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Physician suggestions wanted for new osteoporosis screening guidelines
The U.S. Preventive Services Task Force is considering whether to broaden the group of women it recommends to get routine screening for osteoporosis, and it wants physician input. The proposed recommendations suggest that younger women who have fracture risks equal to or greater than 65-year-old women should be screened for the disease. Currently the task force, an independent panel of nonfederal medical experts in prevention and evidence-based medicine, says women 65 and older, and those 60 or older at higher risk for fractures, should be tested. The guidelines were updated last in 2002. "That is a significant change. We found women as young as age 50 where screening would be appropriate," said Ned Calonge, MD, MPH, task force chair, and the Colorado Dept. of Public Health and Environment's chief medical officer. Physicians and others can comment on the draft recommendations through 5 p.m. EST Aug. 3 online ( Dr. Calonge, a family and preve [Read more]
Hospitals boost response rates for timely angioplasties
American hospitals have made extensive improvements in delivering faster heart attack care in the last five years, and the death rate for heart attack patients is falling. Those are the findings in a study in the July 20 Journal of the American College of Cardiology. Researchers found that 88% of patients with ST-segment elevation acute myocardial infarction received artery-clearing balloon angioplasties within 90 minutes of arriving at one of the 959 hospitals studied in 2009. The "door-to-balloon" time should be 90 minutes or less, according to guidelines adopted in 2004 by the American College of Cardiology and the American Heart Assn. The ACC launched an initiative called the D2B Alliance to help hospitals better their performance by taking steps such as requiring their entire cath lab team to arrive within 20 minutes of being contacted. By 2007, 64% of patients with STEMI were getting angioplasties within the 90-minute time frame, and the figure improved to 75% by mid-2008. [Read more]
Cholesterol screening recommended for all children
Physicians should screen all children for cholesterol regardless of whether they have a family history of premature cardiovascular disease, a new Pediatrics study says. Universal screening would allow early diagnosis and the appropriate treatment of children with significant dyslipidemia, researchers stated. The ULTIMATE goal is to prevent this group from developing atherosclerotic disease when they become adults. Screening should begin when children are about 5 years old, according to senior author William A. Neal, MD. The frequency of screening depends on the patient's original low-density lipoprotein cholesterol levels and family history. Children should be screened more frequently if they have an LDL level in the abnormal or high range, or if they have a family history of cardiovascular disease before the age of 55. The American Heart Assn. recommends that LDL cholesterol be less than 100 mg/dl. High LDL levels (160 mg/dl and greater) increase a person's risk of cardiovasc [Read more]
Nixed Medicare consultation codes force doctors to make cutbacks
Thousands of physicians say they have been forced to adopt a number of damaging cost-cutting measures as a result of Medicare discontinuing its use of consultation codes, a policy adopted by the Centers for Medicare & Medicaid Services that took effect on Jan. 1. Consultation codes are used most frequently by specialists after patients are referred to them by primary care physicians. Starting this year, Medicare eliminated the use of all consultation codes except telemedicine consults. It directed physicians instead to bill for the visits using only evaluation and management codes that apply. According to a June 18 letter sent to CMS by the American Medical Association and more than 30 other physician organizations, the agency predicted that no specialty would see Medicare revenues decline by more than 3% because of the change. CMS also had stated that another goal was to reduce confusion and administrative burdens associated with filing consultation codes. But the AMA said th [Read more]
Liability cap faces legal challenge in West Virginia
West Virginia physicians are planning to defend the state's medical liability cap after the high court there in April accepted a case challenging the law's constitutionality. The 2003 statute limits noneconomic damages in medical liability cases to $250,000 in most cases and $500,000 in actions involving serious or traumatic injuries. The case before the West Virginia Supreme Court of Appeals stems from a $1.6 million jury verdict in 2008 to James D. MacDonald and his wife after he was diagnosed with severe muscle damage following pneumonia treatment at City Hospital in Martinsburg, W.Va. MacDonald, who had an earlier kidney transplant, alleged that the hospital and his treating physician put him on a drug regimen that worsened his kidney condition and caused the muscle damage. The doctor and hospital denied any negligence. A Berkeley County trial court reduced the noneconomic portion of the award, which was $1.5 million, to the $500,000 cap. The court also rejected arguments [Read more]
Medicare physician pay cut reversal in Senate's hands
When Congress returns from its Memorial Day recess on June 7, the Senate will be racing the clock to stem damage from a 21% cut in Medicare physician pay that officially went into effect June 1. This is the third time this year the cut has gone into effect before it could be reversed, and physician organizations say they are growing increasingly frustrated by what they perceive as a lack of urgency on the part of lawmakers to fix the situation in a more permanent fashion. As it did the two previous times, the Centers for Medicare & Medicaid Services said it would instruct Medicare contractors to hold June claims for 10 business days, giving the Senate more time to pass the House bill before the program starts sending doctors' payments at the reduced rate. The extension runs out after June 14. * The bill's other priorities * See related content * Topic: Medicare The extenders bill that the House approved on May 28 includes a 19-month patch, under which doctors wou [Read more]
Vermont to explore single-payer option
A new Vermont health care bill could lead to significant changes in the state's delivery and payment structures, including a possible move toward a single-payer system. Governor Jim Douglas announced May 27 that he would allow the bill to become law without his signature. Douglas, whose term ends in January 2011, said he chose not to put his signature on the bill because of his apprehension about two particular features -- the exploration of a single-payer model and the requirement that pharmaceutical companies publicly release information on expenses related to free drug samples. The law will create a health reform commission, which has until Feb. 1, 2011, to propose to the governor and general assembly three design options for creating a single system of health care in the state. It specifies that one of those options will include the design of a government-administered and publicly financed single-payer benefits system. Douglas called the provision "a wasteful expense of ti [Read more]
Graduate medical education getting Medicaid support from fewer states
Several states have ended or considered ending their Medicaid funding for graduate medical education since 2005, but overall funding for GME still grew since then, according to a 50-state survey released in May by the Assn. of American Medical Colleges. "Compared to earlier reports, this is a significant change in direction overall for Medicaid support," said Tim Henderson, MSPH, report author and consultant for AAMC. He's also a professor in the Dept. of Health Administration and Policy at George Mason University in Northern Virginia. Most states provide additional Medicaid payments to teaching hospitals based on their direct and indirect costs of training medical residents. Direct costs include salaries of residents and the cost of their supervision. Indirect costs include higher spending on patients due to additional tests ordered by residents, for example. The federal government matches the state support. Forty-one states and the District of Columbia made Medicaid payments [Read more]
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