News in brief - Feb. 14, 2005

Medicaid buy-in proposed - Updated guidance for hospital voluntary compliance programs - Fetal pain bill introduced

Medicaid buy-in proposed

Sen. Chuck Grassley (R, Iowa) and Sen. Edward Kennedy (D, Mass.) have reintroduced legislation that would allow families of children with disabilities to buy into Medicaid if they make too much money to qualify for the program.

The bill, which passed the Senate last year, is designed to encourage parents to continue working even if it will place them outside the income range eligible for Medicaid benefits.

"Many parents of disabled children have to drop out of the work force or keep themselves in a low-paying job just to remain eligible for Medicaid. In effect, the government is forcing parents to choose between near-poverty and their children's health care," Grassley said.

Parents would pay into the program on a sliding scale based on their income. For children with disabilities, Medicaid offers comprehensive coverage for things such as physical therapy and medical equipment, which often are not paid for by private health insurance.

Updated guidance for hospital voluntary compliance programs

In an effort to continue promoting voluntary compliance programs at hospitals, the Dept. of Health and Human Services Office of Inspector General in January updated its guidance on how to design effective programs.

The update, "OIG Supplemental Compliance Program Guidance for Hospitals," identifies additional fraud and abuse risk areas for hospitals that participate in Medicare and other federal health programs.

The supplement also takes into account the changes to hospital payment systems and other industry practices that have evolved since the OIG released the original document in 1998.

Risk areas that are discussed include the physician self-referral law, the federal anti-kickback statute and relationships between hospitals and physicians.

More information is on the OIG's Web site (oig.hhs.gov/fraud/docs/complianceguidance/012705hospsupplementalguidance.pdf).

Fetal pain bill introduced

Sen. Sam Brownback (R, Kan.) has introduced legislation that would require physicians to notify women seeking abortions 20 weeks after conception that there is growing medical evidence that a fetus can feel severe and extreme pain during an abortion procedure.

That evidence comes from an expert report prepared for the congressional debate over the partial-birth abortion ban. The ban was passed last year but has been stymied by judicial challenges. The Unborn Child Pain Awareness Act also would require physicians to offer the women the option of anesthesia for the fetus during the procedure.

"It is time to look at the unborn child and recognize that it is really a young human who can feel pain and should be treated with care," Brownback said.