News in brief - April 1, 2002

Health care coverage dropped from stimulus package - Court ruling hailed as win for mental health coverage - Medicare expands nutrition counseling coverage - OIG criticizes ASC oversight - New York bill would protect patient care whistle-blowers - Michigan bill calls for state licenses for doctors evaluating malpractice suits

Health care coverage dropped from stimulus package

The economic stimulus legislation President Bush signed into law on March 9 does not include any form of assistance for unemployed workers to maintain their health coverage.

Earlier Republican and Democratic versions of the bill would have provided coverage, but the two parties differed in their approaches. Republicans favored tax credits to help laid-off workers purchase health insurance, while Democrats would have preferred subsidizing health insurance premiums through COBRA and providing states with a temporary increase in the federal Medicaid matching rate.

Court ruling hailed as win for mental health coverage

A federal ruling has "opened a breach in the artificial wall" separating insurance coverage for physical and mental illnesses, according to the National Alliance for the Mentally Ill.

The U.S. District Court for the District of Columbia said that Fannie Mae and Unum Life Insurance Co. of America were wrong to classify a Fannie Mae employee's bipolar disorder as a mental illness. It should have been classified as a physical illness, the court said in Fitts v. Federal National Mortgage Assn. Benefits for mental illness were limited to 24 months.

"The decision has symbolic importance in the ongoing congressional debate over parity for mental illnesses in health insurance," said Ron Honberg, the alliance's legal director. "It will have a practical impact on precisely how the industry drafts long-term disability insurance contracts in the future."

Medicare expands nutrition counseling coverage

The Centers for Medicare & Medicaid Services recently expanded coverage of medical nutrition therapy for Medicare beneficiaries with diabetes and renal disease. Beneficiaries can receive the new benefit while also getting diabetes self-management training.

Under the benefit, a dietician or nutritionist creates individualized meal plans after a patient assessment. General nutrition is only one component of comprehensive diabetes outpatient self-management.

More information on the benefit can be found online (http://www.hcfa.gov/coverage/8b3-ggg.htm).

OIG criticizes ASC oversight

Medicare's quality oversight for ambulatory surgical centers is "not up to the task," according to reports by the Dept. of Health and Human Services Office of Inspector General. Nearly a third of centers certified by state agencies have not been recertified in five or more years. Those accredited by private groups are surveyed at least every three years, but the process devotes less attention to compliance.and the Centers for Medicare & Medicaid Services does little to hold state certification agencies and accreditors accountable, the OIG stated.

In addition, the conditions of coverage -- the set of minimum health and safety requirements around which oversight revolves -- have not been updated since 1982.

More information can be found online (http://oig.hhs.gov/oei/oei.html).

New York bill would protect patient care whistle-blowers

Physicians and other health care workers in New York who speak up about unsafe patient care are a step closer to better protection from retaliation.

The New York State Assembly in March passed a bill that would let the courts fine a health care facility up to $10,000 if they retaliate against a whistle-blower. It would also protect whistle-blowers who report "potentially harmful" situations. Current law protects health care workers who report cases of actual patient harm. A similar bill is on the state Senate's calendar.

Michigan bill calls for state licenses for doctors evaluating malpractice suits

A Michigan lawmaker last month introduced a bill that would require physicians who certify that medical malpractice lawsuits have merit to be licensed in the state.

Michigan law requires lawyers filing such suits to obtain an affidavit from a physician saying the claim is reasonable. Trial lawyers say the proposed licensing mandate would unfairly deter medical malpractice suits because Michigan doctors would be reluctant to speak out against their colleagues.