HR3962 : Division C

Once again, I apologize for the brevity of each summary post, but I am hoping I’ll have a little time during the debate on the House floor to discuss some of these provisions in more detail. Here we go with Division C.

Section 2201 establishes the National Health Service Corps, just like HR 3200 did, which will require any member of the Corps to perform “half-time” clinical practice as a contractual obligation under the new scholarship program and/or loan repayment program. There’s nothing like involuntary servitude to make a country stronger.

Not only does HR3962 hail the return of involuntary servitude, but it also opens the door to health care discrimination on a wide-reaching scale in Section 2301.

The term ‘health disparities’ includes health and health care disparities and means population-specific differences in the presence of disease, health outcomes, or access to health care. For purposes of the preceding sentence, a population may be delineated by race, ethnicity, primary language, sex, sexual orientation, gender identity, disability, socioeconomic status, or rural, urban, or other geographic setting, and any other population or subpopulation determined by the Secretary to experience significant gaps in disease, health outcomes, or access to health care.

In other words, the Secretary of Health and Human Services will be permitted to use race, ethnicity, sex, sexual orientation, age, and any other criteria he/she wants while determining your access to health care. Every other government entity is prohibited from discrimination, yet HR3962 doesn’t just open that door, it props it open with a 1,990 page bill.

Section 2502 states,

A hospital described in subparagraph (L), (M), (N), (R), (S), or (T) of paragraph (4) shall not obtain covered outpatient drugs through a group purchasing organization or other group purchasing arrangement.

If hospitals are not permitted to participate outpatient drugs in group purchasing organizations, does this mean they have to do so independently, and if so, why? What is the purpose or motive for disallowing such participation?

Section 2502 also sets the requirements for improvement in the 340B program integrity. The 340B program is the drug pricing program which resulted from enactment of Public Law 102-585, the Veterans Health Care Act of 1992, which is codified as Section 340B of the Public Health Service Act. Section 340B limits the cost of covered outpatient drugs to certain federal grantees, federally-qualified health center look-alikes and qualified disproportionate share hospitals. Significant savings on pharmaceuticals may be seen by those entities that participate in this program.

This section of the bill authorizes the Secretary of Health and Human Services

to verify the accuracy of ceiling prices calculated by manufacturers under subsection (a)(1) and charged to covered entities

Nothing in this section will prohibit the Secretary from abusing their power to make this decision, and nothing in this section provides for any type of oversight to ensure that the Secretary is acting in the best interest of the American taxpayer.

School based health clinics will be established using grants defined in Section 2511.

Funds awarded under a grant under this section–

(1) may be used for–

(A) providing training related to the provision of comprehensive primary health services and additional health services;

(B) the management and operation of SBHC programs, including through subcontracts; and

(C) the payment of salaries for health professionals and other appropriate SBHC personnel; and

(2) may not be used to provide abortions.

While section 2511 clearly prohibits “in school abortions”, it does not prevent or prohibit the distribution of materials regarding abortion or access to information on accessing facilities which provide abortions.

Why exactly do we need school based health clinics anyway? Shouldn’t schools teach children, and medical facilities treat them?

Section 2513 requires “FEDERALLY QUALIFIED BEHAVIORAL HEALTH CENTERS” to offer a wide range of services.

Make available to individuals served by the center, directly, through contract, or through linkages with other programs, each of the following:

(i) Adult and youth peer support and counselor services.

(ii) Family support services for families of children with serious mental disorders.

(iii) Other community or regional services, supports, and providers, including schools, child welfare agencies, juvenile and criminal justice agencies and facilities, housing agencies and programs, employers, and other social services.

(iv) Onsite or offsite access to primary care services.

(v) Enabling services, including outreach, transportation, and translation.

(vi) Health and wellness services, including services for tobacco cessation.

