Let's discuss what's in the Health Care Bill

reply to post by Hastobemoretolife


I see ACORN alot in the supositions. But not in the bill. Maybe I missed it, but does it say anything on how these community organizations are enrolled into assisting the plan?
Aare they chosen from a pool? Or are they federally "picked"?

Claim:

PG 740-757 Government sets guidelines for subsidizing the uninsured (That’s your tax dollars peeps)

What it says:

This section is quiet large, but there is nothing in this section for me to believe that the quote is untrue in anyway. What the section does do is expand Medicaid though. If I am reading it right, this means they are decreasing the funding to medicaid, but also expanding it.

reply to post by jdub297


Those are some very good observations, and you're quite right. A doctor doesn't have the legal ability to give advice on legal documents. That's reserved specifically for a lawyer.


reply to post by Hastobemoretolife


Oops! I did mean uninsured. I went back and edited my post to correct that, thanks for pointing it out.

If the states with the least insured get the most rate reductions, the states with the most insured will end up with the highest rates. That's if I'm understanding that section correctly.

PG 354 Line 1177 Government will RESTRICT enrollment of Special needs people!


SEC. 1177. EXTENSION OF AUTHORITY OF SPECIAL NEEDS
4 PLANS TO RESTRICT ENROLLMENT.
5 (a) IN GENERAL.—Section 1859(f)(1) of the Social
6 Security Act (42 U.S.C. 1395w–28(f)(1)) is amended by
7 striking ‘‘January 1, 2011’’ and inserting ‘‘January 1,
8 2013 (or January 1, 2016, in the case of a plan described
9 in section 1177(b)(1) of the America’s Affordable Health
10 Choices Act of 2009)’’.
11 (b) GRANDFATHERING OF CERTAIN PLANS.—
12 (1) PLANS DESCRIBED.—For purposes of sec
13tion 1859(f)(1) of the Social Security Act (42
14 U.S.C. 1395w–28(f)(1)), a plan described in this
15 paragraph is a plan that had a contract with a State
16 that had a State program to operate an integrated
17 Medicaid-Medicare program that had been approved
18 by the Centers for Medicare & Medicaid Services as
19 of January 1, 2004.
20 (2) ANALYSIS; REPORT.—The Secretary of
21 Health and Human Services shall provide, through
22 a contract with an independent health services eval
23uation organization, for an analysis of the plans de
24scribed in paragraph (1) with regard to the impact
25 of such plans on cost, quality of care, patient satis-
1 faction, and other subjects as specified by the Sec
2retary. Not later than December 31, 2011, the Sec
3retary shall submit to Congress a report on such
4 analysis and shall include in such report such rec
5ommendations with regard to the treatment of such
6 plans as the Secretary deems appropriate.

-sigh- Apparently, this one is true. I bolded the pertenent section. If anyone else can make another determination on this, I sure would appreciate it. I would hate to think that it is true.

reply to post by mikerussellus


Well ACORN isn't going to specifically mentioned, but I would imagine that the organizations are picked federally, through applications that "community based organizations submit". You also have to take into account that ACORN has over 300 different "community based organizations" that they run that are not ACORN, but ACORN does manage them.

reply to post by Jenna


Hrmm, I think we are going to need a third party to decifer that one, because the way I'm reading it, it means the states with the least amount of uninsured will have the lowest tax burden, states with the most uninsured highest tax burden.

PG 355-369 Line 1181 Government disguises tax on Drug Companies as rebate to Government to subsidize Drugs. We pay in the end.

