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Hospitals forced to not see non-emergent patients under Obamacare beginning January 2014

In Uncategorized on November 13, 2013 at 12:14 PM

Hospitals forced to not see non-emergent patients under Obamacare beginning January 2014

Hospitals and Emergency Centers are being forced to stop rendering healthcare to non-emergent patients beginning January 1, 2014  under the Affordable Healthcare, Obamacare guidelines.

The DSH or Disproportionate Sharing Hospitals will start seeing a large decrease in reimbursement rates to hospitals currently treating indigent, non insurance bearing patients.This action will force hospitals to seek alternatives to delivering “free” or “uncompensated” care just to survive.

Hospitals across America are starting to either opt to not see uninsured patients in an emergent setting, demand payment up front, link payment to a bank account (as reported by BCN in previous blogs) in order to survive.

DSH Reductions will force Emergency rooms, hospitals and providers to resort to third world tactics to survive in a post Obamacare reimbursement world.

Shadac reports; “A national total of Medicaid DSH money is allotted across the states each year, with a 2011 total of $11.3 billion (closer to 20 billion in 2013). ”

“The ACA (Obamacare) reduces the annual Medicaid DSH total by $500 million in 2014; $600 million in 2015; $600 million in 2016; $1.8 billion in 2017; $5 billion in 2018; $5.6 billion in 2019; and $4 billion in 2020.”  

“In implementing these reductions, the statute requires HHS (Health and Human Services) to develop a “DSH Health Reform methodology” that imposes the largest percentage reduction on states with the lowest percent of uninsured or on states that currently do NOT target their DSH payments to hospitals with high volumes of Medicaid patients or high levels of uncompensated care.”

Uncompensated care, decreased allotments to hospital and providers will tip the scale to the patient placing the burden of payment upon them. Those who wish to remain uninsured and reporting to a hospital with a non emergent condition will begin to be turned away. There is no other viable scenario at this juncture.

If you work in or are associated with providing care in an Emergent Center you know that a great percentage of what presents to the Emergency Room, the entry point of any hospital, is either non emergent or uninsured. This population, presently and in the past, was pretty much taken care of by the DSH allotment now being taken away by the Affordable Healthcare Act or Obamacare. 

This action will leave millions vulnerable and seeking a setting where healthcare is delivered by a cash only scenario with very little regulation, a black market approach if you will. The underground provider or nurse with the ability to diagnose and treat on the spot for cash, bypassing the whole system. Think it will not happen?It’s already happening.

The Patient Affordable Care Act was intended to catch those patients or provide the net that was previously cast by hospitals under the Disproportionate Sharing Hospital plan. That safety net is now being removed and many are not going to like the outcome. The  net now has a wide hole in it and patients will be falling through rapidly.

Obamacare was ideally supposed to be the safety net pulling in some 40  million plus uninsured, give them “free or a terrific deal” on an insurance policy that would fix all their healthcare needs, off setting the total cost of healthcare, leaving “all” to share the load, so to speak.

What the “healthcare system” and the patient population system failed to see coming was the disastrous roll out of Obamacare and the many unexpected costs and high premiums associated with it and the amount of people running from it!

With premiums as high as several thousands of dollars a month for a family plan, three to five hundred  for a single young adult you can easily see why those this bill was intended to help will only hurt.

The recent ACA website rollout with it’s whopping 6 patients enrolled and ballooning premiums has left many seeking healthcare seeing a bad case of sticker shock as hospitals and providers look for survival measure to mediate the losses, to balance their budgets.

The proportional shift of most of the cost to young people is forcing millions to reevaluate the “need” to purchase healthcare instead opting to pay the relatively small fine at the end of the year. This leaves many with the inability to seek non emergent healthcare.

A dilemma has surfaced with no quick fix in site and only surmounting issues. 

Millions of Americans and financially strapped families choosing to not participate in Obamacare are facing yet another hurdle. 

Higher premiums, cancelled policies, opting to not purchase government insurance has left many in a quandry with few options leaving many financially strapped individuals to choose between purchasing a bad government forced  insurance, not seek medical treatment or ultimately choosing to say the heck with it all, Im putting food on the table for my family. The latter is the dignified approach and probably the preferred alternative.

This shifts most of the cost now to the employer, small businesses, the middle class and the everyday citizen……you, John and Jane taxpayer.

Higher taxes, up to 20 new taxes in all, higher premiums, increased shared costs with fewer participants  leaves hospitals with no other viable choice but to cease treating patients ie; the uninsured, the immigrant and the non emergent.

