News in brief - June 2, 2008

Tennessee adopts liability reforms - Medicare EMR demo attracts interest - Schwarzenegger proposes deeper cuts - AAP backs bill to block SCHIP directive

Tennessee adopts liability reforms

For the first time in 30 years, Tennessee enacted reforms to the state's medical liability system. Physicians praised the law, signed by Gov. Phil Bredesen on May 15, saying it will help reduce frivolous lawsuits and keep medical liability costs in check.

The measure requires plaintiffs to give defendant doctors written notice at least 60 days before filing a lawsuit. Plaintiff lawyers must include a certificate of merit from a qualified medical expert showing the basis for the claim. Attorneys who fail to comply with the certification process face penalties, including possible case dismissal. The Tennessee Medical Assn., which backed the law, pointed to state data showing that more than 80% of medical liability claims ended in no payouts to plaintiffs, but resulted in increased health care costs.

Medicare EMR demo attracts interest

More than 30 communities have applied for only 12 spots in an upcoming Medicare demonstration project that will provide financial incentives to primary care physicians to use certified electronic medical record systems. Dept. of Health and Human Services Secretary Michael Leavitt said the project is expected to reduce medical errors for millions of patients.

The Centers for Medicare & Medicaid Services plans to select the 12 participating communities in June.

In the fall, the agency will begin work with its partners in those areas to recruit up to 1,200 small- to medium-sized physician practices to join in the five-year project. The practices will receive incentive payments and financial bonuses for using their EMRs systems to help reach clinical quality targets outlined by CMS. The most successful practices could receive as much as $58,000 per physician or up to $290,000 per practice for the five-year run.

"This is an outstanding response from communities and, in some cases, entire states," Leavitt said. "It shows the great appetite for programs that offer incentives to physicians who efficiently use [EMRs] to improve the quality of care they provide to their patients."

Schwarzenegger proposes deeper cuts

California Gov. Arnold Schwarzenegger -- facing a $17.2 billion budget deficit for fiscal 2008-09 -- last month proposed $5.5 billion in additional cuts, including $1.1 billion in reductions to an array of health and social services. Schwarzenegger had already proposed $7 billion in cuts in January, including a 10% Medicaid pay reduction for physicians, which the state adopted in February. The CMA has filed a lawsuit to block the pay cut, due to take effect July 1.

The latest cuts would save $129 million by instituting limits on legal and undocumented immigrants' Medicaid eligibility, and $31 million by tightening Medicaid eligibility for citizens. Schwarzenegger's cuts would restrict millions of Californians' access to health care, said Richard Frankenstein, MD, president of the California Medical Assn. "If this budget somehow passes and even a fraction of these cuts go into effect, Gov. Schwarzenegger's legacy to the people of California will not be the health care reform he has promised, but instead a health care system damaged beyond belief."

AAP backs bill to block SCHIP directive

The American Academy of Pediatrics has endorsed legislation that would nullify a federal directive curtailing eligibility in the State Children's Health Insurance Program. The measure would stop the Centers for Medicare & Medicaid Services from enacting on Aug. 17 a directive designed to limit children in families earning 250% of more of the federal poverty level from enrolling in SCHIP until 95% of children in eligible families earning 200% of poverty or less had been enrolled. The Protecting Children's Health Coverage Act of 2008 has not yet received a committee vote.

The American Medical Association has asked the Bush administration to rescind the SCHIP directive. The CMS rules come at a bad time, wrote AAP President Renée R. Jenkins, MD, in a May 13 letter to Rep. Frank Pallone (D, N.J.), chair of the House Energy and Commerce health subcommittee. "At a time when the families of uninsured and underinsured children are dealing with financial burdens compounded by high, and at times unaffordable, health care costs, many are forced to turn to Medicaid and SCHIP to access necessary health services," he said.

Vote refines AMA stance on health reform
The AMA House of Delegates rejected attempts to rescind support of a U.S. House health reform bill and any new government-sponsored health insurance plan during the 2009 Interim Meeting.
Story - AMA House - Slideshow