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Underage Drinking Legislation

Congress has passed legislation aimed at curbing teen drinking and better coordinating the efforts of federal agencies in this area. The legislation, the Sober Truth on Preventing (STOP) Underage Drinking Act (H.R. 864), was expected to be signed by the president at press time. The bill authorizes grants to prevent binge drinking by college students and calls for research on the scope of underage drinking. The legislation has support from both the medical community and the alcohol industry. The National Beer Wholesalers Association said the bill provides federal, state, and local governments with the tools they need to help prevent underage drinking. And the American Medical Association praised Congress for passing the first national underage drinking prevention legislation. “Alcohol is the No. 1 drug of choice for young people, and the age of initiation keeps getting younger. Alcohol causes memory and learning impairment, possibly irreversible in the adolescent brain,” Dr. Ronald M. Davis, AMA president-elect, said in a statement.

CMS Adds RVUs for Four Codes

In November, the Centers for Medicare and Medicaid Services added relative value units (RVUs) to four CPT codes, ending months of negotiations between pediatricians and the agency. The American Academy of Pediatrics and the AMA had recommended that RVUs be included for the following codes: 92551 for hearing screening, 99173 for vision screening, 99339 for care plan oversight of 15–29 minutes/month, and 99340 for care plan oversight of 30 or more minutes/month. AAP first met with CMS in May; when the proposed physician fee schedule was issued in September, the four codes were not included. After discussions, the codes were included in the final fee schedule. “Although most pediatricians are not paid by Medicare, 75% of private payers use Medicare rates to set their physician payments,” said Dr. Jay Berkelhamer, AAP President, in a statement. The AAP urges pediatricians to make sure that the new codes are recognized by private payers.

Congress Tackles Prematurity

Members of Congress gave their stamp of approval to legislation aimed at expanding research into prematurity at the end of its last session. The Prematurity Research Expansion and Education for Mothers who deliver Infants Early (PREEMIE) Act (S. 707) would establish a grant program to educate health professionals and the public about the signs of preterm labor. The grants would also provide support for parents caring for a premature baby in a neonatal intensive care unit. The legislation, which at press time was expected to be signed by President Bush, also calls for expanded research at the Centers for Disease Control and Prevention and studies focused on the relationship between prematurity and birth defects and developmental disabilities. The bill was praised by the March of Dimes. “In one of its most important provisions, the bill authorizes a Surgeon General's conference at which scientific and clinical experts from the public and private sectors will sit down together to formulate a national action agenda designed to speed development of prevention strategies for preterm labor and delivery,” Jennifer L. Howse, Ph.D., president of the March of Dimes, said in a statement.

Expanding Autism Research

President Bush recently signed legislation that authorizes a major expansion of autism research, education, and early detection efforts. The Combating Autism Act of 2006 (S. 843) calls for spending nearly $1 billion on activities and research related to autism spectrum disorders over the next 5 years. The new law also calls for research that would aid in developing and validating screening tools for autism spectrum disorders. “As the prevalence of autism grows, the odds are that every American will know a family who will directly benefit from the programs and research made possible by this legislation,” Jon Shestack, cofounder of Cure Autism Now, said in a statement.

Solitary Substance Abuse

Eighth-graders who used alcohol, cigarettes, and marijuana while alone were more likely to have health problems later in life, compared with adolescents who were social users only, according to a study from researchers at the Rand Corporation. Solitary drinkers were also less likely to graduate from college, more likely to engage in predatory violence, and more likely to have a history of drug and alcohol problems by age 23 than were social drinkers. The researchers recruited more than 6,500 seventh-grade students in California and Oregon and assessed their substance use and other social factors through age 23. “While substance use is a problem in itself, these findings suggest that risk among solitary users is especially high,” Joan Tucker, a Rand psychologist and lead author of the study, said in a statement. “Solitary use is a warning sign that youth will be less productive and have more problems as young adults—more problems, even, than others who also used substances during childhood.” The researchers advised that asking adolescent patients whether they engage in substance abuse when alone is an easy way to target substance abuse prevention efforts at those with the highest risk. The study was published in the December issue of Psychology of Addictive Behaviors.

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