Ronald M. Davis, MD
Medicare cuts prevented (for now), SCHIP extended
This week, Congress passed legislation that would replace a scheduled 10.1 percent cut in 2008 Medicare physician payments with a 0.5 percent increase through June 30, 2008. The bill, which is expected to be signed into law, also extends expiring rural physician payment provisions and the Medicare physician quality reporting initiative. And it extends the State Children's Health Insurance Program (SCHIP) until March 31, 2009, while providing funding to help states maintain their current enrollment in the program.
The good news is that this legislation will ward off the 10.1 percent cut for 2008 for six months, giving Congress another opportunity to avert a disastrous situation for physicians and their patients. The adoption of a "skinny" Medicare package also jettisoned some negative proposals, such as limitations on physician-owned hospitals and regulation of imaging services. And the extension of SCHIP maintains access to needed health care services for children in low-income families (although the continuing funding level for SCHIP falls short of the level endorsed by the AMA).
Read More>>
Please send comments, questions, and replies to amaprez@ama-assn.org.
eVoice®
Dec. 20, 2007
AMA eVoice is your regular update on the most important health care issues and recent AMA activities.
The AMA is committed to communication. We encourage you to help us spread the word by forwarding AMA eVoice to your colleagues.
Your news interests
Sign up to receive customized AMA eVoice messages.
Faculty practice physician issues
1) In AMNews: Oklahoma offers up new ideas to bring physicians into rural areas
2) Report: Emory University considers campus relocation for medical, health and research facilities
Group practice physician issues
1) AMA practice tip: Connecting with your patients
2) Massachusetts looks toward future to fund electronic medical records momentum
International medical graduate issues
1) New edition of the AMA-IMG Section work force discussion paper available
2) Now on hand: AMA-IMG Section Interim Meeting presentation materials
3) FSMB 2008 candidate and committee nominations wanted
Medical school news
1) In AMA GME e-Letter: The ethics of "poaching" primary care physicians from the Third World
2) In AMNews: Future doctors fail military medical ethics test
3) In AMNews: Solutions for improving health literacy
Medical student issues
1) Save the dates for upcoming AMA-MSS regional meetings
2) Apply for the physicians-in-training host program
3) Check out this grant opportunity for physician-led free clinics
4) Call for Joan F. Giambalvo Scholarship Fund applications
5) December issue of Virtual Mentor available
Minority health issues and professional concerns of minority
physicians
1) Health Action 2008 conference features minority health track
2) Online program looks for ways to increase the number of underrepresented minority physicians
Organized medical staff issues
1) 2007 AMA-OMSS Interim Assembly Meeting summary PowerPoint now available
2) Make your voice heard on key issues affecting medical staffs
3) Last chance to listen to Joint Commission conference calls on MS.1.20 and new leadership standards
4) AHRQ releases toolkits to help reduce medical errors and improve patient safety
5) In JAMA: Low reimbursements put generalists, surgeons on endangered list
Resident and fellow issues
1) NRMP board looking for residents
2) In New England Journal of Medicine: Starting a family during training could be a problem
3) In JAMA: Will the general surgeon disappear?
Senior physicians issues
1) Flu shots covered under Medicare's preventive services
Women physician and women's health issues
1) Joan F. Giambalvo Scholarship Fund applications due Feb. 1
2) Available now: Updated booklet on managing home care patients
Young physician issues
1) AMA bylaws amended to enhance young physician participation
2) Act now and receive a special discount for AMA's Medical Communications Conference
3) Reminder: Deadline for nominations to AMA-elected councils is Jan. 7
4) In AMA GME e-Letter: The ethics of "poaching" primary care physicians from the Third World
General AMA news:
1) Medicare payment: 10 percent cut averted, modest increase for six months
2) SCHIP funding extended through March 2009
3) Ethics in brief: Physician self-referral
4) Deadline approaching to file for claims in Highmark settlement
5) Enrollment ending Dec. 31, 2007; Act now to travel worry free in 2008
6) Give minority physicians a boost—new online program explains how
7) AMA Foundation awards grants to free clinics that help the uninsured—apply by Jan. 14
8) In JAMA: "False-positive" activation of cardiac catheterization laboratory may occur in some patients with suspected heart attack
Your news interests
Sign up to receive customized AMA eVoice messages.
