Mike Leavitt

New medical refusal rule may go well beyond abortion decisions

Anne Zieger — Tue, 02 Dec 2008 08:51:21 -0500

For years, federal law has permitted doctors and nurses the right to refuse to perform abortions, and things have more or less stood that way. Earlier this year, however, the Bush Administration stepped into the issue. Federal officials argued that new rules that had just been issued by the American College of Obstetricians and Gynecologists--requiring OB/GYNs to refer patients for procedures they didn't want to perform themselves--were unfair to physicians. In fact, outgoing HHS Secretary Mike Leavitt got involved, asking not only ACOG, but also the profession's certifying board, to hold off.

The Bush Administration is involving itself in medical decision-making issues again, however, and this time it has larger goals. The outgoing leadership is planning to announce a much-broader "right of conscience" rule allowing facilities, doctors, nurses, pharmacists and other healthcare workers to refuse to be involved in procedures to which they object. This could extend current rules beyond abortion, to birth control and artificial insemination. The new rules would also clarify that healthcare workers can refuse to give advice or information to patients who might potentially seek an abortion.

HHS intends the rule to apply to any entity that receives federal funds--a whopping 584,000 providers--including hospitals, doctor's offices and pharmacies.

To learn more about this issue:
- read this piece from the Los Angeles Times

Related Articles:
OB/GYN referral guidelines stir controversy
HHS supports stronger 'provider conscience' options
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Born-again medicine

Medicaid spending to increase substantially in the next decade

Dan Bowman — Mon, 20 Oct 2008 15:39:31 -0400

According to a report released last Friday, Medicaid spending will grow at an average rate of 7.9 percent annually over the next 10 years, ultimately reaching a cost of $674 billion per year by 2017. Consequently, spending on Medicaid benefits will reach $4.9 trillion in the next decade.

What does all of this mean? Health and Human Services Secretary Mike Leavitt believes the increased spending trend will become "unsustainable for both federal and state governments," adding that the nation's "most vulnerable citizens" could be at risk. The report shows that the areas where spending has increased the most--and the fastest--are nursing home care and community-based care.

For more:
- read this Wall Street Journal article
- read the report (.pdf)

11 more communities tapped by HHS collaborate to share quality, price info

Anne Zieger — Fri, 05 Sep 2008 09:53:37 -0400

Joining 14 communities already participating in the program, 11 new communities have been named by HHS as Chartered Value Exchanges, collaboratives focused on improving care quality, and sharing quality and price data freely. This round of exchanges will be based in several cities acrsoss the U.S., including York, PA; San Francisco; Denver; Middletown, CT; Louisville; Cincinnati; Kansas City and Glen Allen, VA. The Chartered Value Exchange participants will get information from Medicare measuring quality of care that physicians provide to patients. The groups will possibly use the Medicare data in tandem with private sector data to produce a more comprehensive guide to quality of care in their communities. Other communities can still apply to become CVEs, but they only have between Sept. 15 and Oct. 30, 2008.

To learn more about this program:
- read this Healthcare Finance News piece

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Live from HiMSS08: Mike Leavitt touts local health exchanges
Consumers support health data exchange

OB/GYN referral guidelines stir controversy

Thu, 20 Mar 2008 07:59:58 -0400

New guidelines from the American College of Obstetricians and Gynecologists have stirred up controversy, with parties including the Bush Administration weighing in to complain that they may be inappropriate. Under the ACOG guidelines, OB/GYNs are required to make referrals to other doctors if patients want procedures they won't wish to perform themselves, notably abortions and emergency contraception. However, it's not clear whether a specialist could lose certification for refusing to make such referrals. Now, a war of words has erupted between pro-choice and pro-life physicians within the OB/GYN community over whether such standards are appropriate.

At this point, HHS Secretary Mike Leavitt has stepped in, sending a letter to both ACOG and the profession's certifying board, the American Board of Obstetrics and Gynecology. In his letter, Leavitt said that he was concerned that qualified OB/GYNs could lose their certification over refusing to do something they consider unethical. However, this may be a moot point, as federal law has protected physicians who don't want to perform abortions--or refer to others that do--since 2004.

To learn more about the controversy:
- read this NPR piece