Friday, April 8, 2011

Conyers, Paul Introduce Quality Health Care Coalition Act

Conyers, Paul Introduce Quality Health Care Coalition Act
Leveling the Playing Field Between Insurance Companies and Health Care Providers
(Washington)—Today, House Judiciary Committee Ranking Member John Conyers, Jr. (D-Mich.) and Congressman Ron Paul (R-Texas) introduced the “Quality Health Care Coalition Act of 2011,” H.R. 1409, in an effort to improve the quality of patient care by leveling the playing field between health care professionals and insurance companies in the health care industry.

“Currently, the insurance industry, including health care insurance providers, is immune from federal antitrust laws under the McCarran-Ferguson Act,” said Conyers. “As a result, the playing field is woefully unbalanced. I am pleased to introduce H.R. 1409 the Quality Health Care Coalition Act of 2011 today to strengthen patient safety and quality of care by clarifying the application of the antitrust laws to negotiations between groups of health care professionals and health plans and health care insurance issuers. I am gratified to be joined by my good friend Rep. Paul in this effort.”

“By restoring the freedom of medical professionals to voluntarily come together to negotiate as a group with HMOs and insurance companies, this bill removes a government-imposed barrier to a true free market in health care,” said Paul. “ I thank Mr. Conyers’ for introducing this bill, and I hope all members of Congress will support the Quality Health Care Coalition Act” and restore freedom of contract and association to America's health care professionals.”

The bipartisan Quality Health Care Coalition Act of 2011 will allow health care providers the ability to collectively bargain contractual terms with insurers, including provisions that affect the quality of patient care. Last Congress, the House Judiciary Committee held a hearing on the disparate treatment of physicians and health insurers by the antitrust enforcement agencies. In 2000, the House passed similar legislation, H.R. 1304, the Quality Healthcare Coalition Act of 1999) offered by Rep. Tom Campbell (R-CA) and Rep. Conyers. The bill passed the House by a vote of 276-136, but was not taken up the Senate. Similar legislation was introduced in the 107th (H.R. 3897) and 108th (H.R. 1120) Congresses.

What is Single Payer

What is Single Payer?

Single-payer is a term used to describe a type of financing system. It refers to one entity acting as administrator, or “payer.” In the case of health care, a single-payer system would be setup such that one entity—a government run organization—would collect all health care fees, and pay out all health care costs. In the current US system, there are literally tens of thousands of different health care organizations—HMOs, billing agencies, etc. By having so many different payers of health care fees, there is an enormous amount of administrative waste generated in the system. (Just imagine how complex billing must be in a doctor’s office, when each insurance company requires a different form to be completed, has a different billing system, different billing contacts and phone numbers—it’s very confusing.) In a single-payer system, all hospitals, doctors, and other health care providers would bill one entity for their services. This alone reduces administrative waste greatly, and saves money, which can be used to provide care and insurance to those who currently don’t have it.

What is Single Audit?

Each year, the Federal Government provides over $400 billion in grants to State, local and tribal governments, colleges, universities and other non-profit organizations (non-Federal entities). The Single Audit Act of 1984 (with amendment in 1996) and OMB Circular A-133 ("Audits of State, Local Governments, and Non-Profit Organizations") provide audit requirements for ensuring that these funds are expended properly. All non-Federal entities that expend $500,000 or more of Federal awards in a year ($300,000 for fiscal year ending on or before December 30, 2003) are required to obtain an annual audit in accordance with the Single Audit Act Amendments of 1996 (pdf), OMB Circular A-133, the OMB Circular Compliance Supplement and Government Auditing Standards. A single audit is intended to provide a cost-effective audit for non-Federal entities in that one audit is conducted in lieu of multiple audits of individual programs. The Single Audit provides the Federal government with assurance that these recipients comply with such directives by having anindependent external source (the CPA) report on such compliance.

OMB Circular A-133 Compliance Supplement 2009