Faculty practice physician issues
1) In AMNews: Oklahoma offers up new ideas to bring physicians into rural areas
Lawmakers in Oklahoma have pledged $5.5 million to continue initiatives to bring physicians to practice in
rural communities. In a Dec. 10 article in American Medical News (AMNews), several new programs
have been agreed upon, including offering medical scholarships that provide Oklahoma medical students
$60,000 over four years to practice in communities of 7,500 or fewer people for four years after
residency. Family medicine resident scholarships pay trainees $1,000 per month, in addition to their
salaries, for three years if they practice in a community outside of Tulsa, Okla., or Oklahoma City for
three years after graduating. A physician community match signing bonus offers out-of-state doctors a
one-time $40,000 payment, in addition to their salaries, to practice in rural Oklahoma for three
years.
View the article.
2) Report: Emory University considers campus relocation for medical, health and research
facilities
Emory University is considering a plan to move its school's facilities to a location closer to a major
highway artery, in an effort to modernize its medical facilities and make them more accessible to
patients, according to a report in the Atlanta-Journal Constitution. The hospital, outpatient
clinic and research facilities will be consolidated in a move to better integrate its medical treatment
areas and research buildings currently scattered around its campus. In considering what could be a $2
billion expenditure involving redevelopment, no decisions have been made so far regarding the current
proposal.
>>Return to your news interest contents
Group practice physician issues
1) AMA practice tip: Connecting with your patients
Online medical consultations, also known as e-visits, present opportunities for growth and increased
efficiency in the physician practice.
AMA members can learn more (PDF, 678KB) about this new patient convenience and if it's right for your practice, and access the educational resource, "Online medical consultations: Connecting physicians with patients."
2) Massachusetts looks toward the future to fund electronic medical records momentum
Per an article in the Boston Globe, Massachusetts is currently exploring ways to remain the
leader in electronic medical record technology. While Blue Cross Blue Shield of Massachusetts provided an
original pilot program, a comprehensive plan is needed to begin using electronic medical records more
quickly. Obstacles include how expenses would be divided, considering that electronic medical records
could cost $500 million statewide. Massachusetts is looking toward eventually receiving federal funding.
Other ideas generated include a funding initiative, brought about by a comprehensive law to be passed by
the legislature.
>>Return to your news interest contents
International medical graduate issues
1) New edition of the AMA-IMG Section work force discussion paper available
The AMA-IMG Section is pleased to offer an online version of its latest edition of the IMGs in the U.S.
physician work force discussion paper that provides information on IMG work force–related issues,
including the role of IMGs in the U.S. physician work force, statistics on IMGs, IMG contributions to the
delivery of health care in the U.S. and much more. Additional information on IMG work force issues is also
available online in slide presentation given by Nyapati R. Rao, MD, last June.
View these materials.
2) Now on hand: AMA-IMG Section Interim Meeting presentation materials
Visit the AMA-IMG Section Web site to view the presentation
given by Stephen Seeling, vice president of operations for the Educational Commission for Foreign Medical
Graduates (ECFMG) at the AMA-IMG Section Congress, part of the Interim Meeting of the AMA House of
Delegates. The presentation provided an update on the state of the ECFMG.
Highlights from the AMA-IMG Section leadership session on communicating effectively—led by Mike Lynch, AMA vice president of external communications—include tips on testifying at a reference committee or on the floor of the AMA House of Delegates and the top 10 mistakes made by speakers.
View these highlights.
3) FSMB 2008 candidate and committee nominations wanted
The Federation of State Medical Boards (FSMB) is asking member boards to begin identifying individuals
they wish to nominate for elective office and standing/special committees. Nominations must be submitted
through the state boards by Jan. 11, 2008. Positions available for election in 2008 are: chair-elect,
treasurer, three positions on the board of directors and nominating committee, and a position on the
editorial committee.
