Tuesday, July 28, 2009

Obamacare continued...verbatim

This is a lengthy post as many of mine are and contradictory to the typical blog readership so I apologize but I found this information to important not to post.

This is a followup of the previous post in which I pasted an outline of the issues listed in the bill, this is the verbiage from the bill itself according to items listed.

Page 16:
LIMITATION ON NEW ENROLLMENT.—
(A) IN GENERAL.—Except as provided in
this paragraph, the individual health insurance
issuer offering such coverage does not enroll
any individual in such coverage if the first ef
fective date of coverage is on or after the first
day of Y1.

Pg 22 of the HC Bill mandates the Government will auditbooks of all employers that self insure. Can you imagine what that will do to small businesses? Every one will abandon “selfinsurance” and go on Government insurance. So when Obama says that there will still be private health care, it’s simply a lie: this mandate will force employers to abandon their private plans.


Page 22/23

Such study shall ex
amine the following:
(A) The types of employers by key charac
teristics, including size, that purchase insured
products versus those that self-insure.
(B) The similarities and differences be
tween typical insured and self-insured health
plans.
(C) The financial solvency and capital re
serve levels of employers that self-insure by em
ployer size.
(D) The risk of self-insured employers not
being able to pay obligations or otherwise be
coming financially insolvent.
(E) The extent to which rating rules are
likely to cause adverse selection in the large
group market or to encourage small and mid
size employers to self-insure
(2) REPORTS.—Not later than 18 months after
the date of the enactment of this Act, the Commis
sioner shall submit to Congress and the applicable
agencies a report on the study conducted under
paragraph (1). Such report shall include any rec
ommendations the Commissioner deems appropriate
to ensure that the law does not provide incentives


for small and mid-size employers to self-insure or
create adverse selection in the risk pools of large
group insurers and self-insured employers.

Pg 30 Sec 123 of HC bill – a Government committee (good luck with that!) will decide what treatments/benefits a person may receive.



Page 30

(1) IN GENERAL.—There is established a pri
vate-public advisory committee which shall be a
panel of medical and other experts to be known as
the Health Benefits Advisory Committee to rec
ommend covered benefits and essential, enhanced,
and premium plans.

Pg 29 lines 4-16 in the HC bill - YOUR HEALTHCARE WILL BE RATIONED! (We all knew this, because health care is rationed in Canada and Britain, but Obama kept saying it would not be).


Page 29

(A) ANNUAL LIMITATION.—The cost-shar
ing incurred under the essential benefits pack
age with respect to an individual (or family) for
a year does not exceed the applicable level spec
ified in subparagraph (B). (B) APPLICABLE LEVEL.—The applicable
level specified in this subparagraph for Y1 is
$5,000 for an individual and $10,000 for a
family. Such levels shall be increased (rounded
to the nearest $100) for each subsequent year
by the annual percentage increase in the Con
sumer Price Index (United States city average)
applicable to such year.

Pg 42 of HC Bill – The Health Choices Commissioner will choose your HC Benefits for you. You will have no choice!


Page 42

(a) DUTIES.—The Commissioner is responsible for
carrying out the following functions under this division:
QUALIFIED PLAN STANDARDS.—The estab
lishment of qualified health benefits plan standards
under this title, including the enforcement of such
standards in coordination with State insurance regu
lators and the Secretaries of Labor and the Treas
ury.

PG 50 Section 152 in HC bill - HC will be provided to ALL non US citizens, illegal or otherwise.


Page 50

IN GENERAL.—In the case of health insur
ance coverage offered through the Health Insurance
Exchange—
(A) the requirements of this title do not
supercede any requirements (including require
ments relating to genetic information non
discrimination and mental health) applicable
under title XXVII of the Public Health Service
Act or under State law, except insofar as such
requirements prevent the application of a re
quirement of this division, as determined by the
Commissioner; and
(B) individual rights and remedies under
State laws shall apply.

Pg 58 HC Bill – Government will have real-time access to individual’s finances and a National ID Healthcard will be issued!


