Senate Republicans Unable
to Break Medical Liability Reform Impasse
On April 7, Senate lawmakers, for the second time
this year, defeated legislation that would have provided some
relief to physicians from skyrocketing medical liability insurance
premiums. By a vote of 49 to 48, the Senate blocked a motion
to proceed, or cloture vote, which have allowed the bill,
S. 2207, the Pregnancy and Trauma Care Access Protection Act
of 2004, to be debated on the Senate floor. S. 2207 would
have provided liability protections, including a $250,000
cap on noneconomic damages, for emergency services and trauma
and obstetrical and gynecological (ob-gyn) care. The Senate’s
attempt to pass a bill, S.2601, in February that applied to
ob-gyn services only also failed. The ACC, the American Medical
Association, and a number of physician specialty organizations
supported S. 2207 and S. 2061 as an incremental step toward
medical liability reform for all patients and all physicians.
Senate GOP leaders have indicated they will continue with
their incremental strategy, despite their recent defeats.
House
Lawmakers Request CMS Action on Physician Payment System
On April 1, Ways and Means Committee Chairman Bill Thomas (R-CA),
and Nancy Johnson (R-CT), chairwoman of the Health Subcommittee,
sent a
letter to Dr. Mark McClellan, administrator of the Centers
for Medicare and Medicaid Services (CMS), urging CMS to use
its authority to make certain administrative changes to the
Medicare physician payment formula. In their letter, Reps. Thomas
and Johnson pointed out that if CMS and Congress do nothing
to fix the problems with the current payment formula, physicians
will receive payment updates of about minus 5 percent each year
from 2006 through 2012. Under this scenario, by 2014, physicians
would be paid at rates about 40 percent lower than in 2005.
Specifically, the letter requests that CMS remove prescription
drug expenditures from the SGR baseline; account for the costs
of new benefits; and examine assumptions about behavioral responses
to rate decreases.
OIG Reviewing Physician Investments
in Specialty Hospitals
Lewis Morris, General Counsel to the Inspector General, revealed
that the OIG is reviewing preferential investment opportunities
offered to physicians in a position to refer Medicare patients
to specialty hospitals. Morris's comments were made at the National
Association of Health Lawyers meeting in Baltimore recently.
He believes these arrangements may violate the anti-kickback
statute.
ACC Submits Testimony Supporting Heart
Research Funding
As Congress begins the annual task of appropriating funds for
federal agencies and programs for the next fiscal year; the
ACC has asked lawmakers to increase the government’s financial
commitment to cardiovascular disease research and public education
efforts in fiscal year 2005. On March 31, the ACC submitted
written
testimony for the record to the U.S. Senate Appropriations
Subcommittee requesting $3.5 billion for the National Heart,
Lung, and Blood Institute. The ACC also requested $443 million
for the Agency for Healthcare Research and Quality (AHRQ), $80
million for the Centers for Disease Control and Prevention (CDC)
State Heart Disease and Stroke Prevention Program, and $45 million
for the expansion of both community and rural automated external
defibrillator (AED) public access programs.
Medical Errors Bill Awaits Senate
Resolution
A year ago the House passed H.R.663, the "Patient
Safety and Quality Improvement Act," or the Medical
Errors bill; however, Senate Republicans and Democrats cannot
seem to resolve their differences and move forward with the
Senate version of the patient safety bill. The bill would create
"patient safety organizations" (PSOs) that collect
and analyze confidential reports of medical mistakes, then report
back with ways to avert future mistakes. Although the Senate
bill, S. 720, passed the Health, Education, Labor and Pensions
Committee unanimously last year, it has stalled over objections
by Sen. Edward M. Kennedy (D-MA) who serves as ranking member
of the committee. All sides agree that the patient safety legislation
could help reduce medical errors, enhance patient safety, and
in the long run, reduce malpractice litigation. Senate Majority
Leader Bill Frist (R-TN) has made the bill one of his priorities
this year.
CMS Funds Medicare Education Programs to Help
Seniors
On April 6, the Centers
for Medicare and Medicaid Services (CMS) awarded $21.1 million
in grants to states and programs that help beneficiaries understand
and use Medicare benefits and programs. The first training programs
concentrate on the new discount drug card program, emphasizing
one-on-one advice and counseling for Medicare beneficiaries.
The State Health Insurance Programs (SHIPs) will receive additional
funds, amounting to an overall 69 percent increase over fiscal
year 2003 budgets. "Helping Medicare beneficiaries understand
their new choices and benefits is a key goal, and the counselors
in the local SHIPS will play a critical role in reaching that
goal," said CMS Administrator Mark B. McClellan, Ph.D.,
M.D.
Judge Dismisses HIPAA Injunction
Lawsuit
On April 2, Philadelphia U.S. District Judge Mary McLaughlin
dismissed a lawsuit filed against the Department of Health and
Human Services (HHS) by physicians and consumer advocates who
sought an injunction against HIPAA privacy regulations. Plaintiffs
contended that the new regulations, as they are written, do
not allow patients to have a say in how their medical information
is used or shared. Additionally, patients are required to sign
forms that clear medical providers of liability for wrongful
disclosures of patient information. HHS lawyers argued that
the regulation gives patients "unprecedented power to ensure"
their privacy. In pretrial hearings, McClaughlin ruled that
plaintiffs "had failed to show that regulations were enacted
improperly or were unconstitutional." McLaughlin furthermore
ruled that because the rule is not compulsory in nature, "it
does not affirmatively interfere with any right." (AP,
4/3; Philadelphia Inquirer, 4/3)
Georgia Tort Reform Defeated in
Conference
During the first days of April, the Republican-controlled Georgia
Senate passed wide-ranging tort reform legislation that includes
decreased liability for emergency room workers, hospital immunity
when independent contractors who work there are sued, and mandated
mediation in medical malpractice suits. Although efforts to
include a cap for noneconomic jury awards failed, the senators
were able to obtain almost all their other goals. The measure
moved to a House/Senate conference committee and appeared to
have smooth sailing but ran into problems due some abrupt retrenching
by Sen. Seth Harp, a member of the committee. By re-introducing
elements unacceptable to the Senate compromise effort, Harp
was able to kill the measure. (Macon Telegraph, 4/8)
Congressional Leadership
Gives Lawmakers Medicare Marching Orders
During Congress’ spring recess April 5-16, members of
both political parties were instructed to meet with their constituents
to discuss the new Medicare law and the economy. Republicans
will conduct educational workshops to reassure seniors about
the value of the new law and will stress prescription drug discount
cards and how to enroll. Democrats, on the other hand, will
continue to stress the flaws in the legislation, the scandals
surrounding the Bush administration’s cost estimates for
the prescription drug benefit and their perceived problems with
the legislation. (Roll Call, 4/5) Confusion could be
a problem when the drug discount cards are distributed beginning
in May, according to an article in the Los Angeles Times
(4/5). "They may think this is their new Medicare benefit
card when it is really a drug discount card," John Rother,
policy director for AARP, pointed out. However, there is general
agreement that the discount card will be beneficial to low-income
seniors.
Advocacy
Weekly is a product of the Advocacy Division of the American
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