News in brief - July 28, 2003

Fund calls for immediate Medicare eligibility for disabled - Ad war going on over drug reimportation - State law determines application of damage award cap

Fund calls for immediate Medicare eligibility for disabled

Eliminating a two-year waiting period for disabled adults to qualify for Medicare would expand health care coverage to more than 1.2 million individuals and ease the financial burden for states and employers, a Commonwealth Fund study concluded.

Disabled adults under the age of 65 can enroll in Medicare if they meet Social Security's work history requirements for disability benefits and prove they are too disabled to work. But those beneficiaries must wait five months for the disability benefits to kick in and then another two years to qualify for Medicare coverage.

The study found that 40% of the 1.26 million disabled Americans currently in the two-year waiting period are enrolled in Medicaid programs. If Congress were to waive the requirement, states would save $1.8 billion per year. Medicare costs would increase by about $8.7 billion, although the federal government would save $2.5 billion in Medicaid spending.

"Eliminating the two-year wait would ensure access to care for those already on the way to Medicare," said Karen Davis, president of The Commonwealth Fund, a private research foundation.

Ad war going on over drug reimportation

Congressional proponents of drug reimportation provisions have launched radio ads to counteract radio spots run by the Partnership for Safe Medicines, a coalition that includes the Pharmaceutical Research and Manufacturers of America and the U.S. Chamber of Commerce.

Partnership ads claim that reimportation introduces the possibility of counterfeit and tainted medications, risking patients' health and lives.

Proponents counter that American consumers are being gouged and reimportation is simply a matter of free trade. And they argue that the Canadian system's safety requirements are as stringent as those of the U.S. Food and Drug Administration.

Limited reimportation language was included in Medicare reform bills. A separate House bill allowing broader importation is set for debate.

State law determines application of damage award cap

If a patient from a state without a cap on noneconomic damage awards is injured in a state with cap damages and then tries to file a medical malpractice claim under the federal Tort Claims Act, the lawsuit still is subject to the noneconomic damages cap, the 7th U.S. Circuit Court of Appeals recently ruled.

An 11-year-old Illinois girl had corrective surgery for severe scoliosis of the spine at the Bethesda Naval Hospital in Maryland. The procedure left her paraplegic. After a jury trial in a federal court in central Illinois, a jury awarded her $3.4 million in economic damages and $15.5 million in noneconomic damages. Yet, Maryland's law caps noneconomic damage awards at $530,000.

The appellate court ruled in Carter v. U.S. that Maryland's law capping noneconomic damages should apply because federal laws say that the "law of the place where the act or omission occurred" is the law that should prevail.