Page 58


‘‘(D) enable the real-time (or near real
time) determination of an individual’s financial
responsibility at the point of service and, to the
extent possible, prior to service, including
whether the individual is eligible for a specific
service with a specific physician at a specific fa
cility, which may include utilization of a ma
chine-readable health plan beneficiary identi
fication card;

Pg 59 HC Bill lines 21-24 Government will have direct access to your bank accts for election funds transfer




Page 59

enable electronic funds transfers, in
order to allow automated reconciliation with the
related health care payment and remittance ad
vice;

PG 65 Sec 164 is a payoff subsidized plan for retirees and their families in Unions & community organizations (read: ACORN).




Page 65

(1) IN GENERAL.—Not later than 90 days after
the date of the enactment of this Act, the Secretary
of Health and Human Services shall establish a tem
porary reinsurance program (in this section referred
to as the ‘‘reinsurance program’’) to provide reim
bursement to assist participating employment-based
plans with the cost of providing health benefits to
retirees and to eligible spouses, surviving spouses
and dependents of such retirees.

Pg 72 Lines 8-14 Government will create an HC Exchange to bring private HC plans under Government control.


Page 72

(a) ESTABLISHMENT.—There is established within
the Health Choices Administration and under the direc
tion of the Commissioner a Health Insurance Exchange
in order to facilitate access of individuals and employers,
through a transparent process, to a variety of choices of
affordable, quality health insurance coverage, including a
public health insurance option.

PG 84 Sec 203 HC bill - Government mandates ALL benefitpackages for private HC plans in the Exchange.


Page 84

IN GENERAL.—The Commissioner shall specify
the benefits to be made available under Exchange-partici
pating health benefits plans during each plan year, con
sistent with subtitle C of title I and this section.



PG 85 Line 7 HC Bill - Specifics of Benefit Levels for Plans = The Government will ration your Healthcare!


Page 85

(c) SPECIFICATION OF BENEFIT LEVELS FOR
PLANS

PG 91 Lines 4-7 HC Bill - Government mandates linguistic appropriate services. Example - Translation for illegal aliens.


Page 91

(7) CULTURALLY AND LINGUISTICALLY APPRO
PRIATE SERVICES AND COMMUNICATIONS.—The en
tity shall provide for culturally and linguistically ap
propriate communication and health services.

Pg 95 HC Bil l Lines 8-18 The Government will use groups, i.e. ACORN & Americorps, to sign up individuals for Government HC plan.

Pg 95 HC Bil l Lines 8-18 The Government will use groups, i.e. ACORN & Americorps, to sign up individuals for Government HC plan.



Page 95

(1) OUTREACH.—The Commissioner shall con
duct outreach activities consistent with subsection
(c), including through use of appropriate entities as
described in paragraph (4) of such subsection, to in
form and educate individuals and employers about
the Health Insurance Exchange and Exchange-par
ticipating health benefits plan options. Such out
reach shall include outreach specific to vulnerable
populations, such as children, individuals with dis
abilities, individuals with mental illness, and individ
uals with other cognitive impairments.


PG 102 Lines 12-18 HC Bill - Medicaid Eligible Individuals will be automatically enrolled in Medicaid. No choice.


Page 102

(3) AUTOMATIC ENROLLMENT OF MEDICAID EL
IGIBLE INDIVIDUALS INTO MEDICAID.—The Com
missioner shall provide for a process under which an
individual who is described in section 202(d)(3) and
has not elected to enroll in an Exchange-partici
pating health benefits plan is automatically enrolled
under Medicaid.

pg 124 lines 24-25 HC No company can sue Government on price fixing. No "judicial review" against Government Monopoly.



Page 124


(f) LIMITATIONS ON REVIEW.—There shall be no ad
ministrative or judicial review of a payment rate or meth-
125
odology established under this section or under section


pg 127 Lines 1-16 HC Bill - Doctors/ AMA - The Government will tell YOU what you can earn.


