Better Patient Tracking & Reporting of Symptoms Promotes Better Care

A physician explains that patient reporting and discussion of symptoms with their physician is a critical component of the diagnosis process.

Patients and their caregivers can help improve the quality of care they receive from physicians and other health care providers by accurately tracking and reporting patient symptoms to their physician and other health care providers.  Solutions Law Press, Inc. Project COPE thanks Gene Uzawa Dorio, M.D.  for permission to republish the following February 28, 2018 Doctor’s Diary on Symptoms originally published in the SVC Physician Report.  

Symptoms

Your body talks to you.  Billions of cells work in harmony allowing you to live and survive our environment.  But when something goes wrong, the body cries out = symptoms.

Sometimes symptoms resolve, while persistence could signify a threat.

The symptom of chest pain though doesn’t always mean a heart attack.  A headache doesn’t always mean a brain tumor.  Blood in your stool doesn’t always mean colon cancer.

Heeding symptoms brings us to the doctor, and it is the job of the physician to interpret them and make a diagnosis.  Nowadays, time spent in conversation with a doctor is limited, so bring notes and be prepared to go into detail.

For example, does the chest pain radiate to the arms, back, or abdomen; is it associated with nausea, vomiting, dizziness, or palpitations; does it come with exertion; do you sweat with the chest pain?  Elaborating symptoms allows your doctor to decide if it is a threat.

The body talks to you through symptoms.  Make sure your doctor is listening.

About The Author

Dr. Gene Uzawa Dorio practices geriatric, palliative, and hospice care in Santa Clarita, California.  For additional information or to read other articles by Dr. Dorio, see  SVC Physician Report.  

 

About Solutions Law Press, Inc.™

Solutions Law Press, Inc.™ provides human resources and employee benefit and other business risk management, legal compliance, management effectiveness and other coaching, tools and other resources, training and education on leadership, governance, human resources, employee benefits, data security and privacy, insurance, health care and other key compliance, risk management, internal controls and operational concerns. If you find this of interest, you also be interested reviewing some of our other Solutions Law Press, Inc.™ resources here such as

If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information including your preferred e-mail by creating  your profile here.

HHS Unfetters State Family Planning Regulations

The Department of Health and Human Services (HHS) Centers for Medicare & Medicaid Services (CMS) sent a letter to State Medicaid Directors rescinding 2016 guidance that specifically restricted states’ ability to take certain actions against family-planning providers that offer abortion services.

Additionally, HHS’ Office for Civil Rights (OCR) also announced it is issuing a new proposeds rule (“Conscience Rule”) to enforce 25 existing statutory conscience protections for Americans involved in HHS-funded programs, which protect people from being coerced into participating in activities that violate their consciences, such as abortion, sterilization, or assisted suicide.

Modeled on existing regulations for other civil rights laws, the proposed rule provides protections for Americans’ conscience rights. Interested persons will have 60 days to comment on the proposed rule. However since President Trump took office OCR already has stepped up enforcement of these conscience statutes, many of which saw little to no enforcement activity under the previous administration.

The proposed rule when finalized will apply to entities that receive funds through programs funded or administered in whole or in part through HHS. It requires, for instance, that entities applying for federal grants certify that they are complying with the above-mentioned conscience-protection statutes.

The release of the proposed rule was accompanied by the rescission by the Centers for Medicare and Medicaid Services of a letter to State Medicaid Directors rescinding restrictions on state flexibility to decide when and how their state Medicaid programs cover abortion and certain other reproductive care. It also follows the Trump Administration’s announcement of plans to found a new division within the Office of Civil Rights that will focus on enforcement of conscience and religious rights.

About The Author

Repeatedly recognized by her peers as a Martindale-Hubble “AV-Preeminent” (Top 1%) and “Top Rated Lawyer” with special recognition LexisNexis® Martindale-Hubbell® as “LEGAL LEADER™ Texas Top Rated Lawyer” in Health Care Law and Labor and Employment Law; as among the “Best Lawyers In Dallas” for her work in the fields of “Labor & Employment,” “Tax: ERISA & Employee Benefits,” “Health Care” and “Business and Commercial Law” by D Magazine, a Fellow in the American College of Employee Benefit Council, the American Bar Foundation and the Texas Bar Foundation and board certified in labor and employment law by the Texas Board of Legal Specialization, Cynthia Marcotte Stamer is a practicing attorney, management consultant, author, public policy advocate and lecturer widely known for health and managed care, employee benefits, insurance and financial services, data and technology and other management work, public policy leadership and advocacy, coaching, teachings, and publications. For her profession practice and pro bono work with PROJECT COPE and others she is recognized for her work, experience, leadership and publications on veterans and other health and workforce policy and law and regulation for more than 30 years.

