News in brief - July 11, 2005

AMA vote on Patriot Act supports protecting patient confidentiality - Deviation from guidelines should not be criminalized, AMA says - AMA vote: No uninsured commission - New AMA policy emerges from the Terri Schiavo case - Bill would shine light on companies that rely on Medicaid - VA comes up $1 billion short

AMA vote on Patriot Act supports protecting patient confidentiality

Physicians at the American Medical Association Annual Meeting last month directed the AMA to work to protect patient confidentiality from being violated by a provision of the USA Patriot Act, the federal anti-terrorism legislation passed in 2001.

Physicians were concerned about Section 215 of the law, which states physicians can be forced to provide a patient's record without a warrant or subpoena, and prohibits them from telling the patient of the government demand.

That section of the law sunsets on Dec. 31, but Congress might try to reauthorize it, physicians predicted. The AMA plans to lobby for letting the provision expire as scheduled or for amending it to meet the Association's strong confidentiality guidelines.

Some physicians said the AMA should not irritate Republican leaders whose help it needs on topics such as Medicare payment and medical liability reform. Others urged the AMA to stand by its patient privacy principles.

"This is a major tenet of what the AMA stands for," said Carol Rose, MD, an anesthesiologist from Pittsburgh.

Deviation from guidelines should not be criminalized, AMA says

Physicians and other health care professionals should not face criminal charges for making medical decisions or taking actions that are not in line with care guidelines, according to a Board of Trustees report approved at the American Medical Association Annual Meeting in June.

This action came because several states passed laws during last year's flu vaccine shortage making it illegal to immunize people not on the Centers for Disease Control and Prevention's recommended list. The shortage later became a surplus, but physicians in some areas could not use the vaccine they had, due to the laws.

"Government guidelines often lead to inefficient results when they are solely in response to variable, short-term circumstances," said AMA Trustee Cyril M. Hetsko, MD.

The Association will seek legislation to prevent these kind of laws from getting on the books again.

AMA vote: No uninsured commission

The American Medical Association House of Delegates decided against creating a "crisis commission" looking at health care access for now, stating that such a move could result in a duplication of efforts.

Delegates from Massachusetts proposed a resolution at the AMA Annual Meeting in June to create the commission, which would have included representatives of organized medicine and health care policy-makers.

AMA leaders and other delegates noted that a reform group already being led by Families USA and UnitedHealth Group includes representatives from the Association. That coalition has been discussing care access since late last year.

New AMA policy emerges from the Terri Schiavo case

The American Medical Association will oppose lawmakers' attempts to make artificial hydration and nutrition decisions on behalf of incapacitated patients.

The American Academy of Neurology introduced the resolution at the AMA Annual Meeting in June in response to the Terri Schiavo case, during which Congress and the Bush administration tried to get a court order to reinsert Schiavo's feeding tube.

The AMA will also look at the feasibility of requiring a written advance directive from anyone enrolling in a health plan or applying for a driver's license.

Bill would shine light on companies that rely on Medicaid

Wal-Mart is once again the target of critics who argue that the retail giant has helped launch a new race to the bottom in employer-based health coverage.

In response to recent findings that the company's workers receive more than $210 million in taxpayer-financed health care in 15 states, Sen. Edward Kennedy (D, Mass.), Sen. Jon Corzine (D, N.J.) and Rep. Anthony Weiner (D, N.Y.) last month introduced a bill that would require all states to report annually on the number of employees of large companies who receive health coverage through Medicaid and other public programs.

"American companies must start providing living wages and affordable health benefits to their employees and stop saddling the federal, state, and local governments and the taxpayers with their responsibilities," Corzine said.

VA comes up $1 billion short

Dept. of Veterans Affairs officials recently revealed that they had to shift more than $1 billion in funds allocated for next year and for building and maintenance to pay for health care services this year. The shortfall was in a part driven by the large number of reservists returning from Afghanistan and Iraq, VA officials told a House Veterans Affairs Committee.

The VA came under fire from lawmakers who said the department should have told them about the shortfall sooner. Veterans groups were critical also, saying that the funding problems have resulted in clinic closings and delayed appointments for veterans.

VA Secretary Jim Nicholson defended the agency, saying, "Working with our partners in Congress, I'm confident that VA's budget will continue to provide world-class health care to the nation's veterans."