Bill Would Repeal SGR
Physician groups are hailing the fact that a forthcoming bill from Rep. Nancy Johnson (R-Conn.), chair of the House Ways and Means Subcommittee on Health, would repeal Medicare's sustainable growth rate and base future updates for physician payments on the Medicare Economic Index. At a recent hearing, Mark McClellan, M.D., administrator for the federal Centers for Medicare and Medcaid Services, informed Rep. Johnson that such a measure could come at a high cost: specifically, that MEI-based increases would be $183 billion over 10 years. Her bill seeks to establish a performance measurement and reporting system. C. Anderson Hedberg, M.D., president of the American College of Physicians, testified that Rep. Johnson's bill should provide funding to support quality improvement, so that all physicians would receive a positive update linked to inflation with the opportunity to receive additional reimbursement for participating in performance measurement.
No More Caps in Wisconsin
The Wisconsin Supreme Court's decision to remove a 30-year-old cap on noneconomic damages in malpractice cases opens the door for a medical liability crisis, the American Medical Association said. The court held that the cap, currently set at $445,775, was “unconstitutional beyond a reasonable doubt.” The decision will endanger Wisconsin's stable health care environment, AMA Trustee Cyril M. Hetsko, M.D., said in a statement. Wisconsin medical groups are concerned that the decision “will force a wave of doctors to retire early or stop performing high-risk procedures,” such as delivering babies in rural areas, said Susan Turney, M.D., chief executive officer of the Wisconsin Medical Society.
Information Technology Deficit
Most Medicare fee-for-service outpatient visits in 2001 were to physicians with limited information technology support for patient care, the Center for Studying Health System Change (HSC) reported. Linking Medicare claims data to HSC's national physician survey, researchers found that 57% of Medicare outpatient visits were to physicians in practices that used IT for no more than one of the following five clinical functions: obtaining treatment guidelines, exchanging clinical data with other physicians, accessing patient notes, generating preventive treatment reminders for the physician's use, and writing prescriptions. While half those visits were to physicians using IT to obtain treatment guidelines, the proportion of visits to physicians in practices with IT support for other patient care functions was much lower, falling to 9% for electronic prescribing. While access to “wired” practices was low for all beneficiaries, HSC found there were few differences in access between sicker and healthier beneficiaries.
Air Travel With Medical Oxygen
As of last month, the Federal Aviation Administration began allowing people with respiratory disease to bring their own portable oxygen concentrators on board commercial flights. While pleased with the ruling, the American Thoracic Society's President Peter D. Wagner, M.D., expressed concerns that the rule allows but does not require airlines to let passengers use portable oxygen concentrators. The Department of Transportation should use its regulatory authority under the Air Carrier Access Act to ensure portable oxygen concentrators can be used on all commercial passenger planes, he said.
Widespread Ethics Problems
More than 40 employees at the National Institutes of Health were found to have violated the agency's conflict of interest rules, according to the House Energy and Commerce Committee. Last year, the Committee identified a sample of 81 NIH scientists who were hired by drug companies between 1999 and 2004 but whose activities were not listed in NIH reports to the Committee. An NIH review, which was reported to the Energy and Commerce Committee, cleared 37 of the scientists but found that 44 had violated one or more of the NIH rules, including reporting income on financial disclosure forms, taking personal leave to do private work, and seeking prior approval for consulting arrangements. Of the 44, 36 are still employed at NIH and have been referred for possible disciplinary action, and 9 of the 36 are facing investigation of possible criminal violations by the Health and Human Services Office of Inspector General. After months of congressional hearings on possible financial conflicts of interest by NIH employees, the agency issued an interim final regulation earlier this year that tightens restrictions on outside consulting arrangements with industry.
Soft Drink Wars
The Center for Science in the Public Interest is targeting the public's consumption of soft drinks, something the group labels as “liquid poison.” Carbonated soft drinks are the single biggest source of calories in the American diet—and frequent consumption is a likely contributor to overweight and obesity, the group stated. In a petition, CSPI called on the Food and Drug Administration to require a series of rotating health notices on containers of all nondiet soft drinks (carbonated and noncarbonated) that contain more than 13 g of refined sugars per 12 ounces. In a statement, Susan Neely, president and chief executive officer of the American Beverage Association, thought the CSPI's proposed warning labels on soft drinks patronized consumers and lacked common sense. “Even skim milk and thousands of other food products could potentially fit into a CSPI labeling scheme because of the sugars contained in those products,” she said.