(f) PRESCRIPTION DRUG REBATE AGREEMENT FOR FULL-BENEFIT DUAL ELIGIBLE INDIVIDUALS.—
(1) IN GENERAL.—In this part, the term ‘covered part D drug’ does not include any drug or biologic that is manufactured by a manufacturer that has not entered into and have in effect a rebate agreement described in paragraph (2).
(2) REBATE AGREEMENT.—A rebate agreement under this subsection shall require the manufacturer to provide to the Secretary a rebate for each rebate period (as defined in paragraph (6)(B)) ending after December 31, 2010, in the amount specified in paragraph (3) for any covered part D drug of the manufacturer dispensed after December 31, 2010, to any full-benefit dual eligible individual (as defined in paragraph (6)(A)) for which payment was made by a PDP sponsor under part D or a MA organization under part C for such period. Such rebate shall be paid by the manufacturer to the Secretary not later than 30 days after the date of receipt of the information described in section 1860D 12(b)(7), including as such section is applied under section 1857(f)(3).

The bill doesn't call it a tax, but I'm sure the drug companies will consider mandatory rebates to be a tax. For that reason I'm calling this claim true.

PG 399 If your a subsidy eligible individual under Medicare part D and you don’t enroll, the Government will auto enroll you.

(b) AUTOMATIC ENROLLMENT.—Section 1860D–5 1(b)(1) of the Social Security Act (42 U.S.C. 1395w–101(b)(1)) is amended by adding at the end the following new subparagraph:
(D) SPECIAL RULE FOR SUBSIDY ELIGIBLE INDIVIDUALS.—The process established under subparagraph (A) shall include, in the case of an individual described in section 1860D–1(b)(3)(D) who fails to enroll in a prescription drug plan or an MA–PD plan during the special enrollment established under such section applicable to such individual, the application of the assignment process described in subparagraph (C) to such individual in the same manner as such assignment process applies to a part D eligible individual described in such subparagraph (C). Nothing in the previous sentence shall prevent an individual described in such sentence from declining enrollment in a plan determined appropriate by the Secretary (or in the program under this part) or from changing such enrollment.’’.

The claim is true, but misleading. You will be auto-enrolled, but you have the ability to decline the enrollment or change it.

PG 379 Line 1191 Government creates more bureaucracy – Telehealth Advisory Committee. Can you say HealthCare by phone?

Subtitle F—Medicare Rural Access
9 Protections
10 SEC. 1191. TELEHEALTH EXPANSION AND ENHANCEMENTS.
11 (a) ADDITIONAL TELEHEALTH SITE.—
12 (1) IN GENERAL.—Paragraph (4)(C)(ii) of sec13
tion 1834(m) of the Social Security Act (42 U.S.C.
14 1395m(m)) is amended by adding at the end the fol15
lowing new subclause:
16 ‘‘(IX) A renal dialysis facility.’’
17 (2) EFFECTIVE DATE.—The amendment made
18 by paragraph (1) shall apply to services furnished on
19 or after January 1, 2011.
20 (b) TELEHEALTH ADVISORY COMMITTEE.—
21 (1) ESTABLISHMENT.—Section 1868 of the So22
cial Security Act (42 U.S.C. 1395ee) is amended—
23 (A) in the heading, by adding at the end
24 the following: ‘‘TELEHEALTH ADVISORY COM25
MITTEE’’; and
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380
•HR 3200 IH
1 (B) by adding at the end the following new
2 subsection:
3 ‘‘(c) TELEHEALTH ADVISORY COMMITTEE.—
4 ‘‘(1) IN GENERAL.—The Secretary shall appoint
5 a Telehealth Advisory Committee (in this subsection
6 referred to as the ‘Advisory Committee’) to make
7 recommendations to the Secretary on policies of the
8 Centers for Medicare & Medicaid Services regarding
9 telehealth services as established under section
10 1834(m), including the appropriate addition or dele11
tion of services (and HCPCS codes) to those speci12
fied in paragraphs (4)(F)(i) and (4)(F)(ii) of such
13 section and for authorized payment under paragraph
14 (1) of such section.
15 ‘‘(2) MEMBERSHIP; TERMS.—
16 ‘‘(A) MEMBERSHIP.—
17 ‘‘(i) IN GENERAL.—The Advisory
18 Committee shall be composed of 9 mem19
bers, to be appointed by the Secretary, of
20 whom—
21 ‘‘(I) 5 shall be practicing physi22
cians;
23 ‘‘(II) 2 shall be practicing non24
physician health care practitioners;
25 and
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•HR 3200 IH
1 ‘‘(III) 2 shall be administrators
2 of telehealth programs.
3 ‘‘(ii) REQUIREMENTS FOR APPOINT4
ING MEMBERS.—In appointing members of
5 the Advisory Committee, the Secretary
6 shall—
7 ‘‘(I) ensure that each member
8 has prior experience with the practice
9 of telemedicine or telehealth;
10 ‘‘(II) give preference to individ11
uals who are currently providing tele12
medicine or telehealth services or who
13 are involved in telemedicine or tele14
health programs;
15 ‘‘(III) ensure that the member16
ship of the Advisory Committee rep17
resents a balance of specialties and
18 geographic regions; and
19 ‘‘(IV) take into account the rec20
ommendations of stakeholders.
21 ‘‘(B) TERMS.—The members of the Advi22
sory Committee shall serve for such term as the
23 Secretary may specify.
24 ‘‘(C) CONFLICTS OF INTEREST.—An advi25
sory committee member may not participate
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•HR 3200 IH
1 with respect to a particular matter considered
2 in an advisory committee meeting if such mem3
ber (or an immediate family member of such
4 member) has a financial interest that could be
5 affected by the advice given to the Secretary
6 with respect to such matter.
7 ‘‘(3) MEETINGS.—The Advisory Committee
8 shall meet twice each calendar year and at such
9 other times as the Secretary may provide.
10 ‘‘(4) PERMANENT COMMITTEE.—Section 14 of
11 the Federal Advisory Committee Act (5 U.S.C.
12 App.) shall not apply to the Advisory Committee.’’
13 (2) FOLLOWING RECOMMENDATIONS.—Section
14 1834(m)(4)(F) of such Act (42 U.S.C.
15 1395m(m)(4)(F)) is amended by adding at the end

