PHCA/CALM President/CEO Praises Healthy PA
Additional Lawsuit Abuse Reforms Needed to Stem Suits of Predatory, Out-of-State Law Firms
HARRISBURG — Stuart H. Shapiro, M.D., President and CEO of the Pennsylvania Health Care Association and Center for Assisted Living Management (PHCA/CALM), applauded the recent federal approval of Pennsylvania’s Healthy PA initiative.
“Even the federal government recognized the innovations and value in Healthy PA, which will expand health-care coverage to more than half a million residents without raising taxes and without expanding the state’s already unsustainable Medicaid program,” Shapiro said during a taping of “Pennsylvania Newsmakers,” a statewide public affairs program that is set to begin airing this weekend.
Shapiro noted that PHCA/CALM had been a strong supporter of Healthy PA from the moment it was unveiled. That’s because Healthy PA is a state-specific plan, as opposed to adoption of the federal Affordable Care Act, which utilizes the private insurance marketplace to expand health care without pitting those already in the Medicaid program, namely the frail elderly, against new enrollees for already scarce dollars.
One in six Pennsylvanians is already on Medicaid, and the state already spends nearly a third of its budget on Medicaid. With all-out Medicaid expansion as proposed under “Obamacare,” nearly one in four residents would be enrolled in Medicaid. Healthy PA gets insurance to 500,000 Pennsylvanians without expanding Medicaid.
“Despite the benefits of Healthy PA, Pennsylvania remains on the verge of a long-term care crisis,” said Dr. Shapiro. “Our population is aging rapidly. Entitlement programs are strained. And most people and government simply aren’t prepared to meet future long-term care needs. The conversation about long-term care reforms needs to progress if we want to avert this crisis.”
“At the forefront of this crisis are frivolous lawsuits, which contribute to the rising cost of long-term care, actually jeopardizing quality care by forcing facilities to divert valuable time and resources from patient care to prepare their defenses,” said Shapiro, who stressed that additional tort reforms are needed.
Although sixth in population, Pennsylvania ranked second among all 50 states both in total medical malpractice payouts and payouts per capita in 2014. According to the 2014 Medical Malpractice Payout Analysis published by Diederich Healthcare, those medical malpractice payouts total $357 million — a $41 million increase from 2012. Ninety five percent of the payouts were settlements, not judgments.
For years, long-term care providers have had a bull’s eye on their back, targeted by aggressive and often out-of-state plaintiff attorneys who seek to cash in by forcing facilities to settle out of court rather than risk the prospect of hefty payments.
But the high percentage of malpractice payouts isn’t because providers are subpar. In fact, Pennsylvania’s nursing homes receive fewer deficiencies than the national average and rank the third lowest in serious deficiencies, meaning they rank better than 47 other states. A report in the New England Journal of Medicine on the relationship between the quality of care in U.S. nursing homes and lawsuits brought against nursing homes concluded that the highest quality nursing homes were sued at essentially the same rate as lower performing nursing homes.
Shapiro also noted that the two-year legislative session is set to wrap up in October. With Veterans Day on Nov. 11 this year, he said he remained hopeful that lawmakers would act on an important veterans bill before voting ends for the year.
The Senate recently voted unanimously to approve legislation (S.B. 1224) that would add personal care homes and assisted living residences to the list of locations where Veteran’s Administration (VA) medications may be repackaged for use by veterans at a discounted rate. Right now, the Military and Veterans Code only allows repackaging for veterans who reside in a “long-term care nursing facility,” otherwise referred to as nursing homes. This measure gives veterans access to safe, affordable medications regardless of the place they call home.
He also called on the Senate to approve legislation (H.B. 1907) that would require hospitals to provide notice to a patient if they are in formally admitted or on observation status. Medicare requires a 72-hour “admitted” stay in a hospital before it will pay for a skilled nursing facility visit. Medicare will not pay for a skilled nursing facility visit if the patient was on observation status. This bill passed unanimously through the House in April, and it is now in the Senate Public Health and Welfare Committee.
“Pennsylvania Newsmakers” is one of the state’s premier politics and public policy television talk shows. The show is available at www.phca.org and will air regionally:
- WGAL Channel 8 (Harrisburg and Lancaster) at 7:30 a.m. and 11 a.m. Sunday, Sept. 21.
- WBPH (Lehigh Valley and Philadelphia) at 8:30 p.m. Sept., June 22.
- WKBS 47 (Altoona) at 11:30 a.m. Saturday, Sept. 27.
- WPCB 40 (Pittsburgh) at 11:30 a.m. Saturday, Sept. 27.
- CATV Channel 8 at 7 p.m. Tuesday, Sept. 23 and 1 p.m. Wednesday, Sept. 24.