Fewer Medical Students Choose Family Medicine in 2009 National Resident Match

Fewer U.S. medical students are choosing family medicine as a career at a time when more primary care physicians are needed. According to results from the 2009 National Resident Matching Program, only 1,083 graduating U.S. medical students matched with a family medicine residency program this year, which is 89 fewer students than in 2008. However, more than 91 percent of family medicine residency positions were filled this year, which is a slight increase from last year. American Academy of Family Physicians (AAFP) President Ted Epperly, MD, Boise, Idaho, said that graduate medical education reform is needed to increase the primary care workforce. Epperly accused some medical schools of failing to recruit students who are likely to choose primary care careers, as well as introducing a preference for subspecialist training. The prospect of high medical school debt may also be deterring students from primary care specialties. AAFP leadership has lobbied the U.S. Department of Education to renew the 20/220 pathway program, which allows residents to postpone paying back school loans during their first three years of training. No action has been taken to reinstate the program, which was eliminated in 2007. For more information, visit https://www.aafp.org/news-now/resident-student-focus/20090319match.html.

New HIPAA Provisions Require Tracking of Personal Health Information Disclosures

The recently passed federal stimulus package includes changes to federal health information privacy and security provisions under the Health Insurance Portability and Accountability Act (HIPAA). The Health Information Technology for Economic and Clinical Health Act will require physicians to track any disclosure of a patient's medical information. Beginning January 1, 2014, physicians who use an electronic health record system must have the ability to track all patient information disclosures. The legislation also requires practices to post information about security breaches if a breach affects 10 or more patients. If a breach affects 500 or more patients, practices must notify all patients, a local media outlet, and the U.S. Department of Health and Human Services (HHS) secretary. Fines for security breaches will begin at $100 and could go up to $1.5 million. Physicians will be responsible for tightening their privacy policies and procedures, and making sure staff are familiar with these procedures. According to David C. Kibbe, MD, senior adviser to the AAFP's Center for Health Information Technology, the new regulations will give consumers more control over their personal health information. However, the regulations will also increase the complexity, cost, and risk for organizations that work with personal health information. For more information, visit https://www.aafp.org/news-now/government-medicine/20090318hipaa-security-rules.html.

CMS' Recovery Audit Contractors Program Seeks to Collect Medicare Overpayments

The Centers for Medicare and Medicaid Services (CMS) is preparing to launch its Recovery Audit Contractors (RAC) program, which seeks to recover Medicare overpayments to physicians. In response to the program, 100 medical professional associations, including the AAFP, have joined forces to express their concern. The associations sent a letter to CMS asking it to remove evaluation and management services from the list of services targeted for auditing; limit RAC medical record requests to three in a 45-day period for solo physicians; raise the minimum claim to $100; and require RAC contractors to reimburse physicians for copies of requested medical records before beginning an audit. The letter also urged CMS to improve its efforts to inform physicians about Medicare billing policies. The AAFP Practice Support Division has compiled a guide to help physicians understand how the RAC program may affect their practices. The guide is available at https://www.aafp.org/online/en/home/practicemgt/codingresources/recoveryauditcontractors.html. For more information, visit https://www.aafp.org/news-now/practice-management/20090312rac-guide.html.

Pandemic Update Predicts Rapid Influenza Tests Will Be Ready by the End of 2009

The HHS expects the U.S. Food and Drug Administration to approve point-of-care influenza rapid test devices by the end of 2009, according to Pandemic Planning Update VI, which was released in January 2009. The availability of these tests will allow physicians to diagnose avian or any other potentially pandemic form of influenza quickly and easily. As of March 11, 2009, the World Health Organization has confirmed 411 human cases of avian influenza A (H5N1) and 256 deaths in 15 countries since 2003. Currently, HHS has stockpiled 12.2 million treatment courses of H5N1 pre-pandemic influenza vaccine to be used in clinical trials and to protect health care workers in case of a pandemic. For more information, visit https://www.aafp.org/news-now/health-of-the-public/20090316avian-flu.html or the Pandemic Planning Update at http://www.pandemicflu.gov/plan/pdf/panflureport6.pdf.

