Chiropractic Breakthrough

The new health law established temporary state high-risk “pools,” where people who are uninsurable elsewhere because of pre-existing medical conditions can get coverage. The new high-risk pools will only be open to people who’ve been uninsured for at least six months. But it’s important to act quickly. Applications are being accepted now for coverage starting Aug. 1

With a nudge from the new health care law and pressure from Medicare, hospitals, doctors and nurses are struggling to prepare for explosive growth in the numbers of high-risk elderly patients. More than 40% of adult patients in acute care hospital beds are 65 or older. Seventy million Americans will have turned 65 by 2030.

Starting this fall, patients in all health plans can contest claim denials in an independent state-level review procedure. The provision does not apply to “grandfathered” plans — those in existence on March 23. Nor does the new law make it any easier for consumers to sue for punitive damages or for pain and suffering.

The Obama administration is poised to award contracts worth hundreds of millions of dollars to about 20 states to run new insurance pools for people with serious medical problems. In another 20 states, where local officials chose not to participate, the federal government will run the pools through a private nonprofit entity. Applications will be available to the public in many states on Thursday.

The House on Thursday approved a six-month plan to prevent a steep cut in doctors’ fees paid by Medicare. The $6.4 billion measure reverses a 21 percent cut in physician payments. Medicare officials had announced on Friday that they would begin processing claims for June at the lower rate, raising pressure on the House to accept the short-term adjustment.

In the latest effort to break up the often cozy relationship between doctors and the medical industry, the University of Michigan Medical School has become the first to decide that it will no longer take any money from drug and device makers to pay for coursework doctors need to renew their medical licenses.

On Tuesday, President Obama unveiled new regulations effective this year that should end some insurance companies’ worst practices, such as rescinding policies for frivolous reasons after a person becomes sick and a ban on lifetime coverage limits.

President Obama, whose vilification of insurers helped push a landmark health care overhaul through Congress, plans to sternly warn industry executives at a White House meeting on Tuesday against imposing hefty rate increases in anticipation of tightening regulation under the new law.

On Friday, the Senate passed HR 3962 which delays the scheduled 21% Medicare fee decrease and allows for a 2.2% Medicare fee increase from June 1, 2010 through November 30, 2010. The House of Representatives is scheduled to vote on this bill Tuesday evening.

The Justice Department has asked a federal judge to dismiss a lawsuit by 20 states challenging President Obama’s health care overhaul. Government lawyers say the health care overhaul cannot be moved from the elected branches of government into the courts without a genuine constitutional issue, which they maintain is lacking in this case.