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Let's discuss what's in the Health Care Bill

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posted on Aug, 9 2009 @ 01:13 PM
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This is a very long thread.
for educating me on the bill. There have been lots of talk about what is in the bill and what should or should not be in the bill. But the major problem I see is that it is being made into a complicated argument forcing us into considering something in a different light. It is a manipulation technique. I dont care what is in the bill anymore
Allowing discussion of what is in it makes it easier for it to happen. The argument is a lot less complicated than they are trying to make it appear. It is a simple yes or no. There is no way to sugar coat it. Do you want the government to controll every aspect of your health or not?

It does not matter if they cut out over half the bill. If it goes through it completly changes everything. Permininlty. For ever.




posted on Aug, 9 2009 @ 01:13 PM
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Originally posted by Jenna
reply to post by mikerussellus
 


It's easy to do.


I counted the second claim as partly true since it will be doctors doing it and not the government. Other than that, I think we agreed on them.


I couldn't find where it was "manditory", thus my reasoning. . .



posted on Aug, 9 2009 @ 01:22 PM
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PG 434 Section 1234 Military Active, Reservists, Families - If you’re not enrolled in Tricare it is mandated.

PG 434 Section 1234 Military Active, Reservists, Families - Once HealthCare bill is passed your premiums will go up.


Section 1234:

SEC. 1234. PART B SPECIAL ENROLLMENT PERIOD AND WAIVER OF LIMITED ENROLLMENT PENALTY FOR TRICARE BENEFICIARIES.
(a) PART B SPECIAL ENROLLMENT PERIOD.—
(1) IN GENERAL.—Section 1837 of the Social Security Act (42 U.S.C. 1395p) is amended by adding at the end the following new subsection:
(l)(1) In the case of any individual who is a covered beneficiary (as defined in section 1072(5) of title 10, United States Code) at the time the individual is entitled to hospital insurance benefits under part A under section 226(b) or section 226A and who is eligible to enroll but who has elected not to enroll (or to be deemed enrolled) during the individual’s initial enrollment period, there shall be a special enrollment period described in paragraph (2).
(2) The special enrollment period described in this paragraph, with respect to an individual, is the 12-month period beginning on the day after the last day of the initial enrollment period of the individual or, if later, the 12-month period beginning with the month the individual is notified of enrollment under this section.
(3) In the case of an individual who enrolls during the special enrollment period provided under paragraph (1), the coverage period under this part shall begin on the first day of the month in which the individual enrolls or, at the option of the individual, on the first day of the second month following the last month of the individual’s initial enrollment period.
(4) The Secretary of Defense shall establish a method for identifying individuals described in paragraph (1) and providing notice to them of their eligibility for enrollment during the special enrollment period described in paragraph (2).’’.


Both claims appear to be false. Though this section, that I've bolded above does concern me a bit:


the 12-month period beginning with the month the individual is notified of enrollment under this section.


Notified of enrollment? Why would someone need "notified of enrollment" if they had enrolled on their own?



posted on Aug, 9 2009 @ 01:24 PM
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reply to post by mikerussellus
 


It didn't use the word mandatory, but it says that seniors will have a consultation if they haven't had one in the last five years.



posted on Aug, 9 2009 @ 01:25 PM
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reply to post by Jenna
 


I stand corrected.

I'll change that on my post.



[edit on 9-8-2009 by mikerussellus]



posted on Aug, 9 2009 @ 01:35 PM
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PG 438 Section 1236 The Government will develop a patient decision making aid program that you & Dr. WILL use.


Section 1236:

SEC. 1236. DEMONSTRATION PROGRAM ON USE OF PATIENT DECISIONS AIDS.
(a) IN GENERAL.—The Secretary of Health and Human Services shall establish a shared decision making demonstration program (in this subsection referred to as the ‘‘program’’) under the Medicare program using patient decision aids to meet the objective of improving the understanding by Medicare beneficiaries of their medical treatment options, as compared to comparable Medicare beneficiaries who do not participate in a shared decision making process using patient decision aids.
(b) SITES.—
(1) ENROLLMENT.—The Secretary shall enroll in the program not more than 30 eligible providers who have experience in implementing, and have invested in the necessary infrastructure to implement, shared decision making using patient decision aids.