Ms. Stamer also has an extensive contributes her leadership and insights with other professionals, industry leaders and lawmakers.    Her insights on health care, insurance, benefits and other risk management and compliance concerns often appear in medical privacy related publications of a broad range of health care, health plan and other industry publications Among others, she has conducted privacy training for the Association of State & Territorial Health Plans (ASTHO), the Los Angeles Health Department, SHRM, HIMMS, the American Bar Association, the Health Care Compliance Association, a multitude of health plan, insurance and financial services, education, employer employee benefit and other clients, trade and professional associations and others.  You can get more information about her HIPAA and other experience here. For additional information about Ms. Stamer, see here, e-mail her here or telephone Ms. Stamer at (214) 452-8297.

About Solutions Law Press, Inc.™

Solutions Law Press, Inc.™ provides human resources and employee benefit and other business risk management, legal compliance, management effectiveness and other coaching, tools and other resources, training and education on leadership, governance, human resources, employee benefits, data security and privacy, insurance, health care and other key compliance, risk management, internal controls and operational concerns. If you find this of interest, you also be interested reviewing some of our other Solutions Law Press, Inc.™ resources here including:

Review Your Provider Performance Data

1/18 Comment Deadline on Office Of Child Care Guidance That Allows Background Check Requirement Delays

Bill Allowing FDA Emergency Use Authorizations To Protect Military From Biological Warfare Threats Sent to President

OIG Tells Texas Stop Paying Medicaid MCOs For Dead Patients

1/19 Deadline To Comment On Proposed FDA Premarket Notice Exemption For Over-The-Counter Dental Repair Kits

Michigan Doctor Pleads Guilty To Billing Medicare For Illegally Prescribed Drugs

Anesthesiology Practice Nailed For Improperly Billing For Moderate Sedation

Florida Doctor Sentenced For Multi-Million Dollar Drug & Alcohol Addiction Treatment Health Care Fraud, Money Laundering & Forced Prostitution Scheme

CMS Announces New Medicare Provider Ombudsman

Comment By 1/8 on Guidance for Industry on Expedited Programs for Serious Conditions– Drugs and Biologics

CMS Publishes 2018 Updates To Home Health Prospective Payment Rates & Rules

CMS Publishes 2018 Physician Fee Schedule Rule

Check Your Medicare/Medicaid Compliance Against Against Quarterly Guidance Changes List

CDC Proposed Changes To NIOSH Occupational Health Biological Monitoring Methods for Chemical Exposures

HHS Picks Hargan As Acting HHS Secretary

OCR Gives Health Care Providers, Other Covered Entities Post-Las Vegas Shooting HIPAA Medical Privacy Guidance On Disclosures To Family, Media & Others For Notification & Other Purposes

Novo Nordisk Pays $58M+ For Not Giving FDA-Required Warnings ABout Victoza Cancer Risks

Christus Pays $12.24M Settlement Resolves False Claims Act Charges From “Donations” To New Mexico

Oklahoma Nursing Home Settles HHS HIV Discrimination Charges

HHS Issues Hurricane Irma Relief For Puerto Rico, U.S. Virgin Islands & Florida

HHS Medical Clinic to Provide Healthcare to Hurricane Harvey Victims at Houston Convention Center Starting Wednesday

CMS Proposes Cutbacks To Medicare Bundled Payment Program

CMS Releases 2017 Provider Payment Program Hardship Exception Application

RAISE Act Immigration Visa, Visa Holder Public Benefit Limits Create Potential Health Industry Concerns

SCOTUS Bars State Law Restrictions On Health, Other Arbitration Agreement Enforceability

Health Care, Health Plan & Other Health IT Systems Warned of E-Mail Cyber Attack

$2.4M HIPAA Settlement Warns Providers About Media Disclosures Of PHI

CardioNet $2.5M HIPAA Resolution Agreement Schools HIPAA Entities To Clean Up Their Acts

Medical Clinic HIPAA Resolution Agreement Shows Need For Current Business Associate Agreements

If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information including your preferred e-mail by creating your profile here.

NOTICE: These statements and materials are for general informational and purposes only. They do not establish an attorney-client relationship, are not legal advice or an offer or commitment to provide legal advice, and do not serve as a substitute for legal advice. Readers are urged to engage competent legal counsel for consultation and representation in light of the specific facts and circumstances presented in their unique circumstance at any particular time. No comment or statement in this publication is to be construed as legal advice or an admission. The author reserves the right to qualify or retract any of these statements at any time. Likewise, the content is not tailored to any particular situation and does not necessarily address all relevant issues. Because the law is rapidly evolving and rapidly evolving rules makes it highly likely that subsequent developments could impact the currency and completeness of this discussion. The presenter and the program sponsor disclaim, and have no responsibility to provide any update or otherwise notify any participant of any such change, limitation, or other condition that might affect the suitability of reliance upon these materials or information otherwise conveyed in connection with this program. Readers may not rely upon, are solely responsible for, and assume the risk and all liabilities resulting from their use of this publication.

