California Limits CT Radiation
California Gov. Arnold Schwarzenegger (R) has signed a bill that limits the radiation dose provided in computed tomography scans. The new law comes in the wake of patients at at least six California hospitals having received up to eight times the normal radiation from their CT scans. Beginning in 2012, technicians must record the radiation dose from every scan, and radiology reports must include that information. Each year, a medical physicist will be required to confirm each CT machine's readings. Beginning in 2013, medical imaging facilities need to report to the state any medical injury from CT radiation and any instance in which certain doses have been exceeded.
Off-Label Promotion Targeted
The Food and Drug Administration is warning that it will pursue disciplinary action against physicians, other practitioners, and manufacturers that promote medical devices for off-label uses, according to the Gray Sheet. The newsletter (published by Elsevier, as is this newspaper) reported that Deborah Wolf, a regulatory counsel in the Center for Devices and Radiological Health's Office of Compliance, said that the agency has been sending warning letters to physicians and others. An FDA staff member gave an example of a violation: a laser that is FDA approved for osteoarthritis treatment being promoted for killing toe fungus. “FDA doesn't regulate the practice of medicine but does in fact regulate promotion,” Ms. Wolf said. She spoke to the industry group called the Food and Drug Law Institute.
Stop-Smoking Coverage Expanded
Physicians will be reimbursed for counseling any Medicare patient about smoking cessation, not just those with tobacco-related illness, under new guidelines approved by the CMS. Previously, a patient needed to at least show signs of illness related to smoking before Medicare would pay. Now, any smoker covered by Medicare can have up to eight smoking cessation sessions per year from a physician or another Medicare-recognized health practitioner, CMS said. American Medical Association President Cecil Wilson applauded the coverage expansion. “More than 400,000 Americans die needlessly every year as a direct result of tobacco use,” Dr. Wilson said in a statement. “This expansion of coverage takes an important step toward helping Medicare patients lead healthier, tobacco-free lives.”
Productivity, Ownership Linked
Billable work per patient appears to be increasing only at physician groups under the “private practice model,” but expenses have also grown, according to a Medical Group Management Association study. Over the past 5 years, relative value units per patient rose by 13% at private medical practices, but declined nearly 18% at practices owned by hospitals or integrated delivery systems, analysts found. Meanwhile, operating costs for private practices increased by nearly 2% last year, in contrast to a slight decline for practices owned by the larger entities. MGMA attributed part of the increase in expenses for private practices to the cost of implementing electronic health record systems. “In the private practice model, EHR incentives have provided a catalyst for practices to purchase systems and deploy electronic health records, therefore increasing the practice's information technology expenditures,” said Kenneth Hertz, a principal with MGMA Health Care Consulting Group, in a statement.
Outcomes Research Funded
HHS will provide grants totaling nearly $17 million for “patient-centered outcomes research” (PCOR), which focuses on treatments and strategies that might improve health outcomes from the patient's point of view. Most of the announced grants will support outcomes research in primary care, HHS said. As part of the grant program, five health organizations will attempt to show that providers and academic institutions can partner on PCOR. Each organization – in California, Illinois, Massachusetts, New York, and Oregon – will receive about $2 million over 3 years to create a national network for evaluating the patient-centered approach in patient populations that are not always adequately represented in other studies, according to HHS. “Patient-centered outcomes research can improve health outcomes by developing and disseminating evidence-based information to patients, providers and decision-makers about the effectiveness of different treatments,” said HHS Secretary Kathleen Sebelius in a statement.
Claims Processors Deemed So-So
About 70% of physicians reported they were satisfied with the contractors who process their Medicare claims, in the annual Centers for Medicare and Medicaid Services survey on contractor performance. Meanwhile, 14% of physicians said they were neither satisfied nor dissatisfied, and more than 15% said they were dissatisfied with contractor performance. Hospitals were slightly happier, with three-quarters saying they were satisfied with contractor performance. Improvements in several areas would increase provider satisfaction, according to the CMS. For example, providers said they don't like having to make multiple inquires of claims processors to resolve problems. They also want better information through an automated telephone system, promptly returned calls, and consistently correct information.