934 CAPITAL UNIVERSITY LAW REVIEW [43:933
Medicare and Medicaid Services’ (CMS) 2009 Final Rule, and the Patient
Protection and Affordable Care Act (ACA)—on administrative duties of
small medical practices owned by the independent physicians. Initial
discussions regarding the health care landscape under both the Clinton and
Bush administrations will set a backdrop for the recent health care reform.3
This Comment will then discuss the events surrounding the passage of the
ACA, along with the pertinent provisions affecting small medical
practices.4 This Comment will then analyze the identified ACA provisions
along with provisions of ARRA and CMS’s 2009 Final Rule.5
The discussion and analysis are categorized in two ways.6 Recent
implementations directly affecting administrative tasks of physician
practices are discussed, followed by an analysis of the provisions that will
constructively compel adherence.7 After this analysis, this comment will
analyze the predicted ramifications of these provisions on small private
A. The Clinton Years
In the years leading up to Bill Clinton’s 1992 presidential campaign,
health insurance reform was thrust into the national spotlight.9 The
heightened interest stemmed from a drastic increase in private insurance
premiums and a growing uninsured population.10 Shortly after President
Clinton’s inauguration, he began taking steps towards health insurance
In the month of his inauguration, President Clinton created the
President’s Task Force on National Health Care Reform.12 Despite the
initial haste, it took President Clinton over a year and a half to introduce
3 See infra Part II.A–B.
4 See infra Part II.C.
5 See infra Part III.
6 See infra Parts III.A–B.
7 See infra Parts III.A–B.
8 See infra Part IV.
9 See PAUL STARR, REMEDY AND REACTION 79 (2011).
10 Id. (“From 1987 to 1993, private insurance premiums jumped 90 percent, while
wages increased only 28 percent, with the result that fewer Americans cou ld afford health
coverage. Despite the limited expansion of Medicaid eligibility, the uninsured population
rose to 38.6 million in 1992, an increase of 5.2 million from 1989.”).
11 Id. at 81.