True. More bureaucracy, but at the same time, I do like the idea. Personally, it makes sense especially in rural areas.
Just my humble opinion on this item.

Claim:

PG 724 Lines 16-22 Government reserves right to apply face-to-face certification for patient to ANY other HealthCare service

What it says:

16 (c) APPLICATION TO OTHER AREAS UNDER MEDI
17 CARE.—The Secretary may apply the face-to-face encoun
18 ter requirement described in the amendments made by
19 subsections (a) and (b) to other items and services for
20 which payment is provided under title XVIII of the Social
21 Security Act based upon a finding that such an decision
22 would reduce the risk of waste, fraud, or abuse.

This claim is in fact true. Although it does say if the decision can reduce the risk of waste, fraud, or abuse.

Claim:

PG 722 Section 1639 Government MANDATES Doctors must have face-to-face with patient to certify patient for Home Health Services.

what it says:

17 SEC. 1639. FACE TO FACE ENCOUNTER WITH PATIENT RE
18 QUIRED BEFORE PHYSICIANS MAY CERTIFY
19 ELIGIBILITY FOR HOME HEALTH SERVICES
20 OR DURABLE MEDICAL EQUIPMENT UNDER
21 MEDICARE.

This claim is true. Don't really know what else to say about this.

Claim:

Pg 719-720 Section 1637 ANY Doctor who orders durable medical equipment or home medical services MUST be enrolled in Medicare.

What it says:

11 SEC. 1637. PHYSICIANS WHO ORDER DURABLE MEDICAL
12 EQUIPMENT OR HOME HEALTH SERVICES RE
13 QUIRED TO BE MEDICARE ENROLLED PHYSI
14 CIANS OR ELIGIBLE PROFESSIONALS.

That claim is in fact true.