Circular 230 Compliance. The following disclaimer is included to ensure that we comply with U.S. Treasury Department Regulations. Any statements contained herein are not intended or written by the writer to be used, and nothing contained herein can be used by you or any other person, for the purpose of (1) avoiding penalties that may be imposed under federal tax law, or (2) promoting, marketing or recommending to another party any tax-related transaction or matter addressed herein.

©2018 Cynthia Marcotte Stamer. Non-exclusive right to republish granted to Solutions Law Press, Inc.™ For information about republication, please contact the author directly. All other rights reserved.

Trump Executive Order Promises Better Care To Veterans

Trump Executive Order Promises Better Veteran Health Care

Veterans transitioning back to civilian life can look forward to expanded mental health services, more choices for accessing care under some circumstances and other expanded assistance and support transitioning to civilian life under the Presidential Executive Order on Supporting Our Veterans During Their Transition From Uniformed Service to Civilian Life President Donald J. Trump signed this morning (January 9, 2018) to ensure veterans have the resources they need as they transition back to civilian life..

The Executive Order declares, “t is the policy of the United States to support the health and well-being of uniformed service members and veterans.  After serving our Nation, veterans deserve long, fulfilling civilian lives.  Accordingly, our Government must improve mental healthcare and access to suicide prevention resources available to veterans, particularly during the critical 1-year period following the transition from uniformed service to civilian life,

The Executive Order acknowledges the current system fails adequately to care for veterans transitioning to civilian life. It states, “Unfortunately, in some cases within the first year following transition, some veterans can have difficulties reintegrating into civilian life after their military experiences and some tragically take their own lives.  Veterans, in their first year of separation from uniformed service, experience suicide rates approximately two times higher than the overall veteran suicide rate.” To help prevent these tragedies, the Executive Order states all veterans should have seamless access to high-quality mental healthcare and suicide prevention resources as they transition, with an emphasis on the 1-year period following separation.”

In announcing the Executive Order, President Trump said caring for veterans is a “top priority.”

“We want them to get the highest care and the care that they so richly deserve,” he said.

To implement the necessary improvements to improve veterans care, the Executive Order direct the Secretary of Defense, the Secretary of Veterans Affairs, and the Secretary of Homeland Security to collaborate to address the complex challenges faced by our transitioning uniformed service members and veterans to accomplish the following:

Within 60 days, the Secretary of Defense, the Secretary of Veterans Affairs, and the Secretary of Homeland Security must submit to the President, through the Assistant to the President for Domestic Policy, a Joint Action Plan that describes concrete actions to provide, to the extent consistent with law, seamless access to mental health treatment and suicide prevention resources for transitioning uniformed service members in the year following discharge, separation, or retirement.

Within 180 days, the Secretary of Defense, the Secretary of Veterans Affairs, and the Secretary of Homeland Security shall submit to the President, through the Assistant to the President for Domestic Policy, a status report on the implementation of the Joint Action Plan and how the proposed reforms have been effective in improving mental health treatment for all transitioning uniformed service members and veterans that addresses progress on certain specific reforms and any additional reforms that could help further address the problems that obstruct veterans’ access to resources and continuous mental healthcare treatment, including any suggestions for legislative and regulatory reforms; and

A timeline describing next steps and the results anticipated from continued and additional reforms.

The actual Executive Order tells little about how the Trump Administration intends to implement these directives. The White House press release about the Executive Order states President Trump believes that our veterans deserve the best healthcare in the world, and is working with the Department of Veterans Affairs (VA) to expand and modernize their care including through four already announced initiatives to expand healthcare access for our veterans through technological innovation:

An expansion of the VA’s “Anywhere to Anywhere” healthcare, which allows VA providers to use tele-health technology to remotely treat veterans regardless of geographic location.

A greater adoption of VA Video Connect, an application for mobile phones and computers, which directly connects veterans and healthcare providers from anywhere in the country.

At over 100 VA sites across the nation, a rollout of the new Online Scheduling Tool, which enables veterans to schedule appointments from their mobile devices or computers.

A launch of the VA’s “Access and Quality Tool,” which allows veterans to view online both wait times at VA locations and important quality-of-care data.

The press release also states President Trump has ensured continued access to care in the Veterans Choice Program by signing the VA Choice and Quality Employment Act, authorizing $2.1 billion in additional funds for the Veterans Choice Program (VCP).

The VCP gives eligible veterans their choice of private care if they live more than 40 miles from the closest eligible VA facility, experience wait times over 30 days from the clinically indicated date, or face an excessive burden in accessing VA care.

On addition, the press release states the Department of Veterans Affairs will adopt the same Electronic Health Record (EHR) as the Department of Defense (DOD) so all patient data will reside in one common system, enabling the immediate availability of service member’s medical records and seamless care between the departments.

Concerning veterans mental health, President Trump notes that Secretary Shulkin already expanded access to urgent mental healthcare to former service members with other-than-honorable (OTH) discharges.

