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.

Celebrate DNA Day With Noon CT Twitter Chat

April 25 is National DNA Day!

Celebrate by joining in as NASA Astronaut Dr. Kate Rubins teams up with NIH Director Dr. Francis Collins, NHGRI Director Dr. Eric Green  and the National Human Genome Research Institute (@DNAday) and @NIH for a National DNA Day Twitter Chat using #DNADayChat today from 1:00pm-2:00 pm ET, Noon CT.

NASA Astronaut Kathleen Rubins (@NASA_Astronauts #AstroKate), NIH Director Dr. Francis Collins (@NIHDirector), and NHGRI Director Dr. Eric Green (@Genome_gov) will be answering questions from 1:00 – 1:30 pm ET.  

The full hour will highlight genetic and genomic resources for students, teachers, and the general public interested in learning more about genomics and the impact it may have on their lives.
 

Insist President & Congress Get Real About Health Care Reform

Every American should watch and internalize the insights from these videos and then send them to Mr. Obama and Congress and insist they do the same when making healthcare, war and other policy with a message to get real and start coming up with real solutions for real American families:

A key problem with health care policy made in Washington, D.C. is that most of our leaders make health care policy decisions as if they are playing an Xbox game.  In most cases, the leaders deciding our health care policy are privileged people who don’t currently live in or experience life in the real world that most Americans live in, and either have never really done so or have forgotten what life in the real world is like.

While disability, illness or death eventually come to all families, Mr. Obama and other Presidents, Congress members, and  to a lesser extent, their staffs use billions of dollars of Americans’ tax dollars to get special benefits, perks and privileges that help insulate them and their families from these challenges even as they adopt and enforce an epidemic of rules that these leaders won’t apply to themselves and their families, administered by thousands of newly hired bureaucrats who also enjoy many of those same special benefits, perks and privileges denied to taxpaying Americans. See e.g., on Presidential Perks, here; on Congressional Perks, see here and on Affordable Care Act special treatment, see White House Approves Deal: Congress And Staff Exempt From Obamacare and Members, Staff Will Keep Health-Care Subsidies Under Obamacare.

The President and many members of Congress and their advisors make inappropriate health policy choices because most don’t have a real experience in dealing with these issues that matches the reality of most Americans.  don’t pay real bills or face the limits of a real budget.  The President and members of Congress don’t stand in line at the local clinic, wait hours, much less days, to get a doctor’s appointment, have to leave work to take a parent or child to the doctor or go out-of-pocket to pay for care.  They don’t have to struggle to patch their shoes, turn down their heat or replace hamburger with Mac’N Cheese to pay the health premiums that Obama Care will mandate while concerned about reduced hours or unemployment.  Their knowledge is based instead on political ideology buttressed by filtered and carefully selected anecdotal stories, selected because their re-enforce the already existing world view of the political decision-maker.

We need to insist that the President and Congress make and administer health care policy based on a real world understanding and stop treating health care reform like an Xbox simulation where the budget reloads and the suffering and death are washed away by starting a new game.
Americans should not allow or trust any President or member of Congress to make important decisions about health care, jobs or war when the leader passes laws or supports the adoption of laws and rules that :

  • Force Americans to pay billions and new taxes to submit to a government dictated health care system that wastes trillions for bureaucrats to dictate the care, coverage and premiums that American families will get while the President and Congress have decided that system is not good enough for the President, Congress, their staff and their families;
  • Waste thousands of taxpayer dollars of special perks like allowing the President to spend more than $100K to fly his puppy to meet the First Family on vacation, throw lavish birthday parties, and take a series of expensive vacations;
  • Break promises made to the millions of Medicare-eligible Americans and veterans and their families who constantly find their benefits cut, new costs imposed and wait times lengthened; and
  • Force Americans to “cut back” to pay for a deluge of other expensive new government regulators to create and enforce new and expanded government regulations that only further tax American taxpayer’s pocketbooks, job opportunities, competitiveness and choices.

While Mr. Obama talks a lot about his experiences as an “organizer,” it is clear that he and others either never actually learned, long ago forgot, or don’t care about the real struggles of Americans struggling to care for aging or disabled family members, rising taxes and mandates amid job losses and reduced buying power, military service members and veterans whose families are left struggling with broken promises and the host of other real world issues that impact most average American families.

Americans need to use their e-mail, telephones, social networks and other communication channels, votes, contributions, and their time to remind regularly and hold the President and Congress accountable for understanding and regulating with an awareness and concern for the real world challenges and needs of Americans. Insist our leaders see and experience life from the shoes of real people by sharing the experiences of your and your friends families.  Insist they not only see the world through our eyes by watching these videos, but also by wearing the same shoes and walking the same paths without the special benefits, perks, and privileges that insulate them and their families from really experiencing life the way those who are taxed experience it. Speak up and be persistent until they get the message or are replaced.

