AAFP News Now: AFP Edition
Policy and Health Issues in the News
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Am Fam Physician. 2010 May 1;81(9):1081-1082.
DEA Issues Interim Final Rule Allowing E-Prescribing of Controlled Substances
The Drug Enforcement Administration (DEA) issued an interim final rule, published in the March 31, 2010, issue of the Federal Register, that would allow electronic prescribing (e-prescribing) of controlled substances. Although the federal government is encouraging physicians to adopt e-prescribing technology, e-prescribers currently must use a separate paper process for Schedule II through V drug prescriptions. According to the DEA, these drugs make up more than 10 percent of all prescriptions ordered. In addition to allowing the option of e-prescribing for controlled substances, the DEA rule would permit pharmacies to receive, dispense, and archive e-prescriptions; reduce paperwork for DEA registrants; help pharmacies and hospitals integrate prescription records into other records; reduce the wait time for patients having prescriptions filled; and potentially reduce prescription forgeries. For more information, visit http://www.aafp.org/news-now/practice-management/20100331deainterimrule.html.
FDA Issues Regulations Restricting Tobacco Sales and Marketing to Children
The U.S. Food and Drug Administration (FDA) has issued broad new regulations restricting the sale and marketing of tobacco products to children and adolescents, which were published March 19, 2010, in the Federal Register and take effect June 22, 2010. The regulations will prohibit sales of cigarette packages with fewer than 20 cigarettes; sales of cigarettes and smokeless tobacco in vending machines, self-service displays, or other impersonal modes of sale, except in very limited situations; free samples of cigarettes; tobacco brand name sponsorship of any athletic, musical, or other social or cultural event or team; gifts or other items in exchange for buying tobacco products; and sale or distribution of items, such as hats and tee shirts, with tobacco brands or logos. The new regulations also limit distribution of smokeless tobacco products and require that audio advertisements use only words with no music or sound effects. For more information, visit http://www.aafp.org/news-now/health-of-the-public/20100329tobaccosalestokids.html.
IRS to Refund Pre-2005 FICA Payroll Taxes for Some Medical Residents
The Internal Revenue Service (IRS) has decided that medical residents are exempt from paying Federal Insurance Contributions Act (FICA) payroll taxes, which fund Social Security and Medicare, for tax periods that ended before April 1, 2005. In a March 2, 2010, press release, the IRS said it has accepted the position that medical residents are excluded from the taxes based on the prior student exception. New IRS regulations went into effect April 1, 2005, that specifically exclude any employee who works at least 40 hours a week for a school, college, or university from eligibility for the student exception. Institutions that employed medical residents, as well as individual medical residents, are eligible to receive refunds if they filed FICA refund claims on time. The period for filing a claim has expired, but persons who were medical residents before April 1, 2005, and who did not file an individual FICA refund claim may be covered by a claim filed by their employer. For more information, visit http://www.aafp.org/news-now/resident-student-focus/20100402irsrefunds.html and http://www.irs.gov/newsroom/article/0,,id=219731,00.html.
IOM's Call for Increased Hepatitis Screening Conflicts with Other Recommendations
According to a report from the Institute of Medicine (IOM), inadequate resources are being allocated to viral hepatitis prevention, control, and surveillance programs. The report says many primary care physicians are unaware of the high prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection in some U.S. populations, and often fail to identify infected persons and those at risk of infection so they can be treated appropriately. The IOM committee says the process for identifying infected persons should include risk-factor screening and serologic testing. However, the American Academy of Family Physicians (AAFP) and the U.S. Preventive Services Task Force recommend against routine screening for HBV and HCV infection in asymptomatic adults who are not at increased risk, and have found insufficient evidence to recommend for or against routine screening for HCV infection in adults at high risk of infection. For more information, visit http://www.aafp.org/news-now/clinical-care-research/20100407iom-hep-rpt.html.
