Medical Malpractice Legislation Gains Traction in House, Senate

A medical malpractice reform bill that would allow states to develop alternative methods for resolving medical malpractice lawsuits has been introduced in both the House and the Senate. The Fair and Reliable Medical Justice Act of 2007 (H.R. 2497, S.B. 1481) would award as many as 10 grants to states to develop and evaluate alternatives to litigation for resolving claims for injuries allegedly caused by health care providers. This could include the establishment of health care courts for resolving disputes. If passed, the legislation would provide funds for the U.S. Department of Health and Human Services (HHS) to award $500,000 grants. States receiving grants would be required to develop alternatives to litigation for resolving medical malpractice claims and reducing medical errors. They also would be required to show how their plans would provide prompt and fair dispute resolution while encouraging early disclosure of medical errors and enhancing patient safety. For more information, visit https://www.aafp.org/news-now/government-medicine/20070531malpracticereform.html.

PQRI Allows Physicians to Qualify for 1.5 Percent Medicare Bonus

As of July 1, 2007, family physicians and other qualified professionals can earn a 1.5 percent bonus payment from Medicare for participating in the physician quality reporting initiative (PQRI). The Centers for Medicare and Medicaid Services (CMS) program incorporates a financial incentive for physicians to report on a designated set of quality measures for 80 percent of their Medicare patients to whom the measures apply. The program runs from July 1 to December 31 and was established as a result of the Tax Relief and Health Care Act of 2006. It replaces the Physician Voluntary Reporting Program, which did not offer financial incentives to participants. For more information, visit https://www.aafp.org/news-now/practice-management/20070529pqrilaunch.html.

Special Constituency Representatives Tackle Diverse Issues

Official chapter representatives who attended the American Academy of Family Physicians' (AAFP's) National Conference of Special Constituencies (NCSC) in Kansas City, Mo., May 3–5, endeavored to set Academy policies on such diverse topics as personal health records (PHRs), patient/physician confidentiality, and racial and ethnic health disparities, among other topics. The NCSC called for the Academy to continue its support of PHRs as a communication tool between physicians and patients and to study options to provide education about and promote integration of PHRs into the workflow of physicians' electronic health record (EHR) systems. Representatives also asked the AAFP to advocate that providers of medical services cease violating patient confidentiality by mailing explanation of benefit forms, medical bills, and related paperwork to patients' homes. Minority constituency representatives called for the establishment of minority health fellowships. For more information, visit https://www.aafp.org/news-now/inside-aafp/20070523ncscresolutions.html.

War Funding Bill Halts CMS Proposal to End Medicaid Graduate Education

A proposed CMS regulation that would make cuts of $1.78 billion in federal support for Medicaid graduate medical education (GME) funding during a four-year period has been halted by legislation regarding funding for the war in Iraq and Afghanistan. The CMS proposal would have prohibited states from using federal Medicaid funds for GME. The Bush administration proposed the regulation on May 23; one day later, Congress passed legislation that would continue funding the war and included a provision prohibiting CMS from promulgating or implementing any rule or provisions restricting payments for GME for one year. Forty-seven of 50 states use Medicaid to fund GME, and the program accounted for $3.2 billion in direct GME funds and indirect medical education funds in 2005. For more information, visit https://www.aafp.org/news-now/government-medicine/20070530medicaidgme.html.

IRS Ruling Clears the Way for EHR Donations to Physicians

The Internal Revenue Service (IRS) issued a ruling that allows hospitals to donate health information technology and services to medical staff physicians without jeopardizing their not-for-profit status. The ruling came nine months after CMS and the Office of Inspector General issued regulations that said hospitals, hospital systems, and health plans could provide—within certain parameters—EHR software and services to medical staff physicians without violating federal anti-kickback and physician self-referral laws. However, according to David C. Kibbe, MD, senior advisor to the AAFP's Center for Health Information Technology, family physicians should be cautious when offered software, hardware, or e-prescribing software devices under the Stark and anti-kickback safe harbor. Physicians need to know what systems they want to use, and should not bend to inappropriate hospital pressure to use a particular system, he said. For more information, visit https://www.aafp.org/news-now/government-medicine/20070601irsruling.html.