Start by joining the discussion and sharing your thoughts about health care reform  by joining Project COPE: Coalition for Patient Empowerment here.

About Project COPE: The Coalition On Patient Empowerment & Its  Coalition on Responsible Health Policy

Sharing and promoting the use of practical practices, tools, information and ideas that patients and their families, health care providers, employers, health plans, communities and policymakers can share and offer to help patients, their families and others in their care communities to understand and work together to better help the patients, their family and their professional and private care community plan for and manage these  needs is the purpose of Project COPE, The Coalition on Patient Empowerment & It’s Affiliate, the Coalition on Responsible Health Policy.

The best opportunity to improve access to quality, affordable health care for all Americans is for every American, and every employer, insurer, and community organization to seize the opportunity to be good Samaritans.  The government, health care providers, insurers and community organizations can help by providing education and resources to make understanding and dealing with the realities of illness, disability or aging easier for a patient and their family, the affected employers and others. At the end of the day, however, caring for people requires the human touch.  Americans can best improve health care by not waiting for someone else to step up:  Step up and help bridge the gap when you or your organization can. Speak up to help communicate and facilitate when you can.  Building health care neighborhoods filled with good neighbors throughout the community is the key.

The outcome of this latest health care reform push is only a small part of a continuing process.  Whether or not the Affordable Care Act makes financing care better or worse, the same challenges exist.  The real meaning of the enacted reforms will be determined largely by the shaping and implementation of regulations and enforcement actions which generally are conducted outside the public eye.  Americans individually and collectively clearly should monitor and continue to provide input through this critical time to help shape constructive rather than obstructive policy. Regardless of how the policy ultimately evolves, however, Americans, American businesses, and American communities still will need to roll up their sleeves and work to deal with the realities of dealing with ill, aging and disabled people and their families.  While the reimbursement and coverage map will change and new government mandates will confine providers, payers and patients, the practical needs and challenges of patients and families will be the same and confusion about the new configuration will create new challenges as patients, providers and payers work through the changes.

We also encourage you and others to help develop real meaningful improvements by joining Project COPE: Coalition for Patient Empowerment here by sharing ideas, tools and other solutions and other resources. The Coalition For Responsible Health Care Policy provides a resource that concerned Americans can use to share, monitor and discuss the Health Care Reform law and other health care, insurance and related laws, regulations, policies and practices and options for promoting access to quality, affordable healthcare through the design, administration and enforcement of these regulations.

Other Helpful Resources & Other Information

We hope that this information is useful to you.   If you found these updates of interest, you also be interested in one or more of the following other recent articles published on the Coalition for Responsible Health Care Reform electronic publication available here, our electronic Solutions Law Press Health Care Update publication available here, or our HR & Benefits Update electronic publication available here .  You also can get access to information about how you can arrange for training on “Building Your Family’s Health Care Toolkit,”  using the “PlayForLife” resources to organize low-cost wellness programs in your workplace, school, church or other communities, and other process improvement, compliance and other training and other resources for health care providers, employers, health plans, community leaders and others here. 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 or updating your profile here. You can reach other recent updates and other informative publications and resources.

Recent examples of these publications include:

 

For important information about this communication click here.

©2013 Cynthia Marcotte Stamer.  Nonexclusive right to republish granted to Solutions Law Press, Inc. All other rights reserved.

Logon & Password Creation For Personal Accounts Lend Significance To Consumer Security Concerns About Using HHS Health Insurance Exchange Portal

Report Raises Questions About Security Of Sensitive Personal Information Americans Will Share With HHS Exchange Portal

The reported finding that the Department of Health & Human Services (HHS) has yet to complete the necessary security arrangements and testing for the web-portal Incomplete security arrangements and testing necessary to ensure the security of personal health and other information shared by consumers on the health insurance exchange Hub that Obamacare charged the HHS Centers for Medicare & Medicaid Services (CMS)  with creating under Obama Care raises concerns about whether these security issues might undermine the security of the sensitive personal information that a consumer might share now or in the future when exploring or enrolling in health coverage options offered through the health insurance exchange.

On Monday, August 5, 2013, HHS sought to beef up interest and anticipation among Americans for the new health insurance exchange option by inviting consumers to prepare for the upcoming enrollment period scheduled to begin October 1, 2013 by creating their personal accounts on HHS’ Healthcare.gov website now.

HHS began encouraging Americans to the HHS website “healthcare.gov” to open a personal account, the first step to buying coverage through one of the health insurance exchanges that HHS is creating under the Patient Protection & Affordable Care Act reforms.  See Consumers Can Take First Step To Enrolling In New Insurance Options Today.  HHS is encouraging Americans to prepare for enrollment today by setting up their personal account on the HHS Website, Healthcare.gov.  A HHS Twitter Tweet yesterday announced , “Today you can be 1 step closer to getting health ins. by creating your Marketplace account:.” The Healthcare.gov website main page now invites Americans to “[a]nswer a few questions to get some personalized info here.”

