The Department of Health and Human Services may issue a proposed rule in 2005, although it's questionable that regulators are looking for more feedback at this point, Robert M. Tennant, MGMA's senior policy advisor for health informatics, said in an interview. Such a notice would more likely be designed “to give us a heads-up, rather than ask questions” that could lead to changes in the rule, he said.
Physicians would prefer a staggered implementation date, Mr. Tennant said. In addition, “we would like health plans to be compliant first, so physician practices could have time to get their systems upgraded and complete their testing and staff training,” he said. The goal is to make sure the transition is cost effective and causes as little disruption to the industry as possible, he said.
The new year also brings new leadership to the federal health bureaucracy. At press time, President Bush named Michael O. Leavitt as his pick to lead HHS. Mr. Leavitt served as the administrator of the Environmental Protection Agency in the president's first administration and was previously governor of Utah. Mr. Leavitt must be confirmed by the Senate before assuming his new duties.
At the Centers for Medicare and Medicaid Services, much effort will be focused this year on getting ready to launch the new Medicare prescription drug benefit just 1 year from now.
This year will be the final year for the drug discount cards that were instituted as a bridge to Medicare drug coverage. The lessons of the drug card should prompt Congress to simplify the Part D drug benefit, said Robert M. Hayes, president of the Medicare Rights Center. But conventional wisdom is that Congress won't do anything to address it this year, and will wait until next year to address problems.
Congress should act to ensure that there is one clear Medicare-run drug plan in every region of the country and that Medicare automatically enrolls low-income seniors. Also, Congress should standardize the benefit packages, he said.
A lot of beneficiary education will be needed this year, said John Rother, director of policy and strategy at AARP (formerly the American Association of Retired Persons), especially since the choices will be different across the country.
Medicare officials need to simplify the sign-up process and make sure that there aren't too many choices for beneficiaries, which was one of the major problems with the drug cards, Mr. Rother said.
Joyce Frieden, Jennifer Silverman, and Mary Ellen Schneider contributed to this report.
ACOG Focuses On Liability Reform
Liability reform continues to top the agenda for the American College of Obstetricians and Gynecologists, said President Vivian M. Dickerson, M.D. “We've got probably a better chance of seeing something happen [this year],” she said.
But despite the shifts in the makeup of the Senate this year, ACOG does not believe that the physician community has enough votes to stop a filibuster, she said.
Tort reform that includes a $250,000 cap on noneconomic damages remains the group's first choice for reform, Dr. Dickerson said, but it is willing to consider the range of policy options, including insurance reforms and a medical court.
A cap on noneconomic damages is still a proven solution, she said, but ACOG is willing to consider other options that could decrease insurance premiums.
In addition, ACOG officials plan to work this year on addressing the lack of insurance coverage and access to care, which is especially severe among women. They will also be monitoring coverage of contraception. And the group remains committed to seeing the Food and Drug Administration approve over-the-counter use for emergency contraception across the board, Dr. Dickerson said.
More Doctors in the House—and Senate
Physicians are heading to Capitol Hill this month and not just to lobby. Below are the results of last year's House and Senate races in which a physician ran for office.
House of Representatives
Arkansas, 2nd District:
Florida, 15th District:
Georgia, 6th District: Tom Price, M.D. (R), was unopposed
Georgia, 11th District:
Illinois, 15th District: David Gill, M.D. (D), lost to
Louisiana, 3rd District: Kevin Chiasson, M.D. (R), lost to Charles Melancon (D)
Louisiana, 7th District: Charles Boustany, Jr., M.D. (R), defeated Willie Mount (D)
Michigan, 7th District: Joseph Schwarz, M.D. (R), defeated Sharon Renier (D)
New Jersey, 3rd District: Herb Conaway, M.D. (D), lost to
New York, 24th District: David Walrath, M.D. (Conservative Party), lost to
North Carolina, 12th District: Ada M. Fisher, M.D. (R), lost to
Pennsylvania, 13th District: Melissa Brown, M.D. (R), lost to Allyson Schwartz (D)