News in brief - Jan. 6, 2003

AMA delegates seek to protect prompt-pay laws from ERISA challenge - Patients or insurers should pay for interpreters, AMA house says - Doctors want more HIPAA changes - Signature drive forces Nevada tort reform vote - Employers eye cuts in retiree benefits - Rules proposed for religious organizations accepting HHS funds

AMA delegates seek to protect prompt-pay laws from ERISA challenge

The American Medical Association should continue to look for legal avenues to ensure that the federal Employee Retirement Income Security of Act of 1974 doesn't preempt state prompt-payment laws, the House of Delegates decided at its December 2002 Interim Meeting in New Orleans. The Association's Advocacy Resource Center should provide guidance on how to draft legislation on this ERISA issue, delegates voted.

Delegates also called for the AMA to work with states with prompt-payment laws to make sure statutes on the books are being enforced.

Patients or insurers should pay for interpreters, AMA house says

In the ongoing debate about a federal executive order that requires physicians to provide language interpreters for non-English speaking patients, the AMA has called for a system that doesn't require doctors to pay for the interpreters. Delegates at the Association's Interim Meeting in New Orleans in December 2002 voted that patients or third-party payers need to pay interpreters directly.

AMA delegates also called for doctors to help with and respect patients' choices about whether to use capable family members or friends as interpreters. Physicians should use print materials, telecommunication services or other methods to help non-English speaking patients understand medical care, delegates said.

Doctors want more HIPAA changes

The federal government last year took steps to make the medical records privacy law less burdensome, but doctors want to see even more changes as the April deadline for compliance looms.

The privacy rules are part of the Health Insurance Portability and Accountability Act of 1996. The AMA House of Delegates at its Interim Meeting in New Orleans in December 2002 called for the AMA to continue to identify and work toward repealing onerous HIPAA rules. The group should particularly target sections that don't fully protect patient confidentiality and language that creates criminal sanctions for physicians.

"HIPAA regulations strip away regular, traditional protections patients already had," said Paul Appelbaum, MD, American Psychiatric Assn. president.

The law is expected to cost doctors thousands of dollars to comply. The amount is particularly worrisome to physicians in small, rural practices. "It's going to have a dramatic impact on three- to four-person groups in rural America," said Nebraska family physician Ronald W. Klutman, MD. He estimates that compliance will cost his five-person group about $10,000.

Signature drive forces Nevada tort reform vote

Nevada Secretary of State Dean Heller last month said physicians had collected enough signatures to force the state Legislature to pass or reject a tort reform initiative aimed at strengthening measures passed earlier last year.

The petition had 77,100 valid signatures from voters in 14 counties, Heller said. The group had to collect at least 61,336 signatures in 13 counties. Nevada lawmakers will have to vote on the initiative within the first 40 days of their session, which starts in February. If legislators reject or do not vote on it, the initiative goes to voters in the November 2004 election.

The measure calls for limiting lawyers' fees in medical malpractice cases, allowing physicians to pay over time when awards exceeded $50,000; eliminating exceptions to the $350,000 cap on noneconomic damages; telling juries when an insurance company already has covered the medical expenses that are part of the suit; and ensuring that defendants in medical malpractice cases pay only their portion of the damages.

Employers eye cuts in retiree benefits

Older Americans are likely to face increased health care costs in coming years as one in five large employers said they are likely to curtail coverage for future retirees. Employer-sponsored retiree plans offer health coverage to individuals who retire before becoming eligible for Medicare benefits and provide supplemental coverage for Medicare beneficiaries.

According to a survey by the Kaiser Family Foundation, 22% of employers are likely to eliminate coverage for future retirees, often for those recently hired, within the next three years. Some 82% of the firms expect to increase premiums for retirees, and 85% plan to raise prescription drug co-payments. About 13% said they had terminated benefits for future retirees over the last two years.

"This study is the latest bad news for American workers on the health care front," said Drew Altman, PhD, president and CEO of the Kaiser Family Foundation. "Current retirees are being asked to pay more for their health coverage, and current workers are less likely to get health benefits from their employer when they retire."

Rules proposed for religious organizations accepting HHS funds

The U.S. Health and Human Services Dept. has proposed regulations to clarify the rights and requirements of religious organizations that use HHS funds to deliver services to needy Americans. The rules aim to ensure that religious organizations are treated equally with others when applying for HHS funds and to protect them from having to make changes affecting their religious character when using those funds.

The proposal also would require that faith-based organizations serve all individuals who are eligible for HHS services equally, regardless of their religious beliefs. Under the rules, federal funds could not be used to pay for religious activities and people who are served by federal programs must not be required to take part in those activities.