Unfortunately, HHS kicked off this campaign on the same day that the HHS’s Office of Inspector General (OIG) released a report titled Observations Noted During The OIG Review Of CMS’s Implementation Of The Health Insurance Exchange—Data Services Hub (Report) that raises questions about the adequacy of the current security of the data portal and whether HHS will complete the arrangements and testing to verify it appropriately safeguards the security of the sensitive personal information that consumers will share there when the enrollment period begins and thereafter.

Data shared by Americans as part of the process of exploring and enrolling in coverage through the health insurance exchanges will be collected and shared through a data security Hub that will host and transmit that data.  The OIG Report raises clear concerns about the existing security arrangements that CMS has implemented to protect that data, as well as questions about whether CMS will complete the necessary arrangements to secure and protect that sensitive data before enrollment begins October 1.

The findings reported by OIG in the Report raise significant questions about whether Americans should accept the HHS invitation to establish their personal accounts now in anticipation of the October 1, 2013 beginning of the  enrollment period for applying for coverage through the health insurance exchanges that would take effect on January 1, 2014.

The Report makes clear that OIG found reason for concern about the Hub security currently and whether these issues will be adequately addressed by the time the enrollment period begins on October 1, 2013.

OIG reports many critical tasks required to implement and test necessary security controls are unfinished.  It states “[S]everal critical tasks remain to be completed in a short period of time, such as the final independent testing of the Hub’s security controls, remediating security vulnerabilities identified during testing, and obtaining the security authorization decision for the Hub before opening the exchanges. CMS’s current schedule is to complete all of its tasks by October 1, 2013, in time for the expected initial open enrollment period.”

While acknowledging that CMS has affirmed its commitment to complete and implement the necessary security arrangements before enrollment begins on October 1, 2013, the OIG Report also notes that CMS already has missed several critical target dates in its efforts to implement the required security measures.

The Report additionally states: “CMS is working with very tight deadlines to ensure that security measures for the Hub are assessed, tested, and implemented by the expected initial open enrollment date of October 1, 2013. If there are additional delays in completing the security assessment and testing, the CMS CIO may have limited information on the security risks and controls when granting the security authorization of the Hub.” (emphasis added).

The security concerns highlighted in the Report should raise questions about the adequacy of the security of information that an individual might enter on the Healthcare.gov portal in response to the invitation of HHS extended beginning yesterday. 

The importance of the security concerns raised in the reports becomes evident when one considers that consumers establishing their personal accounts must “Choose  your user name and password; Create security questions to add an extra layer of protecting your information.”   While many may be temped to discount the significance of the security concerns because the information that HHS currently asks individuals to share when they create their personal accounts appears relatively harmless, it merits noting that the creation of the login and security password that will be used to control access to the personal account of registrants are among those initial elements. To the extent security deficiencies compromise the security of this information, these security deficiencies could undermine the security of the personal accounts and all of the information they contain.

In light of the findings contained in the Report, Americans concerned about the security of their personal information may want to hold off entering data in response to the HHS’s invitation.  Additionally, Americans concerned about these and other security issues also may want to share their feedback with HHS and members of Congress.

Are you concerned about whether health care reform preparations are on track or have other health care policy concerns. Tell us what you think by responding to our poll. 

Join the discussion about health care reform and share your input by joining Project COPE: Coalition for Patient Empowerment here.

About Project COPE: The Coalition On Patient Empowerment & Its  Coalition on Responsible Health Policy

Sharing and promoting the use of practical practices, tools, information and ideas that patients and their families, health care providers, employers, health plans, communities and policymakers can share and offer to help patients, their families and others in their care communities to understand and work together to better help the patients, their family and their professional and private care community plan for and manage these  needs is the purpose of Project COPE, The Coalition on Patient Empowerment & It’s Affiliate, the Coalition on Responsible Health Policy.

The best opportunity to improve access to quality, affordable health care for all Americans is for every American, and every employer, insurer, and community organization to seize the opportunity to be good Samaritans.  The government, health care providers, insurers and community organizations can help by providing education and resources to make understanding and dealing with the realities of illness, disability or aging easier for a patient and their family, the affected employers and others. At the end of the day, however, caring for people requires the human touch.  Americans can best improve health care by not waiting for someone else to step up:  Step up and help bridge the gap when you or your organization can. Speak up to help communicate and facilitate when you can.  Building health care neighborhoods filled with good neighbors throughout the community is the key.

