News in brief - Oct. 25, 2004

N.J. panel votes against doctors' "access fees" - Senate passes anabolic steroid bill - Medicaid eats up state budgets

N.J. panel votes against doctors' "access fees"

Some New Jersey lawmakers are trying to bar physicians from charging patients "access fees" that go above and beyond co-payments, co-insurance and deductibles required by health plans.

The New Jersey Senate Commerce Committee Oct. 4 unanimously passed a bill that would prohibit doctors from asking that patients insured by managed care companies pay "a fee, including, but not limited to, an access fee, in excess of the payment provided by a carrier under a managed care plan."

Bill sponsors said the goal is to prevent doctors from charging patients for e-mail, phone consultations and other services. "While I appreciate that there are many services provided by physicians that are not covered by insurance plans, it is not right for doctors to go beyond the contract they signed with the HMO and pass those costs on to the patient," said New Jersey Sen. Joseph F. Vitale, the bill's co-sponsor.

Raymond E. Cantor, director of governmental affairs for the Medical Society of New Jersey, said the organization opposes the bill. MSNJ executives plan to meet with the measure's sponsors to discuss what physicians are experiencing. For example, managed care companies aren't providing reimbursement rates at a reasonable level, they said.

Senate passes anabolic steroid bill

The Senate recently passed legislation to add anabolic steroid precursors to the list of federal controlled substances, which would require individuals to have a doctor's prescription to purchase them. The precursors currently are sold over the counter as dietary supplements. They convert to anabolic steroids once metabolized by the body and can have similar effects, some irreversible and toxic.

"Education and legislation are needed to stop this abuse and protect our high school students, and others, from the dangers of anabolic steroids," said AMA Trustee Ron Davis, MD. The bill must be reconciled with a House version of the measure before it can go to President Bush's desk.

Medicaid eats up state budgets

In 2003, Medicaid accounted for 21.4% of states' budgets, only slightly less than education. This year, the program is expected to exceed education as a percentage of state budgets, according to a new report from the National Assn. of State Budget Officers.

Medicaid's spending growth, which hit 8% between 2002 and 2003, has been fueled by rising health care costs and large declines in private coverage because of growing unemployment.

"Medicaid is crowding out other parts of state budgets," said NASBO Executive Director Scott Pattison. "Medicaid's unsustainable pace of growth means that over both the short and long terms, states must find some source of relief." States have tried to contain the program's growth by limiting physician reimbursement and setting stricter eligibility requirements. Many states have further plans for such cuts.