As in the past, the effect of these promises remains to be seen. The announced changes only provide a portion of the reforms needed and past reform programs have promised much but have failed to resolve access issues and failed to address notorious neglect and abuse recurrently uncovered in many veterans hospitals and other care facilities across the nation. Veterans, their families and treating physicians and others concerned with veterans health issues should monitor proposed changes and provide input as needed to ensure these reforms are properly designed and implemented as well as recommend other improvements.

About The Author

Repeatedly recognized by her peers as a Martindale-Hubble “AV-Preeminent” (Top 1%) and “Top Rated Lawyer” with special recognition LexisNexis® Martindale-Hubbell® as “LEGAL LEADER™ Texas Top Rated Lawyer” in Health Care Law and Labor and Employment Law; as among the “Best Lawyers In Dallas” for her work in the fields of “Labor & Employment,” “Tax: ERISA & Employee Benefits,” “Health Care” and “Business and Commercial Law” by D Magazine, a Fellow in the American College of Employee Benefit Council, the American Bar Foundation and the Texas Bar Foundation and board certified in labor and employment law by the Texas Board of Legal Specialization, Cynthia Marcotte Stamer is a practicing attorney, management consultant, author, public policy advocate and lecturer widely known for health and managed care, employee benefits, insurance and financial services, data and technology and other management work, public policy leadership and advocacy, coaching, teachings, and publications. For her profession practice and pro bono work with PROJECT COPE and others she is recognized for her work, experience, leadership and publications on veterans and other health and workforce policy and law and regulation for more than 30 years.

Ms. Stamer also has an extensive contributes her leadership and insights with other professionals, industry leaders and lawmakers.    Her insights on health care, insurance, benefits and other risk management and compliance concerns often appear in medical privacy related publications of a broad range of health care, health plan and other industry publications Among others, she has conducted privacy training for the Association of State & Territorial Health Plans (ASTHO), the Los Angeles Health Department, SHRM, HIMMS, the American Bar Association, the Health Care Compliance Association, a multitude of health plan, insurance and financial services, education, employer employee benefit and other clients, trade and professional associations and others.  You can get more information about her HIPAA and other experience here. For additional information about Ms. Stamer, see here, e-mail her here or telephone Ms. Stamer at (214) 452-8297.

About Solutions Law Press, Inc.™

Solutions Law Press, Inc.™ provides human resources and employee benefit and other business risk management, legal compliance, management effectiveness and other coaching, tools and other resources, training and education on leadership, governance, human resources, employee benefits, data security and privacy, insurance, health care and other key compliance, risk management, internal controls and operational concerns. If you find this of interest, you also be interested reviewing some of our other Solutions Law Press, Inc.™ resources here including:

Review Your Provider Performance Data

1/18 Comment Deadline on Office Of Child Care Guidance That Allows Background Check Requirement Delays

Bill Allowing FDA Emergency Use Authorizations To Protect Military From Biological Warfare Threats Sent to President

OIG Tells Texas Stop Paying Medicaid MCOs For Dead Patients

1/19 Deadline To Comment On Proposed FDA Premarket Notice Exemption For Over-The-Counter Dental Repair Kits

Michigan Doctor Pleads Guilty To Billing Medicare For Illegally Prescribed Drugs

Anesthesiology Practice Nailed For Improperly Billing For Moderate Sedation

Florida Doctor Sentenced For Multi-Million Dollar Drug & Alcohol Addiction Treatment Health Care Fraud, Money Laundering & Forced Prostitution Scheme

CMS Announces New Medicare Provider Ombudsman

Comment By 1/8 on Guidance for Industry on Expedited Programs for Serious Conditions– Drugs and Biologics

CMS Publishes 2018 Updates To Home Health Prospective Payment Rates & Rules

CMS Publishes 2018 Physician Fee Schedule Rule

Check Your Medicare/Medicaid Compliance Against Against Quarterly Guidance Changes List

CDC Proposed Changes To NIOSH Occupational Health Biological Monitoring Methods for Chemical Exposures

HHS Picks Hargan As Acting HHS Secretary

OCR Gives Health Care Providers, Other Covered Entities Post-Las Vegas Shooting HIPAA Medical Privacy Guidance On Disclosures To Family, Media & Others For Notification & Other Purposes

Novo Nordisk Pays $58M+ For Not Giving FDA-Required Warnings ABout Victoza Cancer Risks

Christus Pays $12.24M Settlement Resolves False Claims Act Charges From “Donations” To New Mexico

Oklahoma Nursing Home Settles HHS HIV Discrimination Charges

HHS Issues Hurricane Irma Relief For Puerto Rico, U.S. Virgin Islands & Florida

HHS Medical Clinic to Provide Healthcare to Hurricane Harvey Victims at Houston Convention Center Starting Wednesday

CMS Proposes Cutbacks To Medicare Bundled Payment Program

CMS Releases 2017 Provider Payment Program Hardship Exception Application

RAISE Act Immigration Visa, Visa Holder Public Benefit Limits Create Potential Health Industry Concerns

SCOTUS Bars State Law Restrictions On Health, Other Arbitration Agreement Enforceability

Health Care, Health Plan & Other Health IT Systems Warned of E-Mail Cyber Attack

$2.4M HIPAA Settlement Warns Providers About Media Disclosures Of PHI

CardioNet $2.5M HIPAA Resolution Agreement Schools HIPAA Entities To Clean Up Their Acts

Medical Clinic HIPAA Resolution Agreement Shows Need For Current Business Associate Agreements

If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information including your preferred e-mail by creating your profile here.