Also due on Jan. 11, 2008, are recommendations for committee appointments for fiscal year 2008. After the 2008 FSMB Annual Meeting, incoming chair Regina Benjamin, MD, will appoint members to the FSMB Bylaws, Editorial, Finance and Program Committees, and potentially to a FSMB special committee(s). Nominations should be sent to J. William McCord, DO, and Dr. Benjamin in care of Pat McCarty or by mail to Federation of State Medical Boards, P.O. Box 619850, Dallas, TX 75261.
>>Return to your news interest contents
Medical school news
(Brought to you by the AMA Section on Medical Schools)
1) In AMA GME e-Letter: The ethics of "poaching" primary care physicians from the Third
World
A study in the Annals of Family Medicine calls into question "the wisdom and ethics of policies
that have resulted in a continuing decline in the U.S. primary care physician supply" and our continued
over-reliance on international medical graduates to meet our primary care needs.
View the study.
Read the December issue of the AMA GME e-Letter, a leading source of news and information on graduate medical education.
Other articles highlighted in this issue, include:
- More physicians: The ultimate challenge for medical education
- Low reimbursements put generalists, surgeons on endangered list
- Reader feedback: Lower medical school tuition, require primary care service
- Starting a family, finishing a residency a tricky balance
- Ethics and public health: Physicians as agents of the state
Subscribe to this free monthly e-mail newsletter.
2) In AMNews: Future doctors fail military medical ethics test
Medical students are not knowledgeable of physicians' ethical obligations during wartime, according to a
new study published in the Oct. issue of the International Journal of Health Services and
reported in the Dec. 17 issue of American Medical News (AMNews). Authors said that medical
schools should educate future doctors more thoroughly on the ethical questions they could face in an age
of terror and torture.
3) In AMNews: Solutions for improving health literacy
According to an article in the Dec. 17 issue of American Medical News (AMNews), a recent
conference, co-sponsored by the American College of Physicians Foundation and the Institute of Medicine,
focused on the scope of the health literacy problem and ways that physicians and others can assist
patients who have trouble understanding instructions and information. The AMA is also engaged in finding
solutions to the health literacy problem and encourages the development of patient education materials and
medical education programs that include ways to communicate more effectively with patients who have
limited literacy skills.
View the article.
Visit the Web site for details on the health literacy initiatives of the AMA Foundation.
>>Return to your news interest contents
Medical student issues
1) Save the dates for upcoming AMA-MSS regional meetings
AMA-MSS Regions 1, 2, 4 and 6 have meetings coming up, and you are invited.
- The AMA-MSS Region 1 Meeting, entitled "Health care for the underserved: How will we achieve our goals?" will be held Jan. 18–20, 2008, at Oregon Health & Science University in Portland, Ore. Visit the Web site for more information. Register by Dec. 22 by sending an e-mail with your name, school, phone and time of arrival/departure.
- The AMA-MSS Region 2 Meeting, entitled "Perspectives on genetic discrimination," will be held Feb. 29–March 1, 2008, at the University of Iowa Carver College of Medicine in Iowa City, Iowa. Visit the Web site for more information.
- The AMA-MSS Region 4 Meeting, entitled "Managing the health care team to achieve better patient care," will be held Jan. 11–12, 2008, at the University of South Alabama in Mobile, Ala. Visit the Web site for more information.
- The AMA-MSS Region 6 Meeting, entitled "Students today, physicians tomorrow: The new face of medicine," will be held Feb. 1–2, 2008, at Temple University in Philadelphia, Pa. Visit the Web site for more information and to register by Jan. 6, 2008.
*The AMA will provide $1,000 for regional meetings if the 60-day deadline requirement (one meeting per region per school year) is met. Visit the Web site for more information. Visit the Web site for a list of states in each region.
2) Apply for the physicians-in-training host program
The AMA Alliance, AMA-MSS and AMA Resident and Fellow Section created the physicians-in-training host
program to provide housing opportunities for fourth-year medical students as they interview for residency.
