HHS Announces $42 Million Initiative for an Estimated 500 FQHCs

According to the U.S. Department of Health and Human Services (HHS), the Centers for Medicare and Medicaid Services (CMS) and the Health Resources and Services Administration will administer payments to participating federally qualified health centers (FQHCs) totaling $42 million during the next three years. The money will be used to determine the effectiveness of the patient-centered medical home (PCMH) in improving quality of care, promoting better health, and reducing costs for Medicare patients. Participating FQHCs will receive a monthly care management fee for each eligible Medicare beneficiary receiving primary care services. In return, FQHCs have agreed to accept care coordination practices recognized by the National Committee for Quality Assurance. The FQHCs are expected to achieve Level 3 PCMH status from the committee. For more information, visit https://www.aafp.org/news-now/news-in-brief/20110622wklynewsbrfs.html#NewsArticleParsys96952, and http://www.hhs.gov/news/press/2011pres/06/20110606a.html.

HIPAA Rule Change Could Mean Patients Can See Who Accesses Their Information

Proposed changes to the Health Insurance Portability and Accountability Act (HIPAA) privacy rule mean that patients could receive a report that lists who electronically accessed their protected health information. According to the HHS, the proposed rule would allow patients to request a report that would document who had accessed and viewed their protected health information. Currently, covered entities are required under HIPAA to track access to protected electronic health information, but they are not required to share this information with patients. Comments on the notice of proposed rulemaking—published in the May 31, 2011, Federal Register —can be submitted through August 1, 2011, at http://www.regulations.gov. For more information, visit https://www.aafp.org/news-now/news-in-brief/20110608wklynewsbrfs.html#NewsArticleParsys38093, and http://www.gpo.gov/fdsys/pkg/FR-2011-05-31/pdf/2011-13297.pdf.

CMS Announces Changes to the Medicare E-Prescribing Incentive Program

Beginning in 2012, CMS will start enforcing penalties for physicians who are not participating in electronic prescribing (e-prescribing) in their practice. These penalties could amount to a 1 percent Medicare pay cut in 2012. The CMS recently released a proposed rule to the program in response to concerns by physicians. The rule change would expand the list of hardship exemptions that physicians are allowed to apply for. The new list of hardship exemptions includes exceptions for physicians with limited prescribing activity, physicians who delay implementing e-prescribing because of their future participation in Medicare's 2011 electronic health record (EHR) incentive program, and physicians who live in a location that restricts e-prescribing. The rule change appears in the June 1, 2011, Federal Register. Under the new rule, physicians could apply for an exemption until October 1, 2011. For more information, visit https://www.aafp.org/news-now/news-in-brief/20110615wklynewsbrfs.html#NewsArticleParsys99987, and http://www.gpo.gov/fdsys/pkg/FR-2011-06-01/pdf/2011-13463.pdf.

Top Five Recommendations to Improve Quality and Lower Costs in Your Practice

The Archives of Internal Medicine recently published an article listing the top five evidence-based practices that physicians in three subspecialties can follow to improve their quality of care and lower costs. The list gives recommendations to physicians for common tests and procedures that should be avoided. Recommendations for family medicine include avoiding the following: imaging for low back pain within the first six weeks after the patient presents with symptoms unless red flags are present; annual electrocardiography or other cardiac screening for asymptomatic, low-risk patients; dual energy x-ray absorptiometry screening for osteoporosis in women younger than 65 years or men younger than 70 years with no risk factors; Papanicolaou smears in patients younger than 21 years or who have had a hysterectomy for a benign disease; and routine prescribing of antibiotics for acute mild to moderate sinusitis unless symptoms worsen after initial improvement. The National Physicians Alliance convened working groups in family medicine, internal medicine, and pediatrics to compile the list of items, which was then finalized using field testing. The research was funded by a grant from the American Board of Internal Medicine Foundation. For more information, visit https://www.aafp.org/news-now/health-of-the-public/20110620topfivetips.html, and http://archinte.ama-assn.org/cgi/content/abstract/archinternmed.2011.231.