EMTALA, a regulation that forces hospitals and providers to care for patients regardless of their ability to
pay will be challenged under new Obamacare guidelines. 

The challenge will now be if you want healthcare in my hospital, you must purchase the insurance that your government is forcing upon you or we cannot see you!

Obamacare or the Affordable Care Act has created a major “boondoggle” of sorts.

It has offered unaffordable, unreliable care, a poor payment structure, reduced reimbursements for hospitals, higher premiums while forcing you to participate and not doing so will result in higher taxes and fines for you not doing so. 

Obamacare has forgotten to close or mend the hole in the safety net. That proverbial hole being hospitals have now trumped the administration using their own rules closing the door to healthcare by opting out of your health care if you don’t buy the mandated government insurance. 

What does a patient do? What does a hospital or provider do?

Well, simply put, patients will continue out of neccesity to not purchase this high premium government insurance forcing hospitals and providers to shut their doors till you purchase the insurance for your non emergent needs?

Will the government now say to the hospitals you must treat these patients regardless of their ability to pay per EMTALA regulations or force you to buy the insurance that the hospitals are now both saying you must buy to dart the door of our emergency room?

 Nothing would surprise me but a simple statement like that would not support the governments plan of forced or mandated healthcare for everyone, this rendering EMTALA non-existent.

Obamacare has contributed to this boondoggle by introducing the Individual Shared Responsibility plan and has placed upon you yet another way to make you pay for your healthcare.

Introducing the Individual Shared Responsibility plan under the  Affordable Care Act directly from the ACA healthcare exchange site.

Beginning January 2014, the Individual Shared Responsibility provision calls for each individual to either have minimum essential coverage (whatever that is) for each month, qualify for an exemption, or make a payment when filing his or her federal income tax return. 

On Aug. 27, 2013, the Department of the Treasury and the IRS issued final regulations on the Individual Shared Responsibility provision, Notice 2013-42….

The open enrollment period to purchase health insurance coverage for 2014 through the Health Insurance Marketplace runs from Oct. 1, 2013, through March 31, 2014.

The American Emergency Physician Association has prepared a statement regarding reimbursement under the ACA or Obamacare and I summarize. (See link below for full statement)

The ACA forces doctors, hospitals and providers to treat every pt under EMTALA while reimbursement rates go down. 

The ACA forces non good faith reimbursement scenarios where the hospital is forced to take care of patients with shrinking reimbursement from the government while private insurers reap the benefit of taking advantage of a low loss scenario having the distinct advantage of bypassing the benefit of a high cost uninsured patient population.

This has left hospitals, mainly Emergency Centers to force payment up front or stop treating non emergent patients.

Recently information was passed to Bradley County News from a social media website that depicts the following,

The Appalachian Regional Healthcare system in Kentucky has made the unprecedented move to opt out of treating non-emergent patients. 

A flyer or memo has  recently been sent out to patients and posted in their ERs which states, “Attention patients: Consistent with the Affordable Care Act, we will no longer be able to see  non emergent patients without healthcare coverage beginning January 2014!” The saga begins!

Can you see what is happening here? 

The government is saying you must purchase insurance, the hospitals must provide care  regardless of ability to pay under EMTALA, decreasing reimbursement to those providing care and now the hospitals are taking the desperate steps to say NO, we can no longer see you unless you purchase mandated insurance by the Federal government.  

The end scenario: 

Patients will be unable to enter the ER for non emergent care. They will be unable to pay for a Doctors office visit. This will leave millions without a portal of entry and forced to stand outside hospital doors begging for care and access or seek alternative, perhaps underground behind the scenes treatment inside a newly developed black market.

This is reminiscent of third world country healthcare, then again this end product is intentional isn’t it?

 It is about control of the populace?

Right?

Sources of info:

Disproportionate hospital share is going down!

Click to access PatientProtectionsandAffordableCareAct_PPACA_Position_Statement.pdf

http://www.shadac.org/blog/aca-data-note-hospitals-medicaid-expansion-and-disproportionate-share-hospital-dsh-payments

DSH Hospital Allotments through 2011. TN included.

Click to access DSH%20summary.pdf

http://www.nytimes.com/2012/07/27/nyregion/affordable-care-act-reduces-a-fund-for-the-uninsured.html?pagewanted=all&_r=0

Click to access 2013-21157.pdf

Click to access media.352.pdf

Many Americans seeing Medical Excise Tax sticker shock as OBAMACARE costs kick in

In Uncategorized on January 2, 2013 at 7:24 AM

It is true! Many Bradley Countians as well as many Americans are starting to see a new tax being applied to the purchase of many products to include medical devices as well as items that you would not think would be categorized as medical devices.

