New Regulation Requires Physician Supervision of Anesthesia Care

The Centers for Medicare and Medicaid Services, formerly the Health Care Financing Administration, published a final regulation in November mandating physician supervision of anesthesia care in all hospitals and ambulatory surgical centers approved by Medicare and Medicaid. The newly rewritten Condition of Participation changes the previous Medicare rule that would have allowed nurse anesthetists to administer anesthesia without physician involvement before, during, and after surgery. The American Academy of Family Physicians (AAFP), along with many other physician organizations, has advocated for a rule mandating physician supervision. However, the new rule does allow exceptions by the governors of states where the exception is consistent with state law. Implementation of the exception requires governors to consult with the state boards of medicine and nursing and demonstrate that the change is consistent with state law and is in the best interest of the citizens of that state.

Congress Provides Budget for FDA in Fiscal Year 2002

Congress recently approved a record $1.4 billion budget for the U.S. Food and Drug Administration (FDA) in fiscal year 2002, including full funding of the Salaries and Expenses account ($1.345 billion). Increases in the budget will be appropriated as follows: $45.2 million to fund a full 4.6 percent pay raise to meet mandated cost-of-living and pay-related increases for FDA employees; $15 million to protect consumers against the new variant of Creutzfeldt-Jakob Disease, a fatal illness associated with “Mad Cow's Disease”; $10.3 million to prevent substandard food and health care products from reaching markets in the United States; $9.4 million to upgrade food safety by expanding the Food Safety Initiative beyond microbiologic contaminants to chemical and physical food hazards; $10 million to protect patients against adverse effects associated with the use of drugs, biologic agents, and medical devices by improving the FDA's system for monitoring marketed products; $10 million to protect human subjects and research data in clinical trials; $10.1 million to enhance the FDA's scientific potential and operational deficiency through infrastructure improvement; and $13.1 million for current low user fees, including increases to the Prescription Drug User Fees Act and Mammography Quality Standards Act fees, Certification Fund, and Export Fund. For more detailed information on the appropriation of these funds, visit the FDA Web site athttp://www.fda.gov/bbs/topics/NEWS/2001/NEW00782.html.

STOP Stroke Act to Increase Awareness, Improve Quality of Care

The Stroke Treatment and Ongoing Prevention Act (STOP Stroke Act) was introduced in the U.S. House of Representatives in December by Reps. Lois Capps (D-Calif.) and Charles Pickering, Jr. (R-Miss.) to help raise public awareness about stroke and provide resources for states that will improve the quality of care stroke patients receive from health care providers. The STOP Stroke Act emphasizes the importance of prevention of stroke, as well as early intervention and rehabilitation of patients who have had a stroke. The bill establishes a national public education campaign about stroke risk factors, signs, symptoms, and treatment of stroke; forms a grant program to provide states with funding; provides training opportunities for appropriate medical personnel in newly developed approaches for preventing and treating this disease; and creates a research program to identify best practices, barriers, disparities, and measure the effectiveness of public awareness campaigns. Stroke is the third leading cause of death in the United States, annually afflicting over 600,000 persons, of whom 160,000 die. The legislation was introduced to the Senate by Sen. Edward Kennedy (D-Mass.) and Sen. William Frist (R-Tenn.).

HRSA Child Health Report Shows Reduction in Birth Rate Among Adolescents

The Health Resources and Services Administration's (HRSA) recently released Child Health USA 2001, the 12th annual report on the health status and service needs of America's children. The report's most significant finding was a record low birth rate of less than 50 births per 1,000 adolescents aged 15 to 19 years in 1999. Other findings of the report include: the 1999 mortality rate among black infants was more than twice that of white infants (14.6 versus 5.8 deaths per 1,000 infants, respectively); in 2000, nearly 73 percent of children aged 18 to 35 months were fully immunized, with nearly 1 million children still needing one or more doses of vaccine; and between 1998 and 1999, the percentage of uninsured children declined from 15.4 to 13.9 percent, including a reduction from 26.4 to 24.2 percent among children living in poverty. A large portion of Child Health USA 2001 focuses on children with special health care needs. The report found that among children ages five to 14 years, 20 percent of patients with disabilities made four to five physician visits per year, compared with less than 5 percent of nondisabled children. To order a hard copy of the 2001 edition, visit the HRSA Web site athttp://www.ask.hrsa.gov and click on ”Search Publications.”

New Family Medicine Research Journal Is Announced

At a press event in December in San Francisco, the AAFP and four other organizations announced the launch of a new family medicine research journal in late 2002—the Annals of Family Medicine. The four organizations partnering with the AAFP are the American Board of Family Practice, the Association of Family Practice Residency Directors, the North American Primary Care Research Group, and the Society of Teachers of Family Medicine. For more information on the announcement of the new journal, visithttps://www.aafp.org/news/20011204stmt.html.