I just thought I would throw this little tid-bit in here too:

10 (c) DISCRETION TO EXPAND APPLICATION.—The
11 Secretary may extend the requirement applied by the
12 amendments made by subsections (a) and (b) to durable
13 medical equipment and home health services (relating to
14 requiring certifications and written orders to be made by
15 enrolled physicians and health professions) to other cat
16 egories of items or services under this title, including cov
17 ered part D drugs as defined in section 1860D–2(e), if
18 the Secretary determines that such application would help
19 to reduce the risk of waste, fraud, and abuse with respect
20 to such other categories under title XVIII of the Social
21 Security Act.

So in other words the "secretary" can expand the requirements has he/she sees fit and expand what things people get.

If I am reading this right, this is rationing.

PG 401 Section 1221 Americans will fund Medicare Language & Translation Services Program. Can you say MORE taxes?


(A) How to develop and structure appro
8priate payment systems for language services
9 for all Medicare service providers.
10 (B) The feasibility of adopting a payment
11 methodology for on-site interpreters, including
12 interpreters who work as independent contrac
13tors and interpreters who work for agencies
14 that provide on-site interpretation, pursuant to
15 which such interpreters could directly bill Medi
16care for services provided in support of physi
17cian office services for an LEP Medicare pa
18tient.
19 (C) The feasibility of Medicare contracting
20 directly with agencies that provide off-site inter
21pretation including telephonic and video inter
22pretation pursuant to which such contractors
23 could directly bill Medicare for the services pro
24vided in support of physician office services for
25 an LEP Medicare patient.

I don't see anything specific about taxes, but cost? Heck yes. This is silly. In every hospital I have ever worked at, there has always been a "pool" of people that spoke a variety of languages. These people (already working for the hospital) were called upon, to provide translations when needed.
Just another useless cost burden on Medicare. IMHO

PG 404 Lines 12-16 Government exempts itself again from - Chap 35 of title 44, USC including privacy of Americans.

PG 404 Lines 17-19 Government doesn’t know the cost of Language services but states that money is there.

Page 404 Lines 6-21:

(6) AUTHORIZATION OF APPROPRIATIONS.— There is authorized to be appropriated to carry out this subsection such sums as are necessary.
(b) HEALTH PLANS.—Section 1857(g)(1) of the Social Security Act (42 U.S.C. 1395w–27(g)(1)) is amended—
(1) by striking ‘‘or’’ at the end of subparagraph (F);
(2) by adding ‘‘or’’ at the end of subparagraph (G); and
(3) by inserting after subparagraph (G) the following new subparagraph:
(H) fails substantially to provide language services to limited English proficient beneficiaries enrolled in the plan that are required under law;’’.

SSA Section 1857(g)(1):

(g) Intermediate Sanctions.—

(1) In general.—If the Secretary determines that a Medicare+Choice organization with a contract under this section—
(A) fails substantially to provide medically necessary items and services that are required (under law or under the contract) to be provided to an individual covered under the contract, if the failure has adversely affected (or has substantial likelihood of adversely affecting) the individual;
(B) imposes premiums on individuals enrolled under this part in excess of the amount of the Medicare+Choice monthly basic and supplemental beneficiary premiums permitted under section 1854;
(C) acts to expel or to refuse to re–enroll an individual in violation of the provisions of this part;
(D) engages in any practice that would reasonably be expected to have the effect of denying or discouraging enrollment (except as permitted by this part) by eligible individuals with the organization whose medical condition or history indicates a need for substantial future medical services;
(E) misrepresents or falsifies information that is furnished—
(i) to the Secretary under this part, or
(ii) to an individual or to any other entity under this part;
(F) fails to comply with the applicable requirements of section 1852(j)(3) or 1852(k)(2)(A)(ii); or
(G) employs or contracts with any individual or entity that is excluded from participation under this title under section 1128 or 1128A for the provision of health care, utilization review, medical social work, or administrative services or employs or contracts with any entity for the provision (directly or indirectly) through such an excluded individual or entity of such services;

the Secretary may provide, in addition to any other remedies authorized by law, for any of the remedies described in paragraph (2).