Page 127

(1) PHYSICIANS.—The Secretary shall provide
for the annual participation of physicians under the
public health insurance option, for which payment
may be made for services furnished during the year,
in one of 2 classes:
(A) PREFERRED PHYSICIANS.—Those phy
sicians who agree to accept the payment rate
established under section 223 (without regard
to cost-sharing) as the payment in full.
(B) PARTICIPATING, NON-PREFERRED
PHYSICIANS.—Those physicians who agree not
to impose charges (in relation to the payment
rate described in section 223 for such physi
cians) that exceed the ratio permitted under
section 1848(g)(2)(C) of the Social Security
Act.

Pg 145 Line 15-17 An Employer MUST auto enroll employees into public optio n plan. NO CHOICE.


Page 145

(4) AUTOENROLLMENT OF EMPLOYEES.—The
employer provides for autoenrollment of the em
ployee in accordance with subsection (c).

Pg 126 Lines 22-25 Employers MUST pay for HC for part time employees AND their families.


Page 126

IN GENERAL.—The Secretary shall establish con
ditions of participation for health care providers under the
public health insurance option

Pg 149 Lines 16-24 ANY Employer with payroll $400k & above who does not provide public option pays 8% tax on all payroll.

pg 150 Lines 9-13 Businesses with payroll between $251k & $400k who don’t provide public option pay 2-6% tax on all payroll.




Page 149/150

SPECIAL RULES FOR SMALL EMPLOYERS.—
(1) IN GENERAL.—In the case of any employer
who is a small employer for any calendar year, sub
section (a) shall be applied by substituting the appli
cable percentage determined in accordance with the
following table for ‘‘8 percent’’:
If the annual payroll of such employer for
the preceding calendar year:
The applicable
percentage is:
Does not exceed $250,000 ..................................... 0 percent
Exceeds $250,000, but does not exceed $300,000 2 percent
Exceeds $300,000, but does not exceed $350,000 4 percent
Exceeds $350,000, but does not exceed $400,000 6 percent
(2) SMALL EMPLOYER.—For purposes of this
subsection, the term ‘‘small employer’’ means any
employer for any calendar year if the annual payroll
of such employer for the preceding calendar year
does not exceed $400,000.

Pg 167 Lines 18-23 ANY individual who doesn’t have acceptable HC according to Government will be taxed 2.5% of income.


Page 167

‘‘SEC. 59B. TAX ON INDIVIDUALS WITHOUT ACCEPTABLE
HEALTH CARE COVERAGE.
‘‘(a) TAX IMPOSED.—In the case of any individual
who does not meet the requirements of subsection (d) at
any time during the taxable year, there is hereby imposed
a tax equal to 2.5 percent of the excess of—

Pg 170 Lines 1-3 HC Bill Any NONRESIDENT Alien is exempt from individual taxes. (Americans will pay.)


Page 170

‘‘(2) NONRESIDENT ALIENS.—Subsection (a)
shall not apply to any individual who is a non
resident alien.

Pg 195 HC Bill -officers & employees of HC Admin (the GOVERNMENT) will have access to ALL Americans’ finances and personal records.



Page 195/196

Health Choices Act of 2009, shall disclose to of
ficers and employees of the Health Choices Ad
ministration or such State-based health insur
ance exchange, as the case may be, return in
formation of any taxpayer whose income is rel
evant in determining any affordability credit de
scribed in subtitle C of title II of the America’s
Affordable Health Choices Act of 2009. Such
return information shall be limited to—
‘‘(i) taxpayer identity information
with respect to such taxpayer,
‘‘(ii) the filing status of such tax
payer,
‘‘(iii) the modified adjusted gross in
come of such taxpayer (as defined in sec
tion 59B(e)(5)),
‘‘(iv) the number of dependents of the
taxpayer,
‘‘(v) such other information as is pre
scribed by the Secretary by regulation as
might indicate whether the taxpayer is eli
gible for such affordability credits (and the
amount thereof), and
‘‘(vi) the taxable year with respect to
which the preceding information relates or,

1 if applicable, the fact that such informa
tion is not available.