Page 442:

(2) PATIENT DECISION AID.—The term ‘‘patient decision aid’’ means an educational tool (such as the Internet, a video, or a pamphlet) that helps patients (or, if appropriate, the family caregiver of the patient) understand and communicate their beliefs and preferences related to their treatment options, and to decide with their health care provider what treatments are best for them based on their treatment options, scientific evidence, circumstances, beliefs, and preferences.


This claim is partially true. There won't be more than 30 providers in the program, in the beginning at least, so it won't affect everyone.



posted on Aug, 9 2009 @ 01:37 PM
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Claim:

PGs 701-704 Section 1619 If your part of HealthCare plan that isn’t in Government HealthCare Exchange but you qualify for Federal aid, no payment.


What it says:


15 SEC. 1619. EXCLUSION OF CERTAIN INDIVIDUALS AND EN
16 TITIES FROM PARTICIPATION IN MEDICARE
17 AND STATE HEALTH CARE PROGRAMS.
18 (a) IN GENERAL.—Section 1128(c) of the Social Se
19 curity Act, as previously amended by this division, is fur
20 ther amended—
21 (1) in the heading, by striking ‘‘AND PERIOD’’
22 and inserting ‘‘, PERIOD, AND EFFECT’’; and
23 (2) by adding at the end the following new
24 paragraph:
1 ‘‘(4)(A) For purposes of this Act, subject to
2 subparagraph (C), the effect of exclusion is that no
3 payment may be made by any Federal health care
4 program (as defined in section 1128B(f)) with re
5 spect to any item or service furnished—
6 ‘‘(i) by an excluded individual or entity; or
7 ‘‘(ii) at the medical direction or on the pre
8 scription of a physician or other authorized in
9 dividual when the person submitting a claim for
10 such item or service knew or had reason to
11 know of the exclusion of such individual.
12 ‘‘(B) For purposes of this section and sections
13 1128A and 1128B, subject to subparagraph (C), an
14 item or service has been furnished by an individual
15 or entity if the individual or entity directly or indi
16 rectly provided, ordered, manufactured, distributed,
17 prescribed, or otherwise supplied the item or service
18 regardless of how the item or service was paid for
19 by a Federal health care program or to whom such
20 payment was made.
21 ‘‘(C)(i) Payment may be made under a Federal
22 health care program for emergency items or services
23 (not including items or services furnished in an
24 emergency room of a hospital) furnished by an ex
25 cluded individual or entity, or at the medical direc-
1 tion or on the prescription of an excluded physician
2 or other authorized individual during the period of
3 such individual’s exclusion.
4 ‘‘(ii) In the case that an individual eligible for
5 benefits under title XVIII or XIX submits a claim
6 for payment for items or services furnished by an ex
7 cluded individual or entity, and such individual eligi
8 ble for such benefits did not know or have reason to
9 know that such excluded individual or entity was so
10 excluded, then, notwithstanding such exclusion, pay
11 ment shall be made for such items or services. In
12 such case the Secretary shall notify such individual
13 eligible for such benefits of the exclusion of the indi
14 vidual or entity furnishing the items or services.
15 Payment shall not be made for items or services fur
16 nished by an excluded individual or entity to an indi
17 vidual eligible for such benefits after a reasonable
18 time (as determined by the Secretary in regulations)
19 after the Secretary has notified the individual eligi
20 ble for such benefits of the exclusion of the indi
21 vidual or entity furnishing the items or services.
22 ‘‘(iii) In the case that a claim for payment for
23 items or services furnished by an excluded individual
24 or entity is submitted by an individual or entity
25 other than an individual eligible for benefits under
1 title XVIII or XIX or the excluded individual or en
2 tity, and the Secretary determines that the indi
3 vidual or entity that submitted the claim took rea
4 sonable steps to learn of the exclusion and reason
5 ably relied upon inaccurate or misleading informa
6 tion from the relevant Federal health care program
7 or its contractor, the Secretary may waive repay
8 ment of the amount paid in violation of the exclusion
9 to the individual or entity that submitted the claim
10 for the items or services furnished by the excluded
11 individual or entity. If a Federal health care pro
12 gram contractor provided inaccurate or misleading
13 information that resulted in the waiver of an over
14 payment under this clause, the Secretary shall take
15 appropriate action to recover the improperly paid
16 amount from the contractor.’’.


