Five States Pass Medical Liability Reform Legislation

Illinois became the fifth state this year to pass medical liability reform legislation that promises to provide insurance rate relief to family physicians in upcoming years. The bill caps non-economic damages in medical liability lawsuits at $500,000. Illinois Gov. Rod Blagojevich has announced he will sign the bill into law. Among the Illinois law’s provisions are: public hearings when insurers seek rate increases, assurance that physician apologies cannot be used as evidence in litigation, required disclosure of insurance companies’ actuarial data, and required certification by a board-certified physician that a plaintiff’s claims merit a trial. Illinois joins Georgia, Missouri, South Carolina, and Montana in moving to rein in medical liability insurance rates that have driven many family physicians out of hospital practice and obstetric care.

Physician Supply Increases in States with Caps on Malpractice Awards

States that have capped malpractice lawsuit awards have had a larger growth in the number of practicing physicians over the past three decades than states without such caps, according to a new study from the Agency for Healthcare Research and Quality (AHRQ). Between 1970 and 2000, the number of physicians per 100,000 residents more than doubled in the 13 states that enacted caps on noneconomic damages during the 1980s, compared with only an 83 percent growth rate in the 23 states that did not cap malpractice awards before 2000, according to the study. The dollar amount of the cap also had an impact on the supply of physicians, especially in rural areas. Currently, 27 states have caps on malpractice awards; of those, five have caps with a $250,000 limit. Surgeons and obstetrician-gynecologists, who are most likely to be sued and who often pay the highest malpractice premiums, were most likely to be affected by caps of $250,000. The full report is available online at http://content.healthaffairs.org/cgi/content/abstract/hlthaff.w5.250.

HHS Approves Second Multistate Drug Purchasing Pool

The U.S. Department of Health and Human Services (HHS) has approved plans by three states—Louisiana, Maryland, and West Virginia—to pool their purchasing power to gain deeper discounts on prescription medicines for state programs. This is the second multistate purchasing plan using the framework established by the Centers for Medicare and Medicaid Services (CMS) in 2004. The first multistate plan included five states: Michigan, Vermont, New Hampshire, Alaska, and Nevada. Since its approval, Hawaii, Minnesota, and Montana have joined the original pool. Louisiana estimates that its Medicaid program will save $27 million in 2006 as a result of the arrangement. Maryland reports that its Medicaid program will save $19 million in 2006, and West Virginia expects to save $16 million. Altogether, the pooled purchasing program will cover more than 1.3 million beneficiaries. Although the states are pooling their efforts in buying drugs, they will maintain their own preferred drug lists and exercise clinical oversight of those lists to assure adequate access to needed medicines for their beneficiaries. Because of overlaps on states’ preferred drug lists, pooling across states can lead to larger discounts on certain drugs.

AMA Primer Aims to Help Physicians Improve Immunization Rates

The American Medical Association (AMA) has released a new primer to help physicians improve immunization rates, particularly among minority groups. The free four-booklet primer, “Roadmaps for Clinical Practice, Improving Immunization: Addressing Racial and Ethnic Populations,” provides tools to help physicians ensure that patients are up-to-date with their vaccinations, including immunization schedules for children and adults. Coverage rates for vaccine-preventable diseases among adolescents and adults averages less than 70 percent nationally. Recent data show that influenza vaccine coverage for adults 65 years and older is 70 percent for whites, 52 percent for blacks, and 46 percent for Hispanics. Vaccine-preventable disease is the fifth leading cause of death in patients 65 years and older. The primer is available online at http://www.amaassn.org/go/roadmaps.

AHRQ Awards $8 Million in Grants for Evidence-Based Safety Practices

The AHRQ will award over $8 million in funding for 15 projects designed to help physicians, health care facilities, and patients implement evidence-based patient safety practices. The grants will use interventions that are ready to be implemented; more than one half of the projects focus on reducing medication errors, an area known to be in need of patient safety solutions. Many of the projects will apply interventions to improve health care team communication, which is also a well-known source of errors. In addition, the interventions are designed to be generalizable to other settings of care. A key component of the projects is the development of a set of free, publicly available toolkits for physicians and other health care professionals that will share lessons learned on how to best implement patient safety practices. The projects span a wide spectrum of settings and populations, including small rural facilities and large urban hospitals, clinics, and emergency departments, as well as pediatric and geriatric patients.

SAMHSA Updates Drug and Alcohol Treatment Facility Locator

The Substance Abuse and Mental Health Services Administration’s (SAMHSA’s) updated database of more than 11,000 addiction treatment programs is now available online at http://findtreatment.samhsa.gov. Persons seeking treatment can use the Substance Abuse Treatment Facility Locator to find local drug and alcohol abuse treatment centers. The database includes private and public substance abuse treatment facilities that are licensed, certified, or otherwise approved for inclusion by their state substance abuse agency. The Web site also includes a list of state substance abuse agencies, contact information for those agencies, and links to their Web sites. A link is provided to SAMHSA’s Buprenorphine Physician Locator, which identifies physicians who are authorized to prescribe buprenorphine and is searchable by ZIP code, city, county, and state. Instructions for using the treatment facility locator are available online at http://www.oas.samhsa.gov.

AAFP’s Physicians With Heart Program Heads for Tajikistan this Fall

The American Academy of Family Physicians (AAFP) is seeking physicians interested in participating in this year’s Physicians With Heart airlift from October 21 to 23. This year the former Soviet republic of Tajikistan will receive donated pharmaceuticals and medical instruments. In addition to documenting the safe arrival of the medical aid, AAFP members will present symposia about family medicine, give an update on using the pharmaceuticals, and present courses in advanced life support in obstetrics during the program. The Physicians With Heart delegation also will bring donations to a residential school for orphans and other children in Yavan, Tajikistan. The annual airlift is a partnership of the Academy, AAFP Foundation, and Heart to Heart International, a relief organization based in Olathe, Kan. For more information, call Heart to Heart staff at (405) 787–5200, ext. 104, or visit the Physicians With Heart Web site at https://www.aafp.org/physicianswithheart.xml, or the Heart to Heart Web site at http://www.hearttoheart.org.