I'm calling the first claim false and the second one possibly true. There isn't anything in the referenced section of the bill that implies the government is exempt for anything. The second claim I'm calling possibly true because it says "There is authorized to be appropriated to carry out this subsection such sums as are necessary."

Claim:

PG 711 Lines 8-14 The Secretary has broad powers to deny HealthCare providers/suppliers admittance into HealthCare Exchange.

What it says:

8 ‘‘(3) AUTHORITY TO DENY PARTICIPATION.—If
9 the Secretary determines that there has been at
10 least one such affiliation and that such affiliation or
11 affiliations, as applicable, of such provider or sup
12 plier poses a serious risk of fraud, waste, or abuse,
13 the Secretary may deny the application of such pro
14 vider or supplier.’’.

I will call this claim misleading, but let's see what the affiliation consists of to determine grounds for denial.


This is the relevant section:

9 ‘‘(1) DISCLOSURE.—A provider of services or
10 supplier who submits on or after July 1, 2011, an
11 application for enrollment and renewing enrollment
12 in a program under title XVIII, XIX, or XXI shall
13 disclose (in a form and manner determined by the
14 Secretary) any current affiliation or affiliation with
15 in the previous 10-year period with a provider of
16 services or supplier that has uncollected debt or with
17 a person or entity that has been suspended or ex
18 cluded under such program, subject to a payment
19 suspension, or has had its billing privileges revoked.

I had to read this a few times but what I think it is saying is, that the "secretary" can deny health care suppliers/providers, based off of uncollected debt, affiliation with a person or entity that has been suspended or excluded from the programs they are setting up and has been subject to payment suspension or had billing privileges revoked, within a 10 year period.

This bill is indeed a trojan horse to implement a single payer system. They can exclude any providers/suppliers, based off of the criteria that the government has mandated.

Claim:

PG 705-709 SEC. 1128 If Secretary gets complaints (ACORN) on HealthCare provider or supplier, Government can do background check.

What it says:

1 ‘‘SEC. 1128G. ENHANCED PROGRAM AND PROVIDER PRO
2 TECTIONS IN THE MEDICARE, MEDICAID, AND
3 CHIP PROGRAMS.
4 ‘‘(a) CERTAIN AUTHORIZED SCREENING, ENHANCED
5 OVERSIGHT PERIODS, AND ENROLLMENT MORATORIA.—
6 ‘‘(1) IN GENERAL.—For periods beginning after
7 January 1, 2011, in the case that the Secretary de
8 termines there is a significant risk of fraudulent ac
9 tivity (as determined by the Secretary based on rel
10 evant complaints, reports, referrals by law enforce
11 ment or other sources, data analysis, trending infor
12 mation, or claims submissions by providers of serv
13 ices and suppliers) with respect to a category of pro
14 vider of services or supplier of items or services, in
15 cluding a category within a geographic area, under
16 title XVIII, XIX, or XXI, the Secretary may impose
17 any of the following requirements with respect to a
18 provider of services or a supplier (whether such pro
19 vider or supplier is initially enrolling in the program
20 or is renewing such enrollment):
21 ‘‘(A) Screening under paragraph (2).
22 ‘‘(B) Enhanced oversight periods under
23 paragraph (3).
24 ‘‘(C) Enrollment moratoria under para
25 graph (4).
1 In applying this subsection for purposes of title XIX
2 and XXI the Secretary may require a State to carry
3 out the provisions of this subsection as a require
4 ment of the State plan under title XIX or the child
5 health plan under title XXI. Actions taken and de
6 terminations made under this subsection shall not be
7 subject to review by a judicial tribunal.
8 ‘‘(2) SCREENING.—For purposes of paragraph
9 (1), the Secretary shall establish procedures under
10 which screening is conducted with respect to pro
11 viders of services and suppliers described in such
12 paragraph. Such screening may include—
13 ‘‘(A) licensing board checks;
14 ‘‘(B) screening against the list of individ
15 uals and entities excluded from the program
16 under title XVIII, XIX, or XXI;
17 ‘‘(C) the excluded provider list system;
18 ‘‘(D) background checks; and
19 ‘‘(E) unannounced pre-enrollment or other
20 site visits.
21 ‘‘(3) ENHANCED OVERSIGHT PERIOD.—For
22 purposes of paragraph (1), the Secretary shall estab
23 lish procedures to provide for a period of not less
24 than 30 days and not more than 365 days during
25 which providers of services and suppliers described
1 in such paragraph, as the Secretary determines ap
2 propriate, would be subject to enhanced oversight,
3 such as required or unannounced (or required and
4 unannounced) site visits or inspections, prepayment
5 review, enhanced review of claims, and such other
6 actions as specified by the Secretary, under the pro
7 grams under titles XVIII, XIX, and XXI. Under
8 such procedures, the Secretary may extend such pe
9 riod for more than 365 days if the Secretary deter
10 mines that after the initial period such additional
11 period of oversight is necessary.
12 ‘‘(4) MORATORIUM ON ENROLLMENT OF PRO
13 VIDERS AND SUPPLIERS.—For purposes of para
14 graph (1), the Secretary, based upon a finding of a
15 risk of serious ongoing fraud within a program
16 under title XVIII, XIX, or XXI, may impose a mor
17 atorium on the enrollment of providers of services
18 and suppliers within a category of providers of serv
19 ices and suppliers (including a category within a spe
20 cific geographic area) under such title. Such a mora
21 torium may only be imposed if the Secretary makes
22 a determination that the moratorium would not ad
23 versely impact access of individuals to care under
24 such program.