I'm going to have to call this claim true. It says it in the language what the claim says, but something I am starting to notice in this bill is that it is giving the "secretary" and various government agencies to change things on a whim.

edit to fix tags

[edit on 9-8-2009 by Hastobemoretolife]



posted on Aug, 9 2009 @ 01:38 PM
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PG 443 Lines 7-24 Government at taxpayers expense test out an “Accountable Care Org” program (Government doesn’t have plan.)

‘‘SEC. 1866D. (a) IN GENERAL.—The Secretary shall
11 conduct a pilot program (in this section referred to as the
12 ‘pilot program’) to test different payment incentive mod
13els, including (to the extent practicable) the specific pay
14ment incentive models described in subsection (c), de
15signed to reduce the growth of expenditures and improve
16 health outcomes in the provision of items and services
17 under this title to applicable beneficiaries (as defined in
18 subsection (d)) by qualifying accountable care organiza
19tions (as defined in subsection (b)(1)) in order to—
20 ‘‘(1) promote accountability for a patient popu
21lation and coordinate items and services under parts
22 A and B;
23 ‘‘(2) encourage investment in infrastructure and
24 redesigned care processes for high quality and effi
25cient service delivery; and
1 ‘‘(3) reward physician practices and other phy
2sician organizational models for the provision of high
3 quality and efficient health care services.


True. Which provides the question, is this bill actually going to stay within budget? Lots of "soft" programs with no specific structure or associated cost.



posted on Aug, 9 2009 @ 01:42 PM
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PG 444 Lines 1-6 Government’s Accountable Care Program will mandate services & infrastructure thru reward/penalty system.


Pages 443-444 (bolded section is the part referenced in claim):

SEC. 1301. ACCOUNTABLE CARE ORGANIZATION PILOT PROGRAM.
Title XVIII of the Social Security Act is amended by inserting after section 1866C the following new section:
ACCOUNTABLE CARE ORGANIZATION PILOT PROGRAM SEC. 1866D.
(a) IN GENERAL.—The Secretary shall conduct a pilot program (in this section referred to as the ‘pilot program’) to test different payment incentive models, including (to the extent practicable) the specific payment incentive models described in subsection (c), designed to reduce the growth of expenditures and improve health outcomes in the provision of items and services under this title to applicable beneficiaries (as defined in subsection (d)) by qualifying accountable care organizations (as defined in subsection
(b)(1)) in order to—
(1) promote accountability for a patient population and coordinate items and services under parts A and B;
(2) encourage investment in infrastructure and redesigned care processes for high quality and efficient service delivery; and
(3) reward physician practices and other physician organizational models for the provision of high quality and efficient health care services.


This claim is partially true. There will be a pilot program that experiments with incentives to reward doctors for high quality and efficient services. I don't see anything about penalties in this section though.



posted on Aug, 9 2009 @ 01:43 PM
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PG 448 Lines 4-17 Government will set performance targets for ALL Accountable Care Organizations including private.


‘‘(i) IN GENERAL.—The Secretary
6 shall establish a performance target for
7 each qualifying ACO comprised of a base
8 amount (described in clause (ii)) increased
9 to the current year by an adjustment fac
10tor (described in clause (iii)). Such a tar
11get may be established on a per capita
12 basis, as the Secretary determines to be
13 appropriate.


No mention, but no exclusion either.
True, but with another caveat.



posted on Aug, 9 2009 @ 01:44 PM
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reply to post by Hastobemoretolife
 


I've noticed that too, there's an awful lot of leeway for the Secretary and Commissioner to change things as they see fit. That, to me, is almost more disturbing than the claims that have so far been shown true.



posted on Aug, 9 2009 @ 01:48 PM
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PG 455 Lines 3-4 Government exempts itself from Chapter 35, Title 44 Paperwork Reduction & Citizens Privacy Protection Act

‘‘(5) ADMINISTRATION.—Chapter 35 of title 44,
22 United States Code shall not apply to this section.


