Am Fam Physician. 2006 Sep 1;74(5):703-704.
Senators Contest Proposed Five-Year Medicaid Cuts of $12.2 Billion
In a letter to U.S. Department of Health and Human Services (HHS) Secretary Mike Leavitt, U.S. senators objected to proposed cuts in Medicaid funding. The HHS plans to implement President Bush’s fiscal year 2007 budget proposals reducing Medicaid spending by $12.2 billion over five years; in 2005, Congress rejected similar cut proposals for the 2006 budget. One concern is a reduction in the allowable provider assessment (used by states to fund Medicaid programs) from 6 to 3 percent, which could result in a loss of funding for nursing homes amounting to $1.57 billion nationwide. The letter also criticized payment caps to government providers, advocating instead a focus on improving health care quality and efficiency through information technology and reduction of medical errors. The HHS later announced that states will get federal government support for elderly and disabled Medicaid recipients living in the community, rather than in institutions, through competitive grants totaling $1.75 billion over five years. This is part of an effort to shift the emphasis of Medicaid away from institutional long-term care and toward home and community-based services. For more information, visithttp://www.aafp.org/news-now/government-edicine/20060721medicaidcutsletter.html andhttp://www.hhs.gov/news/press/2006pres/20060726.html.
CMS Proposes Policy, Payment Changes for Physicians’ Services in 2007
In a proposed rule released in August, the Centers for Medicare and Medicaid Services (CMS) set out revised payment rates and policies under the Medicare Physician Fee Schedule. These proposals are in addition to the methodology changes released in the June 29 Federal Register. Under the proposed rule, coverage for preventive services would expand, with Medicare coverage for abdominal aortic aneurysm screening in certain patients and exemption of colorectal cancer screening from the Part B deductible. There also would be a reduction of the dosage equivalent required to qualify for bone mass measurement because of long-term steroid therapy, and diabetes outpatient self-management training and medical nutrition therapy services would be added to the covered and separately payable services included in the Federally Qualified Health Center benefit. However, payments for multiple imaging procedures under the physician fee schedule would be capped. In addition, a negative update in payment rates for physician-related services is projected for 2007 because of an increased rate of spending on these and other Part B services. CMS said it will work with Congress and physician groups to identify and support higher-quality, efficient care. For more information, visithttp://www.cms.hhs.gov/center/physician.asp.
House Reviews Bill Proposing Medicare Physician Payment Reform
A bill introduced to the House in July proposes legislation that would link annual physician pay increases to the Medicare economic index (MEI). The Medicare Physician Payment Reform and Quality Improvement Act of 2006 (HR 5866) calls for payments to be based on the MEI minus 1 percent, which would guarantee some pay increase every year, although the increase would be less than the medical cost inflation rate. Under the sustainable growth rate formula currently used to set physician payment, physicians would see a 5 percent pay cut in 2007, according to the American Academy of Family Physicians. The goals of the bill are to ensure fair payment for services rendered, to create quality performance measures and improve Quality Improvement Organization accountability and flexibility, and to find reasonable methods of paying for these benefits, said Rep. Mike Burgess, M.D. (R-Texas). For more information, visithttp://www.aafp.org/news-now/government-medicine/20060808fixsgr.html.
Labor-HHS Bill Includes $50 Million in Funds for Primary Care Training
The Senate Appropriations Committee has approved the Labor-HHS-Education bill (HR 5647), which includes $50 million in funding for primary care training and $1.9 billion for community health centers. Funding for primary care training was cut in 2006, and although the 2007 level represents an increase of 22.4 percent, it still is not as high as the 2005 funding level of $89 million. The community health center funding level is $145 million more than in 2006. Also included in the bill is $304 million for health professions programs, up from $295 million in 2006. Overall, the budget includes $142.8 billion in spending ($5 billion more than the figure requested by President Bush), and some senators are looking to increase the total by an additional $2 billion. The bill is not expected to be consolidated with the House measure until after the November elections. For more information, visithttp://www.aafp.org/news-now/government-medicine/20060804titleviibill.html.
Survey Shows Americans Don’t Know When to Get Cancer Screening
Analysis of data from the Health Information National Trends Survey shows that most Americans do not know when they should receive cancer screening examinations. According to the data, representing telephone surveys conducted in 2002-2003 and 2005, more than one half of U.S. women did not know they should receive mammograms to screen for breast cancer beginning at age 40. However, about three quarters of women said their health care providers had recommended the test, and the same proportion had received one within the recommended time frame. Most women did not know that a Papanicolaou test every year to screen for cervical cancer is not necessary, and 61 percent of women had never heard of human papillomavirus. Knowledge of screening recommendations varied by age and ethnicity —more than 70 percent of Hispanic, black, and Native American respondents did not know the recommended age for colon cancer screening, compared with 38 percent of whites. For more survey data, visithttp://cancercontrol.cancer.gov/hints.
NIH Osteoarthritis Initiative Releases First Set of Research Data
Researchers conducting a study of the development and progression of osteoarthritis for the Osteoarthritis Initiative have released their first set of data. The Osteoarthritis Initiative is a partnership between the National Institutes of Health (NIH) and private industry aiming to improve the diagnosis, monitoring, and treatment of the condition. The study includes nearly 5,000 participants who have or are at risk of osteoarthritis of the knee. Data gathered from these participants, including symptoms and pain measurements, are available to researchers athttp://www.oai.ucsf.edu. Subsequent data sets will be released in late 2006 and early 2007, then at six-month intervals for the next five years. The NIH hopes that the availability of this information will facilitate the identification of biological and structural markers for osteoarthritis. For more information, visithttp://www.nih.gov/news/pr/aug2006/niams-01.htm.
SAMHSA, SPAN Establish National Alliance for Suicide Prevention
The Substance Abuse and Mental Health Services Administration (SAMHSA) announced a partnership with the Suicide Prevention Action Network (SPAN) to establish the National Action Alliance for Suicide Prevention. Creation of the alliance was a key recommendation of the National Strategy for Suicide Prevention (NSSP) in 2001, and of the Federal Health Action Agenda in 2005. Twenty-five to 30 alliance members will be chosen to represent various ages, ethnicities, and races. The aims of the alliance are to turn the goals and objectives outlined by the NSSP into measurable actions that can be implemented by institutions and communities, and to build the knowledge, policies, and programs needed to stop suicide in communities throughout the United States. For more information, visit the SAMHSA Web site athttp://www.samhsa.gov.
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