In other words, these newly named “federally qualified behavioral health centers” will be required to offer counseling services, family support for families of children with serious mental disorders, access to schools and a wide range of other public services, as well as access to primary care services and health and wellness services including services for tobacco cessation.

Which health and wellness services would be offered that wouldn’t be covered by a primary care service provider? Is this an implication of some other health service that normally isn’t performed inside hospitals and other medical facilities? And since when is smoking a mental health issue?

Section 2534 allows community organizations to provide services to low-income and uninsured patients and nothing in the section prevents a community-based collaborative care network from providing care to individuals.

Section 2525 establishes the “Community Based Overweight and Obesity Prevention Program which will be administered by eligible entities which will be awarded grants to run the program.

(a) Program- The Secretary shall establish a community-based overweight and obesity prevention program consisting of awarding grants and contracts under subsection (b).

(b) Grants- The Secretary shall award grants to, or enter into contracts with, eligible entities–

(1) to plan evidence-based programs for the prevention of overweight and obesity among children and their families through improved nutrition and increased physical activity; or

(2) to implement such programs.

These grants will be awarded to “representatives of public and private entities that have a history of working within and serving the community. Think ACORN.

As if this bill wasn’t painful enough, Section 2562 actually deals with pain research. Apparently HR3962 establishes an Interagency Pain Research Coordinating Committee. Just thinking of the bureaucracy of this new committee is painful. You may want to read this section to learn how the committee will be comprised, because this committee will be making decisions that could affect your treatment if you have chronic pain.

Just what you need when you’re in pain. A committee deciding if you have had enough medication, whether or not your pain threshold has changed, and whether or not your treatment protocol needs to be changed. You know, for your well-being, since you’re in pain and all.

Believe me, the fun does not stop there. Under Section 2572, the Secretary of Health and Human Services will be regulating every menu in America.

The Secretary shall establish by regulation standards for determining and disclosing the nutrient content for standard menu items that come in different flavors, varieties, or combinations, but which are listed as a single menu item, such as soft drinks, ice cream, pizza, doughnuts, or children’s combination meals, through means determined by the Secretary, including ranges, averages, or other methods.

In addition to menus, vending machines will also be tightly regulated.

In the case of an article of food sold from a vending machine that–

(I) does not permit a prospective purchaser to examine the Nutrition Facts Panel before purchasing the article or does not otherwise provide visible nutrition information at the point of purchase; and

(II) is operated by a person who is engaged in the business of owning or operating 20 or more vending machines,

the vending machine operator shall provide a sign in close proximity to each article of food or the selection button that includes a clear and conspicuous statement disclosing the number of calories contained in the article.

But that’s not all. In addition to deciding which information should be required to appear on menus and next to vending machines, the Secretary of Health and Human Services will also be responsible for the standardization of recipes, methods of preparation, serving size, menu items, space on menus, menu boards, and even human error. Read it if you don’t believe me.

In promulgating regulations, the Secretary shall–

(aa) consider standardization of recipes and methods of preparation, reasonable variation in serving size and formulation of menu items, space on menus and menu boards, inadvertent human error, training of food service workers, variations in ingredients, and other factors, as the Secretary determines; and

(bb) specify the format and manner of the nutrient content disclosure requirements under this subclause.

That Secretary of Health and Human Services must be a talented person. In addition to administering the entire Health and Human Services department of the government, they will also need to know everything there is about health care, pharmaceutical drugs, food, recipes, menus, vending machines, and who knows what else by the time we get done here.

Getting back to health care, yeah I know, it’s such a stretch now isn’t it? Section 2581 amends the Public Health Service Act by requiring the automatic enrollment of employees into a health care plan by the employer, and the inability to disenroll except once per year during an annual enrollment period. If I remember correctly, this same provision appeared in HR 3200.

It’s getting late and my mind is turning to mush, but I’m almost done with this review of HR3962. All that remains is Division D, which will be following this post within the next couple hours. We’ll pick up with Division D, “Indian Health Care Improvement” on page 1635 then.