True. Here's the smoking gun on HIPPA violations brought about by the government.



posted on Aug, 9 2009 @ 01:54 PM
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PG 460 Section 1302 Knock, Knock - It’s the Government and I’m here with the Medical Home Program - YOUR home.

PG 460 Section 1302 The Government WILL provide medical services in your home. Paging Nurse Pelosi!!



SEC. 1302. MEDICAL HOME PILOT PROGRAM.
(a) IN GENERAL.—Title XVIII of the Social Security Act is amended by inserting after section 1866D, as inserted by section 1301, the following new section:
MEDICAL HOME PILOT PROGRAM
SEC. 1866E. (a) ESTABLISHMENT AND MEDICAL HOME MODELS.—
(1) ESTABLISHMENT OF PILOT PROGRAM.—
The Secretary shall establish a medical home pilot program (in this section referred to as the ‘pilot program’) for the purpose of evaluating the feasibility and advisability of reimbursing qualified patient-centered medical homes for furnishing medical home services (as defined under subsection (b)(1)) to high need beneficiaries (as defined in subsection (d)(1)(C)) and to targeted high need beneficiaries (as defined in subsection (c)(1)(C)).


I'm calling these claims false. There will be patient-centered medical homes, but this doesn't sound much different than the assisted living places that are currently operational. The only difference being these will be ran by the government, which is another issue entirely.



posted on Aug, 9 2009 @ 01:56 PM
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Claim:

PG 686-700 Increased Funding to Fight Waste, Fraud, and Abuse. LMAO!! You mean the Government with an $18 mil website?


What it says:

I'm not going to post the whole section because the title says it all, but I did notice something that has caught my interest I will post that too.


6 TITLE VI—PROGRAM INTEGRITY
7 Subtitle A—Increased Funding to
8 Fight Waste, Fraud, and Abuse


This subsection caught my eye though:

9 SEC. 1601. INCREASED FUNDING AND FLEXIBILITY TO
10 FIGHT FRAUD AND ABUSE.


This is the flexibility clause:


8 (b) FLEXIBILITY IN PURSUING FRAUD AND
9 ABUSE.—Section 1893(a) of the Social Security Act (42
10 U.S.C. 1395ddd(a)) is amended by inserting ‘‘, or other
11 wise,’’ after ‘‘entities’’.


This is the section they are amending in the SSA:


(a) Establishment of Program
There is hereby established the Medicare Integrity Program (in this section referred to as the “Program”) under which the Secretary shall promote the integrity of the medicare program by entering into contracts in accordance with this section with eligible entities to carry out the activities described in subsection (b) of this section.


This is the way it would read if this bill was to pass:

Establishment of Program
There is hereby established the Medicare Integrity Program (in this section referred to as the “Program”) under which the Secretary shall promote the integrity of the medicare program by entering into contracts in accordance with this section with eligible, or otherwise entities to carry out the activities described in subsection (b) of this section.


So this looks like it will open the door to other organizations to conduct these duties as described in subsection (b) of the section in the SSA act:


(b) Activities described
The activities described in this subsection are as follows:
(1) Review of activities of providers of services or other individuals and entities furnishing items and services for which payment may be made under this subchapter (including skilled nursing facilities and home health agencies), including medical and utilization review and fraud review (employing similar standards, processes, and technologies used by private health plans, including equipment and software technologies which surpass the capability of the equipment and technologies used in the review of claims under this subchapter as of August 21, 1996).
(2) Audit of cost reports.
(3) Determinations as to whether payment should not be, or should not have been, made under this subchapter by reason of section 1395y (b) of this title, and recovery of payments that should not have been made.
(4) Education of providers of services, beneficiaries, and other persons with respect to payment integrity and benefit quality assurance issues.
(5) Developing (and periodically updating) a list of items of durable medical equipment in accordance with section 1395m (a)(15) of this title which are subject to prior authorization under such section.
(6) The Medicare-Medicaid Data Match Program in accordance with subsection (g).


