On Wednesday, February 16, the House Judiciary Committee voted 18-15 to approve the HEALTH Act (H.R. 5), medical liability reform legislation supported by the Medical Society of DC and the American Medical Association. The HEALTH Act was introduced by Congressmen Phil Gingrey, M.D. (R-GA), Lamar Smith (R-TX) and David Scott (D-GA).  The legislation is designed to create medical liability reforms on a national level that are similar to reforms that exist in Texas and California.  This current bill would cap non-economic damages at $250,000.

     The HEALTH Act will now go to the House floor for debate and a vote. In recent years, similar measures have in the House but failed in the Senate.  There is currently a similar bill in the Senate, S.218, also called the HEALTH Act, which has been introduced by Senator John Ensign (R-NV) and referred to the Committee on the Judiciary.

     On February 15, Councilmember David Catania (I-At-Large) introduced B-19-0115, titled "Pharmacy Access Amendment Act of 2011." This bill removes the prescription requirements currently in place that are necessary to obtain birth control pills from pharmacies in the District.  The bill is co-sponsored by Councilmembers Phil Mendelson, Michael Brown and Tommy Wells and is currently awaiting a hearing in the Committee on Health, which is chaired by Councilmember Catania.  The MSDC Board of Directors has several concerns with certain provisions in the current version of the legislation, and will continue working with Councilmember Catania's staff on addressing any changes to the bill.

     Wednesday, February 23, Mayor Vincent C. Gray announced the creation of the Mayor's Commission on HIV/AIDS to help end the HIV epidemic in the District of Columbia. The Commission will focus on treatment, the needs of people living with HIV/AIDS and prevention to stop new infections. Mayor Gray also announced that the DC Department of Health (DOH) has taken steps to improve access and quality of care for residents living with HIV/AIDS immediately.

While the Commission is working, DOH will implement immediate programmatic changes to improve care. The changes will affect residents, medical providers and the system of care as a whole.

Treatment on Demand: DOH will immediately start work to create a system that provides HIV/AIDS treatment to anyone who requires it in the District. Treatment of HIV/AIDS both improves the health of the patient and significantly reduces the risk of transmission.

Returning Citizens: DOH has engaged the Chair of the US Parole Commission to coordinate care so that all citizens with HIV/AIDS returning to the community after time in the federal prison system remain on treatment and are immediately connected to care.

Medical Education: DOH will develop a required Continuing Medical Education (CME) course for all healthcare professionals on working with HIV/AIDS patients.  The course will keep all health professionals up to date on the new developments in the management of the disease. The course will be part of the CME requirements for the renewal of licenses in the District.

Certificates of Need: As the population of residents living with HIV/AIDS ages, they face the same diseases that affect the rest of the population and threaten everyone's health such as heart disease and diabetes.  So that medical professionals can treat the whole person and not just the HIV/AIDS infection Dr. Akhter has authorized the State Health Planning and Development Agency to create an exemption for the Certificate of Need process for expansions of outpatient primary care, substance abuse and mental health services at certain HIV/AIDS treatment providers.

     The AMA continues to engage the Administration and Congress regarding the development and implementation of a Physician Compare Web Site. To help inform these efforts, we are requesting physician feedback specifically on the design and data content of the current Web Site, located at www.medicare.gov/find-a-doctor. Please submit your completed feedback form via email to

Jennifer.Shevchek@ama-assn.org

  by 5:00pm on Wednesday, March 2.

     As background, on December 30, 2010, the Centers for Medicare and Medicaid Services (CMS) enhanced the Physician Directory tool. The new feature, called Physician Compare, expands and updates CMS' Healthcare Provider Directory. The new site, which was required by the Affordable Care Act of 2010, contains information about physicians enrolled in the Medicare program. The information on the site-connected to the Medicare Provider Enrollment, Chain, and Ownership System (PECOS)-includes contact and address information for offices, the professional's medical specialty, where the professional completed his or her degree as well as residency or other clinical training, whether the professional speaks a foreign language, and the professional's gender. The tool can also help Medicare beneficiaries identify which physicians are "par" or "non-par" status under the Medicare program. In addition to information about the physician's practice, Physician Compare also shows beneficiaries whether the practice reported certain data to CMS through the Physician Quality Reporting System (formerly known as PQRI). Currently, the PQRS reporting system is a voluntary reporting program that rewards physicians and other eligible healthcare professionals for reporting data on quality measures related to services furnished to Medicare beneficiaries. Later in 2011, CMS plans a second phase of the Physician Compare Web Site, which will indicate whether professionals chose to participate in the Medicare electronic prescribing program (https://www.cms.gov/eprescribing/).

