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Obamacare and Dentistry
[By D. Kellus Pruitt DDS]
It seems that problems with the PP-ACA have migrated from traditional medicine to the world of dentistry.
“MaineCare dentists hit with massive fines for minor clerical errors, they say – Some clinics face more than $200,000 in penalties under a new audit system that threatens to wipe out services for kids.”
-Joe Lawlor [Staff writer] Portland Press Herald [November 6, 2013]
“The new system gives auditors, who work for a private contractor, financial incentives to find small errors by paying them more for each mistake they discover.” Maine adopted the auditing system to comply with the federal Affordable Care Act, otherwise known as Obamacare.
Lawlor continues: “The audits are intended to root out fraud and abuse, but dentists told the Portland Press Herald that auditors are finding typographical or clerical errors that do not compromise patients’ care or defraud the government.”
A Clawback?
Dr. Michael Dowling, co-owner of Falmouth Pediatric Dentistry, tells the Herald, “This is not finding fraud and abuse. This is a clawback. They (state officials) are trying to take back money that we billed them legitimately.”
Still want to help the poor so much that you are willing to take your chances with the ACA auditing system, Doc?
Dentists facing bankruptcy
According to Lawlor, some dentists are actually facing bankruptcy because of ridiculously expensive fines over minor errors. Other Maine dentists who are otherwise willing to work for charity-level fees in order to help children who have nowhere else to turn, are dropping out of MaineCare. President Obama’s plan to use outrageous fines to fund the state and federal coffers, as well as the bonuses of ambitious auditors, is destined to fail.
How can the Affordable Care Act [PP-ACA] possibly make care more affordable for children with toothaches, if it runs off all the dentists?
Assessment
Is it beginning to look to you like Obamacare might have been designed to serve the interests of unaccountable healthcare stakeholders rather than the interests of doctors and patients – the healthcare principals? Why do we put up with this crap, Doc?
Conclusion
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Filed under: Health Insurance, Information Technology, Professional Liability, Pruitt's Platform | Tagged: Affordable Care Act., D. Kellus Pruitt DDS, Joe Lawlor, Michael Dowling, ObamaCare, Obamacare and Dentistry, Portland Press Herald, PP-ACA |
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Obamacare
Darrell – Nearly four years after President Barack Obama signed the Affordable Care Act into law promising the biggest expansion of health care coverage in half a century, the public remains deeply split over it.
So, here are 6 factors that may move public opinion of Obamacare
http://www.govhealthit.com/news/6-factors-may-move-public-opinion-obamacare?topic=30,31,29
Donna
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ACA Loophole
Feds move to close Obamacare loophole
http://www.msn.com/en-us/money/insurance/buh-bye-feds-move-to-close-obamacare-loophole/ar-BBcZTbw
http://blog.riskmanagers.us/?p=16831
Click to access n-14-69.pdf
Zane
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Over 214,000 Doctors Refuse ObamaCare
Over 214,000 doctors won’t participate in the new plans under the Affordable Care Act (ACA,) analysis of a new survey by Medical Group Management Association shows.
Click to access aca-surveyreport_online_2
That number of 214,524, estimated by American Action Forum, is through May 2014, but appears to be growing due to plans that force doctors to take on burdensome costs. It’s also about a quarter of thetotal number of 893,851 active professional physicians reported by the Kaiser Family Foundation.
Ann Miller RN MHA
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Global Physician “Capitation” Payments Making a Comeback
Since passage of the PP-ACA many insurance carriers are making a major change in the way they pay physicians? It’s moving from [discounted] fee-for-service pay to per-patient per-year capitation rates, adjusted for age and sickness (severity adjustments), plus a bonus for those MDs who improve patient health status. No definition of this term was given; however. Under the new “incentive” plan, these plans hope to transfer risk to primary medical care groups.
Typically, capitation will cover all primary care, specialist, counselor and hospital costs. Interestingly, BCBS has publicly denied that this system is “capitation”, and assured the public that it has safeguards in place to make sure patients won’t be under-treated and doctors won’t be underpaid.
Yet, BCBS for the State of Massachusetts hopes to cut the growth in medical costs in half in two to four years among providers who accept this cloaked global capitation-redux.
Dr. Franklin
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Operating costs of the ACA?
An analysis, published in Health Affairs this week, found that about $273.6 billion, or roughly 22.5 percent, of the total estimated $2.76 trillion cost of the Affordable Care Act through 2022 will go to overhead costs.
The authors of the study, Drs. David Himmelstein and Steffie Woolhandler, professors at the City University of New York School of Public Health and lecturers at Harvard Medical School, attribute the soaring overhead to rising enrollment in private plans, as well as the law’s Medicaid expansion. This year 9.6 million people signed up for plans on the state and federal exchanges.
The study also attributes the uptick in overhead to the high cost of setting up and running the exchanges, which are essentially brokers between the government and private health plans.
http://www.msn.com/en-us/money/other/obamacare-brings-dollar273-billion-bonanza-for-paper-pushers/ar-BBkmf95?ocid=iehp
In comparison, the federal government spends just 2 percent in overhead costs on its traditional Medicare program.
Wie Chen
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