News in brief - Oct. 19, 2009

Lawmakers question tobacco firms over ban on flavored cigarettes

Two members of the House Energy and Commerce Committee sent letters to two tobacco distributors regarding reports the companies were attempting to circumvent the Food and Drug Administration ban on the sale of certain flavored cigarettes.

Committee Chair Henry Waxman (D, Calif.) and Rep. Bart Stupak (D, Mich.) wrote Kretek International in Moorpark, Calif., and Cheyenne International in Grover, N.C., and addressed concerns that both companies had repackaged their flavored cigarettes as filtered or "little" cigars.

On Sept. 22, the FDA, under authority of the Family Smoking Prevention and Tobacco Control Act, banned sales of most flavored cigarettes.

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OIG to review imaging payments

The Dept. of Health and Human Services Office of Inspector General plans to examine Medicare Part B imaging payments for scans provided in emergency departments, looking for any fraud or abuse.

Due to the heightened scrutiny, the American College of Radiology recommends radiologists properly document medical necessity and correctly code for their services.

The OIG also is continuing an examination of imaging services and billing patterns in locations with a high density of independent diagnostic testing facilities. In addition, it will start inspecting the degree to which data and safety monitoring boards assess safety data in clinical trials, the ACR said.

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Case challenges employer mandate

The U.S. Supreme Court has asked the Obama administration to weigh in on a pending case testing San Francisco's universal care program.

The case centers on the Golden Gate Restaurant Assn.'s challenge to an ordinance under Healthy San Francisco. It requires employers to spend a certain amount on workers' health coverage or else pitch into the universal program's funding pool.

The high court invited the solicitor general to file a friend-of-the-court brief expressing the government's views, but justices have yet to accept the case for full review.

President Obama has expressed general support for such employer mandates. While he has not taken a position on San Francisco's program, he praised the effort in a February address to city mayors. "Instead of just talking about health care, mayors like Gavin Newsom in San Francisco have been ensuring that those in need receive it," Obama said.

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GAO: Medicaid dental care still needs work

Although the Centers for Medicare & Medicaid Services has improved its oversight of state Medicaid programs' dental care, the agency needs to take more action to ensure that states and health plans provide better access, according to recent Government Accountability Office testimony to Congress.

The GAO credited CMS for conducting reviews of 17 state Medicaid dental programs between October 2007 and May 2008 and for improving communications with states. But CMS did not take any actions in eight states that were found to contract with managed care organizations without adequate networks of dentists, according to testimony by Katherine M. Iritani, a director in GAO's health care division.

GAO also surveyed Medicaid programs in all 50 states and the District of Columbia. The states reported that low payment rates, administrative burdens, insufficient funding and missed appointments by enrollees continue to hamper their ability to provide dental care through their Medicaid programs. Only one state has a Medicaid dental care utilization rate higher than 50%, despite a Dept. of Health and Human Services goal of having 66% of children on Medicaid access preventive dental care.

The GAO testimony is online (www.gao.gov/products/gao-10-112t).

The print version of this content appeared in the Oct 26, 2009 issue of American Medical News.

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