Friday, January 07, 2011

Obama pulls the plug

---not on Grandma, but on the end of life counseling provision. This is actually the second time the plug was pulled. First time around it was from the House draft of the health care reform bill. This time it's from the “regs” which Obama added via the regulation writing process.

So let's look at the sequence of events in this marvelous example of Obama administration transparency:

A provision regarding reimbursement for end of life counseling was included in a draft of the health care reform bill.

In the debate that followed it was never explained what the provision added to counseling reimbursement already embedded in the CPT codes.

The provision was dropped from the final version of the bill that passed and signed into law.

Boosters of the provision urge implementation via the regulation writing process.

The provision was included in a list of proposed regs.

But the provision was missing from the list when the proposals were submitted for public feedback.

The reg was implemented anyway, more or less in secret.

One of the provision's chief supporters urged it be kept secret for as long as possible, warning in an email “The longer this goes unnoticed, the better our chances of keeping it.”

But the secret didn't last long; it hit the newspapers and the blogs in no time.

The White House failed to respond to a request for comment about why they yanked the provision.

Clearly they want to hide this from public debate. What is concerning is this arrogance on the part of the administration and the obfuscation in the media. Reimbursement for counseling itself, as I explained here, is a non-issue. We've had reimbursement for counseling for a long time, explicitly written into the regs as far back as 1994.

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