Div A, Tit 2, part 6: Miscellaneous.

Subtitle E, and a mix of boilerplate and some real kickers. Let’s get the boilerplate out of the way first.

This bill doesn’t supercede Public Health Services Act, Employee retirement Security Act, or state law except where specifically identified as doing so by the commissioner. Except where specified (such as age) no discrimination in services and costs is allowed. Whistleblowers are protected. No requirement (for or against) collective bargaining agreements (ie unions and such) or modifications of existing law and regulations regarding them. A standard ‘if the courts rule one part of this dead, the rest still live.’ (What I call the kudzu rule.) Integration with Hawaii’s prepaid health care act. State attorney generals have standing to bring civil suit against the agency in re rules and regs.

Then there are the four interesting things that are NOT boilerplate.

Abortion, which we’ve seen twice before, comes up again. (Methinks it’s a hot button issue or something.) Mostly it’s a repeat of what was said before – federal law cannot require and cannot deny service, etc. It’s emphasized with a ‘conscience clause’ that there can be no discrimination by the agency against any organization or individual who refuses to provide, support, or REFER abortions. I emphasized that last as it may turn into a bit of stickiness. It’s saying that if a doctor or hospital is asked if they know of an abortion provider they are allowed to say “no” even if they know otherwise. Yes, technically a medical referral is contacting the specialist and telling them the original provider is sending the patient to them for service. Still, it’s getting into a bit of stickiness. Expect some narrow focus here.

The FTC is given the power to stick its nose into insurance companies’ business even if the insurance business is privately held or is non-profit or, well, regardless. No more legal hiding of data.

Here’s one that’ll have insurance companies fighting to remove. Most of the anti-trust exemptions that insurance companies used to have is removed. Blue Cross/Blue Shield? meet competition. Or rather, meet the auditors who are required to do extra review of your behavior to ensure your effective cornering of the market (in some areas) is not from underhanded actions against potential competitors.

Finally, the SecHHS is to provide a list of ways to encourage small QHBPs to use electronic health records. This is a wonky element. See, the places that have gone to this (VA on the large side, several metropolitan hospitals on smaller scale) have had significant improvements in service and cost control. Barcode scan wrist tag, barcode scan cup containing pills, give pills – record is set. (more advanced systems also have a “WRONG CUP” alert for this situation. That’s a cheap addition after all the other costs.) Handwriting reading errors go away (though typos are still around). So on and so forth. One year to report, report to include recommended legislation and regulations to include costs of incentive programs.

And we are DONE with Division A Title 2. We are on page 154 of 1990 pages at this time, for those trying to follow along at home.

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