MMA News
MMA to Weigh In on Appeals Case
In October, the Minnesota Court of Appeals granted the MMA’s and Minnesota Podiatric Medical Association’s (MPMA) petition to submit an amicus brief in the case O’Rourke versus Buckmaster. The case questions whether an agreement for corrective action may be used as evidence against a licensed health care professional in a malpractice lawsuit.
In filing the brief, the MMA and MPMA hope to inform the court about the practical and legal consequences that this decision will have on physicians beyond what is apparent from the party-specific issues raised in a case.
In O’Rourke versus Buckmaster, patient Sandra O’Rourke filed a complaint pertaining to her care against Roy Wayne Buckmaster, D.P.M., with the Minnesota Board of Podiatric Medicine.
The Board sent the complaint to the Attorney General for investigation. Following the investigation, the Board’s complaint review committee and Buckmaster entered into a nondisciplinary agreement for corrective action. Later, Sandra O’Rourke brought a medical negligence lawsuit against Buckmaster, in which the judge allowed the agreement for corrective action to be used as evidence against the podiatrist.
Buckmaster is appealing that decision. The question for the Minnesota Court of Appeals is whether an agreement for corrective action is considered a “settlement” or a “compromise negotiation,” both of which would mean the evidence must be excluded under the Minnesota Rules of Evidence and supporting case law. The court’s decision on this issue will conceivably affect all licensed health care professionals in Minnesota who are involved in the complaint process under Minnesota Statute Chapter 214 and are considering entering into an agreement for corrective action rather than pursuing a full, contested case hearing.
MMA Dispels Myths about SCHIP Coverage
In October, MMA leaders reaffirmed their support for legislation that would have expanded the State Children’s Health Insurance Program (SCHIP) to nearly 4 million more children.
The MMA called for Congress to pass and for President Bush to sign the bill.
On October 3, the president vetoed the measure, which would have increased funding for the program by $60 billion.
Efforts on the part of the MMA, the American Medical Association, and others urging Congress to override the veto failed, when on October 18 a vote in the House fell short by 13 votes.
Debate about SCHIP has resulted in some common misconceptions about the compromise proposal.
The following are some of the myths that the MMA tried to dispel.
MYTH
The compromise would have covered a family of four making $83,000 or 400 percent of poverty.
FACT
Eligibility for coverage for a family of four would have stayed at $41,000 or 200 percent of the poverty level for such families. In fact, the compromise proposal would have placed more restrictions on states’ abilities to get waivers to provide coverage to higher earners. The $83,000 number came from a failed attempt by New York State to expand its program to include children in families at 400 percent of the poverty level.
MYTH
The compromise bill would have only covered 800,000 more children.
FACT
The Congressional Budget Office estimated it would have covered 3.8 million more children.
MYTH
This bill would have expanded coverage for adults.
FACT
This bill phased out coverage for adults.
Source: AMA Advocacy Update, October 11, 2007
MMA Urges Sen. Coleman to Fix Medicare Reimbursement
Leaders from the MMA and the Minnesota chapter of the American Association of Retired Persons (AARP) met with Sen. Norm Coleman last month to discuss the need for Congress to stop a proposed 10 percent cut in Medicare reimbursement for physicians.
The cut will occur if Congress fails to act before the end of the year. The MMA and AARP stressed that a payment cut would create a health care access problem for Minnesota seniors.
MMA Immediate Past President G. Richard Geier, M.D., told Coleman he fears physicians in rural Minnesota and other areas that heavily rely on Medicare payment will have difficulty practicing because of the financial challenges such cuts will present.
Skip Humphrey, president of the Minnesota chapter of AARP, delivered a similar message and told Coleman that AARP was with physicians on this issue because of concern about seniors’ continued access to doctors.
Coleman responded by saying that he would work with other senators to pass legislation this year that would stop the cuts. He did not commit to a payment increase, however. The AMA has been urging Congress to pass a 0.5 percent increase for 2008 and 2009.
Coleman and the MMA differ as to where the money to prevent the cuts should come from. The MMA, the American Medical Association, and AARP support a proposal to replace the cuts with a small rate increase by using money currently given to insurers as a subsidy for offering Medicare Advantage health plans.
Coleman shared his concerns that cutting the Medicare Advantage subsidy would cause insurers to stop offering such plans in rural Minnesota, which could create a different sort of access problem.
Dave Renner, MMA director of state and federal legislation, says Coleman’s top priority should be protecting access to doctors for the vast majority of Minnesota seniors who don’t belong to Medicare Advantage plans. “I don’t think it is clear that health plans will pull out of those rural areas if subsidies are cut,” Renner says. “And besides, the bigger concern here is that more than 80 percent of Minnesota seniors in traditional fee-for-service plans will have a hard time finding a doctor if these cuts take place.”
Coleman says he is still thinking through the issue and asked AARP, which he considers a neutral source, to provide him with more data about the value of the Medicare Advantage subsidy.
This is the first year that the Minnesota chapter of AARP has joined with the MMA to try to stop proposed Medicare cuts.
Having the influential organization as a partner has helped the MMA’s position, Geier says. “AARP’s participation shows that this isn’t a doctor problem, it’s a patient problem.”
As for a long-term solution, Coleman says, given the national interest in health care reform, he believes Congress will try to pass major reform legislation in the coming years, and he hopes that the Medicare payment formula could be fixed as part of a larger package. The current formula automatically generates a cut in physician reimbursement each year.
Geier found Coleman’s health reform comments encouraging, noting that Coleman said the competing proposals for health care reform are coming closer together and seem to be getting more compatible with the MMA’s positions.