HHS Continues to Push for Implementation of EHR Systems

HHS secretary Michael Leavitt issued a report to Congress announcing the results of an electronic prescribing pilot project designed to test whether new electronic prescribing standards are ready for widespread adoption. The pilot project successfully demonstrated that three initial standards already are capable of supporting e-prescribing transactions that give physicians information about their patients' formularies and benefits, medication history, and drug fill statuses. The HHS also announced that it was seeking permission from the Office of Management and Budget to conduct a survey that would measure rates of adoption of EHRs among physicians and group practices. For more information, visit https://www.aafp.org/news-now/government-medicine/20070530ehrpush.html.

United States Still Ranks Last in Study Comparing Health Care Systems

Despite spending more than $6,000 per person per year on health care, the United States continues to rank last among six nations in a study comparing access, quality, efficiency, equity, and healthy lives. According to an international update by the Commonwealth Fund, among the six nations studied (Australia, Canada, Germany, New Zealand, the United Kingdom, and the United States), the United States is last in dimensions of access, patient safety, efficiency, and equity. Most noteworthy about the U.S. system is the absence of universal access to health care, something that all the other countries studied have, according to the report. For more information, visit https://www.aafp.org/news-now/health-of-the-public/20070531usranking.html, or http://www.commonwealthfund.org/usr_doc/Davis_mirrormirrorinternationalpdate_1027.pdf?section=4039.

Members of Congress Extol Contributions of Family Physicians

Congress needs to adopt a Medicare payment system that compensates physicians for providing primary health care services, said Rep. Lois Capps, D-Calif., a member of the House Energy and Commerce Committee, during the AAFP Family Medicine Congressional Conference in Washington, D.C. Capps, a registered nurse, also called for increases in funding for Title VII of the Public Health Service Act, which funds academic departments and programs for the training of primary care health professionals. In addition, Rep. Jesse Jackson, Jr., D-Ill., a member of the House Appropriations Committee, told conference attendees that health care should be a constitutional right for all Americans. Jackson was at the conference to receive the AAFP's National Leadership in Government Service Award for his work on health care issues in Congress. For more information, visit https://www.aafp.org/news-now/government-medicine/20070524congressconf.html.

Smoking Status May Identify Potential Alcohol Abuse

Smoking status may be used as a clinical indicator of alcohol misuse, according to a study published in the April 9 issue of Archives of Internal Medicine. Researchers examined 42,374 adults from the National Epidemiological Survey on Alcohol and Related Conditions and discovered that daily, occasional, and ex-smokers were more likely than those who had never smoked to also be hazardous drinkers. In addition, daily and occasional smokers were more likely to meet criteria for alcohol abuse diagnoses. Researchers say this is the first study to link occasional, non-daily smoking with the greatest risk of hazardous drinking and alcohol-related diagnoses. The data are important to family physicians because research has shown that most physicians screen for smoking, but many do not inquire about alcohol abuse. For more information, visit https://www.aafp.org/news-now/clinical-care-research/20070523smokingstatus.html.

Spanish Language Resource Offers Advice on Parenting

The National Institutes of Health (NIH) has released a free Spanish-language guide for Hispanic parents looking for advice on parenting. “Qué Significa ser Padres?” (“What Does It Mean to Be Parents?”) offers evidence-based parenting guidelines and uses a model that encourages responding to children in an appropriate manner, preventing risky behaviors, monitoring children's contact with the surrounding world, mentoring, and modeling positive and consistent behaviors. It offers real-life examples of how parents can use the information in the guide when interacting with their children. Copies may be ordered online or by calling 800–370–2943. For more information, visit https://www.aafp.org/news-now/health-of-the-public/20070523spanishparents.html, or http://www.nichd.nih.gov/publications/pubs_details.cfm?from=&pubs_id=5050.

— AFP and AAFP NEWS NOW staff