PG 203 Line 14-15 HC - "The tax imposed under this section shall not be treated as tax" Yes, it says that.


Page 203


NOT TREATED AS TAX IMPOSED BY THIS
CHAPTER FOR CERTAIN PURPOSES.—The tax im
posed under this section shall not be treated as tax

Pg 239 Line 14-24 HC Bill Government will reduce physician services for Medicaid. Seniors, low income, poor affected.


Page 239/240

(c) LIMITATION ON PHYSICIANS’ SERVICES IN
CLUDED IN TARGET GROWTH RATE COMPUTATION TO
SERVICES COVERED UNDER PHYSICIAN FEE SCHED
ULE.—Effective for services furnished on or after January
1, 2009, section 1848(f)(4)(A) of such Act is amended
striking ‘‘(such as clinical’’ and all that follows through
‘‘in a physician’s office’’ and inserting ‘‘for which payment
under this part is made under the fee schedule under this
section, for services for practitioners described in section
1842(b)(18)(C) on a basis related to such fee schedule,
or for services described in section 1861(p) (other than
VerDa201 C:\TEMP\AAHCA0~1.XML HO
240
1 such services when furnished in the facility of a provider
of services)’’.

Pg 241 Line 6-8 HC Bill – Doctors – doesn’t matter what specialty – will all be paid the same.



Page 241

Service categories established under this paragraph
shall apply without regard to the specialty of the
physician furnishing the service.’’.

PG 253 Line 10-18 Government sets value of Doctor’s time, professional judgment, etc. Literally, value of humans.





Page 253


‘‘(ii) COMPONENTS AND ELEMENTS
OF WORK.—The process described in
clause (i) may include validation of work
elements (such as time, mental effort and
professional judgment, technical skill and
physical effort, and stress due to risk) in
volved with furnishing a service and may
include validation of the pre, post, and
intra-service components of work.

PG 265 Sec 1131Government mandates & controls productivity for private HC industries.

Page 265

PART 2—MARKET BASKET UPDATES
SEC. 1131. INCORPORATING PRODUCTIVITY IMPROVE
MENTS INTO MARKET BASKET UPDATES
THAT DO NOT ALREADY INCORPORATE SUCH
IMPROVEMENTS.


PG 268 Sec 1141 Federal Government regulates rental & purchase of power driven wheelchairs.


Page 268

PART 3—OTHER PROVISIONS
SEC. 1141. RENTAL AND PURCHASE OF POWER-DRIVEN
WHEELCHAIRS

PG 272 SEC. 1145. TREATMENT OF CERTAIN CANCER HOSPITALS - Cancer patients - welcome to rationing!


Page 272

SEC. 1145. TREATMENT OF CERTAIN CANCER HOSPITALS.
Section 1833(t) of the Social Security Act (42 U.S.C.
1395l(t)) is amended by adding at the end the following
new paragraph:
‘‘(18) AUTHORIZATION OF ADJUSTMENT FOR
CANCER HOSPITALS.—
‘‘(A) STUDY.—The Secretary shall conduct
a study to determine if, under the system under
this subsection, costs incurred by hospitals de
scribed in section 1886(d)(1)(B)(v) with respect
to ambulatory payment classification groups ex
ceed those costs incurred by other hospitals fur
nishing services under this subsection

Page 280 Sec 1151 The Government will penalize hospitals for what Government deems preventable readmissions.