The outcome of this latest health care reform push is only a small part of a continuing process.  Whether or not the Affordable Care Act makes financing care better or worse, the same challenges exist.  The real meaning of the enacted reforms will be determined largely by the shaping and implementation of regulations and enforcement actions which generally are conducted outside the public eye.  Americans individually and collectively clearly should monitor and continue to provide input through this critical time to help shape constructive rather than obstructive policy. Regardless of how the policy ultimately evolves, however, Americans, American businesses, and American communities still will need to roll up their sleeves and work to deal with the realities of dealing with ill, aging and disabled people and their families.  While the reimbursement and coverage map will change and new government mandates will confine providers, payers and patients, the practical needs and challenges of patients and families will be the same and confusion about the new configuration will create new challenges as patients, providers and payers work through the changes.

We also encourage you and others to help develop real meaningful improvements by joining Project COPE: Coalition for Patient Empowerment here by sharing ideas, tools and other solutions and other resources. The Coalition For Responsible Health Care Policy provides a resource that concerned Americans can use to share, monitor and discuss the Health Care Reform law and other health care, insurance and related laws, regulations, policies and practices and options for promoting access to quality, affordable healthcare through the design, administration and enforcement of these regulations.

Other Helpful Resources & Other Information

We hope that this information is useful to you.   If you found these updates of interest, you also be interested in one or more of the following other recent articles published on the Coalition for Responsible Health Care Reform electronic publication available here, our electronic Solutions Law Press Health Care Update publication available here, or our HR & Benefits Update electronic publication available here .  You also can get access to information about how you can arrange for training on “Building Your Family’s Health Care Toolkit,”  using the “PlayForLife” resources to organize low-cost wellness programs in your workplace, school, church or other communities, and other process improvement, compliance and other training and other resources for health care providers, employers, health plans, community leaders and others here. 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 or updating your profile here. You can reach other recent updates and other informative publications and resources.

Recent examples of these publications include:

For important information about this communication click here.

©2013 Cynthia Marcotte Stamer.  Nonexclusive right to republish granted to Solutions Law Press, Inc. All other rights reserved.

OIG Questions Security For American’s Personal Information On HHS Health Insurance Exchange-Data Services Hub

Report Raises Questions About Security Of Data Americans Will Share With HHS Exchange Portal

A report released today by the Department of Health & Human Services (HHS) Office of Inspector General (OIG) raises serious questions about whether Americans should accept the opportunity made available by HHS for the first time today to establish a personal account and begin entering their data into HHS data banks in preparation to apply for health care coverage through health insurance exchanges to be created under the Patient Protection & Affordable Care Act when enrollment begins on October 1, 2013.  In light of the OIG findings, Americans concerned about protecting their personal information may want to hold off entering information on the Healthcare.gov website and to share their concerns with HHS and Congress.

HHS Invites Americans To Enter Their Personal Information At Healthcare.Gov Beginning Today

Health insurance exchanges are State-based competitive marketplaces where individuals and small businesses will be able to purchase private health insurance.

Today, HHS began encouraging Americans to the HHS website “healthcare.gov” to open a personal account, the first step to buying coverage through one of the health insurance exchanges that HHS is creating under the Patient Protection & Affordable Care Act reforms.  See Consumers Can Take First Step To Enrolling In New Insurance Options Today.  HHS began encouraging Americans to prepare for enrollment today by setting up their personal account on the HHS Website.  A HHS Twitter Tweet earlier today proclaimed, “Today you can be 1 step closer to getting health ins. by creating your Marketplace account:.” The website today invites Americans to “[a]nswer a few questions to get some personalized info here.”

While many are likely to view the information that HHS asks individuals to share when they create their personal accounts as relatively harmless, it merits noting that the creation of the login and password that will be used to control access to the personal account of registrants is one of those key elements. The text of an e-mail broadcast by HHS restated this invite by stating:  “Starting today you can be one step closer to getting health insurance by creating your Marketplace account. Setting up your account is the first step in the process to get you ready for October 1.  Follow these quick, easy steps and you’ll be on your way:  Provide  basic information like your name, address, and email address;  Choose  your user name and password; Create security questions to add an extra layer of protecting your information.  When open enrollment begins October 1, you’ll be set up to apply for health coverage, compare plans side-by-side, and enroll in a plan.  Create your account today! And after you’ve set up your account, make sure to tell your family and friends to set up theirs too.  Coverage starts as soon as January 1, 2014.”

 

OIG Report Questions Security Of Data Shared With HHS

On the same day as HHS invited Americans to begin entering their personal data on the Healthcare.gov website, the HHS OIG released a report titled Observations Noted During The OIG Review Of CMS’s Implementation Of The Health Insurance Exchange—Data Services Hub (Report) that raises serious questions about the security of the sensitive personal data that Americans accepting the HHS invitation to explore health care coverage offered through health insurance exchanges will share with HHS as part of the process.