     My 10-year-old grandson proudly lifted his shirt to display a neat row of surgical staples from his recent appendectomy. Then he asked one of his favorite questions, "Grandma, did they have staples back in the olden days?" This dredged up a long-suppressed memory of my first encounter with surgical staples. The year was 1974, and I was the scrub nurse on an emergency C-section that had proceeded smoothly until the moment the obstetrician decided he would like to use those "new-fangled staples" to close the skin. Surgical staplers at that time were a far cry from the sleek packaged versions we have today. They were a clumsy stainless steel device, dispensing clips that looked like staples on steroids. The circulating nurse dropped the device with a clunk onto the back table. Unaware that a pin needed to be pulled to release the staples, I smoothly handed the device to the obstetrician. After a few unsuccessful attempts he examined the device, decided it was jammed, and flipped open the top. This jettisoned a powerful spring and fifty clips into the air. Spring and clips hit the operating room ceiling and rained down on our caps and on the Mayo stand, glinting from the forehead of the anesthetist's upturned face and, to our horror, into the still-open wound.
     With tears of laughter running down his face, my grandson blurted, "Oh no, Grandma; that doctor must have been terrified he would be sued!" Stunned into silence, I sat quietly for a moment.

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Physician comment sought on proposed Joint Commission Primary Care Home Requirements

     The Joint Commission (TJC) is developing a Primary Care Home (PCH) designation as an optional add-on to its Ambulatory Care Accreditation Program.  As part of this process, TJC has released for review Proposed Standards outlining requirements with which ambulatory care centers seeking PCH designation must comply.

     A preliminary analysis suggests that the Proposed Standards are not entirely congruent with AMA policy on the patient-centered medical home as adopted by the AMA House of Delegates.  In particular, the Proposed Standards do not appear to require that the PCH be led by a physician.

     All physicians are encouraged to review the Proposed Standards and respond to TJC by completing a short survey on the TJC Web site.  Physicians may also submit general comments to TJC via the Web site.  The deadline to complete the survey or submit comments is March 14.

     Please contact the AMA Organized Medical Staff Section with any questions.  Thank you for your continued advocacy on behalf of your patients and your profession.

 

Take advantage of the Blue Cross Blue Shield Settlement Agreement before it expires May 31 with free webinar

     One way organized medicine has addressed unfair payer practices has been settlements with major commercial health insurers. A key settlement still in effect is the Blue Cross Blue Shield settlement. Make sure your practice is benefiting from the physician protections this settlement offers before the settlement expires on May 31, 2011.

     Visit the AMA's Web site at www.ama-assn.org/go/settlements to access numerous resources on the Blue Cross Blue Shield settlement, including an archived webinar explaining how the settlement agreement helps your practice and how to file a compliance dispute, a summary of the key business practices mandated in the settlement, and an interactive map that lets you determine which Blue Cross Blue Shield plans and subsidiaries in your state have settled. Because contracts provided by Blue Cross Blue Shield to physicians in its provider network must conform to the settlement agreement, be sure to review your contracts to ensure you are receiving all the protections the settlement provides.

     As you know, the MSDC has strong support in helping our members lower their vaccine costs. Atlantic Health Partners helps thousands of physicians save money and advocates on your behalf with payers and manufacturers.
     In addition to offering our members the lowest prices for Sanofi Pasteur and Merck vaccines, Atlantic also provides the best terms for Sanofi's Fluzone and High Dose Fluzone. MSDC members that join Atlantic and pre-book their Fluzone order by March 31st receive Atlantic's contract price discount, the maximum Sanofi 5% Gold Level discount, and Sanofi's on-line order and prompt pay discounts.
     Furthermore, Atlantic can save you money on pediatric, adolescent and adult vaccines when purchased directly from Sanofi and Merck. Our members that joined Atlantic report strong satisfaction with the program, most notably for the savings, ability to make smaller purchases, and customer support.

Additional benefits offered by Atlantic:

• Medical supply discount program
• Office and business supply discounts with Staples Advantage
• MedImmune Flumist discounts
• Discounted patient recall program

     Jeff Winokur and Cindy Berenson are the primary contact persons at Atlantic, and we encourage you to contact them at 800-741-2044 or at info@atlantichealthpartners.com for more information and details about how your practice can benefit from participation.