HHS Outlines Principles for Reauthorization of Ryan White CARE Act

The U.S. Department of Health and Human Services (HHS) has called on Congress to reauthorize the Ryan White Comprehensive AIDS Resources Emergency Act with five key principles that HHS says will make the legislation more responsive to patients in need. These principles include serving the neediest patients first; focusing on life-saving and life-extending services; and increasing prevention efforts, accountability, and flexibility. Under this plan, funding would be distributed by severity of need, unspent funds would be reallocated to state antiretroviral drug assistance programs with the greatest need, a list of core medical services would be developed to prioritize federal funding, states and local providers would be required to increase coordination of delivery of care, and states would be required to implement routine voluntary human immunodeficiency virus (HIV) testing in public facilities. The act funds primary health care and support services that provide medical care, antiretroviral treatments, and counseling and testing for patients with HIV; it is the federal government’s largest HIV treatment program. Additional information is available online at http://www.hhs.gov/news/press/2005pres/ryanwhite.html.

CDC Finds Record Immunization Coverage Rates in U.S. Children

Childhood immunization coverage rates in the United States continue at record high levels, according to data from the CDC. Approximately 81 percent of the nation’s 19-to-35-month-old children have received all recommended vaccinations, the first time that coverage for the baseline series of vaccines (i.e., 4:3:1:3:3 series) exceeded 80 percent. In 2004, coverage for the 4:3:1:3:3 series, which includes four doses of diphtheria, tetanus, and pertussis vaccines; three or more doses of polio vaccine; one or more doses of measles-containing vaccine; three or more doses of Hib vaccine, which can prevent meningitis and pneumonia; and three doses of hepatitis B vaccine, increased to 80.9 percent, compared with 79.4 percent in 2003, 74.8 percent in 2002, 73.7 percent in 2001, and 72.8 percent in 2000. The CDC also found significant increases in the percentage of young children receiving varicella and pneumococcal conjugate vaccines, two relatively recent additions to the childhood immunization schedule. National coverage with varicella vaccine increased to 87.5 percent in 2004 from 84.8 percent in 2003. Coverage for three or more doses of pneumococcal conjugate vaccine increased to 73.2 percent in 2004 from 68.1 percent in 2003. Additional information on the CDC report is available online at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5429a1.htm.

Registration Open for STFM’s Conference on Patient Education

Online registration is now available for the 2005 Conference on Patient Education, sponsored by the Society for Teachers of Family Medicine (STFM) and the AAFP. This year’s conference is scheduled for November 17 through 20 in Orlando, Fla., and will focus on childhood and adolescent obesity. Additional information about the conference is available online at http://www.stfm.org/PatientEducConf/PE05/index.htm.

Bill Would Stop Medicare Pay Cuts, Institute Pay-for-Performance

Medicare would increase physician payments by 1.5 percent for 2006, permanently fix the formula by which those payments are calculated, and implement a pay-for-performance system under a new bill proposed in the House of Representatives. The legislation, the Medicare Value-Based Purchasing for Physicians’ Services Act of 2005 (H.R. 3617), would eliminate the sustainable growth rate formula on which current physician payment is calculated and replace it with the Medicare economic index. In 2007, physician payment would be tied to meeting performance measures. A one-time, 1.5 percent payment increase in 2006 would help stabilize medical practices’ incomes and increase the feasibility of investing in the technology, staff, and training necessary to participate in pay-for-performance. The bill calls for implementing pay-for-performance by first turning to a consensus-building organization, such as the National Quality Forum, which would establish efficiency and quality measures after reviewing care standards submitted by medical specialty organizations. In 2007, Medicare would base physician payment on the Medicare economic index minus 1 percent. Physicians who meet quality and efficiency standards established by HHS would earn the additional 1 percent. The full text of the bill is available online at http://thomas.loc.gov.

National Project Launched To Reduce Surgical Complications by 25 Percent

A group of public and private U.S. health care organizations has launched a project to reduce surgical complications by 25 percent by the year 2010.The Surgical Care Improvement Project (SCIP) is designed to provide hospitals, physicians, nurses, and other health care professionals with effective strategies to reduce four common surgical complications: surgical wound infections, blood clots, perioperative heart attack, and ventilator-associated pneumonia. SCIP focuses on process measures, such as the appropriate use of antibiotics near the time of surgery and the use of beta blockers to prevent cardiovascular events. The project includes the Agency for Healthcare Research and Quality, American College of Surgeons, American Hospital Association, American Society of Anesthesiologists, Association of periOperative Registered Nurses, Centers for Disease Control and Prevention (CDC), Centers for Medicare and Medicaid Services, Institute for Healthcare Improvement, Joint Commission on Accreditation of Healthcare Organizations, and Veterans Health Administration. Additional information about the project is available online at http://www.medqic.org/scip.

CMS Sets October 1 Deadline for Non-HIPAA–Compliant Claims

The Centers for Medicare and Medicaid Services (CMS) will no longer process incoming non-HIPAA–compliant electronic Medicare claims beginning October 1, 2005. Claims that do not meet standards required by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) will be returned to the filer for resubmission. As of June 2005, only about 0.5 percent of Medicare fee-for-service providers submitted non-HIPAA–compliant electronic claims. The highest rate of noncomplaint claims was from clinical laboratories (1.72 percent). Only 1.45 percent of claims from hospitals and 0.45 percent of claims from physicians were noncompliant. The change will affect claims for services provided under fee-for-service Medicare, ending a portion of a HIPAA contingency plan in effect since October 2003, under which Medicare continued accepting noncompliant electronic claims after the deadline. The contingency continues for other electronic health care transactions, but CMS expects to end the contingency plan for these transactions in the near future.

Grants Announced for Substance Abuse Treatment for Juvenile Offenders

The Substance Abuse and Mental Health Services Administration has awarded more than $19.2 million in grants over four years to support substance abuse treatment and related services for juveniles and young adults returning to their communities after incarceration. The grants are designed to provide substance abuse treatment to juveniles and young offenders up to 24 years of age. The grants will be used to form partnerships among community organizations, including correctional or juvenile facilities, to plan, develop, and provide substance abuse treatment and related reentry services. The grants were awarded to programs in the District of Columbia and the following states: Colorado, Florida, Georgia, Massachusetts, New York, Ohio, Oregon, Texas, Virginia, and Washington.