You've got some VAWA on your Obamacare

From Obamacare...

SEC. 10212. ESTABLISHMENT OF PREGNANCY ASSISTANCE FUND.

(a) In General- The Secretary, in collaboration and coordination with the Secretary of Education (as appropriate), shall establish a Pregnancy Assistance Fund to be administered by the Secretary, for the purpose of awarding competitive grants to States to assist pregnant and parenting teens and women.
(b) Use of Fund- A State may apply for a grant under subsection (a) to carry out any activities provided for in section 10213.

SEC. 10213. PERMISSIBLE USES OF FUND.

(d) Improving Services for Pregnant Women Who Are Victims of Domestic Violence, Sexual Violence, Sexual Assault, and Stalking-

(1) IN GENERAL- A State may use amounts received under a grant under section 10212 to make funding available to its State Attorney General to assist Statewide offices in providing--

(A) intervention services, accompaniment, and supportive social services for eligible pregnant women who are victims of domestic violence, sexual violence, sexual assault, or stalking.
(B) technical assistance and training (as described in subsection (c)) relating to violence against eligible pregnant women to be made available to the following:
(i) Federal, State, tribal, territorial, and local governments, law enforcement agencies, and courts.
(ii) Professionals working in legal, social service, and health care settings.
(iii) Nonprofit organizations.
(iv) Faith-based organizations.

(2) ELIGIBILITY- To be eligible for a grant under paragraph (1), a State Attorney General shall submit an application to the designated State agency at such time, in such manner, and containing such information, as specified by the State.
(3) TECHNICAL ASSISTANCE AND TRAINING DESCRIBED- For purposes of paragraph (1)(B), technical assistance and training is--

(A) the identification of eligible pregnant women experiencing domestic violence, sexual violence, sexual assault, or stalking;
(B) the assessment of the immediate and short-term safety of such a pregnant woman, the evaluation of the impact of the violence or stalking on the pregnant woman's health, and the assistance of the pregnant woman in developing a plan aimed at preventing further domestic violence, sexual violence, sexual assault, or stalking, as appropriate;
(C) the maintenance of complete medical or forensic records that include the documentation of any examination, treatment given, and referrals made, recording the location and nature of the pregnant woman's injuries, and the establishment of mechanisms to ensure the privacy and confidentiality of those medical records; and
(D) the identification and referral of the pregnant woman to appropriate public and private nonprofit entities that provide intervention services, accompaniment, and supportive social services.

(4) ELIGIBLE PREGNANT WOMAN- In this subsection, the term `eligible pregnant woman' means any woman who is pregnant on the date on which such woman becomes a victim of domestic violence, sexual violence, sexual assault, or stalking or who was pregnant during the one-year period before such date.

(e) Public Awareness and Education- A State may use amounts received under a grant under section 10212 to make funding available to increase public awareness and education concerning any services available to pregnant and parenting teens and women under this part, or any other resources available to pregnant and parenting women in keeping with the intent and purposes of this part. The State shall be responsible for setting guidelines or limits as to how much of funding may be utilized for public awareness and education in any funding award.

In other words, finding evidence of abuse in pregnant women, and referring pregnant women to agencies specializing in handling abuse cases, will earn federal dollars for medical facilities.
So what happens when that's applied to the hospital environment?


From Hospitals: The cost of admission, aired Dec. 2, 2012:

Health Management Associates owns 70 hospitals in 15 states. It's thrived buying small, struggling hospitals in non-urban areas, turning them into profit centers by filling empty beds. Generally speaking, the more patients a hospital admits, the more money it can make, a business strategy that HMA has aggressively pursued.

Steve Kroft: Did you feel the hospital was putting pressure on doctors to admit people?

Nancy Alford: Yes.

Steve Kroft: For what reason?

Nancy Alford: Money.

Steve Kroft: You're sure of that?

Nancy Alford: Uh-huh (affirm).

Until she was fired, Nancy Alford was director of case management at the HMA hospital in Mesquite, Texas, where she oversaw the auditing of patient records and signed off on the accuracy of bills sent to Medicare and Medicaid. She'd never met former HMA doctors Jeff Hamby, Cliff Cloonan, and Scott Rankin until we brought them together in New York to discuss their experiences at HMA.

Scott Rankin: What's really remarkable is we're from very different areas of the country. Yet, the pressures placed upon the emergency physicians and the mechanism in place to enforce those procedures and policies, exactly the same.

Cliff Cloonan is a retired colonel who spent 21 years as an Army doctor before joining the Carlisle Regional Medical Center in Pennsylvania as the assistant emergency room director. Dr. Scott Rankin worked in the same department. Both say they were told by HMA and its ER staffing contractor, EmCare, that if they didn't start admitting more patients to the hospital, they would lose their jobs.

We've seen how federal incentives effect the level of honesty in efforts to assign and collect child support at the state level, and we've seen how federal funding incentives have effected law enforcement, court systems, and the domestic violence victim's advocacy industry. Now, there's an incentive for medical facilities to find domestic violence victims to serve that is similar to the incentive offered to law enforcement and the courts to find domestic violence victims to protect. How long will it take before hospital administrators start pressuring doctors to "see" abuse where abuse is not present?