January 2002 • Volume 8 • Number 1
AAFP fuels fire
'Unfunded federal mandates' come under attack at AMABY PAULA BINDER
The Academy came to the fore on two different issues related to "unfunded federal mandates" for physicians during the AMA House of Delegates interim meeting here Dec. 1 5.
INTERPRETER SERVICES
Thanks in part to efforts by the AAFP delegation, the AMA will urge that payments for medical interpreter services for patients with limited English proficiency, or LEP, be made directly to the interpreter. In addition, the AMA will continue to oppose requirements that hold physicians responsible for interpreter expenses.
Dale Moquist, M.D.
"The house of medicine really needs to take a look at the whole issue"of HIPAA.According to an AMA Board of Trustees report on medical interpreter services, in August 2000 the HHS Office of Civil Rights published requirements for health care organizations that treat patients with LEP. Under those requirements, physicians face an unfunded mandate to provide a clinical interpreter for each LEP patient if the physician receives any federal financial assistance, including Medicaid payments.
Hiring an interpreter could cost between $30 and $400, the report said, while physician payment for a Medicaid office visit could range from $30 to $50 in many states.
The report recommended that the AMA actively oppose the inappropriate extension of the Office of Civil Rights' LEP requirements to physicians in private practice, and that it continue efforts to correct the problems imposed on physicians in private practice by the OCR language interpretation requirements.
Dale Moquist, M.D., of Bryan, Texas, vice chair of the AAFP delegation, rose on the house floor to propose an additional recommendation, which directs the AMA to urge that interpreter payments go directly to the interpreter. The house adopted all of the recommendations.
"Direct, adequate reimbursement to interpreters would help patients with limited English proficiency get the services they need," said Moquist. "It would also relieve physicians of a financial burden and hassle imposed on them by the federal government."
HIPAA
The AAFP delegation took on another unfunded mandate by suggesting the AMA adopt the language of an AAFP policy on the Health Insurance Portability and Accountability Act.
The Utah and Oklahoma delegations brought resolutions about HIPAA concerns to the house; then the delegates adopted an amended substitute resolution that incorporated much of the Academy's HIPAA language.
The adopted language reads: "Resolved, that our AMA shall continue to make it an urgent priority to undertake a comprehensive review, including unfunded physician costs, of HIPAA transaction, privacy and security rules to identify provisions that should be clarified, improved or repealed, and communicate these urgently needed changes to the Department of Health and Human Services and Congress for prompt action, including any necessary delays in implementation, as appropriate."
FP Report is published by the AAFP News Department.
Copyright © 2002 by American Academy of Family Physicians.
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