Baucus Healthcare Bill Amends Medicare Anti-Kickback Provision
We at FCDB read H.R.3200, “America's Affordable Health Choices Act of 2009,” earlier this year (well okay, perhaps we didn’t “read” it all, maybe skimmed is a better description) and were surprised to find that it appeared to add nothing to our nation’s ever-growing corpus of criminal provisions. Well, yesterday, Montana Senator Max Baucus released the long-awaited America’s Healthy Future Act, better known as the “Baucus Bill,” the text of which can be read here, which does contain an alteration of note to existing criminal law . We’ll leave it to others to outline all the proposed changes to the nation’s healthcare industry.
The most notable change by the Baucus Bill is amends the Medicare Anti-Kickback statute, 42 U.S.C. § 1320a-7b(b), which makes it illegal to “knowingly and willfully” solicit or receive any remuneration for referring an individual to a person for the purpose of furnishing any item or service for which payment may be made in whole or in part under a Federal health care program; or in return for purchasing, leasing or ordering any good, facility, service, or item for which payment may be made in whole or in part under a Federal health care program; or to “knowingly and willfully” refer an individual to a person for the furnishing any item or service for which payment may be made in whole or in part under a Federal health care program; or purchase, lease or order any good, facility, service, or item for which payment may be made in whole or in part under a Federal health care program. The Bill proposes to “amend the Anti-kickback statute to add language defining “willfully” as “a person acted voluntarily and purposefully to do what the law forbids and the person need not have actual knowledge of the law or specific intent to violate that law.” The Bill does not give the reason for the change, but it is undoubtedly to foreclose some defense or close some loophole which has arisen in practice or actual cases.
There is a very large demographic of people that are being overlooked right now and a public option would benefit them. That would be the 45+ million Americans, most of which are the youth of this country, who are uninsured. Maya Rockeymoore frames the point well by stating, “It is not true that a public plan will kill private industry. A public plan provides Americans with more options for affordable, efficient health care. Medicare is a public/private partnership and the industry remains alive, well and very much a part of the system. Also, the Federal Employees Health Benefit program, which is maintained by the U.S. Office of Personnel Management, is in partnership with private insurers. Similarly, the Department of Defense’s TRICARE plan for military personnel and families and the Department of Veterans Affairs CHAMPVA for veterans both enjoy a relationship with private insurers. In each of these cases, private insurers participate in a plan sponsored by the federal government. These partnerships allow beneficiaries to access high quality, affordable care.” http://www.ourblook.com/component/option,com_sectionex/Itemid,200076/id,8/view,category/#catid107
The entire industry is bloated with cost. I wish that the primary focus of reform actually had significant regard for the medical industry in reform policy, as opposed to simply being insurance reform. However, I do also hope that the changes being made will target and impact practice.