Well, this claim is in fact true. As Jenna and Mike have pointed out this guy has a fascination about ACORN, but there is nothing excluding them from issuing complaints against providers/suppliers.

The sections in bold, or things that I found to be concerning. One the "Secretary" will be the one determining what is a relevant complaint and there will be no judicial review of his actions determining his actions based off of these complaints.

Edit to add -

This opens up the health care industry to gross politicization and no channel for legal recourse, this also opens up the health care industry to rampant corruption fraud and waste.

[edit on 9-8-2009 by Hastobemoretolife]

Claim 1: PG 425 Lines 4-12 Government mandates Advance Care Planning Consult. Think Senior Citizens end of life.

Claim 2: PG 425 Lines 17-19 Government will instruct & consult regarding living wills, durable powers of atty. Mandatory!

Claim 3: PG 425 Lines 22-25, 426 Lines 1-3 Government provides approved list of end of life resources, guiding you in death.

I've labeled these as claims 1, 2, and 3 for ease of reference.

Page 424-426:

Advance Care Planning Consultation
(hhh)(1) Subject to paragraphs (3) and (4), the term ‘advance care planning consultation’ means a consultation between the individual and a practitioner described in paragraph (2) regarding advance care planning, if, subject to paragraph (3), the individual involved has not had such a consultation within the last 5 years. Such consultation shall include the following:
(A) An explanation by the practitioner of advance care planning, including key questions and considerations, important steps, and suggested people to talk to.
(B) An explanation by the practitioner of advance directives, including living wills and durable powers of attorney, and their uses.
(C) An explanation by the practitioner of the role and responsibilities of a health care proxy.
(D) The provision by the practitioner of a list of national and State-specific resources to assist consumers and their families with advance care planning, including the national toll-free hotline, the advance care planning clearinghouses, and State legal service organizations (including those funded through the Older Americans Act of 1965).
(E) An explanation by the practitioner of the continuum of end-of-life services and supports available, including palliative care and hospice, and benefits for such services and supports that are available under this title.
(F)(i) Subject to clause (ii), an explanation of orders regarding life sustaining treatment or similar orders, which shall include—
(I) the reasons why the development of such an order is beneficial to the individual and the individual’s family and the reasons why such an order should be updated periodically as the health of the individual changes;
(II) the information needed for an individual or legal surrogate to make informed decisions regarding the completion of such an order; and
(III) the identification of resources that an individual may use to determine the requirements of the State in which such individual resides so that the treatment wishes of that individual will be carried out if the individual is unable to communicate those wishes, including requirements regarding the designation of a surrogate decisionmaker (also known as a health care proxy).

