New Medicare Policy Mandates Medical Error Disclosure

Federal officials will reverse a policy that prevented Medicare beneficiaries who filed complaints about the quality of their health care from obtaining data about physicians under investigation, according to an article in the January 2, 2001, issue of The New York Times. Current rules allow patients to request information from investigative findings about a physician, but only with the consent of that practitioner, effectively limiting disclosure to patients. Under the new policy, physicians would no longer have the power to veto disclosure of these findings. Investigators also will have to tell patients who file complaints whether the care they received met “professionally recognized standards of health care” and inform them about actions against physicians or hospitals. While consumer advocates praise the new rules, physician and peer review organizations worry about the repercussions. “If doctors know that anything they provide can potentially be revealed, they will be more worried about lawsuits, penalties and a punitive reaction,” said Dr. Ferdinand Richards, medical director of a Florida peer review group, in the report.

Surgeon General Satcher Warns of Children's Mental Health Crisis

One in 10 American children suffers from mental illness severe enough to cause some level of impairment, warned Surgeon General David Satcher, M.D., in announcing the release of a report on the topic. However, only one in five children receives needed treatment, according to the “Action Agenda for Children's Mental Health.” The report outlines goals and strategies to improve services for children and adolescents with mental health problems. Dr. Satcher stressed the need to educate people who are involved in the care of children—from families to front-line care providers—on how to identify indicators of mental health problems. The full-length text of the action agenda is available online athttp://www.surgeongeneral.gov/cmh/childreport.htm. Print copies of the report are available through the National Institute of Mental Health by telephoning 301-443-4513.

Registry Is Established for Two Types of Muscular Dystrophy

Persons with myotonic dystrophy and facioscapulohumeral dystrophy will benefit from a national research registry established by the National Institute of Arthritis and Musculoskeletal and Skin Diseases and the National Institute of Neurological Disorders and Stroke, both parts of the National Institutes of Health. The registry will be a central information source where researchers can obtain data for analysis. Registry scientists, based at the University of Rochester in New York, will seek out and classify patients diagnosed with the diseases and store their medical and family history data. Enrollment in the registry is expected to begin in the fall. For information about the registry, contact the Neuromuscular Disease Center at the University of Rochester, 716-275-7680; e-mail:lynn_cos@urmc.rochester.edu.

Study of State CHIP Programs Finds Access Problems

In a study of the Children's Health Insurance Program (CHIP) in five states, the Kaiser Family Foundation has found that access to care continues to be a problem for children with special health care needs. Three of the states—California, Connecticut and Utah—enrolled CHIP-eligible children into private health insurance arrangements, and two states—Maryland and Missouri—insured children through Medicaid. However, problems were found with both arrangements in respect to provider availability and service authorization, according to the study. Accessing services for mental health and developmental conditions proved more difficult than accessing services for physical conditions. The report was prepared as part of a larger study focusing on implementation issues during the first year of the CHIP program in the five states. The study can be downloaded athttp://www.kff.org/content/2000/2226/2226.pdf.

HHS Issues Rule on Physician Self-Referrals

Outgoing Department of Health and Human Services (HHS) Secretary Donna Shalala announced final regulations regarding self-referrals by physicians. The regulations will protect beneficiaries and taxpayers from potentially abusive referral patterns, while making it easier for physicians to comply with the law. The law will prohibit a physician from referring Medicare patients for certain health care services to entities with which the physician has a financial relationship. The law permits a number of exceptions. “We've taken a commonsense approach to the law to prevent potentially abusive referrals while recognizing many legitimate business practices and financial arrangements,” Shalala said. “Physicians should be able to structure their business arrangements to comply with the law, while continuing to provide high-quality health care to beneficiaries.” The rule will become effective in January 2002.

NIH Launches Plan for Global AIDS Research

In an attempt to mobilize support in the fight against acquired immunodeficiency syndrome (AIDS), Jack Whitescarver, Ph.D., acting director of the National Institutes of Health (NIH) announced a new initiative and strategic plan for global research on the disease. His announcement came at the NIH World AIDS Day ceremony in December on the NIH campus in Bethesda, Md. Whitescarver said that the new plan would reaffirm the NIH's commitment to AIDS research and increase research efforts to benefit underdeveloped countries. Also at the event was Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, who spoke about recent developments in the study of human immunodeficiency virus. To carry out the plan, the Office of AIDS Research is establishing the Global AIDS Research Initiative. Goals of the initiative include increasing investment in AIDS research, establishing new funding approaches and providing support for long-term research infrastructure. For more information, visithttp://www.nih.gov/od/oar.