NOTICE: These statements and materials are for general informational and purposes only. They do not establish an attorney-client relationship, are not legal advice or an offer or commitment to provide legal advice, and do not serve as a substitute for legal advice. Readers are urged to engage competent legal counsel for consultation and representation in light of the specific facts and circumstances presented in their unique circumstance at any particular time. No comment or statement in this publication is to be construed as legal advice or an admission. The author reserves the right to qualify or retract any of these statements at any time. Likewise, the content is not tailored to any particular situation and does not necessarily address all relevant issues. Because the law is rapidly evolving and rapidly evolving rules makes it highly likely that subsequent developments could impact the currency and completeness of this discussion. The presenter and the program sponsor disclaim, and have no responsibility to provide any update or otherwise notify any participant of any such change, limitation, or other condition that might affect the suitability of reliance upon these materials or information otherwise conveyed in connection with this program. Readers may not rely upon, are solely responsible for, and assume the risk and all liabilities resulting from their use of this publication.

Circular 230 Compliance. The following disclaimer is included to ensure that we comply with U.S. Treasury Department Regulations. Any statements contained herein are not intended or written by the writer to be used, and nothing contained herein can be used by you or any other person, for the purpose of (1) avoiding penalties that may be imposed under federal tax law, or (2) promoting, marketing or recommending to another party any tax-related transaction or matter addressed herein.

©2018 Cynthia Marcotte Stamer. Non-exclusive right to republish granted to Solutions Law Press, Inc.™ For information about republication, please contact the author directly. All other rights

Protect Your Loved One From Abuse

Millions of elderly and disabled Americans live in nursing, assisted living and other care facilities. 

While patients and their families admit patients to these facility rightly expect these care providers to appropriately and safely care for their patients, unfortunately and too many instances the care that their family member receives not only is disappointing, but actually harmful.

And alarmingly long list of negligence and other liability judgments as well as oversight and enforcement work by the Department of Health and Human Services, States’ department of aging, watchdog agencies, nursing home litigators reveal commonly recurring problems account for many of these tragedies   Problems range from overmedicating residents, or patient abuse or neglect. 

Patients and their families need to recognize the need to carefully select and oversee the care of their family member in these facilities   Many resources are available to help educate family members and friends search as this YouTube video about nursing home abuse recently shared by the Department of Health and Human Services.  

Careful investigation and credentialing at the facilities your love will stay in before and during their stay is an important part of the process.  No matter how good the facility looks in this credentialing, families and caregivers and patient must keep in mind that even the best facilities can experience problems of neglect, unawareness, miscommunication, miss perception and even abuse.  For this reason, families should keep in mind that frequent visits from family members and other visitors familiar with and loyal to the patient at different times can make a huge difference in helping the patient to get the best care possible, identifying potential issues services or quality and detecting more quickly service disruptions or deficiencies, changes in their family members conditions that need attention, signs of abuse or neglect and other concerns.

To learn more about what you and your family can do to be more effective participants in your healthcare and help improve health care for others, follow, share input and resources and get involved in our Project COPE initiative by following and sharing our updates in this ProjectCOPE.blog, on Facebook @ProjectCOPECOALITION or on LinkedIn.

Call To Action: Become a Project COPE Healthcare Hero

Despite an endless stream of well-meaning market and governmental reforms over the past 25 years, the U.S. health care system is in crisis. American patients, their families and other caregivers, their employers, their health benefit programs, their health care providers, the communities and even our federal health care budget increasingly are burdened and overwhelmed by the mounting obstacles to caring for our ill, disabled, and aging citizens within our health care system and the extraordinary expense of maintaining and using that system. 

 As Congress takes up reform again, it is critical that Americans act to protect their own and their families’ health care and control the financial burdens of health care by getting informed, providing clear and consistent direction to Congress and other reformers and taking other actions to empower and care for themselves and their loved ones within our evolving health care system.
©2017 Cynthia Marcotte Stamer. Non-exclusive right to republish licensed to Solutions Law Press, Inc. For information about republication of this or other materials and programs of the author, email the author here. All rights reserved.

Empowering Dying Patients Through Choice

The self-composed obituary of Sonia Todd is a touching reminder of the power and importance of patient choice even for patients facing death.  

