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Medicaid Cuts Maintained in New Obamacare Repeal Bill


Senate GOP leadership released a revised version of its healthcare bill, upping opioid crisis capital, among other changes, but Medicaid funding is still due to be cut.

Welcome to Practice Rounds, our weekly column exploring what's being covered in the larger world of healthcare.

Senate GOP Releases Updated Healthcare Bill

Senate Republican leadership released an updated version of the Better Care Reconciliation Act (BCRA) on Thursday. The bill is the latest attempt to repeal much of the Affordable Care Act (ACA), also known as Obamacare. Although much of the original BCRA remains intact such as cuts to Medicaid funding and rules that would allow states to weaken protections for people with pre-existing conditions, there are some notable changes.

The revised bill calls for a hike in funding for the opioid crisis. The original bill allotted $2 billion in funding, while the new version is expected to increase that number to $45 billion. The new version would preserve the 3.8 percent income tax on people making over $200,000 a year, while other taxes including one on health insurance executives and a Medicare health insurance tax would no longer be repealed.

Sen. Ted Cruz's (R-Texas) amendment, which would allow individuals to opt out of ACA's costly health insurance regulations, if insurers simultaneously offered ACA-compliant plans to all comers, including patients with preexisting conditions was modified. If an insurer offers a plan on the individual insurance exchanges that qualifies with Obamacare's regulations, it can also offer plans off the exchanges that do not adhere to those regulations. The bill will also include a $70 billion fund to offset costs for insurers that sign up "high risk individuals" to off-exchange, deregulated plans, according to Business Insider.

A vote on the bill is tentatively scheduled for next week, according to The Hill. The American Medical Association's President, David A Barbe, MD, released a statement, saying it's still not in favor of the bill: “The revised bill does not address the key concerns of physicians and patients regarding proposed Medicaid cuts and inadequate subsidies that will result in millions of Americans losing health insurance coverage. The additional funding to address the opioid epidemic is a positive step, however, those suffering from substance use disorder have other health care needs that are not likely to be addressed if they lose coverage through a rollback of the Medicaid expansion."

400 Medical Professionals Charged with Fraud

On Thursday, the Department of Justice (DOJ) announced charges against 412 physicians, nurses, pharmacists, and other medical professionals from at least 20 states, in the largest healthcare fraud scam in U.S. history, according to federal officials.

The investigation focused on medical professionals who were involved in the unlawful distribution of opioids and other prescription narcotics, according to officials. The scam totaled about $1.3 billion in false billings, including for the prescription and distribution of opioids, according to The Washington Post.

According to the DOJ, Arrests were made over the course of last week for a variety of indiscretions including, embezzling funds from medical offices in Maine, distribution of medically unnecessary drugs in Iowa and Texas, and engaging in kickback schemes with medical facilities in New York, among many others.

Among the 412 defendants, 120 were charged with opioid-related crimes. The doctors allegedly billed Medicare for $164 million in false claims, according to federal officials.

Study: Opioid Use and Mental Health Disorders Linked

According to a new study by researchers at Dartmouth-Hitchcock Medical Center and the University of Michigan, adults with mental health disorders are consuming more than half of all painkillers prescribed in the United States.

The study used a U.S. health survey, gathering data from providers and facilities on prescription medications, health status, and basic demographics for about 51,000 adults. It found that 19 percent of the 38.6 million Americans with mood disorders use prescription opioids, compared to 5 percent of the general population.

"When we got the results, we were completely shocked at the large discrepancy in prescribing," said Brian Sites, MD, an anesthesiologist at the Dartmouth-Hitchcock Medical Center and a co-author of the study published in the Journal of the American Board of Family Medicine.

Quote of the week:

Is the Health IT Industry Failing Physicians?

"The idea of an EHR was utopian in a sense, everything digitized, all the data structured and reformattable for different purposes…..The first vendor that came in made this fancy little marketing speech and once we implemented it, it just bogged down the practice tremendously."

- Jose Almeida, MD

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