Monday, December 2, 2013

December 2013: a busy month ahead


30 days as this is written until the 2013 Meaningful Use Stage 1 Attestation deadline. Stage 2 Year 1 commences on January 1, 2014 for those having completed at least two years of Stage One under the calendar year schedule.

And, of course, there's this:


Having moved the goalposts by redefining "fixed," the Obama administration has its aggregate fingers crossed over the performance of HealthCare.gov going forward. We shall see. From WaPo this morning:
Consumer tips for HealthCare.gov show administration’s cautious optimism
BY JOSH HICKS, Washington Post, December 2 at 6:00 am


The Obama administration on Sunday reported vast improvement with the HealthCare.gov health-insurance portal that opened with extensive glitches in October, while acknowledging that the site still needs more work.

One sign of ongoing problems came in the form of a blog entry and infographic that Health and Human Services Secretary Kathleen Sebelius published on Huffington Post. Both items provide tips for consumers visiting the site, most notably by encouraging them to use it during off-peak hours — mornings, nights and weekends.
The online exchange, which helps users shop for insurance to meet the government’s Jan. 1 deadline for virtually all Americans to obtain coverage or incur a penalty, is now functioning at a success rate of about 90 percent, according to administration officials. That’s compared to about 43 percent in October...
The viability of the health-care legislation largely depends on the administration’s ability to meet its goal of enrolling 7 million uninsured people, particularly those who are relatively young and healthy, in coverage by the end of March.

Failure to do so could force officials to delay some of the key provisions of the law, such as the so-called individual mandate. It would also keep costs high for those who have obtained insurance on the exchanges, since they are likely to be less healthy and therefore more costly...
Also coming right up:


Hope to see you there. Conference schedule here (large pdf). Twitter hashtag #IHI25Forum.
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HEALTHCARE.GOV UPDATE

(Tuesday, Dec 3rd) Well, one day after it seemed that the partisan hubbub over the PPACA HealthCare.gov site might be waning comes this:
Health-care enrollment on Web plagued by bugs
Amy Goldstein and Juliet Eilperin, Washington Post

The enrollment records for a significant portion of the Americans who have chosen health plans through the online federal insurance marketplace contain errors — generated by the computer system — that mean they might not get the coverage they’re expecting next month.

The errors cumulatively have affected roughly one-third of the people who have signed up for health plans since Oct. 1, according to two government and health-care industry officials. The White House disputed the figure but declined to provide its own.


The mistakes include failure to notify insurers about new customers, duplicate enrollments or cancellation notices for the same person, incorrect information about family members, and mistakes involving federal subsidies. The errors have been accumulating since HealthCare.gov opened two months ago, even as the Obama administration has been working to make it easier for consumers to sign up for coverage, the government and industry officials said.

Figuring out how to clean up the backlog of errors and prevent similar ones in the future is emerging as the new imperative if the federal insurance exchange is to work as intended. The problems were the subject of a meeting Monday between administration officials and a new “Payer Exchange Performance Team” made up of insurance industry leaders...

Recall my prior post (404)^n, the upshot of dirty data.

HealthCare.gov woes aside, the broader and deeper challenges continue unabated:
NYT: A new wave of challenges to health law
Sheryl Gay Stolberg The New York Times


WASHINGTON — More than a year after the Supreme Court upheld the central provision of President Obama’s health care overhaul, a fresh wave of legal challenges to the law is playing out in courtrooms as conservative critics — joined by their Republican allies on Capitol Hill — make the case that Mr. Obama has overstepped his authority in applying it.

A federal judge in the District of Columbia will hear oral arguments on Tuesday in one of several cases brought by states including Indiana and Oklahoma, along with business owners and individual consumers, who say that the law does not grant the Internal Revenue Service authority to provide tax credits or subsidies to people who buy insurance through the federal exchange.

At the same time, the House Judiciary Committee will convene a hearing to examine whether Mr. Obama is “rewriting his own law” by using his executive powers to alter it or delay certain provisions. The panel also will examine the legal theory behind the subsidy cases: that the I.R.S., and by extension, Mr. Obama, ignored the will of Congress, which explicitly allowed tax credits and subsidies only for those buying coverage through state exchanges.

“We have agencies under this administration having an attitude that they can fix a statute, that they can improve upon a statute, that they can look at a statute’s clear language and disregard it,” Scott Pruitt, the Oklahoma attorney general, who is bringing one of the cases, said in an interview Monday. “The president himself has said on more than one occasion, ‘I can’t wait on Congress.’ In our system of government, he has to.”

The subsidy lawsuits grow out of three years of work by conservative and libertarian theorists at Washington-based research organizations like the Cato Institute, the American Enterprise Institute and the Competitive Enterprise Institute. The cases are part of a continuing, multifaceted legal assault on the Affordable Care Act that began with the Supreme Court challenge to the law and shows no signs of abating.

“After the A.C.A. was enacted and after the president signed it, a lot of people — me included — decided that we weren’t going to take this lying down, and we were going to try to block it and ultimately either get the Supreme Court to overturn it or Congress to repeal it,” said Michael F. Cannon, a health policy scholar at the libertarian-leaning Cato Institute, who helped develop the legal theory for the subsidy cases and will testify in the House on Tuesday...
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More to come...

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