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White House Woos Doctors for Meeting on Health Care Law

By Jane Norman, CQ HealthBeat Associate Editor

December 15, 2010 -- White House officials are holding a meeting with health care providers—apparently mostly physicians—to "exchange ideas on areas in need of attention" in connection with the health care law, according to a letter sent out to invitees that was circulated by Republicans on the Hill.

Leading physician organizations such as the American Medical Association (AMA) backed the law and were viewed as key allies in its passage. But since then doctors have been unhappy about cuts in Medicare physician reimbursements and overdue Medicare payments. The cuts have been postponed for a year but doctors remain worried about such areas of the law as the formation of accountable-care organizations, which some fear will bring independent physicians under the control of hospitals or large provider groups.

The speakers at the meeting are expected to be Donald M. Berwick, administrator of the Centers for Medicare and Medicaid Services, and Ezekiel J. Emanuel, special adviser for health policy in the Office of Management and Budget. The meeting apparently is the first in a series.

Julius Hobson, a former AMA lobbyist who now serves as a senior policy adviser to the law firm Polsinelli Shughart, said he thinks the White House wants to meet with doctors to smooth implementation of the overhaul law.

Hobson said it is significant that invitations were sent to "community physicians," suggesting that the administration is particularly concerned about primary-care physicians. Their ranks must be strengthened if Americans who obtain insurance under the law are going to get actual access to care, analysts say.

Hobson also noted that doctors are worried about taking a back seat to hospitals in accountable-care organizations created under the law. He said hospitals are busy buying physician practices. "There's a lot of concern in the physician community that they won't be leaders in an ACO," Hobson said.

The White House and Department of Health and Human Services did not respond to a request for a list of the organizations invited. Officials also did not say whether the meeting will be open for press coverage. A spokesman said in a statement that the meeting is intended to bring together stakeholders as the law gradually is put in place (PL 111-148, PL 111-152).

"The administration is focused on implementing the health reform law, and we will continue to seek input from experts across the country," said Nick Papas, spokesman for the White House Office of Health Reform. "Just as we engage with members of Congress, we believe it's critical to seek input from providers and leaders in the medical community. Listening to doctors, academic leaders and other experts has been and will continue to be one of our top priorities."

Republicans used the letter to launch yet another attack on Berwick, a regular target of criticism for the GOP, as well as closed meetings. Chris Jacobs, a health policy analyst for the Senate Republican Policy Committee, in a memo asked if lobbyists would be present and whether C-SPAN cameras would be allowed in the room.

Obama during his campaign said that when the health care law was written, "we'll have the negotiations televised on C-SPAN, so that people can see who is making arguments on behalf of their constituents, and who are making arguments on behalf of the drug companies or the insurance companies."

The White House does have a policy on voluntary disclosure of visitor records, but in general disclosures are made on a monthly basis.

The White House letter, sent under Emanuel's signature, said he and Berwick will be hosting the meeting "to provide an update on delivery system reforms."

Emanuel added, "While it will be a short briefing, the primary focus of this meeting will be an open dialogue, so all participants are invited to come prepared with any questions or concerns they would like to raise."

He asks that each organization invited nominate two of its "top community physicians" to attend.

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