The success of our health science and the ever extraordinary miracles it achieves to delay death often dupes Americans into forgetting that life is a process that ultimately leads to death.   Regardless of the ultimate pathway traveled from life to death by any particular person, health care ultimately is mostly about delaying death and hopefully, wringing out as much joy and functionality for the afflicted individual with the minimum of pain and suffering. 

Aging, illness, injury and disability often disempower those afflicted and those who love and care for them.   Eventually, everyone runs out of options to keep living. The realization that this time has come for a patient often is devastating for patients and their families. 

When the fight for life becomes futile, loved ones often don’t know what to do next to help the patient.

When death ultimately can not be avoided, empower the patient by supporting reasonable choices about their death and dying.  Allowing patients to make choices about how to live out their last days or moments, their treatment, and other details of their impending death and to plan and talk about what will happen after their death can empower many patients and their families through the process of death and coping after death.  

About The Author

Recognized by LexisNexis® Martindale-Hubbell® as a “AV-Preeminent” (Top 1%/ the highest) and “Top Rated Lawyer,” with special recognition as “LEGAL LEADER™ Texas Top Rated Lawyer” in Health Care Law and Labor and Employment Law; as among the “Best Lawyers In Dallas” for her work in the fields of “Health Care,” “Labor & Employment,” “Tax: Erisa & Employee Benefits” and “Business and Commercial Law” by D Magazine, Cynthia Marcotte Stamer is nationally and internationally known for her 29 plus years’ of work as a practicing attorney on health care, health benefit, health policy and regulatory affairs and other health industry concerns as a practicing attorney as well as her lifelong involvement as a health, disability  and retirement and workforce thought leader, management consultant, author, public policy advocate and lecturer.

Throughout her adult life and nearly 30-year legal career, Ms. Stamer’s legal, management and governmental affairs work has focused on helping health industry, health benefit and other organizations and their management use the law, performance and risk management tools and process to manage people, performance, quality, compliance, operations and risk. Highly valued for her rare ability to find pragmatic client-centric solutions by combining her detailed legal and operational knowledge and experience with her talent for creative problem-solving, Ms. Stamer supports these organizations and their leaders on both a real-time, “on demand” basis as well as outsourced operations or special counsel on an interim, special project, or ongoing basis with strategic planning and product and services development and innovation; workforce and operations management, crisis preparedness and response as well as to prevent, stabilize and cleanup legal and operational crises large and small that arise in the course of operations. Her experience encompasses helping health industry clients manage workforce, medical staff, vendors and suppliers, medical billing, reimbursement, claims and other provider-payer relations, business partners, and their recruitment, performance, discipline, compliance, safety, compensation, benefits, and training ;board, medical staff and other governance; compliance and internal controls; strategic planning, process and quality improvement; change management; assess, deter, investigate and address staffing, quality, compliance and other performance; meaningful use, EMR, HIPAA and other data security and breach and other health IT and data; crisis preparedness and response; internal, government and third-party reporting, audits, investigations and enforcement; government affairs and public policy; and other compliance and risk management, government and regulatory affairs and operations concerns.

The American Bar Association (ABA) International Section Life Sciences Committee Vice Chair, a Scribe for the ABA Joint Committee on Employee Benefits (JCEB) Annual OCR Agency Meeting, former Vice President of the North Texas Health Care Compliance Professionals Association, past Chair of the ABA Health Law Section Managed Care & Insurance Section, past ABA JCEB Council Representative, past Board President of Richardson Development Center (now Warren Center) for Children Early Childhood Intervention Agency, past North Texas United Way Long Range Planning Committee Member, and past Board Member and Compliance Chair of the National Kidney Foundation of North Texas, Ms. Stamer has worked closely with a diverse range of physicians, hospitals and healthcare systems, DME, Pharma, clinics, health care providers, managed care, insurance and other health care payers, quality assurance, credentialing, technical, research, public and private social and community organizations, and other health industry organizations and their management deal with governance; credentialing, patient relations and care; staffing, peer review, human resources and workforce performance management; outsourcing; internal controls and regulatory compliance; billing and reimbursement; physician, employment, vendor, managed care, government and other contracting; business transactions; grants; tax-exemption and not-for-profit; licensure and accreditation; vendor selection and management; privacy and data security; training; risk and change management; regulatory affairs and public policy and other concerns.