Data shared by Americans as part of the process of exploring and enrolling in coverage through the health insurance exchanges will be collected and shared through a data security Hub that will host and transmit that data.  The OIG Report raises clear concerns about the existing security arrangements that CMS has implemented to protect that data, as well as questions about whether CMS will complete the necessary arrangements to secure and protect that sensitive data before enrollment begins October 1.

The findings reported by OIG in the Report raise significant questions about whether Americans should accept the HHS invitation to begin sharing their data with HHS now, as well as provide another basis for Congressional and public concern about whether CMS’ system for enrolling Americans in and administering the exchanges will be ready for prime time in October..

The findings contained in the Report are disquieting. The Report details the results OIG’s review of the efforts of CMS to implement and test the security of the Hub.  While acknowledging that CMS stated that it is confident that the Hub will be operationally secure before October 1, 2013, the Report makes clear that OIG found reason for concern about the Hub security.

The Report reflects that critical tasks required to implement and test necessary security controls remain unfinished, stating: “[S]everal critical tasks remain to be completed in a short period of time, such as the final independent testing of the Hub’s security controls, remediating security vulnerabilities identified during testing, and obtaining the security authorization decision for the Hub before opening the exchanges. CMS’s current schedule is to complete all of its tasks by October 1, 2013, in time for the expected initial open enrollment period.”

While acknowledging that CMS has indicated that it is committed to complete and implement the necessary security arrangements before enrollment begins on October 1, 2013, the OIG Report also notes that CMS already has missed several critical target dates in its efforts to implement the required security measures.  The Report additionally states: “CMS is working with very tight deadlines to ensure that security measures for the Hub are assessed, tested, and implemented by the expected initial open enrollment date of October 1, 2013. If there are additional delays in completing the security assessment and testing, the CMS CIO may have limited information on the security risks and controls when granting the security authorization of the Hub.” (emphasis added).

The security concerns highlighted in the Report should raise questions about the adequacy of the security of information that an individual might enter on the Healthcare.gov portal in response to the invitation that HHS began extending today.  Furthermore, the reported findings are likely to prompt additional questions about whether ACA and its health insurance exchanges are ready for prime time.  For policymakers, the security questions and delays in implementation also suggest additional security issues may arise when insurers and other parties required to exchange and access information through the CMS Hub interact with the Hub.   This is because CMS must complete its arrangements before other agencies and parties can implement and test their system’s interaction with the Hub and the adequacy of the security of these processes.  The continuing delay by CMS to finalize the Hub and its security will leave little time to identify and resolve issues that might stem from these interactiosn.

In light of the findings contained in the Report, Americans concerned about the security of their personal information may want to hold off entering data in response to the HHS’s invitation.  Additionally, Americans concerned about these and other security issues also may want to share their feedback with HHS and members of Congress.

 Other Questions About Exchange Readiness Remain

Today’s OIG Report of security concerns is just one of many growing concerns about the readiness of CMS and its health insurance exchanges and other health care reforms slated to take effect over the next few months are ready to go effective as scheduled.

Beyond the security issues in the OIG Report, for instance, the General Accounting Office (GAO) and others have expressed concern about arrangements and the need for added funding to prepare for the massive conversion in the U.S. health care system slated to take effect January 1, 2014.  Despite these concerns, Obama Administration officials are continuing to claim readiness to begin enrollment of Americans In federal health care marketplace on schedule on October 1, 2013 and to meet other crucial deadlines necessary to effectively implement the next wave of ACA’s health care reforms in the Department of Health & Human Service’s rollout of new consumer health care education and decision-making tools on its newly designed healthcare.gov website.

While HHS says its tools and other preparations ready to meet the October 1, 2013 enrollment commencement and the January 1, 2014 rollout of the new health insurance exchange system, others are less confident.  For instance, GAO officials recently found that major work that federal and state officials  must complete to timely begin enrollment by October 1 remains unfinished, making it unclear if they will meet the impending October 1, 2013 enrollment kickoff deadline.  See GAO Report and  GAO Report such as::

  • 17 states committed to run their own exchanges have missed March 2013 deadlines on 44% of key activities;
  • Officials creating the small business exchanges still must review plans and train and certify the “navigators” that are supposed to help companies and individuals enroll in plans and complete other key arrangements;
  • A federal  the “data hub” designed to help individuals determine their eligibility and enroll in plans offered through the exchanges has only  undergone initial testing; and
  • The current planned process for coordination of data between employer and insurer plans and the health care exchanges to evaluate eligibility of the millions of Americans expected to apply for subsidies for enrolling in coverage through the exchange presently is for HHS to contact employers by telephone employers to ask if that employer asked that employee enrollee minimum essential coverage providing minimum essential value at an affordable cost that would disqualify the applicant for the subsidy.