Page 281/282

HOSPITALS.—
6 (1) IN GENERAL.—Section 1886 of the Social
Security Act (42 U.S.C. 1395ww), as amended by
section 1103(a), is amended by adding at the end
the following new subsection:
‘‘(p) ADJUSTMENT TO HOSPITAL PAYMENTS FOR
EXCESS READMISSIONS.—
‘‘(1) IN GENERAL.—With respect to payment
for discharges from an applicable hospital (as de
fined in paragraph (5)(C)) occurring during a fiscal
year beginning on or after October 1, 2011, in order
to account for excess readmissions in the hospital,
the Secretary shall reduce the payments that would
otherwise be made to such hospital under subsection
(d) (or section 1814(b)(3), as the case may be) for
such a discharge by an amount equal to the product
of—
‘‘(A) the base operating DRG payment
amount (as defined in paragraph (2)) for the
discharge; and

281
‘‘(B) the adjustment factor (described in
paragraph (3)(A)) for the hospital for the fiscal
year.


Pg 298 Lines 9-11 Doctors who treat a patient during initial admission that results in a readmission - Government will penalize you.


Page 298

(C) applying a payment reduction for phy
sicians who treat the patient during the initial
admission that results in a readmission


Pg 317 L2013-20 OMG!! PROHIBITION on ownership/investment. Government tells Doctors what/how much they can own.


Page 317

‘‘(B) PROHIBITION ON PHYSICIAN OWNER
SHIP OR INVESTMENT.—The percentage of the
total value of the ownership or investment in
terests held in the hospital, or in an entity
whose assets include the hospital, by physician
owners or investors in the aggregate does not
exceed such percentage as of the date of enact20
ment of this subsection.

Pg 317-318 lines 21-25,1-3 PROHIBITION on expansion - Government will mandate hospitals cannot expand.



Page 317/318


‘‘(C) PROHIBITION ON EXPANSION OF FA22
CILITY CAPACITY.—Except as provided in para23
graph (2), the number of operating rooms, pro24
cedure rooms, or beds of the hospital at any
25 time on or after the date of the enactment of

318
1 this subsection are no greater than the number
2 of operating rooms, procedure rooms, or beds,
3 respectively, as of such date.

pg 321 2-13 Hospitals have opportunity to apply for exception BUT community input required. Can u say ACORN?!



Page 321

‘‘(A) PROCESS.—
‘‘(i) ESTABLISHMENT.—The Secretary
shall establish and implement a process
under which a hospital may apply for an
exception from the requirement under
paragraph (1)(C).
‘‘(ii) OPPORTUNITY FOR COMMUNITY
INPUT.—The process under clause (i) shall
provide persons and entities in the commu
nity in which the hospital applying for an
exception is located with the opportunity to
provide input with respect to the applica
tion

Pg335 L 16-25 Pg 336-339 - Government mandates establishment of outcome-based measures which of course forces health care rationing.


Page 335

‘‘(ii) ESTABLISHMENT OF OUTCOME
BASED MEASURES.—By not later than for
2013 the Secretary shall implement report
ing requirements for quality under this
section on measures selected under clause
(iii) that reflect the outcomes of care expe
rienced by individuals enrolled in Medicare
Advantage plans (in addition to measures
described in clause (i)). Such measures
may include

Pg 341 Lines 3-9 Government has authority to disqualify Medicare Adv Plans, HMOs, etc., forcing people into Government plan.


Page 341

‘‘(iv) AUTHORITY TO DISQUALIFY
CERTAIN PLANS.—In applying clauses (ii)
and (iii), the Secretary may determine not
to identify a Medicare Advantage plan if
the Secretary has identified deficiencies in
the plan’s compliance with rules for such
plans under this part.

Pg 354 Sec 1177 - Government will RESTRICT enrollment of Special needs people!