Claim 1 is true. Senior citizens will be required to have a consultation with their doctor on end of life planning if they haven't had one in five years.

Claim 2 is partly true. It won't be the government itself directing seniors on these issues, it will be their doctor. As was pointed out in a previous post, doctors are not licensed to practice law and as such are not qualified to give advice on any of these legal documents.

Claim 3 is true to an extent. There is a short list of things doctors will be required to discuss with patients, but I don't believe that this list can be considered an all encompassing list.

This is a large section, I'll try to fit it on one page. . .

PG 425 Lines 4-12 Government mandates Advance Care Planning Consult. Think Senior Citizens end of life.

‘‘Advance Care Planning Consultation
21 ‘‘(hhh)(1) Subject to paragraphs (3) and (4), the
22 term ‘advance care planning consultation’ means a con
23sultation between the individual and a practitioner de
24scribed in paragraph (2) regarding advance care planning,
25 if, subject to paragraph (3), the individual involved has
1 not had such a consultation within the last 5 years. Such
2 consultation shall include the following:
3 ‘‘(A) An explanation by the practitioner of ad
4vance care planning, including key questions and
5 considerations, important steps, and suggested peo
6ple to talk to.
7 ‘‘(B) An explanation by the practitioner of ad
8vance directives, including living wills and durable
9 powers of attorney, and their uses.
10 ‘‘(C) An explanation by the practitioner of the
11 role and responsibilities of a health care proxy.

Possibly true. Much has been read into this. Will explore further. . .

PG 425 Lines 17-19 Government will instruct & consult regarding living wills, durable powers of atty. Mandatory!

‘‘(E) An explanation by the practitioner of the
20 continuum of end-of-life services and supports avail
21able, including palliative care and hospice, and bene
22fits for such services and supports that are available
23 under this title.

I haven't seen manditory. False. So far. Correction, when the government makes the 5 year visit manditory, then it is.

PG 425 Lines 22-25, 426 Lines 1-3 Government provides approved list of end of life resources, guiding you in death.

‘‘(F)(i) Subject to clause (ii), an explanation of
2 orders regarding life sustaining treatment or similar
3 orders, which shall include—
4 ‘‘(I) the reasons why the development of
5 such an order is beneficial to the individual and
6 the individual’s family and the reasons why
7 such an order should be updated periodically as
8 the health of the individual changes;

Dark claim, but true.

PG 427 Lines 15-24 Government mandates program for orders for end of life. The Government has a say in how your life ends.

‘‘(II) distributes or makes accessible such
14 orders to physicians and other health profes
15sionals that (acting within the scope of the pro
16fessional’s authority under State law) may sign
17 orders for life sustaining treatment;
18 ‘‘(III) provides training for health care
19 professionals across the continuum of care
20 about the goals and use of orders for life sus
21taining treatment; and
22 ‘‘(IV) is guided by a coalition of stake
23holders includes representatives from emergency
24 medical services, emergency department physi
25cians or nurses, state long-term care associa-
1 tion, state medical association, state surveyors,
2 agency responsible for senior services, state de
3partment of health, state hospital association,
4 home health association, state bar association,
5 and state hospice association.

True.

PG 429 Lines 1-9 An “advance care planning consultant” will be used frequently as patients health deteriorates.