Meanwhile, the GAO Reports also provide a glimpse at what the federal government has spent so far on preparing the federal exchanges and the data hub. They indicate that hat the Obama Administration had approximately $394 million on exchange efforts as of March 2013 including:

  • $84 million to CGI Federal, which is building the federal exchange computer infrastructure;
  • $55 million to Quality Software Services, which is building the data hub; and
  • $38 million to Booz Allen Hamilton to provide technical assistance for enrollment and eligibility.

Contractor Booz Allen Hamilton recently has drawn attention as the National Security Association contractor through which the notorious fugitive Edward Snowden allegedly accessed information he disclosed to the public about NSA surveillance of “big data” on Americans and others through the internet.

The GAO also estimated the Obama administration needs Congress to approve an extra $1.5 billion from the budget to provide the Administration with the additional $2 billion that the GAO projects the Administration will need over the next fiscal year to create and run the federal exchanges.  Existing budget  and the political impass between the House and Senate over these and other concerns make it unlikely that Congress will approve these extra funds.

Are you concerned about whether health care reform preparations are on track or have other health care policy concerns. Tell us what you think by responding to our poll. 

Join the discussion about health care reform and share your input by joining Project COPE: Coalition for Patient Empowerment here.

About Project COPE: The Coalition On Patient Empowerment & Its  Coalition on Responsible Health Policy

Sharing and promoting the use of practical practices, tools, information and ideas that patients and their families, health care providers, employers, health plans, communities and policymakers can share and offer to help patients, their families and others in their care communities to understand and work together to better help the patients, their family and their professional and private care community plan for and manage these  needs is the purpose of Project COPE, The Coalition on Patient Empowerment & It’s Affiliate, the Coalition on Responsible Health Policy.

The best opportunity to improve access to quality, affordable health care for all Americans is for every American, and every employer, insurer, and community organization to seize the opportunity to be good Samaritans.  The government, health care providers, insurers and community organizations can help by providing education and resources to make understanding and dealing with the realities of illness, disability or aging easier for a patient and their family, the affected employers and others. At the end of the day, however, caring for people requires the human touch.  Americans can best improve health care by not waiting for someone else to step up:  Step up and help bridge the gap when you or your organization can. Speak up to help communicate and facilitate when you can.  Building health care neighborhoods filled with good neighbors throughout the community is the key.

The outcome of this latest health care reform push is only a small part of a continuing process.  Whether or not the Affordable Care Act makes financing care better or worse, the same challenges exist.  The real meaning of the enacted reforms will be determined largely by the shaping and implementation of regulations and enforcement actions which generally are conducted outside the public eye.  Americans individually and collectively clearly should monitor and continue to provide input through this critical time to help shape constructive rather than obstructive policy. Regardless of how the policy ultimately evolves, however, Americans, American businesses, and American communities still will need to roll up their sleeves and work to deal with the realities of dealing with ill, aging and disabled people and their families.  While the reimbursement and coverage map will change and new government mandates will confine providers, payers and patients, the practical needs and challenges of patients and families will be the same and confusion about the new configuration will create new challenges as patients, providers and payers work through the changes.

We also encourage you and others to help develop real meaningful improvements by joining Project COPE: Coalition for Patient Empowerment here by sharing ideas, tools and other solutions and other resources. The Coalition For Responsible Health Care Policy provides a resource that concerned Americans can use to share, monitor and discuss the Health Care Reform law and other health care, insurance and related laws, regulations, policies and practices and options for promoting access to quality, affordable healthcare through the design, administration and enforcement of these regulations.

Other Helpful Resources & Other Information

We hope that this information is useful to you.   If you found these updates of interest, you also be interested in one or more of the following other recent articles published on the Coalition for Responsible Health Care Reform electronic publication available here, our electronic Solutions Law Press Health Care Update publication available here, or our HR & Benefits Update electronic publication available here .  You also can get access to information about how you can arrange for training on “Building Your Family’s Health Care Toolkit,”  using the “PlayForLife” resources to organize low-cost wellness programs in your workplace, school, church or other communities, and other process improvement, compliance and other training and other resources for health care providers, employers, health plans, community leaders and others here. 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 or updating your profile here. You can reach other recent updates and other informative publications and resources.

Recent examples of these publications include:

For important information about this communication click here.

©2013 Cynthia Marcotte Stamer.  Nonexclusive right to republish granted to Solutions Law Press, Inc. All other rights reserved.

House Leaders Plan To Work Out Differences In 3 Versions of Health Care Reform Legislation Passed By Key Committees During Recess

Democratic Leaders in the House of Representatives plan to hammer out differences three versions of the America’s Affordable Health Choices Act (H.R. 3200) as separately passed by three key House Committees in July before House members return from their August recess in hopes of bringing the agreed to version of H.R. 3200 to the full house in September.  