New Government Regulations Lead to Changes in CCHIT Program
The Certification Commission for Health Information Technology (CCHIT) has announced that it will adjust its current certification programs for electronic health records (EHRs) as a result of new regulations in the American Reinvestment and Recovery Act (ARRA), which was passed in 2009. The organization said it will separate its CCHIT Certified program, which has been operational since 2006, from its Preliminary ARRA program, which launched in October 2009. CCHIT has been the sole entity designated by the federal government as a certification body for EHRs since October 2006. However, CCHIT Communications Director Sue Reber expects multiple certifying organizations to be established soon because the ARRA mandates the development of a national EHR certification program. Reber said it is important for CCHIT to prepare vendors now so physicians will be able to get certified EHR products quickly in the future. For more information, visit http://www.aafp.org/news-now/practice-management/20100401cchitchanges.html.
AAFP to Test New Translation to Practice CME, Enhances CME Reporting Program
The AAFP is piloting a new category of continuing medical education (CME) Prescribed credit called Translation to Practice, which allows physicians who take an AAFP Prescribed CME credit activity to earn as many as two additional credits for each activity by completing the Translation to Practice activity. Physicians can elect to participate after completing the course evaluation form for AAFP Prescribed CME credit activities that are included in the pilot. They are then invited to fill out a commitment-to-change statement that summarizes what they learned in the CME activity, identifies the change they plan to integrate into their practice, clarifies their motivation for implementing the change, and states what they think will be improved. The AAFP also has upgraded its Web-based CME reporting program to help AAFP members track and plan their CME. The AAFP CME Learning Portal (https://nf.aafp.org/LearningPortal/, available to AAFP members only) provides personalized features, including a self-assessment, customized profile, learning plan, and progress tracking. Members begin by answering a few questions, then the program suggests relevant CME in the AAFP CME database. For more information, visit http://www.aafp.org/news-now/cme-lifelong-learning/20100407translationtopractice.html and http://www.aafp.org/news-now/cme-lifelong-learning/20100330learningportal.html.
Conference Report Gives Recommendations for Future of Primary Care
A new conference report on primary care in the United States has been released based on the national conference, Who Will Provide Primary Care and How Will They Be Trained? The 49 primary care experts who participated in the conference developed recommendations to increase the number of students who choose a career in primary care. They also provided recommendations about changing the way primary care is valued, delivered, and integrated into the health care system, including the creation of incentives to develop innovative models of primary care. However, a number of primary care physician organizations, including the AAFP, have taken issue with the report's call for changes in policies to remove barriers to nurse practitioners and physician assistants serving as primary care providers and leaders of patient-centered medical homes or other models of primary care delivery. For more information, visit http://www.aafp.org/news-now/professional-issues/20100331macyreport.html and http://www.josiahmacyfoundation.org/documents/jmf_ChairSumConf_Jan2010.pdf.
Surveys Show Most Primary Care Physicians Lack Obesity Treatment Resources
According to two separate but companion surveys commissioned and released by the Strategies to Overcome and Prevent (STOP) Obesity Alliance, most primary care physicians lack the resources to appropriately counsel their patients about weight management. Therefore, many patients who are overweight or obese are not receiving the right type of information about how to manage their condition. According to survey results, nearly 90 percent of primary care physicians believe it is their responsibility to help patients who are overweight or obese lose weight, yet 72 percent of the 290 primary care physicians surveyed said no one in their practice had been trained to manage weight-related issues. The findings from both surveys indicate that physicians and patients agree that establishing a 5 to 10 percent goal for weight loss would benefit patients' overall health. The STOP Obesity Alliance recently released a white paper highlighting approaches to help address obesity within primary care, which stemmed from an expert roundtable organized by the Alliance that focused on adult primary care treatment and the management of obesity. It outlines five areas that could lead to significant advancements in obesity-related patient outcomes, including monitoring weight, health indicators, and risk; assessing patient motivation; defining success; increasing integration and care coordination; and implementing EHRs. For more information, visit http://www.aafp.org/news-now/professional-issues/20100330stopalliance.html and http://www.stopobesityalliance.org/wp-content/assets/2010/03/STOP-Obesity-Alliance-Primary-Care-Paper-FINAL.pdf.
— AFP and AAFP NEWS NOW staff
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