So in other words this amendment allows them to hire whoever to conduct investigations to enforce these regulations. (edited to make it more readable)

[edit on 9-8-2009 by Hastobemoretolife]



posted on Aug, 9 2009 @ 01:59 PM
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PG 1001 The Government will establish a National Medical Device Registry. Will you be tracked?

PG 1003 9-11 National Medical Dev Reg ‘‘(iii) other postmarket device surveillance activities” you WILL be tracked.


Ok I've read these a few times below is my short version of what they are saying they will do. It goes way beyond the pages lsited and you have to reference other pages it mentions. Anything in quotes is taken directly from the bill. Non-quoted is my comments.

Every device implanted or used on or with a patient must have a serial #, that number and who has what device will be in the database. Follow up data on how well it works and any side effects will also be in the database.


trends, adverse event patterns, incidence and prevalence of adverse events, and other information the
Secretary determines appropriate, which may include
data on comparative safety and outcomes trends;
and
‘‘(E) shall establish procedures to permit public
access to the information in the registry in a manner
and form that protects patient privacy and proprietary information and is comprehensive, useful, and
not misleading to patients, physicians, and scientists.
‘‘(5) To carry out this subsection, there are author
ized to be appropriated such sums as may be necessary
for fiscal years 2010 and 2011.’’.


Ok they also say anyone with a device from before the effective date of the bill will be required to inform them they have said device and that they can access sales records of companies to find out who has what (I assume in case someone doesn't register there device). I don't like the bit about appropriated funds to build the database? Where do they come from?

Ok I think the original comments where partially true. They make it seem like you will be tracked in real time but I think the parts that are quoted are talking about tracking you in a database.

Ok I found a mention on page 1007 to all new devices being required to have an electronic exchange capability to send the unique device identifiers. That sounds like an RFID chip to me


ELECTRONIC EXCHANGE AND USE IN CERTIFIED
4 ELECTRONIC HEALTH RECORDS OF UNIQUE DEVICE
5 IDENTIFIERS.—
6 (1) RECOMMENDATIONS.—The HIT Policy
7 Committee established under section 3002 of the
8 Public Health Service Act (42 U.S.C. 300jj–12)
9 shall recommend to the head of the Office of the Na10
tional Coordinator for Health Information Tech11
nology standards, implementation specifications, and
12 certification criteria for the electronic exchange and
13 use in certified electronic health records of a unique
14 device identifier for each device described in section
15 519(g)(1) of the Federal Food, Drug, and Cosmetic
16 Act, as added by subsection (a).
17 (2) STANDARDS, IMPLEMENTATION CRITERIA,
18 AND CERTIFICATION CRITERIA.—The Secretary of
19 the Health Human Services, acting through the
20 head of the Office of the National Coordinator for
21 Health Information Technology, shall adopt stand22
ards, implementation specifications, and certification
23 criteria for the electronic exchange and use in cer24
tified electronic health records of a unique device
25 identifier for each device described in paragraph (1),



posted on Aug, 9 2009 @ 02:00 PM
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PG 464 Lines 17-22 Independent Patient Center Home Medical Services - Drs. don’t have to be at your home just some directed by D


Page 464 Line 10 - Page 465 Line 2:

(B) INDEPENDENT PATIENT-CENTERED MEDICAL HOME DEFINED.—In this section, the term ‘independent patient-centered medical home’ means a physician-directed or nurse-practitioner-directed practice that is qualified under paragraph (2) as—
(i) providing beneficiaries with patient-centered medical home services; and
(ii) meets such other requirements as the Secretary may specify.
(C) TARGETED HIGH NEED BENEFICIARY DEFINED.—For purposes of this subsection, the term ‘targeted high need beneficiary’ means a high need beneficiary who, based on a risk score as specified by the Secretary, is generally within the upper 50th percentile of Medicare beneficiaries.


True in that a nurse-practitioner can be qualified to perform the care instead of a doctor, false in that I still don't see anything that leads me to believe that this is different than existing assisted living places.



posted on Aug, 9 2009 @ 02:01 PM
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PG 469 Community Based Home Medical Services=Non profit organizations. Hello, ACORN Medical Services here!!?


