Would the “Doc Fix” Allow the Feds to Tell Doctors How to Practice Medicine?

This database would eventually be used to identify “outlier ordering professionals.” These are doctors who show a “low adherence” to the “appropriate use criteria.” Starting in 2020, these “outlying” doctors would then be required to seek the advance permission of the government through a “prior authorization” process administered by a government website before they can order services for their patients.

docfixAll of these provisions are written to pertain to imaging services and radiologists. But language included at the end of this section of the legislation gives the HHS secretary broad discretion to establish an “appropriate use program for other Part B services.”

This includes everything doctors do outside the hospital. The legislation allows Medicare to apply the same regulatory framework to other medical specialties like oncology.

These provisions are part of a much broader, secular shift toward increasing control of the practice of medicine by the federal government. With “applicable appropriate use criteria,” Washington would have the tool to effectively control the practice of medicine for America’s senior citizens.

Scott Gottlieb in the WSJ.

Comments (12)

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  1. Trent says:

    “It should be clear to everyone by now that the delivery of medical care isn’t something that can be micromanaged from Washington or be administered by a secretary of Health and Human Services with wide latitude to interpret and reinterpret the rules.”

    We are still making laws though

  2. Lucas says:

    “It rewards doctors based on the volume of services they deliver, with no measure of their quality of care. And it doesn’t reward doctors based on delivering better outcomes.”

    The only thing that doesn’t need to be mass produced is about to be. It’s all about the bottom line. Care is not even considered anymore.

  3. Trent says:

    Probably 5 less stitches.

  4. Perry says:

    First, I am glad I am in Occupational Medicine instead of Primary Care right now.
    Second, I am glad I can retire sooner than later.

  5. Kevin says:

    Can’t they pretty much tell them how to practice currently?

  6. JFA says:

    I don’t mind the senior’s insurance (Medicare) telling doctors what procedures it will pay for because they already do that. From my understanding of most diagnostic tests, this just tends to be wasteful spending anyway (an X-ray or good use of a stethoscope can tell us the same information as an MRI). Those are my tax dollars that old people are spending, and I would rather them spend less. Also, my fear is that the appropriate use criteria would be too broad rather than too narrow. Don’t forget that CMS is a regulatory agency subject to the possible (or already complete) capture of interested parties (the AMA). I do find it strange that when conservatives talk about regulations on the medical industry, they tend not to use the lessons of public choice theory to predict how loose or tight those regulations will be. In all likelihood, doctors will not be hurt nearly as bad as the doomsaying commenters on this blog post.

  7. Linda Gorman says:

    An X-ray or stethoscope gives the same information as an MRI? Really?