The program helps students cut down on interviewing costs and get to know the community surrounding their
potential residency program, and introduces them to the local medical society and alliance. Through the
physicians-in-training host program, students can expect a one- or-two-night stay in an Alliance member's
home.
The AMA Alliance is the largest organization representing the family of medicine in the United States. The Alliance network of physicians and physicians' spouses, represents all stages of the medical lifestyle, from the training years to retirement. As the proactive volunteer voice of the AMA, the Alliance is dedicated to promoting better public health, ensuring sound health care legislation and fundraising for medical education.
Please visit the Web site for more information on the program or to apply.
3) Check out this grant opportunity for physician-led free clinics
Entering its second year, the AMA Foundation grant program—"Healthy communities, healthy
America"—awards $10,000 to $25,000 grants to physician-led clinics that provide free or low-cost
direct care to the underserved and uninsured.
Grants will be awarded to those clinics with implemented, already-tested projects, regular and considerable operating hours and significant physician involvement. Preference will be given to applicants who demonstrate how grant dollars will be leveraged to provide the greatest amount of care to uninsured populations.
Please visit the Web site for more information or to apply.
4) Call for Joan F. Giambalvo Scholarship Fund applications
Applications for the 2008 Joan F. Giambalvo Scholarship Fund are due Feb. 1, 2008. This scholarship was
established by the AMA Women Physicians Congress with the goal of advancing the progress of women in the
medical profession and strengthening the AMA's ability to identify and address the needs and interests of
women physicians and medical students.
Visit the Web site for additional information and to download an application.
5) December issue of Virtual Mentor available
December's Virtual Mentor investigates how physicians can best carry out their public
health-related duties without compromising their obligation to put the patient's interest first or
endangering the trust that is essential to the patient-physician relationship. The clinical case
commentaries explore school-based initiatives to monitor student obesity, one state's controversial
Medicaid program with wellness incentives, and the fear of deportation that prevents immigrants from
seeking health care. John Stuart Mill asked, "Where does the authority of society begin?" This month's
Virtual Mentor takes up the search for an answer—at least in the sphere of patient-physician
relationships.
Visit the Web site to learn more.
>>Return to your news interest contents
Minority health issues and professional concerns of minority physicians
(brought to you by the AMA Minority Affairs Consortium)
1) Health Action 2008 conference features minority health track
For the second year in a row, Families USA is offering a track that will focus on health equity and
minority health issues at its annual Health Action 2008 conference, taking place in Washington, D.C., from
Jan. 24–26, 2008, at the Renaissance Mayflower Hotel. Attendees will learn about activities at the
national, state and local levels to eliminate racial and ethnic health disparities; meet advocates from
around the country engaged in this work; and reconnect with colleagues in the field.
Visit the Web site for more information or e-mail to inquire about scholarships to attend the conference.
2) Online program looks for ways to increase the number of underrepresented minority
physicians
The AMA has released "Too few racial and ethnic minority physicians in the work force: Why should we care
and what can we do about it?" as part of its online educational series—Educating Physicians on
Controversies in Health. This program looks at the low number of minority physicians and identifies the
barriers many minority students face when considering a career in medicine and how these barriers can be
overcome. Physicians are also shown how they can become involved in inspiring minority students to choose
a career in medicine.
Visit the Web site to view the five-minute program free of charge.
>>Return to your news interest contents
Organized medical staff issues
1) 2007 AMA-OMSS Interim Assembly Meeting summary PowerPoint now available
The AMA-OMSS has developed a new tool for AMA-OMSS representatives to use to communicate with their
medical staffs and medical societies, regarding what policy and education activities occurred at the 2007
AMA-OMSS Interim Assembly Meeting. This meeting summary PowerPoint serves as the foundation for reports
AMA-OMSS representatives make following the 2007 Interim Meeting of the AMA House of Delegates.
Please send an e-mail to Courtney Perlino to receive the PowerPoint. Don't forget that the disposition of actions, meeting summary and highlighted reports from the 2007 AMA-OMSS Interim Assembly Meeting are also available. Access them.
Access the presentations and handouts of the faculty of the AMA-OMSS educational programs.
2) Make your voice heard on key issues affecting medical staffs
Now is the time to make your voice heard and share your experience concerning key issues affecting medical
staffs across the country.
Members can visit the Web site to access the AMA-OMSS online message board and give us your feedback and thoughts on the following issues:
- Protection of medical staff members' personal proprietary information
- Medical staff criminal background checks
- Joint Commission Standard MS.1.20
All AMA-OMSS representatives were sent an invitation via e-mail in August to participate in the newly launched AMA-OMSS online message board, and new representatives were sent an invitation last week. The subject of the e-mail was either "Invitation to Join the American Medical Association Discussion Facility's Collaboration Workspace" or "You have been added to the Organized Medical Staff Section (OMSS) Workspace."
If you did not receive an invitation, please send an e-mail to Courtney Perlino and your invitation will be re-sent to you.
3) Last chance to listen to Joint Commission conference calls on MS.1.20 and new leadership
standards
Did you miss the Joint Commission conference calls on the new leadership standards and Standard MS.1.20 on
Oct. 25 and Nov. 1? If so, you can listen to the conference calls by calling (877) 919–4059. The replay
will be available for 60 days. The conference replay password for the Nov. 1 call on MS.1.20 and new
leadership standards is 25460006. The conference replay password for the Oct. 25 call on new leadership
standards is 24759244.
Learn more about these conference calls and access playback instructions.
4) AHRQ releases toolkits to help reduce medical errors and improve patient safety
The Agency for Healthcare Research and Quality has released 17 toolkits to help physicians, nurses, other
health professionals and patients reduce medical errors. Toolkits are available based on setting and user,
patient safety issue and Joint Commission National Patient Safety Goal, and at no cost.
Learn more about and access these new patient safety tools.
5) In JAMA: Low reimbursements put generalists, surgeons on endangered list
Two recent commentaries in the Journal of the American Medical Association (JAMA) discuss the effects of
federal reimbursement policies on the declining interest in careers in general practice (family medicine,
internal medicine and pediatrics) and general surgery, respectively.
Preview "Unintended consequences of resource-based relative value scale reimbursement" from the Nov. 21 issue of JAMA.
Preview "The impending disappearance of the general surgeon" from the Nov. 14 issue of JAMA.
>>Return to your news interest contents
Resident and fellow issues
1) NRMP board looking for residents
The AMA-RFS is accepting nominations for the National Resident Matching Program (NRMP) Board of Directors.
There are two resident positions available, including one whom must be an international medical school
graduate (IMG). The NRMP board governs and oversees the Main Residency Match and the Specialties Matching
Service, ensures all match participants abide by match policies and informs the medical education
community about trends in graduate medical education. Deadline for nominations is Dec. 21.
Visit the Web site for a nomination form and more information. IMGs may send an e-mail with nomination forms, statements of interest and curricula vitae with the subject line "NRMP Nominee."
2) In New England Journal of Medicine: Starting a family during training could be a
problem
Women now account for half of all medical students—many with training in specialties that extend into
their 40s, according to a Nov. 8 New England Journal of Medicine article. With more women having
children during training, leaves of absence have become more of an issue. Though boards' policies on
leaves of absence vary, the trend is moving toward requiring a fixed number of months of active training.
A strict regulation on length of training may cause substantial hardship for both trainees and programs if
training needs to be extended. Some possible solutions for physicians who are also parents may be "the
broadened availability of on-site child care and other support, the exemption of competent trainees from
making up leave time, the extension of federal reimbursement for graduate medical education to include
paid family leave, and increased part-time training options."
Read the article.
3) In JAMA: Will the general surgeon disappear?
A Nov. 14 Journal of the American Medical Association (JAMA) article examines the decline of the
general surgeon work force. A survey of surgeons found that an unfavorable work environment is the single
most important factor in deciding on early retirement, practice restriction and career change. Other
causes of this shortage include reimbursement issues, professional liability and change in the nature of
the work force of individuals who are entering medicine. With fewer residents choosing general surgery and
existing general surgeons aging, this has affected patient access to surgical care as well as the survival
of small and rural hospitals.
Read the article.
>>Return to your news interest contents
Senior Physicians issues
1) Flu shots covered under Medicare's preventive services
In an effort to help spread the word about preventive services covered under Medicare, the AMA-SPG will
feature a specific covered service regularly in AMA eVoice.
Did you know Medicare will pay for your flu shots once a year in the fall or winter? Each year, an estimated 10 to 20 percent of the population contracts influenza. "Receiving the flu vaccine will provide immunity to most of the influenza strains that are prevalent during the season," said AMA-SPG Governing Council Chair William Jacott, MD. "Contrary to the common myth, the side effects from the shot are minimal or nonexistent. However, contracting influenza, especially in individuals with chronic disease, can be deadly."
Read more about this service. If you are unable to get a flu shot and contract the flu, Medicare beneficiaries can get help paying for antiviral medicines under a new demonstration project. Medicare will cover up to two prescriptions for certain antiviral drugs for beneficiary with influenza.
>>Return to your news interest contents
Women physician and women's health issues
(brought to you by the AMA Women Physicians Congress)
1) Joan F. Giambalvo Scholarship Fund applications due Feb. 1
Applications for the 2008 Joan F. Giambalvo Scholarship Fund are due Feb. 1, 2008. This scholarship was
established by the AMA-WPC with the goal of advancing the progress of women in the medical profession and
strengthening the AMA's ability to identify and address the needs and interests of women physicians and
medical students.
Visit the Web site for additional information and to download an application.
2) Available now: Updated booklet on managing home care patients
The third edition of Medical Management of the Home Care Patient: Guidelines for Physicians is
available for purchase. This valuable resource is made possible through the close collaboration of the AMA
and the American Academy of Home Care Physicians. With more than 100,000 copies of previous editions
distributed, the new edition contains the latest information on continuity of care, based on a decade of
proven approaches. Bound copies are available, 10 per package for $50, plus state sales tax and $9.95 for
shipping/handling.
Order bound copies of the booklet. Limited quantities are available.
>>Return to your news interest contents
Young physician issues
1) AMA bylaws amended to enhance young physician participation
A bylaws change approved at the 2007 Interim Meeting of the AMA House of Delegates aims to enhance
participation in the AMA-YPS Assembly by instituting a new proportional representation formula.
The new formula entitles state medical societies and national specialty medical societies to send at least two voting delegates—and no alternate delegates—to AMA-YPS Assembly Meetings.
This change, which becomes effective on Jan. 1, 2008, is applicable only to the AMA-YPS. Help spread the word by letting young physician colleagues and constituent/specialty societies know about this noteworthy change.
Read (PDF, 25KB) the updated AMA-YPS bylaws.
2) Act now and receive a special discount for AMA's Medical Communications Conference
Young physicians interested in improving their message delivery should consider attending the AMA Medical
Communications Conference, scheduled for April 16–18, 2008, in San Diego. For a limited time, the AMA is
offering members a $100 discount off the regular "early bird" rate of $695.
Online registration is not yet available, but you can take advantage of the special discount by visiting the Web site or sending an e-mail by Dec. 31. If sending an e-mail, please provide your name and contact information so the AMA-YPS can follow up with you—and be certain to mention the discounted rate of $595.
3) Reminder: Deadline for nominations to AMA-elected councils is Jan. 7
The deadline for submitting nominations to AMA-elected councils for 2008 is Jan. 7, 2008. Please submit
your nominations, via e-mail, to Brenda Vidana as soon as
possible.
Visit the Web site for nomination forms and instructions. The AMA-elected councils are:
- AMA Council on Constitution and Bylaws
- AMA Council on Medical Education
- AMA Council on Medical Service
- AMA Council on Science and Public Health
4) In AMA GME e-Letter: The ethics of "poaching" primary care physicians from the Third
World
A study in the Annals of Family Medicine calls into question "the wisdom and ethics of policies
that have resulted in a continuing decline in the U.S. primary care physician supply" and our continued
over-reliance on international medical graduates to meet our primary care needs.
Read more on this and other issues in the December issue of the AMA GME e-Letter.
Other articles highlighted in this issue, include:
- More physicians: The ultimate challenge for medical education
- Low reimbursements put generalists, surgeons on endangered list
- Reader feedback: Lower medical school tuition, require primary care service
- Starting a family, finishing a residency a tricky balance
- Ethics and public health: Physicians as agents of the state
>>Return to your news interest contents
General AMA news
1) Medicare payment: 10 percent cut averted, modest increase for six months
Physicians who care for seniors will be spared—at least temporarily—the 10.1 percent cut in
payments from Medicare and instead will see a 0.5 percent increase until June 30, 2008.
The U.S. Senate and House this week passed the reprieve in a bill that also extends for six months rural physician payment provisions that had been set to expire. While replacing the 10.1 percent cut with a modest increase is an important outcome, the six-month solution creates uncertainty for Medicare patients and their doctors, who are left wondering what to expect come July 1.
"We strongly urge Congress to break the tradition of short-term interventions that are not fully funded and fail to chart a course for replacing a flawed payment formula that is a barrier to improving quality and access to care for seniors," said AMA Board Chair Edward L. Langston, MD.
In light of the legislation, the Centers for Medicare & Medicaid Services is expected to extend the period in which physicians can change their 2008 Medicare participation status. Watch for details about that in upcoming issues of AMA eVoice.
Read (PDF, 44KB) details about how the legislation will affect your practice.
>>Return to your general news contents
2) SCHIP funding extended through March 2009
Legislation passed by Congress this week includes an additional 15 months of funding for the State Children's Health Insurance Program (SCHIP) at current enrollment levels. This includes federal funding to cover state budget shortfalls for the program that covers children in low-income families.
The reauthorization of SCHIP has been a major priority for the AMA and many other health care organizations this year, as the program had been set to expire this month. The House and Senate passed legislation twice this year to reauthorize the program but those bills did not survive a presidential veto. The AMA will continue to advocate for long-term reauthorization of the program.
>>Return to your general news contents
3) Ethics in brief: Physician self-referral
There has been renewed debate this year about physician ownership of medical facilities and the effect those interests could have on Medicare costs. Many believe that these facilities provide quality and efficient health care, while others argue that the possible conflicts of interest created by facility ownership outweigh any benefits.
Physician ownership interests in commercial ventures can provide important benefits in patient care for a variety of reasons, particularly in situations when a needed facility would not be built if referring physicians were prohibited from investing in the facility. However, there are still ethical risks that should be considered. Physician-owned hospitals may increase the possibility of unnecessary laboratory tests or procedures because of the incentive—created by the ownership interest—for physicians to refer their patients. This can threaten the integrity of the patient-physician relationship, which hinges on the ability of a patient to trust the expertise and intentions of the physician.
Ultimately, referral decisions should be made on the basis of necessity and quality of care. Physician-owned health facilities may offer quality and cost benefits, but possible conflicts of interest must be disclosed to patients, as well as care alternatives. As always in the patient-physician relationship, the interests of the patient should be the primary factor in medical decision-making.
For ethical guidelines on physician ownership of health facilities, view (PDF, 49KB) the Council on Ethical and Judicial Affairs ethics Opinion E-8.032.
>>Return to your general news contents
4) Deadline approaching to file for claims in Highmark settlement
Physicians who wish to collect their share of an approximately $10 million settlement payout recently agreed upon by Highmark Inc., which also does business under the name Mountain State Blue Cross and Blue Shield, must file a claim by Feb. 27, 2008.
The proposed agreement is in addition to and separate from the earlier Blue Cross Blue Shield (BCBS) settlement. Settlement forms, which include the notice of the proposed settlement, instructions for filing a proof of claim and the claim form itself, were mailed to physicians on Nov. 29. Completed proof-of-claim forms must be postmarked no later than Feb. 27, 2008, and sent to: Highmark/Mountain State, Settlement Administrator, P.O. Box 3775, Portland, OR 97208-3775.
To opt out of the settlement, physicians must ensure that the settlement administrator receives written notice by Jan. 14, 2008.
Download copies of the settlement documents.
Learn more about this settlement and view the BCBS settlement interactive state map to locate the BCBS parties involved in your state or region in the recent BCBS settlement.
>>Return to your general news contents
5) Enrollment ending Dec. 31, 2007; Act now to travel worry free in 2008
Should you or a family member become sick or injured when traveling abroad—or more than 100 miles away from home in the United States—one phone call can connect you to experienced multilingual professionals ready to help, 24 hours a day.
That's because AMA Insurance Agency Inc. has negotiated an exclusive, deeply discounted rate with Assist America, the premier provider of global emergency services. This arrangement is only available from Assist America in recognition of the AMA as the nation's leading medical organization, dedicated to serving the needs of its members. Enrollment for the 2008 service is available only until Dec. 31, 2007.
Learn more about the program and how to enroll by mail, or call the AMA Insurance Agency at (800) 458–5736 weekdays between 8 a.m. and 5 p.m. CST to enroll using your checking account number. The agency's office will be closed on Dec. 31.
>>Return to your general news contents
6) Give minority physicians a boost—new online program explains how
African-Americans, Hispanic-Americans and American Indians make up nearly a quarter of the U.S. population today and are expected to make up a third of the population within 30 years. But only 7 percent of physicians and 6 percent of medical school faculty members are from one of these underrepresented minority populations.
The AMA's new online educational program, "Too few racial and ethnic minority physicians in the work force: Why should we care and what can we do about it?"—part of the Educating Physicians on Controversies in Health series—looks at ways the physician population can work to increase the number of underrepresented minority physicians in medicine. The program delves deeper into why minority physicians are underrepresented and identifies barriers that prevent minority students from entering the profession and how these barriers can be overcome.
View this free video and others in the series. Each video is designed to inform physicians about the challenges and controversies at the interface of clinical medicine and public health and offer strategies to address these issues in physicians' practices.
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7) AMA Foundation awards grants to free clinics that help the uninsured—apply by Jan. 14
The AMA Foundation is currently accepting applications for its 2008 Healthy Communities/Healthy America program—an initiative that awards $10,000 to $25,000 grants to physician-led free clinics that provide direct care to the underserved and uninsured. To help fund the program, Pfizer Inc. gave the AMA Foundation a major gift of $500,000 earlier this month.
"Pfizer's generous donation will allow us to continue addressing the growing problem of the uninsured and recognizing the extraordinary efforts of physician and community volunteers," said AMA Foundation President Barbara A. Rockett, MD.
Grants will be awarded to existing free clinics that request funds for specific projects and demonstrate excellence in providing affordable medical services, physician volunteerism, resourcefulness and leveraging abilities. Federally-qualified health centers and referral networks that coordinate care but do not provide direct care themselves are ineligible to apply.
This year, the AMA Foundation awarded Healthy Communities/Healthy America grants to 10 free clinics across the country. The 2008 cycle marks the second year for the program, and grants will be awarded next summer.
Learn more and apply. Letters of inquiry are due Jan. 14, 2008.
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8) In JAMA: "False-positive" activation of cardiac catheterization laboratory may occur in some patients with suspected heart attack
Physicians caring for patients suspected of having a heart attack may trigger "false-positive" activation of the cardiac catheterization laboratory based on test results suggestive of a heart attack, according to a study in the Dec. 19 issue of the Journal of the American Medical Association (JAMA). In an accompanying editorial, an author comments on the findings regarding treatment for ST-segment elevation myocardial infarction.
Preview the study.
Preview an editorial on this topic.
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