‘‘(4) A consultation under this subsection may in
2clude the formulation of an order regarding life sustaining
3 treatment or a similar order.
4 ‘‘(5)(A) For purposes of this section, the term ‘order
5 regarding life sustaining treatment’ means, with respect
6 to an individual, an actionable medical order relating to
7 the treatment of that individual that—
8 ‘‘(i) is signed and dated by a physician (as de
9fined in subsection (r)(1)) or another health care
10 professional (as specified by the Secretary and who
11 is acting within the scope of the professional’s au
12thority under State law in signing such an order, in
13cluding a nurse practitioner or physician assistant)
14 and is in a form that permits it to stay with the in
15dividual and be followed by health care professionals
16 and providers across the continuum of care;
17 ‘‘(ii) effectively communicates the individual’s
18 preferences regarding life sustaining treatment, in
19cluding an indication of the treatment and care de
20sired by the individual;
21 ‘‘(iii) is uniquely identifiable and standardized
22 within a given locality, region, or State (as identified
23 by the Secretary); and
1 ‘‘(iv) may incorporate any advance directive (as
2 defined in section 1866(f)(3)) if executed by the in
3dividual.

True.

PG 429 Lines 10-12 “advance care consultation” may include an ORDER for end of life plans. AN ORDER from Government.

(as specified by the Secretary and who
11 is acting within the scope of the professional’s au
12thority under State law in signing such an order, in
13cluding a nurse practitioner or physician assistant)
14 and is in a form that permits it to stay with the in
15dividual and be followed by health care professionals
16 and providers across the continuum of care;

True, in that IT MAY INCLUDE. Not mandated.

PG 429 Lines 13-25 The Government will specify which Doctors can write an end of life order. Logan’s Run anyone?

(as specified by the Secretary and who
11 is acting within the scope of the professional’s au
12thority under State law in signing such an order, in
13cluding a nurse practitioner or physician assistant)
14 and is in a form that permits it to stay with the in
15dividual and be followed by health care professionals
16 and providers across the continuum of care;

True. See bolded section.

PG 430 Lines 11-15 The Government will decide what level of treatment you will have at end of life.

‘‘(B) The level of treatment indicated under subpara
5graph (A)(ii) may range from an indication for full treat
6ment to an indication to limit some or all or specified
7 interventions. Such indicated levels of treatment may in
8clude indications respecting, among other items—
9 ‘‘(i) the intensity of medical intervention if the
10 patient is pulse less, apneic, or has serious cardiac
11 or pulmonary problems;
12 ‘‘(ii) the individual’s desire regarding transfer
13 to a hospital or remaining at the current care set
14ting;
15 ‘‘(iii) the use of antibiotics; and
16 ‘‘(iv) the use of artificially administered nutri
17tion and hydration.’’.

True.

PG 432 Lines 18-21 The Government will publish “quality measures” for individual’s end of life in Federal Register.

‘‘(B) PROPOSED SET OF MEASURES.—The
11 Secretary shall publish in the Federal Register
12 proposed quality measures on end of life care
13 and advanced care planning that the Secretary
14 determines are described in subparagraph (A)
15 and would be appropriate for eligible profes
16sionals to use to submit data to the Secretary.
17 The Secretary shall provide for a period of pub
18lic comment on such set of measures before fi
19nalizing such proposed measures.’’.

True, but the public will be able to comment, if desired.


This was a huge section, I hope I got it all right, if there are any issues/corrections/mistakes please let me know.

Mike



[edit on 9-8-2009 by mikerussellus]

reply to post by Jenna


Apologies Jenna, didn't realize we were both working on the same items.

I hope I got my points correct though.

EXCELLENT WORK!!!
By most involved.
The point now should be to bring this to the attention of your reps, who should be home now (if not in hiding), and all other people who will be affected by this legislation. (All Americans, among others.)
The outcry on this issue is vocal and prevalent, and we can only assume many portions will be changed, for better and for worse, when our elected officials go back to work.
Our DUTY is to assure that those changes are for the better, and to constantly be vigilant on their actions.

It has been said that a very vocal 2% can change the course of government, and I think the number is currently around 10%.

I think the majority agree reform is critical, but by the hew and cry of the vocal opponents, not THIS reform.

Thank you, *some* of my hope for the American way of life is restored.

reply to post by mikerussellus


It's easy to do.

I counted the second claim as partly true since it will be doctors doing it and not the government. Other than that, I think we agreed on them.