Page 354/355



SEC. 1177. EXTENSION OF AUTHORITY OF SPECIAL NEEDS
PLANS TO RESTRICT ENROLLMENT.
(a) IN GENERAL.—Section 1859(f)(1) of the Social
Security Act (42 U.S.C. 1395w–28(f)(1)) is amended by
striking ‘‘January 1, 2011’’ and inserting ‘‘January 1,
2013 (or January 1, 2016, in the case of a plan described
in section 1177(b)(1) of the America’s Affordable Health
Choices Act of 2009)’’.
(b) GRANDFATHERING OF CERTAIN PLANS.—
(1) PLANS DESCRIBED.—For purposes of sec
tion 1859(f)(1) of the Social Security Act (42
U.S.C. 1395w–28(f)(1)), a plan described in this
paragraph is a plan that had a contract with a State
that had a State program to operate an integrated
Medicaid-Medicare program that had been approved
18 by the Centers for Medicare & Medicaid Services as
of January 1, 2004.
(2) ANALYSIS; REPORT.—The Secretary of
Health and Human Services shall provide, through
a contract with an independent health services eval
uation organization, for an analysis of the plans de
scribed in paragraph (1) with regard to the impact
of such plans on cost, quality of care, patient satis-

355
1 faction, and other subjects as specified by the Sec
retary. Not later than December 31, 2011, the Sec
retary shall submit to Congress a report on such
analysis and shall include in such report such rec
ommendations with regard to the treatment of such
plans as the Secretary deems appropriate.



Pg 379 Sec 1191 Government creates more bureaucracy - Telehealth Advisory Committee. HC by phone.



Page 379

SEC. 1191. TELEHEALTH EXPANSION AND ENHANCEMENTS.
.
(a) ADDITIONAL TELEHEALTH SITE.——
(1) IN GENERAL.—Paragraph (4)(C)(ii) of sec
tion 1834(m) of the Social Security Act (42 U.S.C.
1395m(m)) is amended by adding at the end the fol
lowing new subclause:
‘‘(IX) A renal dialysis facility.’’
(2) EFFECTIVE DATE.—The amendment made
by paragraph (1) shall apply to services furnished on
or after January 1, 2011.
(b) TELEHEALTH ADVISORY COMMITTEE.—
(1) ESTABLISHMENT.—Section 1868 of the So
cial Security Act (42 U.S.C. 1395ee) is amended—

PG 425 Lines 4-12 Government mandates Advance Care Planning Consultations. Think Senior Citizens end of life prodding.



Page 425


‘‘Advance Care Planning Consultation
6 ‘‘(hhh)(1) Subject to paragraphs (3) and (4), the
7 term ‘advance care planning consultation’ means a con8
sultation between the individual and a practitioner de9
scribed in paragraph (2) regarding advance care planning,
10 if, subject to paragraph (3), the individual involved has
11 not had such a consultation within the last 5 years. Such
12 consultation shall include the following:

Pg 425 Lines 17-19 Government will instruct & consult regarding living wills, durable powers of attorney. Mandatory!


Page 425


‘‘(B) An explanation by the practitioner of ad
vance directives, including living wills and durable
powers of attorney, and their uses.

PG 425 Lines 22-25, 426 Lines 1-3 Government provides approved list of end of life resources, guiding you in how to die.


Page 425

The provision by the practitioner of a list
of national and State-specific resources to assist con
sumers and their families with advance care plan
ning,


PG 427 Lines 15-24 Government mandates program for orders for end of life. The Government has a say in how your life ends.


Page 427

‘‘(iii) A program for orders for life sustaining
treatment for a States described in this clause is a
program that—
‘‘(I) ensures such orders are standardized
and uniquely identifiable throughout the State;
‘‘(II) distributes or makes accessible such
orders to physicians and other health profes
sionals that (acting within the scope of the pro
fessional’s authority under State law) may sign
orders for life sustaining treatment;

Pg 429 Lines 1-9 An "advanced care planning consultant" will be used frequently as patients’ health deteriorates.



Page 429

‘‘(B) An advance care planning consultation with re
spect to an individual may be conducted more frequently
than provided under paragraph (1) if there is a significant
change in the health condition of the individual, including
diagnosis of a chronic, progressive, life-limiting disease, a
life-threatening or terminal diagnosis or life-threatening
injury, or upon admission to a skilled nursing facility, a
long-term care facility (as defined by the Secretary), or
a hospice program.

PG 429 Lines 10-12 "advanced care consultation" may include an ORDER for end of life plans. AN ORDER from the Government to end a life!