After negotiating a last minute pre-August recess deal with certain Blue Dog Democrat Committee members, the House Energy and Commerce Committee on July 31, 2009 passed its version of H.R. 3200, the America’s Affordable Health Choices Act (H.R. 3200). The version of H.R. 3200 passed by the House Energy and Commerce Committee incorporates a series of amendments to the language of H.R. 3200 as originally introduced.  For instance, this version of H.R. 3200 provides incentives for states to adopt certain tort reforms, provides for a public plan option that would reimburse physicians based on negotiated rates rather Medicare rates, and would allow states to offer both state-based heath insurance exchanges and health insurance co-ops. To review H.R. 3200 as amended by the House Energy and Commerce Committee, see here.

The approval by the Energy and Commerce Committee of its version of H.R. 3200 follows the July 17, 2009 approval by the House Ways and Means Committee and Education and Labor Committee of their own versions of H.R. 3200.  For details on the version of H.R. 3200 approved by the House Ways and Means Committee, see here.  For details on the version of H.R. 3200 approved by the House Education and Labor Committee, see here

Leading House Democrats have announced their intention to work to resolve differences between these three versions of H.R. 3200 as passed by these Committees during August recess in hopes of  bringing the agreed to version of H.R. 3200 to a vote  of the full House of Representatives in September.

Meanwhile, House members from both parties also generally are using the August recess as an opportunity to reconnect with local constituents on health care reform and other core issues.

For More Information 

 The author of this article, Curran Tomko and Tarski LLP Health Care Practice Chair Cynthia Marcotte Stamer has extensive experience advising and assisting health industry clients and others about a diverse range of health care policy, regulatory, compliance, risk management and operational concerns.  You can get more information about her health industry experience here.  

We hope that this information is useful to you.  If you need assistance monitoring, evaluating or responding to these or other proposed health care or other regulatory reforms or with other health care compliance, risk management, transaction or operation concerns, please contact the author of this update, Curran Tomko Tarski LLP Health Practice Group Chair, Cynthia Marcotte Stamer, at (214) 270-2402, cstamer@cttlegal.com or your other favorite Curran Tomko Tarski LLP Partner.

We also encourage you and others to join the discussion about these and other health care reform proposals and concerns by joining the Coalition for Responsible Health Care Reform Group on Linkedin, registering to receive these updates here.

The author of this article, Curran Tomko and Tarski LLP Health Care Practice Chair Cynthia Marcotte Stamer has extensive experience advising and assisting health industry clients and others about a diverse range of health care policy, regulatory, compliance, risk management and operational concerns.  You can get more information about her health industry experience here.  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 or updating your profile at here or e-mailing this information to cstamer@cttlegal.com.

The Real Opportunities To Improve Health Care- A 10 Step Program

The ongoing health care reform debate in Washington requires that all Americans including those in Congress to seize the opportunity to show true leadership on health care reform by dong their part to making health care work.

To really make a difference, Congress and Americans need to stop pretending that they can waive a magic wand and “fix” health care.  There are no easy fixes.  There are just a series of tough realities and steps that all Americans have to embrace to improve health care in the United States.   If you agree with the health care truths discussed in this Article, let all members of Congress know your feelings and join the Coalition For Responsible Health Care Reform group on linkedin to discuss and plan specific steps that you can take to improve health care for your family and others in your community.

10 Health Care Truths

The following are 10 key realities: 