As a core component of her work, Ms. Stamer has worked extensively throughout her career with health care providers, health plans and insurers, managed care organizations, health care clearinghouses, their business associates, employers, banks and other financial institutions, management services organizations, professional associations, medical staffs, accreditation agencies, auditors, technology and other vendors and service providers, and others on legal and operational compliance, risk management and compliance, public policies and regulatory affairs, contracting, payer-provider, provider-provider, vendor, patient, governmental and community relations and matters including extensive involvement advising, representing and defending public and private hospitals and health care systems; physicians, physician organizations and medical staffs; specialty clinics and pharmacies; skilled nursing, home health, rehabilitation and other health care providers and facilities; medical staff, accreditation, peer review and quality committees and organizations; billing and management services organizations; consultants; investors; technology, billing and reimbursement and other services and product vendors; products and solutions consultants and developers; investors; managed care organizations, insurers, self-insured health plans and other payers; and other health industry clients to establish and administer compliance and risk management policies; comply with requirements, investigate and respond to Board of Medicine, Health, Nursing, Pharmacy, Chiropractic, and other licensing agencies, Department of Aging & Disability, FDA, Drug Enforcement Agency, OCR Privacy and Civil Rights, Department of Labor, IRS, HHS, DOD, FTC, SEC, CDC and other public health, Department of Justice and state attorneys’ general and other federal and state agencies; JCHO and other accreditation and quality organizations; private litigation and other federal and state health care industry investigation, enforcement including insurance or other liability management and allocation; process and product development, contracting, deployment and defense; evaluation, commenting or seeking modification of regulatory guidance, and other regulatory and public policy advocacy; training and discipline; enforcement, and a host of other related concerns for public and private health care providers, health insurers, health plans, technology and other vendors, employers, and others.and other compliance, public policy, regulatory, staffing, and other operations and risk management concerns.

Past Chair of the ABA Managed Care & Insurance Interest Group and, a Fellow in the American College of Employee Benefit Counsel, the American Bar Foundation and the Texas Bar Foundation, Ms. Stamer also has extensive health care reimbursement and insurance experience advising and defending health care providers, payers, and others about Medicare, Medicaid, Medicare and Medicaid Advantage, Tri-Care, self-insured group, association, individual and group and other health benefit programs and coverages including but not limited to advising public and private payers about coverage and program design and documentation, advising and defending providers, payers and systems and billing services entities about systems and process design, audits, and other processes; provider credentialing, and contracting; providers and payer billing, reimbursement, claims audits, denials and appeals, coverage coordination, reporting, direct contracting, False Claims Act, Medicare & Medicaid, ERISA, state Prompt Pay, out-of-network and other nonpar insured, and other health care claims, prepayment, post-payment and other coverage, claims denials, appeals, billing and fraud investigations and actions and other reimbursement and payment related investigation, enforcement, litigation and actions.

Heavily involved in health care and health information technology, data and related process and systems development, policy and operations innovation and a Scribe for ABA JCEB annual agency meeting with OCR for many years who has authored numerous highly-regarded laws, regulations, policies, programs, publications and training programs on HIPAA and other data security, privacy and use, EMR, billing and reimbursement, quality measurement,  privacy and other health , HIPAA, FACTA, PCI, trade secret, physician and other medical confidentiality and privacy, federal and state data security and data breach and other information privacy and data security rules and many other data, technology and systems concerns.  

A former lead consultant to the Government of Bolivia on its Pension Privatization Project with extensive domestic and international public policy and governmental and regulatory affairs experience, Ms. Stamer also is widely recognized for regulatory and policy work, advocacy and outreach on healthcare, education, aging, disability, savings and retirement, workforce, ethics, and other policies. Throughout her adult life and career, Ms. Stamer has provided thought leadership; policy and program design, statutory and regulatory development design and analysis; drafted legislation, proposed regulations and other guidance, position statements and briefs, comments and other critical policy documents; advised, assisted and represented health care providers, health plans and insurers, employers, professional. and trade associations, community and government leaders and others on health care, health, pension and retirement, workers’ compensation, Social Security and other benefit, insurance and financial services, tax, workforce, aging and disability, immigration, privacy and data security and a host of other international and domestic federal, state and local public policy and regulatory  reform and enforcement.      Her work includes both regulatory and public policy advocacy and thought leadership, as well as advising and representing a broad range of health industry and other clients about policy design, drafting, administration, business associate and other contracting, risk assessments, audits, breach prevention and mitigation and other risk prevention and mitigation, investigation, reporting, mitigation and resolution of known or suspected violations or other incidents and responding to and defending investigations or other actions by plaintiffs, DOJ, OCR, DOL, HHS, FTC, Insurance Departments, state attorneys’ general and other federal or state agencies, other business partners.  Her advocacy and regulatory affairs and public policy work, involvement and participation also includes numerous client engagements, as well as as founder and Executive Director of the Coalition for Responsible Health Policy and its PROJECT COPE: the Coalition on Patient Empowerment, adviser to the National Physicians Congress for Healthcare Policy, leadership involvement with the US-Mexico Chamber of Commerce, the Texas Association of Business, the ABA JCEB, Health Law, RPTE, Tax, Labor, TIPS, International Life Sciences, and other Sections and Committees, SHRM Governmental Affairs Committee and a host of other involvements and activities.