Page 429

‘‘(5)(A) For purposes of this section, the term ‘order
regarding life sustaining treatment’ means, with respect
to an individual, an actionable medical order relating to
the treatment of that individual that—
‘‘(i) is signed and dated by a physician (as de
fined in subsection (r)(1)) or another health care
professional (as specified by the Secretary and who
is acting within the scope of the professional’s au
thority under State law in signing such an order, in
cluding a nurse practitioner or physician assistant)
and is in a form that permits it to stay with the in
dividual and be followed by health care professionals
and providers across the continuum of care;

PG 430 Lines 11-15 The Government will decide what level of treatment you will have at end of life.


Page 430


‘‘(B) The level of treatment indicated under subpara
graph (A)(ii) may range from an indication for full treat
ment to an indication to limit some or all or specified
interventions. Such indicated levels of treatment may in
clude indications respecting, among other items—

Pg 469 - Community Based Home Medical Services/Non profit orgs. (ACORN Medical Services here?)




Page 469


‘‘(B) COMMUNITY-BASED MEDICAL HOME
DEFINED.—In this section, the term ‘commu
nity-based medical home’ means a nonprofit
community-based or State-based organization
that is certified under paragraph (2) as meeting
the following requirements:

Page 472 Lines 14-17 PAYMENT TO COMMUNITY-BASED ORGANIZATION. 1 monthly paymentto a community-based organization. (Like ACORN?)




Page 472


‘‘(i) PAYMENT TO COMMUNITY-BASED
ORGANIZATION.—One monthly payment to
a community-based or State-based organi
zation.

PG 489 Sec 1308 The Government will cover Marriage & Family therapy. Which means they will insert Government into our marriages.



Page 489

SEC. 1308. COVERAGE OF MARRIAGE AND FAMILY THERA
PIST SERVICES AND MENTAL HEALTH COUN
SELOR SERVICES.
(a) COVERAGE OF MARRIAGE AND FAMILY THERA
PIST SERVICES.—

Pg 494-498 Government will cover Mental Health Services including defining, creating, rationing those services. You’d better speak up now before you are on the "advanced care consultation" list.



Page 494/498


‘‘Mental Health Counselor Services
(1) The term ‘mental health counselor services’
means services performed by a mental health counselor (as
defined in paragraph (2)) for the diagnosis and treatment
of mental illnesses which the mental health counselor is
legally authorized to perform under State law (or the
State regulatory mechanism provided by the State law) of

495
the State in which such services are performed, as would
otherwise be covered if furnished by a physician or as inci3
dent to a physician’s professional service, but only if no
facility or other provider charges or is paid any amounts
with respect to the furnishing of such services.

(B) DEVELOPMENT OF CRITERIA WITH RE
SPECT TO CONSULTATION WITH A PHYSICIAN.—
The Secretary of Health and Human Services
shall, taking into consideration concerns for pa
tient confidentiality, develop criteria with re-

497
spect to payment for mental health counselor
services for which payment may be made di
rectly to the mental health counselor under part
B of title XVIII of the Social Security Act (42
U.S.C. 1395j et seq.) under which such a coun
selor must agree to consult with a patient’s at
tending or primary care physician in accordance
with such criteria.
(5) EXCLUSION OF MENTAL HEALTH COUN
SELOR SERVICES FROM SKILLED NURSING FACILITY
PROSPECTIVE PAYMENT SYSTEM.—Section
1888(e)(2)(A)(ii) of the Social Security Act (42
U.S.C. 1395yy(e)(2)(A)(ii)), as amended by section
1307(a) and subsection (a), is amended by inserting
‘‘mental health counselor services (as defined in sec
tion 1861(kkk)(1)),’’ after ‘‘marriage and family
therapist services (as defined in subsection
(jjj)(1)),’’.
(6) COVERAGE OF MENTAL HEALTH COUN
SELOR SERVICES PROVIDED IN RURAL HEALTH
CLINICS AND FEDERALLY QUALIFIED HEALTH CEN
TERS.—Section 1861(aa)(1)(B) of the Social Secu
rity Act (42 U.S.C. 1395x(aa)(1)(B)), as amended
by subsection (a), is amended by striking ‘‘or by a
marriage and family therapist (as defined in sub-