FDA Reports Record High Drug Shortages in 2010, Increase Continues into 2011

According to the U.S. Food and Drug Administration (FDA), there were record high drug shortages in the United States in 2010. A total of 178 drug shortages were reported and the increase has continued into 2011, prompting the FDA to encourage physicians to report any shortages that they encounter. The FDA is also asking physicians to alert the agency when the drug shortage Web page does not reflect what they are experiencing in their practices. In addition, anyone with concerns regarding price gouging should contact the FDA's Office of Criminal Investigations. For more information, visit https://www.aafp.org/news-now/news-in-brief/20110615wklynewsbrfs.html#NewsArticleParsys74394, and http://www.fda.gov/Drugs/DrugSafety/DrugShortages/ucm142398.htm.

U.S. Surgeon General Releases the National Prevention and Health Promotion Strategy

The Patient Protection and Affordable Care Act called for the creation of a plan that would increase the number of Americans who are healthy during each stage of their life. This plan, the National Prevention and Health Promotion Strategy, outlines how public and private sectors can help Americans achieve their health goals through prevention. The plan suggests that society attempt to achieve four objectives: building healthy and safe community environments, expanding quality preventive services in both clinical and community settings, empowering people to make healthy choices, and eliminating health disparities. The plan is then further divided into seven priority areas: tobacco-free living, preventing drug abuse and excessive alcohol use, healthy eating, active living, injury and violence-free living, reproductive and sexual health, and mental and emotional well-being. For more information, visit https://www.aafp.org/news-now/news-in-brief/20110622wklynewsbrfs.html#NewsArticleParsys56788, and http://www.healthcare.gov/center/councils/nphpphc/strategy/report.pdf.

NLM Offers Free Service to Link EHRs to MedlinePlus Government Web Site

MedlinePlus.gov compiles information from the National Institutes of Health (NIH) and other federal agencies and health professionals on health conditions and wellness issues. According to HHS, the goal of MedlinePlus.gov is to inform patients about their health. A new service, MedlinePlus Connect, will allow health organizations and health information technology providers to link patient portals or EHRs to MedlinePlus.gov at no charge. Physicians and patients who are using MedlinePlus Connect will be able to access health information on MedlinePlus that is related to diagnoses, medications, and laboratory tests. The new Web site was launched by the National Library of Medicine (NLM), a division of the NIH. For more information, visit https://www.aafp.org/news-now/news-in-brief/20110622wklynewsbrfs.html#NewsArticleParsys65985, and http://www.nlm.nih.gov/medlineplus/connect/overview.html.

MedWatch: FDA Releases New Safety Information for Diabetes Medications

The FDA has recently released updated safety information on three diabetes medications. Studies have shown an increased risk of bladder cancer in patients taking pioglitazone (Actos) for at least one year. The FDA recommends that physicians not prescribe pioglitazone to patients with bladder cancer and use caution for patients with a history of bladder cancer. This warning comes shortly after the FDA restricted the use of products containing rosiglitazone, another thiazolidinedione, because of cardiovascular risks. In a separate announcement, the FDA reiterated the safety risks associated with liraglutide (Victoza). The drug can increase the risk of thyroid C-cell tumors and acute pancreatitis. The manufacturer of liraglutide, Novo Nordisk, released a letter detailing the risks after an assessment showed that some physicians are not aware. The letter reminds physicians that liraglutide is not recommended as a first-line treatment for patients who have poor glycemic control with diet and exercise. For more information, visit https://www.aafp.org/news-now/health-of-the-public/20110622pioglitazone.htmll, and https://www.aafp.org/news-now/health-of-thepublic/20110620liraglutide.html.

Graphic Photos to Be Added to Cigarette Packaging to Enhance Warnings

Starting in September 2012, cigarette packaging will include one of nine photos depicting the risks of tobacco use, such as lung cancer and death. Manufacturers will be required to devote one-half of the front and back of every cigarette package to the photos and written warnings about the dangers of tobacco use. The FDA hopes that the new images, the first major change to cigarette warnings in 25 years, will have a significant impact on public health by increasing the awareness of specific health risks from smoking, encouraging smoking cessation, and empowering young people not to start smoking. For more information, visit https://www.aafp.org/news-now/health-of-the-public/20110622cigarettegraphics.html.

—AFP and AAFP NEWS NOW staff