When the Medical Device Tax started hitting the retail stores yesterday, January 1, 2013, people began scratching their heads at the new tax at the bottom of their reciept of 2.3 percent. “I didn’t buy a medical device, I bought Q tips, a fishing rod and some ammo for my Ruger and I got taxed an additional 2.3 percent.” One consumer was overheard saying at the checkout counter recently.

Congress recently voted to tweak the bill because the bill came across as purely another retail tax. The ever encompassing IRS code and FDA labeling codes are what is driving the hordes of extra items categorized as “medical devices.”

When I think of medical devices I think of splints, stents, prosthetic hips and walkers. The IRS and our Federal Government sees “medical devices” as fishing rods, bows and arrows, ammo, Q tips and gas guzzling cars.

The new medical device tax started yesterday will be one of many planned taxes, that will take precious income away from many hard working Americans and place it into the US Treasuries pockets and assorted other coffers to assist in funding the dreaded unconstitutional, socialistic OBAMACARE Healthcare system.

The medical device tax is expected to raise upward of 40 billion dollars every decade to offset the cost of providing care for the influx of 30 to 40 million presently uninsured Americans.

As the OBAMACARE health system is fully implemented in 2014 with it’s many non restraints such as the unlimited pre existing provision, costs are expected to sore into the 100s of millions perhaps trillions some analysts say, over the next decade. This will leave many unemployed, broke and desolate, looking for government handout
to just survive in the environment the fake president has directed us with his hugely expensive healthcare tax.

Aside from the cost to us, our grandchildren and their grandchildren extensive job loss will be a fallout, numerous “medical device companies” closed, pack up and move overseas via outsourcing or simply close their doors.

The medical device industry employs around 420,000 state side
and millions world wide. Analysts are predicting a loss of 42,000 jobs in the first year as Americans begin to find out what items are taxes heavily and begin to dodge the tax and many companies that may only see a 2 to 3 percent profit margin will simply have to shut the doors.

Some say, just don’t label your products as medical devices and avoid the tax, well the IRS and the Feds have that covered also. If a company attempts to avoid the excise tax which to date has very loose guidelines as to what a medical device is will be faced with up to 10,000 dollars, more likely a daily fine of
1,000 dollars a day for trying to manipulate the system to their benefit.

The death spiral of our economy is just beginning and with each new tax the Senate, Congress and this fake president pile up on we are one step closer to the socialist utopia many of our elected and nonelected bureaucrats have been trying so hard to create.

Our present tax structure will be dim by comparison to the one that is coming in the next decade. I have often joked that eventually the government will receive 100 percent or more
Of my paycheck just as the Cloward-Piven strategists have predicted. Overload and overwhelm our economic system and you will have created a socialist America with Communistic overtones.

Please continue to read the links below directly from the IRS website. What you will not see in most cases is strictly medical devices but an array of assorted retail items and that list is only expected to grow as the extra capital is needed to fund OBAMACARE. what you will not see directly, but you will see higher prices for the products you purchase daily, is the import/export taxes and the extra taxes on manufacturers up to 10 to 12 percent just to make “medical devices!”

The following discussion of manufacturers taxes applies to the tax on:

Sport fishing equipment;

Fishing rods and fishing poles;

Electric outboard motors;

Fishing tackle boxes;

Bows, quivers, broadheads, and points;

Arrow shafts;

Coal;

Taxable tires;

Gas guzzler automobiles; and

Vaccines.

Q1. What is the medical device excise tax?
A1. Section 4191 of the Internal Revenue Code imposes an excise tax on the sale of certain medical devices by the manufacturer or importer of the device.
Q2. When does the tax go into effect?
A2. The tax applies to sales of taxable medical devices after Dec. 31, 2012.
Q3. How much is the tax?
A3. The tax is 2.3 percent of the sale price of the taxable medical device. See Chapter 5 of IRS Publication 510, Excise Taxes, and Notice 2012-77 for additional information on the determination of sale price.

http://www.irs.gov/uac/Medical-Device-Excise-Tax:-Frequently-Asked-Questions

http://www.natlawreview.com/article/excise-tax-kicks-jan-1-certain-medical-devices

http://beforeitsnews.com/gadgets/2012/12/the-diabolical-medical-device-excise-tax-2443956.html

http://news.yahoo.com/analysis-medtech-companies-face-job-cuts-excise-tax-190739057–finance.html
http://m.mddionline.com/node/9528

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