  1. Being old or being sick (or having a loved one who is) stinks. Not everyone was born with a BMW for a body and even some BMW’s are lemons.  Wellness can delay this reality for some people but not everyone.  I don’t live an unhealthy life.  I don’t smoke, don’t do drugs, exercise, etc., yet I’ve had cancer twice.  A good friend who lives a totally healthy life is awaiting a heart transplant at 47.   Even for a car, there isn’t always a clear “evidence based” answer to the questions what’s wrong, how to fix it, when the expense is worth it and how do I find the money and other resources? Sometimes you just have to just keep pouring in more oil and let it leak. The government can’t change this anymore than anyone else. 
  2. Money only can do so much to fix item 1 and there isn’t enough money to fix what can be fixed for everyone (assuming there is a fix).   We can put more money into the system if Americans support taking money from somewhere else to provide more money for health care.  Individual families currently make these choices by deciding whether to buy and how much coverage they can afford without giving up other things that their family views as more necessary than health care coverage.  Congressional proposals would take this choice away from American families by dictating both how much and the price of coverage a family must buy as well as how much that American family also must pay to buy health coverage for other Americans. 
  3. The aging population means that the gap between 1 and 2 will continue to grow unless we adopt a rationing plan that decides to let people die by denying care. Many old and sick people are extraordinary functional, valuable and important to someone.   If the government chooses to replace private insurers in running the health care system, grieving families of ill and individuals will be mad at the government when their family members die or suffer because they can’t access or afford health care that the doctors say would help.
  4. Just because the most health care dollars are spent in the last months of life doesn’t mean that these dollars are necessarily wasted. Likewise, pouring dollars into “prevention” doesn’t mean that a large number of people won’t still get older or sick.  People that live healthy lives get sick, have accidents, and get old.  The body wears out.  The ability and practice of the US health care system in saving hands of minimum wage workers, providing diagnosis that extends the range of treatment options and gives people with terminal illness 6 months to 5 years of life, providing treatments that minimize disability and maximize functionality are all good things. The U.S. willingness to invest in our aging and disabled is part of the reason our disabled and aging people tend to be more productive than in other countries less willing to invest in these treatments.  The question should be what quality of life and value was realized for the dollars spent.   
  5. The most overlooked opportunities for quality and cost improvements rest with the people in health care. Studies show that physicians and the RNs working with them agree in less than 70 percent of the times about the care ordered and how to administer it. Communication elsewhere among health care providers further erodes cost effectiveness and quality. Government regulation and the tension that results from regulation and practices that break up health care teams makes this worse contributes to this problem.   Congress’ over regulation of health care and efforts to manipulate health care by manipulation of the Medicare rules already has done tremendous damage by forcing providers to run rabbit trails to try to deliver care.  More Federal involvement will just make this worse. 
  6. Americans want to be good health care consumers.  They just need training and tools to do it better.  We need a national health care consumer education campaign that teaches Americans to better participate in our health care system.  Patients and their families will better manage their own health care when they have better health care information and health care skills training.  Skills training can reduce waste and suffering that happens when patients don’t comply with health care advice and make misinformed decisions.  When families and patients get good information that indicates that the $20,000 spent for a procedure will only cause a lot of suffering and expense to extend a life already suffering for another 48 hours, they usually chose quality of life over length of life.  Families that learn that the less expensive drug works as well as the more expensive one usually will opt for the less expensive one to realize the smaller co-pay. Patients and their families need to be taught to be good and responsible health care patients and to help others in their families and the community to do the same.  The government, health care providers, insurers and community organizations can help by providing education and resources to share this education.  make this easier. Let’s give American’s a health care loaf and turn them loose.  
  7. Americans dont want someone else to manage their health care;  they want more power to manage it themselves.  Current proposals that would give government more control over health care is the last things Americans want.  Instead of taking more control away from individual Americans, Congress should work to empower patients by creating real jobs, funding public, charity, and private indigent care health clinics, hospitals and other venues that service the poor, reducing taxes and other actions that will free uo dollars for businesses and individuals to invest more in wellness and health care coverage.
  8. Change creates additional costs and disruptions that will drive up costs and reduce quality.  The constant changing of the system and the resulting confusion that patients, payers and providers experience accounts for much of the lost quality, high cost and dissatisfaction in the system. 
  9. You can’t change patient conduct by fiat.  Overcoming obesity and other lifestyle diseases is tough even when micromanaged.  Lack of money isn’t the only reason people don’t have health insurance coverage or obtain care with the rationality of a mad scientist accountant. 
  10. Government is the last entity that should have the right to determine – directly or through a politically appointed board – the value of a life and the quality of life members of my family and yours are allowed to access. Government action is always political – even when made by private politically appointed boards. Letting the government “manage” care instead of insurers just lets a bigger, more insulated fox in the hen house. This fox is bigger, more powerful, less accessible, harder to talk to, impossible to be heard by and doesn’t give a darn individually about you, me, or your family.  Anyone who has relied on home health benefits from Medicare or benefits from the VA knows you can’t trust Congress to deliver on its promises.  Whatever the government allocates for health care funding today, informed American voters know that they can’t count on government providing the funds to keep its promises.  These American’s and the millions who know they know this reality:   When the government says “trust me,” run!

What Congress Should Do  To Improve Health Care

Let’s stop pretending there is an easy fix and get onto the business of working item by item on what we can do with these and the hundreds of other little things that together actually will make a massive difference in the real life of patients and their families AND produce meaningful improvements in heath care cost, quality and access.

  • Tell every member of Congress to say “no” to proposals to spend $1 trillion dollars to give the federal government the ability to “manage” health care
  • Tell Congress you want to manage and coordinate your own health care, not delegate that to government to handle
  • Tell Congress to adopt legislation that would make it easier for churches and other community and business associations to pool together and offer coverage along side the existing employer-provided systems
  • Tell Congress to support and fund public and private efforts to develop and communicate tools and education to empower patients to better manage their own health, wellness and their family’s health care needs
  • Tell Congress not to tax employer provided health care coverage and to provide tax-credits to businesses and individuals to make maintaining private health care coverage more affordable
  • Get involved in your family and community in building your own, your family’s and your community’s health care plan.  Build and use your health care consumer and management skills to manage your family’s health and health care.