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 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.
Joyce Frieden, Jennifer Silverman, and Mary Ellen Schneider contributed to this report.
ACR Eyes Bottom Line, Formularies
The top focus for the American College of Rheumatology this year will be changing physician reimbursement under Medicare, said Joseph Flood, M.D., chairman of ACR's government affairs committee.
Unless there's a significant change in the statute next year, there will be cuts to physicians' pay, he said. This comes at a time when prices for everything in the physician's office have gone up, but reimbursement has not, he said. And the rates set by Medicare affect how other insurers reimburse physicians because they usually follow Medicare's lead.
ACR is also keeping an eye on the list of covered drugs that will be available under Medicare's Part D drug benefit. If the list of drugs is too restrictive, it's not a real step forward, Dr. Flood said.
For example, ACR is concerned that the proposed framework for structuring drug formularies would allow prescription drug plans to exclude important medications like cyclooxygenase-2 (COX-2) inhibitors. “We need to have the opportunity of looking at different drugs for our patients,” Dr. Flood said.
In addition, formularies shouldn't include heavy administrative burdens for physicians, he said.
Rheumatologists will be advocating for passage of the Arthritis Prevention, Control, and Cure Act, which would support programs in arthritis and encourage research. It would also help efforts to recruit people into pediatric rheumatology. The bill was introduced in 2004 and had a lot of support, Dr. Flood said. ACR officials expect that the bill will be reintroduced this year.
ACR will also be focusing on the payments for the purchase of Part B drugs under Medicare. The Centers for Medicare and Medicaid Services recently announced the addition of new codes for drug administration that pay physicians more for performing complex infusion therapy. But this increase is offset by declines in payments for the drugs themselves.
Although ACR favors a system that pays appropriately for the administration of the drug, Dr. Flood said, officials want to ensure that the calculation of the average sales price of the drug is not detrimental to individual physicians who lack the buying power of larger groups.
ACR is concerned about the annual congressional appropriations process. They would like to see more money appropriated for research at the National Institutes of Health and the Department of Veterans Affairs in the area of arthritis.
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)
Pennsylvania, 18th District: Mark Boles, M.D. (D), lost to
Texas, 14th District:
Texas, 26th District:
Washington, 7th District:
Senate
Kentucky: Dan Mongiardo, M.D. (D), lost to
New York: Marilyn O'Grady, M.D. (Conservative Party), lost to
Oklahoma: Tom Coburn, M.D. (R), defeated Brad Carson (D)