Kassenbaum-Kennedy bill - Bizarre Hazard to Fee-For-Service Care?

Thorana Nelson tnelson at CC.USU.EDU
Mon Jun 3 12:41:48 EST 1996


John Ambrose of AAMFT, PLEASE RESPOND!


At 09:46 PM 6/1/96 -0400, JMRoraback at aol.COM wrote:
>
>
>List members,
>
>I am forwarding this from another mail list with the thought that you may
>wish to be aware of the apparent provisions of this bill. Can anyone expand
>on this? It seems somewhat totalitarian in nature, to say the least.
>
>Dr. Rosenberg has given permission to forward this message to any other mail
>group which may be interested in this issue. Please feel free to do so.
>
>John Roraback, Ph.D.
>
>-----------  forwarded message  ----------------
>Subj:	Hazard to Fee-For-Service Care?
>Date:	96-05-31 23:24:18 EDT
>From:	jordanr at CREATIVE.NET (Jordan Rosenberg)
>
>
>Wall Street Journal 5/30/96  p. A14
>
>Jane Orient finds the following provisions in the already passed House and
>Senate versions of the Kassenbaum-Kennedy bill:
>
>5 years in prison for making a misstatement to your health plan (eg, failing
>to mention a pre-existing condition)
>
>10 years in prison for intentionally misapplying any assets of the plan to a
>medically unnecessary service even if it helps you
>
>5 years in prison for failing to turn over to a prosecutor the patient's
>records, even if it is you being prosecuted.
>
>Life in prison if a plan is defrauded in connection with a patient who dies
>(no mention of whether the fraud contributed to the death)
>
>$10000 fine for each instance of incorrect coding, even if honest mistake
>
>Fine or prison for those who transfer items for free or less than fair value
>(providing charity)
>
>Automatic seizure of property bought with money tainted by these offences.
>
>Paid informants; prosecutors keep fines and seized property
>
>Dr. Orient contends this makes health care very risky. However, the risk is
>only for providers in private practice. Those who work through an HMO are
>exempt. So is the HMO. If it does wrong it need only provide a plan of
>correction.
>
>I haven't seen the legislation but if the article is right it sounds
>devastating for fee-for-service practice. None of this is being debated,
>perhaps very few people know, and it should be addressed before the bill
>becomes law.
>
>Jordan Rosenberg
>jordanr at creative.net
>
>
>




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