Legislation Calls for More Funding to Expand Community Health Centers

Sen. Bernie Sanders, I-Vt., and House Majority Whip James Clyburn, D-S.C., recently introduced the Access for All America Act to provide funding increases for U.S. community health centers (CHCs). If enacted, the legislation could expand the nation's primary care infrastructure to accommodate health care reform efforts and meet the growing need for primary care services. The bill calls for increasing funding for CHCs from $2 billion to $8.3 billion over a five-year period, which would expand the number of patients receiving services from 18 million to 60 million. The funding would also increase the number of CHCs from 1,100 to 4,800 facilities by 2015, which is enough of an increase to virtually eliminate federally designated medically underserved areas. For more information, visit https://www.aafp.org/news-now/government-medicine/20090317access-act.html.

AAFP's Connect for Reform Campaign Aims to Engage Members in Health Care Reform

The AAFP has launched an online advocacy campaign to engage and energize members around health care reform issues. Members who sign up to participate in the Connect for Reform campaign will receive regular analyses of health care reform efforts and initiatives in Washington. These reports will provide an insider's view of health care reform on the federal level. The campaign will also allow members to respond to federal reform efforts, express their opinions, and promote family medicine. Additionally, the campaign will contact participating members to ask their opinions on what the AAFP can do to improve its advocacy efforts. For more information, visit https://www.aafp.org/news-now/inside-aafp/20090318connect-for-reform.html or the Connect for Reform Web site at http://blogs.aafp.org/cfr/connect4reform/.

Prescription Savings Program Expands Eligibility Rules to Include More Patients

Together Rx Access, a prescription savings program sponsored by some of America's largest pharmaceutical companies, has adjusted its income eligibility requirements to expand the number of consumers who qualify for the program. The new income guidelines increase the maximum annual income to $45,000 for a single person; $60,000 for a family of two; $75,000 for a family of three; and $90,000 for a family of four. Nearly 90 percent of uninsured Americans will now qualify for the program, which can save patients 25 to 40 percent on more than 300 brand-name prescription products. To participate, patients must not be eligible for Medicare, must not have any other prescription drug coverage, and must be legal residents of the United States or Puerto Rico. For more information, visit https://www.aafp.org/news-now/health-of-the-public/20090325together-rx.html or the Together Rx Access Web site at http://www.togetherrxaccess.com/Tx/jsp/about_press.jsp.

CMS Switches to Revised Version of Medicare Advance Beneficiary Notice Form

As of March 1, 2009, CMS is using a revised version of Medicare's Advance Beneficiary Notice (ABN) form. The new form, Advance Beneficiary Notice of Noncoverage, is given to Medicare beneficiaries to convey that Medicare is not likely to provide coverage for a specific service. Beneficiaries now have three options from which to choose. They may choose to receive the services offered and ask the physician to bill Medicare; they may choose to refuse the services offered; or they may choose to receive the services and ask the physician to not bill Medicare. Beneficiaries who choose the third option may not submit a beneficiary appeal. The revised ABN form and instructions are available in English and Spanish at http://www.cms.hhs.gov/BNI/02_ABNGABNL.asp. For more information, visit https://www.aafp.org/news-now/practice-management/20090311rev-abn.html.

National Research Network Receives Grant to Implement Diabetes Mentoring Program

The AAFP's National Research Network (NRN) is scheduled to receive a research evaluation grant of $805,000 to adapt a peer mentoring program for patients with diabetes. The grant will be awarded by the AAFP Foundation's Peers for Progress program, which is designed to establish or expand the evidence for peer support as a core component in diabetes care. The NRN will base its mentoring program on the Carpeta Roja project in Los Angeles, which uses community workers to help mentor uninsured, Hispanic patients with diabetes. The NRN will adapt this model to an insured, middle-class population in San Antonio. Patients with controlled diabetes will serve as mentors to more than 300 patients who need help managing the disease. NRN researchers will monitor patients' clinical measures and then analyze overall health outcomes. For more information, visit https://www.aafp.org/news-now/health-of-the-public/20090318peers-nrn-grant.html.

—AFP and AAFP NEWS NOW staff