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HHS makes preexisting condition coverage more accessible
Washington -- The Dept. of Health and Human Services is trying to increase enrollment in a temporary insurance program for people with preexisting medical conditions by reducing premiums and easing application requirements. HHS announced on May 31 that an applicant for the Preexisting Condition Insurance Plan will be able to qualify in part by submitting a letter from a physician, physician assistant or nurse practitioner stating that the patient has or has had a preexisting medical condition, disability or illness. The department previously had required PCIP applicants to submit a letter of denial from a health plan before qualifying. HHS runs the special plan in 23 states and the District of Columbia. The other 27 states run their own federally funded PCIPs. HHS also is lowering plan premiums by up to 40% in 18 states and notifying other states that they can enact similar premium reductions. The application and premium changes will take effect on July 1. "Reducing premium [Read more]
Medical board could discipline physicians for torture under N.Y. bill
A New York bill that is the first of its kind in the nation would make participation in torture or interrogation of prisoners grounds for board discipline of physicians and other health professionals. Dozens of medical students and other health professionals in training lobbied in favor of the legislation in late May, meeting with nearly 40 New York state legislators, said Allen Keller, MD. He helped organize the lobbying trip and directs the Bellevue Hospital Center/New York University Program for Survivors of Torture in New York City. The bill, which was introduced in March by Democratic Assemblyman Richard N. Gottfried and has 39 co-sponsors, would give the state medical board and other health professional licensing boards the explicit authority to suspend or revoke practice rights based on evidence presented in accordance with the state's usual due-process procedures. Under the bill, physicians and other health professionals would be barred from directly participating in t [Read more]
CDC stresses need for flu shot every year
Although this year's seasonal influenza vaccine will be identical to the one administered in the 2010-11 season, physicians still should provide the vaccine to patients who are 6 months and older, says the Centers for Disease Control and Prevention. The recommendation is in response to comments by some health experts that young, healthy people who received the 2010-11 flu immunization might not need it this year. They say that such patients already could have sufficient immunity to the three widely circulating influenza viruses included in the vaccine. The CDC disagrees vehemently with that position. "We know that, over time, immunity wanes. For someone to be fully protected against influenza, they have to be vaccinated each and every flu season," said CDC spokesman Tom Skinner. "While the [seasonal influenza] vaccine is not changing, you still have to get the vaccine to be fully protected." The 2011-12 seasonal flu vaccine will contain the pandemic 2009 influenza A(H1N1)-l [Read more]
Surgical liability cases drop nearly 80% at Texas medical center
Texas trauma surgeon Basil Pruitt Jr., MD, was confident the state's tort reform measures had reduced lawsuits at the medical center where he practices. But he and fellow physicians were shocked when they learned by how much. A study published in the April issue of the Journal of the American College of Surgeons found a nearly 80% decrease in surgical liability lawsuits at the University of Texas Health Science Center at San Antonio since tort reform was enacted in 2003. That year, the Texas Legislature passed a comprehensive package of tort reforms that included a $250,000 cap on noneconomic damages in most medical negligence cases. The lack of lawsuits led to a dramatic drop in legal costs at the center, the study showed. "It confirmed our hypothesis that [tort reform] was important, but the magnitude of the decrease was quite striking," said Dr. Pruitt, one of the study's co-authors. Researchers studied pre-tort reform surgery data at the medical center from 1992 to 2004 [Read more]
Arkansas looks at bundling Medicaid pay
Arkansas Medicaid Director Eugene Gessow is aiming to transform the state's Medicaid program, starting by re-evaluating the costs to physicians and hospitals of providing quality health care. Gessow wants to examine not just Medicaid spending but all health care spending in the state -- public and private -- to find a benchmark for Medicaid payment. He envisions paying teams of physicians and other health professionals based on patients' episodes of care and allowing doctors to keep any savings they might generate. These partnerships would be similar to the health system reform law's accountable care organizations but would not be defined as specifically as ACOs. "In order to have a patient-centered approach, you need a team approach," Gessow said. Arkansas Gov. Mike Beebe has directed Gessow to move Medicaid away from fee-for-service payment. The current system won't allow the state to improve quality and control costs as needed, he said. "We need to stop paying fees for the [Read more]
Frequent ED users take toll on emergency physicians
About 60% of emergency physicians say they have less empathy for so-called frequent-flier patients who visit the ED more than 10 times a year. Nearly 80% told researchers they hold some bias against these patients, and 82% said caring for them contributes to their level of burnout, according to survey data presented at the Society for Academic Emergency Medicine's June annual meeting in Boston. "The emergency room is becoming their primary source of care, and it's not any ER's goal to be an outpatient care provider. That's not the model of what the ER is supposed to be," said Jennifer Peltzer-Jones, PsyD, who led the survey team. "If you look at burnout, there's that lack of a sense of personal accomplishment. The ER model is you fix the patient and you get them out. If the patient keeps coming back for whatever social reasons or constraints, you can easily understand how ER physicians would not feel like they're accomplishing anything." Nearly all the 418 emergency physicians [Read more]
Outgoing AMA president urges doctors to move medicine forward
In a call to action to the nation's physicians, AMA President Cecil B. Wilson, MD, urged doctors to "move forward" and work for changes to improve the health care system. Speaking at the opening of the AMA House of Delegates in Chicago on June 18, Dr. Wilson said Congress needs to repeal the sustainable growth rate formula and replace it with a mechanism that pays for costs of care and enhances quality and care coordination. He also called on Congress to approve legislation that allows Medicare patients and their doctors to contract privately without penalty. Dr. Wilson said moving forward means correcting areas of the Patient Protection and Affordable Care Act, such as the Medicare Independent Payment Advisory Board, which "puts physicians in double jeopardy by adding yet another target to the currently discredited SGR." "Moving forward means bulldogging the regulatory process to assure that the provisions of the Affordable Care Act are implemented in ways that benefit physic [Read more]
Health disparities persist despite quality improvements
Despite slow but steady improvements in the quality of health care nationwide, closing disparities in care for minorities and low-income residents continues to be a challenge, according to the Agency for Healthcare Research and Quality. Overall, there were improvements in about two-thirds of 179 health care quality measures tracked by the federal government in the AHRQ's 2010 National Healthcare Quality and Disparities Reports. But only 30% of 22 measures of access to care showed improvement, while 30% remained stagnant and 40% showed declines. "Every American should have access to high-quality, appropriate and safe health care," said AHRQ Director Carolyn M. Clancy, MD. "We need to increase our efforts to achieve that goal because our slow progress is not acceptable." The reports, released June 1, show that blacks had worse access to care than whites for one-third of six core measures, such as having a usual primary care physician and insurance coverage. Hispanics had worse a [Read more]
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