‘‘(ii) The organization provides med
25ical home services under the supervision of
1 and in close collaboration with the primary
2 care or principal care physician or nurse
3 practitioner designated by the beneficiary
4 as his or her community-based medical
5 home provider.


ACORN, again. This time I think he's off the mark. Community-based medical personnel are a different animal. Usually non-profit organizations that treat the poor, homeless, etc.



posted on Aug, 9 2009 @ 02:09 PM
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reply to post by Jenna
 


Oh joy, government run nursing homes. Talk about scary, that it absolutely terrifying.

So that begs me to ask the question, the Obama Eugenics "hoax" or whatever you want to call it.

Do you think this actually lends some credence to that?

Edit to add -

Also about the secretary and what not, being able to change things on a whim it is the only way I could see a program this large to even have a chance at success. Which is a huge problem.

[edit on 9-8-2009 by Hastobemoretolife]



posted on Aug, 9 2009 @ 02:11 PM
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PG 489 Section 1308 The Government will cover Marriage & Family therapy. Which means they will insert Government into your marriage.


‘‘Marriage and Family Therapist Services
8 ‘‘(jjj)(1) The term ‘marriage and family therapist
9 services’ means services performed by a marriage and
10 family therapist (as defined in paragraph (2)) for the diag
11nosis and treatment of mental illnesses, which the mar
12riage and family therapist is legally authorized to perform
13 under State law (or the State regulatory mechanism pro
14vided by State law) of the State in which such services
15 are performed, as would otherwise be covered if furnished
16 by a physician or as incident to a physician’s professional
17 service, but only if no facility or other provider charges
18 or is paid any amounts with respect to the furnishing of
19 such services.
20 ‘‘(2) The term ‘marriage and family therapist’ means
21 an individual who—
22 ‘‘(A) possesses a master’s or doctoral degree
23 which qualifies for licensure or certification as a
24 marriage and family therapist pursuant to State
25 law;
1 ‘‘(B) after obtaining such degree has performed
2 at least 2 years of clinical supervised experience in
3 marriage and family therapy; and
4 ‘‘(C) is licensed or certified as a marriage and
5 family therapist in the State in which marriage and
6 family therapist services are performed.’’.


True. Strange, but true.



posted on Aug, 9 2009 @ 02:20 PM
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Page 472 Lines 14-17 PAYMENT TO COMMUNITY-BASED Organization - 1 monthly payment to a community-based organization Like ACORN?



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


The claim is true, but it's not necessarily going to be ACORN.


PG 476 19-20 Chapter 35/ title 44, (Privacy of personal records) shall not apply Home Medical Services. ACORN ACCESS



(3) ADMINISTRATION.—Chapter 35 of title 44, United States Code shall not apply to this section.


The section this applies to is SEC. 1302. MEDICAL HOME PILOT PROGRAM.

This claim is true.


PG 494-498 Government will cover Mental Health Services including defining, creating, rationing those services.


The entire section is too long, so I'm only posting the relevant parts:


(2) DEFINITION.—Section 1861 of the Social Security Act (42 U.S.C. 1395x), as previously amended, is amended by adding at the end the following new subsection:
Mental Health Counselor Services
(kkk)(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 the State in which such services are performed, as would otherwise be covered if furnished by a physician or as incident 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 RESPECT TO CONSULTATION WITH A PHYSICIAN.— The Secretary of Health and Human Services shall, taking into consideration concerns for patient confidentiality, develop criteria with respect to payment for mental health counselor services for which payment may be made directly 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 counselor must agree to consult with a patient’s attending or primary care physician in accordance with such criteria.



(7) INCLUSION OF MENTAL HEALTH COUNSELORS AS PRACTITIONERS FOR ASSIGNMENT OF CLAIMS.—Section 1842(b)(18)(C) of the Social Security Act (42 U.S.C. 1395u(b)(18)(C)), as amended by subsection (a)(7), is amended by adding at the end the following new clause:
(viii) A mental health counselor (as defined in section 1861(kkk)(2)).’’.


Claim is partially true. The government will cover mental health services, but I see nothing about defining, creating, or rationing them.



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