the date of the enactment of this Act, without regard to whether or not final regulations to establish and operate the registry have been promulgated by such date.
(3) CONFORMING AMENDMENT.—Section 303(f)(1)(B)(ii) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 333(f)(1)(B)(ii)) is amended by striking ‘‘519(g)’’ and inserting ‘‘519(h)’’.
(b) ELECTRONIC EXCHANGE AND USE IN CERTIFIED ELECTRONIC HEALTH RECORDS OF UNIQUE DEVICE IDENTIFIERS.—
(1) RECOMMENDATIONS.—The HIT Policy Committee established under section 3002 of the Public Health Service Act (42 U.S.C. 300jj–12) shall recommend to the head of the Office of the National Coordinator for Health Information Technology standards, implementation specifications, and certification criteria for the electronic exchange and use in certified electronic health records of a unique device identifier for each device described in section 519(g)(1) of the Federal Food, Drug, and Cosmetic Act, as added by subsection (a).
(2) STANDARDS, IMPLEMENTATION CRITERIA, AND CERTIFICATION CRITERIA.—
The Secretary of the Health Human Services, acting through the head of the Office of the National Coordinator for Health Information Technology, shall adopt standards, implementation specifications, and certification criteria for the electronic exchange and use in certified electronic health records of a unique device identifier for each device described in paragraph (1), if such an identifier is required by section 519(f) of the Federal Food, Drug, and Cosmetic Act (21U.S.C. 360i(f)) for the device.
Note: Will they be coming to my door to check the number on my titanium heart valve?
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Subtitle D—Grants for Comprehensive Programs to Provide Education to Nurses and Create a Pipeline to Nursing
Basically a bunch of gobldegook, what happened to Nursing school? Download and read it if you like. I think you should!!!!