A Fellow in the American College of Employee Benefit Counsel, the American Bar Foundation and the Texas Bar Foundation, Ms. Stamer also shares her thought leadership, experience and advocacy on these and other related concerns by her service in the leadership of the Solutions Law Press, Inc. Coalition for Responsible Health Policy, its PROJECT COPE: Coalition on Patient Empowerment, and a broad range of other professional and civic organizations including North Texas Healthcare Compliance Association, a founding Board Member and past President of the Alliance for Healthcare Excellence, past Board Member and Board Compliance Committee Chair for the National Kidney Foundation of North Texas; former Board President of the early childhood development intervention agency, The Richardson Development Center for Children (now Warren Center For Children); current Vice Chair of the ABA Tort & Insurance Practice Section Employee Benefits Committee, current Vice Chair of Policy for the Life Sciences Committee of the ABA International Section, Past Chair of the ABA Health Law Section Managed Care & Insurance Section, a current Defined Contribution Plan Committee Co-Chair, former Group Chair and Co-Chair of the ABA RPTE Section Employee Benefits Group, past Representative and chair of various committees of ABA Joint Committee on Employee Benefits; a ABA Health Law Coordinating Council representative, former Coordinator and a Vice-Chair of the Gulf Coast TEGE Council TE Division, past Chair of the Dallas Bar Association Employee Benefits & Executive Compensation Committee, a former member of the Board of Directors of the Southwest Benefits Association and others.

Ms. Stamer also is a highly popular lecturer, symposium and chair, faculty member and author, who publishes and speaks extensively on health and managed care industry, human resources, employment and other privacy, data security and other technology, regulatory and operational risk management. She has authored, published and presented s hundreds of publications, programs and workshops on these and other concerns for the American Bar Association, ALI-ABA, American Health Lawyers, Society of Human Resources Professionals, the Southwest Benefits Association, the Society of Employee Benefits Administrators, the American Law Institute, Lexis-Nexis, Atlantic Information Services, The Bureau of National Affairs (BNA), InsuranceThoughtLeaders.com, Benefits Magazine, Employee Benefit News, Texas CEO Magazine, HealthLeaders, the HCCA, ISSA, HIMSS, Modern Healthcare, Managed Healthcare, Institute of Internal Auditors, Society of CPAs, Business Insurance, Employee Benefits News, World At Work, Benefits Magazine, the Wall Street Journal, the Dallas Morning News, the Dallas Business Journal, the Houston Business Journal, and many other symposia and publications. She also has served as an Editorial Advisory Board Member for human resources, employee benefit and other management focused publications of BNA, HR.com, Employee Benefit News, Insurance Thought Leadership and many other prominent publications and speaks and conducts training for a broad range of professional organizations.

For more information about Ms. Stamer or her health industry and other experience and involvements, see here or contact Ms. Stamer via telephone at (469) 767-8872 or via e-mail here.

About Solutions Law Press, Inc.™

Solutions Law Press, Inc.™ provides human resources and employee benefit and other business risk management, legal compliance, management effectiveness and other coaching, tools and other resources, training and education on leadership, governance, human resources, employee benefits, data security and privacy, insurance, health care and other key compliance, risk management, internal controls and operational concerns. If you find this of interest, you also be interested reviewing some of our other Solutions Law Press, Inc.™ resources here.

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©2017 Cynthia Marcotte Stamer. Non-exclusive right to republish granted to Solutions Law Press, Inc.™ All other rights reserved. For information about republication or other use, please contact Ms. Stamer here.

Technology Shouldn’t Come Before Care

Remember when your doctor spent more time focusing on you than typing on the computer during your visit?  Government “meaningful use” and other “administrative simplification” reforms are replacing health care with accounting and technology.  Tell Congress keep the Care in healthcare!  Read more here.

Tell Congress To Vote on Obamacare Reform Starting With House’s Vote Tonight

The US House of Representatives is scheduled to vote again tonight on the revised Majority-leadership lead first step healthcare reform legislation seeking to provide Americans and American business with some initial relief from the soaring premium and health care costs, care access barriers  and regulatory and other burdens that have resulted under the ObamaCare law and regulations.  Every American should call, e-mail or fax the leaders and their Congressperson as soon as possible today and tell them to pass this legislation and get busy passing the next set of reforms with no further delay, the get and stay II formed and involved until it gets it done starting with the House hearing and vote slated tonight starting at 8:30 Eastern.  Get details here.

Health care and its reform is a complex challenge.  Americans and American businesses, health payers,  and States and their healthcare needs are highly diverse. The ambitious but far from successful Obamacare law shows the dangers of well-meaning but unrealistic To try to fix these challenges with a sweeping, one shot fix.  

While passage of this legislative package won’t magically fix these challenges, it will provide quick relief for some of the ObamaCare expense and restrictions and expand the choices that Americans, American business, payers, providers and States while Congress works with American to identify and pursue legislative, regulatory, marketplace and other improvements.