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GOVERNMENT & MEDICINE

News in brief - May 19, 2008

Stakeholders support mandatory electronic prescribing in Medicare - Medicare to cover artificial hearts - Most docs want health system reform - Report: 12 million uninsured are eligible for public coverage - 200 million children younger than 5 worldwide lack basic health care - Georgia law lifts requirements on general surgery centers

Stakeholders support mandatory electronic prescribing in Medicare

The Pharmaceutical Care Management Assn. has gained more allies in its campaign calling for a requirement that physicians use electronic prescribing in Medicare.

The PCMA, which represents benefit managers that administer the Medicare drug benefit, along with dozens of consumer groups, business organizations and prescription drug stakeholders, sent a letter to Congress on May 1 supporting an e-prescribing mandate. The signatories included AARP, General Motors Corp., Express Scripts Inc. and the American Medical Group Assn.

The PCMA wants lawmakers to add e-prescribing to a Medicare physician payment bill expected this spring. The American Medical Association and community pharmacists oppose a mandate but support voluntary e-prescribing initiatives.

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Medicare to cover artificial hearts

The Centers for Medicare & Medicaid Services on May 1 issued a final national coverage determination allowing Medicare to cover artificial hearts used in federally approved clinical studies.

A 1986 policy had prevented coverage of the devices for Medicare beneficiaries for more than 20 years. But artificial heart manufacturers have conducted clinical trials since then showing that the devices are a promising treatment option for patients with severe heart failure who are about to die, CMS said.

Under the new policy, Medicare will pay for artificial heart implantation for eligible patients who are enrolled in a study approved by both the Food and Drug Administration and CMS. The Medicare agency then will collect and analyze scientific evidence to determine how well the devices work for Medicare patients.

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Most docs want health system reform

Only 5% of physicians want to keep the U.S. health care system as it is, according to a LocumTenens.com online survey of 1,379 doctors conducted in March and April. Physician support for reform was divided nearly evenly between tax credits for the uninsured to buy coverage, a universal health insurance system with a single payer, and a universal system with multiple payers.

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Report: 12 million uninsured are eligible for public coverage

About 12 million of the 47 million uninsured people in the U.S. are eligible for public health coverage but fail to enroll because they fear the stigma attached to such programs, do not know the programs exist, or are unsure how to enroll or stay enrolled, according to a new report by the National Institute for Health Care Management Foundation, a Washington, D.C.-based think tank.

Also, although childless adults account for more than half of the uninsured, states generally restrict this population's access to public health programs more than they do for children or parents, the report stated. "The paucity of public coverage for low-income childless adults is really troubling," said Nancy Chockley, the foundation's president and CEO. "This is a population that really can only be helped by an expansion of public programs or some form of subsidy, yet we don't see a lot of that out there across the states." The report, "Understanding the Uninsured: Tailoring Policy Solutions for Different Subpopulations," is online (www.nihcm.org/publications/uninsured1).

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200 million children younger than 5 worldwide lack basic health care

Save the Children, a global humanitarian organization, announced on May 1 that more than 200 million children under age 5 around the world lack basic health care.

The estimate is from the group's ninth annual "State of the World's Mothers" report, which defines basic health care as prenatal care, skilled care at childbirth, immunizations, and treatment for diarrhea and pneumonia.

The report also ranked 55 developing nations in terms of providing basic care to children under age 5, placing the Philippines first and Ethiopia last. More than 80% of Ethiopian children do not receive basic lifesaving care. The report recommends a global effort to provide more community health workers to the poorest, most marginalized countries.

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Georgia law lifts requirements on general surgery centers

Georgia physicians say a new law easing certificate-of-need requirements on some ambulatory surgery centers will help expand access to care and lower health care costs.

The measure, enacted April 9, reclassifies general surgery as a single specialty, rather than multiple specialties, and lifts certain restrictions requiring general surgical centers to demonstrate need before offering services. The Medical Assn. of Georgia supported the change, which takes effect July 1.

The legislation was prompted, in part, by a lawsuit the hospital industry brought challenging a similar rule approved by the state Dept. of Community Health last December. The state medical society joined the case as a defendant. Lawyers involved now expect the suit to be dismissed.

An attorney for the Georgia Alliance of Community Hospitals said the new law resolves some of the hospitals' concerns by mandating general surgical centers to meet minimum charity and indigent care requirements. But hospitals still worry that the measure could jeopardize patient care by allowing the ambulatory facilities to pick higher-paying patients.

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Copyright 2008 American Medical Association. All rights reserved.