News in brief - June 13, 2011

Senate Medicare private contracting bill introduced

Sen. Lisa Murkowski (R, Alaska) has introduced legislation that would allow doctors and patients to agree to their own fees for physician services without having to give up Medicare payments.

The Medicare Patient Empowerment Act, introduced on May 23, is the companion piece to a House measure introduced earlier in May. Both bills would give patients and doctors the right to negotiate fees for non-emergent care.

"At the age when many Americans begin to need extra medical attention, the current Medicare system puts hurdles in their path to care," Murkowski said. "Now more than ever, with the added scrutiny Medicare is getting, our seniors need solutions and certainty."

The Alaska State Medical Assn. supports the legislation because it puts control over prices in the patients' hands and preserves the doctor-patient relationship, the association said in a statement. Democratic opponents on Capitol Hill insist it will drive up out-of-pocket costs for vulnerable beneficiaries.

The Murkowski bill had one co-sponsor, Sen. Jim DeMint (R, S.C.), at this article's deadline. The House legislation, sponsored by Rep. Tom Price, MD (R, Ga.), had 12 co-sponsors.

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Florida governor signs Medicaid managed care bill

Florida Gov. Rick Scott on June 2 signed legislation to change Florida's Medicaid program into a system of managed care and to offer health plans -- either HMOs or provider service networks of physicians and hospitals -- capitated rates that are 5% less than projected fee-for-service spending. The health plans can keep up to 7.5% worth of savings as profits if they meet certain quality standards.

The Florida Medical Assn. opposed the statewide expansion to managed care. Florida physician organizations and patient advocates are concerned that the savings goal will lead managed care plans to restrict access to services for the state's 3 million Medicaid enrollees. Florida must obtain a federal waiver from the Dept. of Health and Human Services to implement the law.

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Geriatrician appointed to MedPAC

A New York geriatrician and a former U.S. congressman from Ohio were appointed to seats on the Medicare Payment Advisory Commission on May 31.

William Hall, MD, a professor at the University of Rochester (N.Y.) School of Medicine, and former Rep. Willis Gradison Jr., currently a scholar in residence at Duke University's Fuqua School of Business, will serve three-year terms on MedPAC, the Government Accountability Office announced.

Dr. Hall is a member of AARP's board of directors and previously served as the president of the American College of Physicians. Gradison served as a Republican member of the House from 1975 to 1993.

The 17-member commission advises Congress on payment issues affecting the Medicare program. MedPAC authors annual reports on the program, and provides Congress with nonbinding recommendations on access to care, quality of care and other issues related to Medicare.

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Lawsuit fear identified as top challenge to cutting ED costs

Nearly 45% of emergency physicians say "fear of lawsuits" is their biggest challenge to cutting costs in the emergency department, according to a recent poll conducted by the American College of Emergency Physicians.

The poll, released online May 23, also concluded that 53% of emergency physicians listed lawsuit fear as the primary reason they conducted high numbers of medical tests. In addition, many specialists cited fear of being sued as one of the top reasons they will not treat emergency patients.

ACEP conducted the email poll between March 3 and March 11. About 1,800 physicians responded to the survey, according to a release accompanying the poll.

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