498
section (jjj)(2)),’’ and inserting ‘‘by a marriage and
family therapist (as defined in subsection (jjj)(2)),
or a mental health counselor (as defined in sub
section


Page 879-909 covers racial preferences, underrepresented minorities…read undereducated and ill prepared, will have to be admitted into Medical School‘s. So expect the medical Schools to lower their standards! What the hell if you die because of a mistake by a break dancer from the hood who got a Dr. in front of his name because he was “an unrepresented minority”…well that is just the price you have to pay for racial diversity, Multiculturalism and Political Correctness? You will pay with your life!

Page 879/909

SEC. 2213. TRAINING IN FAMILY MEDICINE, GENERAL IN
TERNAL MEDICINE, GENERAL PEDIATRICS,
GERIATRICS, AND PHYSICIAN
ASSISTANTSHIP.


‘‘(2) Training individuals who are from under
represented minority groups or disadvantaged back
grounds.


Supporting teaching programs that ad
dress the health care needs of vulnerable popu
lations.





SEC. 2215. TRAINING FOR GENERAL, PEDIATRIC, AND PUB2
LIC HEALTH DENTISTS AND DENTAL HYGIEN3
ISTS.

PP‘‘(b) SUPPORT AND DEVELOPMENT OF DENTAL
16 TRAINING PROGRAMS
C:\TEMP\AAHCA0~1.XML HOLCPC

PREFERENCE.—In awarding grants or contracts
under this section, the Secretary shall give preference to
entities that have a demonstrated record of the following:
‘‘(1) Training the greatest percentage, or sig
nificantly improving the percentage, of oral health
professionals who practice general, pediatric, or pub
lic health dentistry.

890
‘‘(2) Training individuals who are from under
represented minority groups or disadvantaged back
grounds.
‘‘(3) A high rate of placing graduates in prac
tice settings having the principal focus of serving in
underserved areas or populations experiencing health
disparities (including serving patients eligible for
medical assistance under title XIX of the Social Se
curity Act or for child health assistance under title
XXI of such Act or those with special health care
needs).
‘‘(4) Supporting teaching programs that ad
dress the dental needs of vulnerable populations.
‘‘(5) Providing instruction regarding the oral
health status, dental care needs, and risk-based clin
ical disease management of all pediatric populations
with an emphasis on underserved children.


‘‘SEC. 749. TRAINING FOR GENERAL, PEDIATRIC, AND PUB
LIC HEALTH DENTISTS AND DENTAL HYGIEN
ISTS.


ELIGIBILITY.—To be eligible for a grant or con
tract under subsection (a), an entity shall be—
‘‘(1) an accredited school of dentistry, training
program in dental hygiene, or public or nonprofit
private hospital;
‘‘(2) a training program in dental hygiene at an
accredited institution of higher education;
‘‘(3) a public or private nonprofit entity; or
‘‘(4) a consortium of—
‘‘(A) 2 or more of the entities described in
paragraphs (1) through (3); and
‘‘(B) an accredited school of public health.
‘‘(d) PREFERENCE.—In awarding grants or contracts
under this section, the Secretary shall give preference to
entities that have a demonstrated record of the following:
‘‘(1) Training the greatest percentage, or sig
nificantly improving the percentage, of oral health
professionals who practice general, pediatric, or pub
lic health dentistry.


890
1 ‘‘(2) Training individuals who are from under
represented minority groups or disadvantaged back
grounds.
‘‘(3) A high rate of placing graduates in prac
tice settings having the principal focus of serving in
underserved areas or populations experiencing health
disparities (including serving patients eligible for
medical assistance under title XIX of the Social Se
curity Act or for child health assistance under title
XXI of such Act or those with special health care
needs).

No comments: