News in brief - July 31, 2000

Physician training scheduled on Medicare data collection - Florida verdict hits tobacco industry with major damages - New Senate GOP Medicare drug plan comes under fire - Medical records privacy action unlikely to pass this year - Clinton names advisory panel for alternative medicine

Physician training scheduled on Medicare data collection

Washington -- The Health Care Financing Administration will hold five regional physician training sessions on the collection of data that accurately reflect the health of patients in the Medicare+Choice program. Doctors will be required to submit the data to HCFA beginning Oct. 1. The training dates and locations are: Aug. 23, Palo Alto, Calif.; Aug. 29, Philadelphia; Sept. 7, Chicago; Sept. 13, Tampa, Fla.; and Sept. 20, San Diego.

The sessions are intended as "train the trainer" courses. Attendees will be given CD-ROMs that can be used to help train other physicians. The data gathered will be used to develop a new payment method, called risk adjustment, that will attempt to adequately compensate health plans that care for sicker patients. Register at the Web site (http://www.ritecode.com/regform/regform.htm).

Florida verdict hits tobacco industry with major damages

Sick smokers who took on the tobacco industry in a Florida class action lawsuit won a big battle earlier this month when a jury imposed a verdict of $145 billion in punitive damages against cigarette makers.

"Today's $145 billion verdict against Big Tobacco is a victory for public health," said AMA President Randolph D. Smoak Jr., MD. "The jurors' message is loud and clear: The tobacco industry must pay for addicting and poisoning people for profit."

During court arguments, the industry asked that the verdict not exceed $400 million, maintaining that anything more would put them out of business. Plaintiffs sought nearly $200 billion. In the end, the award broke all existing U.S. jury award records.

Tobacco industry lawyers immediately promised to pursue appeals and maintained that no final order could be signed until all the smokers' claims are decided -- a process that could take decades. Meanwhile, plaintiffs planned to press the court to develop a speedy mechanism to begin disbursing funds.

One of the first postverdict issues for the court's review will be consideration of a state law passed last spring limiting to $100 million the amount of money a defendant in a Florida lawsuit must post during appeal. Under the previous rule, a defendant had to post the entire verdict.

If this law is upheld, the industry would gain considerable leeway in pursuing appeals.

For now, some experts say the verdict could spur more claims in other states. Others point to this case as evidence that Congress should act.

"While the Engle decision is a critical step in holding the tobacco industry responsible for what it has done, it is not a substitute for a national tobacco policy," said Matthew Myers, president of the Campaign for Tobacco-Free Kids.

New Senate GOP Medicare drug plan comes under fire

Senate Finance Committee Chair William Roth (R, Del.) met resistance from his Democratic and Republican colleagues when he released an outline of his Medicare outpatient prescription drug plan in mid-July.

Under Roth's plan, seniors would choose between their existing Medicare coverage and a new "expanded option," which would have the prescription drug benefit. Roth said the proposal's cost estimates were still pending. The plan includes a $500 deductible for drug coverage plus new co-payments for some services, such as home health care. Other provisions include subsidies to help low-income beneficiaries pay their out-of-pocket costs and the creation of a new Medicare Competitive Benefits Office to oversee the drug benefit and the Medicare+Choice program.

Sen. John Breaux (D, La.) said Roth's proposal would never get out of the Finance Committee nor pass in the full Senate because of opposition from both parties. "My biggest complaint is that it creates a multibillion-dollar entitlement and puts it back into the 1965 Medicare model -- top-down, government-micromanaged, government-regulated," said Breaux, who chaired the National Bipartisan Commission on the Future of Medicare.

Medical records privacy action unlikely to pass this year

Protecting the privacy of medical records is a hot issue this year, but perhaps too hot for an election year, say many advocates who fear Congress will fail to pass any major protections this session.

"We were hoping something would actually happen this year," said Joy Pritts, senior counsel with the Health Privacy Project at Georgetown University. "But in our heart of hearts we realized there would be a lot of grandstanding, this being an election year."

The Senate Banking, Housing and Urban Affairs Committee followed that scenario July 13 when, after several committee members spoke of the need for medical records privacy, it rejected an amendment offered by Sen. Richard Shelby (R, Ala.) that would have provided some protection.

Advocates, including the AMA, support legislation that would restrict the unauthorized use of consumers' medical records.

Of particular concern is a banking law, enacted last fall, that allows affiliated financial institutions to swap consumer information. For example, privacy advocates fear that a life insurer could share data with an affiliated mortgage firm without a consumer's permission.

The banking and insurance communities, however, say those fears are unfounded. "Our industry has a stellar record on consumer privacy," the American Insurance Assn. told the Senate committee.

In the House, the Banking and Financial Services Committee passed a bill that would require consumers to provide their consent before financial institutions could disclose medical records to affiliates. The AMA favored the "opt-in" provision but urged that the bill be strengthened.

Clinton names advisory panel for alternative medicine

The Clinton administration recently named James S. Gordon, MD, as chair of the White House Commission on Complementary and Alternative Medicine Policy. Dr. Gordon, a Washington, D.C., psychiatrist, is director of the Center for Mind-Body Medicine and former chair of the program advisory council at the National Institute of Health's Office of Alternative Medicine.

The commission is charged with developing a set of legislative and administrative recommendations to guide the national agenda on alternative medicine.

Other physician members are: George M. Bernier Jr., MD, a Galveston, Texas, hematologist-oncologist; William R. Fair, MD, a Long Boat Key, Fla., urologist; Joseph J. Fins, MD, a New York City internist; Wayne B. Jonas, MD, Alexandria, Va., a member of the Dept. of Family Medicine at the Uniformed Services University of Health Sciences; Dean Ornish, MD, Sausalito, Calif., president and director of the Preventive Medicine Research Institute; and Conchita M. Paz, MD, a Las Cruces, N.M., family physician.