News in brief - July 17, 2006

CMA executive to head American College of Cardiology - CMS gives safe harbor to CME - N.Y. case with questioned expert witness testimony can go forward

CMA executive to head American College of Cardiology

John C. "Jack" Lewin, MD, has been appointed chief executive officer of the American College of Cardiology and will start his new position after the college's move to Washington, D.C., in September.

Dr. Lewin is currently CEO of the 35,000-member California Medical Assn., where he has served as chief staff officer the past 11 years. He has served on various advisory panels and boards, including Californians Allied for Patient Protection, the American Medical Association's Commission on Unity and the Navajo Nation Health Advisory Board.

"Dr. Lewin brings a lifetime of experience in health care leadership and innovation," ACC President Steven E. Nissen, MD, said in a statement. "His vision and passion will greatly enhance our ability to fulfill our mission: to advocate for quality cardiovascular care -- through education, research promotion, development and application of standards and guidelines -- and to influence health care policy."

CMS gives safe harbor to CME

The Centers for Medicare & Medicaid Services has given hospitals the OK to pay for physicians' continuing medical education done on site, such as grand rounds.

The decision follows concern that such free CME could be interpreted as a kickback for patient referrals in violation of Stark self-referral laws and the anti-kickback statute. As a result, CME providers say some hospitals had begun to limit such continuing education.

To protect hospital-based CME, the AMA sent a letter in May 2005 to CMS Administrator Mark McClellan, MD, PhD, that asked for an exception. Other organizations also petitioned for the exception.

Dr. McClellan's response in March was that "traditional, on-site hospital grand rounds and other similar in-house education programs provided by hospitals are important and convenient ways for physicians to earn CME credit and for hospitals to ensure high quality patient care. We do not believe that such programs ... necessarily constitute remuneration to the physicians who attend them."

The clarification is expected to be formalized in the Federal Register.

N.Y. case with questioned expert witness testimony can go forward

A New York appeals court this summer declined to rehear a case doctors challenged saying that the initial ruling lowered the standards on expert witness testimony allowed in medical liability lawsuits. The ruling clears the way for the lawsuit to go to trial.

The Appellate Division of the Supreme Court ruled in April that medical experts did not need to use peer-reviewed medical literature to show that their opinion was accepted in the scientific community. Judges found that a trial court applied the testimony rule "too restrictively" when it dismissed the case, Zito v. Zabarsky.

The appeals court allowed the case to go forward based largely on a single incident report to support Patricia Zito's claim that an alleged excessive dose of cholesterol medication caused her to develop an autoimmune disease. The physician has denied the accusations.

Doctors sought to overturn the appellate court's ruling, fearing it could set a dangerous precedent for enabling unreliable "junk science" to influence a jury. The Medical Society of the State of New York and the AMA filed a friend-of-the-court brief, contending that state law requires strict review of expert testimony.

MSSNY General Counsel Donald Moy said, "We feel the issues are important and could exacerbate the liability crisis if the court is going to relax the rules of causation, and we will continue to monitor the case."