ACR Expert Witness Guidelines
New guidelines from the American College of Rheumatology spell out the relevant qualifications and ethical parameters for providing expert witness testimony. Under the new policy, adopted by the college board of directors in February, ACR members must not provide false or misleading testimony or testimony without medical foundation; those who do could be disciplined by the college. Rheumatologists are also obligated to distinguish between an “unfortunate medical outcome” and “actual negligence,” the guidelines state. The new policy also outlines the appropriate qualifications of an expert witness. For example, rheumatologists who serve as experts in court should have a current, valid, and unrestricted medical license issued by any state. The rheumatologist should also be board certified and have practiced rheumatology for no less than 3 years. Those who choose to be expert witnesses should also not accept compensation that is linked to the outcome of the case, the guidelines state. The guidelines were drafted by the ACR Committee on Ethics and Conflict of Interest.
Courts Favor Merck in Vioxx Cases
Merck has had the upper hand in some recent cases over Vioxx. Most recently, a federal judge in New Jersey dismissed a securities class action case filed against Merck by investors related to disclosures about the cyclooxygenase-2 inhibitor. In addition, a plaintiff in Los Angeles has asked the court to dismiss his lawsuit, which had alleged that Vioxx caused his 2004 heart attack. And in March, an Illinois jury sided with Merck against allegations that Vioxx had resulted in the sudden cardiac death of a 52-year-old woman. Merck, which has pursued a strategy of fighting each Vioxx claim in court, has racked up 10 courtroom victories and 5 losses, according to the company. There have also been two mistrials.
CMS Extends NPI Deadline
Physicians and other health care providers who fail to comply with the May 23 deadline to acquire and start using National Provider Identifiers will not be penalized if they can show they deployed a “contingency plan,” the Centers for Medicare and Medicaid Services announced. “Covered entities that have been making a good faith effort to comply with the NPI provisions may, for up to 12 months, implement contingency plans that could include accepting legacy provider numbers on HIPAA transactions in order to maintain operations and cash flows,” said CMS Acting Administrator Leslie Norwalk in a statement. The agency decided to create this grace period “after it became apparent that many covered entities would not be able to fully comply with the NPI standard” by the original deadline, Ms. Norwalk said. The new compliance guideline can be downloaded online from the agency's Web site (
http://www.cms.hhs.gov/NationalProvIdentStand
Penalized by High-Deductible Plans
High-deductible health insurance plans discriminate against women by leaving them with far higher out-of-pocket health bills than men, according to a study from Harvard Medical School, Boston. The study also found that adults aged 45–64 years, those with any chronic condition such as asthma or high blood pressure, and children taking even one medication were likely to suffer financially in high-deductible plans. Under the plans, patients must pay at least $1,050 before their health coverage kicks in. In 2006, the median cost of care (both insurance and out-of-pocket) for women ages 18–64 was $1,844, compared with $847 for men. For middle-aged adults, the mean expenditure was $1,849 for men and $2,871 for women.
Docs Abuse Tax System
Thousands of Medicare Part B physicians, health professionals, and suppliers abused the federal tax system with little consequence, an analysis from the Government Accounting Office found. More than 21,000 Medicare Part B providers—about 5% of the total—had tax debts totaling more than $1 billion, mainly individual income and payroll taxes. Sen. Norm Coleman (R-Minn.), ranking member of the Permanent Subcommittee on Investigations, is using the report to press the Centers for Medicare and Medicaid Services to adopt the federal levy system, which would allow the Internal Revenue Service and the Treasury Department to tap into Medicare payments to providers in order to cover back taxes. “This is a classic case of the right hand not knowing what the left hand is doing,” Sen. Coleman said in a statement, noting that the federal government could have collected between $50 million and $140 million in 2005 if CMS had participated in the levy program. Medicare officials said at a hearing in March that they are working with the IRS and other agencies to manage payment policies.