 Oct. 18, 2002 |
| ASSEMBLY EDITION • SAN DIEGO |
The Congress of Delegates pulled out all the stops Tuesday in acting on issues such as prior hospitalization for nursing home placement. The delegates unanimously voted for the Academy to tell the Centers for Medicare & Medicaid Services, "The regulation concerning mandatory hospitalization prior to Medicare qualified skilled nursing placement is obsolete, wasteful of valuable resources and should be abolished."
No restraint in that statement.
"If my patients are not sick enough to be hospitalized but need placement in the nursing home next door to my practice, I don't know why they need to go to a hospital 50 miles away (for three days) to be eligible for Medicare coverage in the nursing home," Beulette Hooks, M.D., of Midland, Ga., chair of the Commission on Resident and Student Issues, told a reference committee Monday.
Here's how another AAFP member described the hospitalization requirement: "This represents a 'stupid factor.'"
A range of other issues, including those noted below, prompted strong action from the delegates.
Tobacco settlement funds. Several years ago, states received funds for settling a lawsuit with tobacco companies. The funds, meant for projects preventing tobacco use and helping people stop using tobacco, are being siphoned off. "I sit on the tobacco council for Iowa, and we had been given $9 million, we just lost $4 million, and we'll probably lose more," delegate David Carlyle, M.D., of Ames told a reference committee Monday. "The tobacco companies are to blame for the loss."
The delegates voted Tuesday to have the Academy compile a "national scorecard" showing how states have allocated their tobacco settlement funds. The Congress also decided the Academy would serve as an information resource for states using their funds for tobacco-use prevention and cessation efforts.
Prohibitions on prescribing. Family physicians' prescribing privileges are being curtailed, the delegates said, by the CMS and the Department of Defense -- in rules against the prescription of certain drugs by certain groups of physicians. "There is a persistent effort to wean away the privileges family physicians have,' delegate Tanya Jones, M.D., of Atlanta told a reference committee. "The Academy has to be proactive about this."
The Congress said the Academy should ask the CMS and the Department of Defense to eliminate the prescription prohibitions if there is no evidence-based research justifying the prohibitions.
Gender equity in health plan benefits. Whatever terms and conditions an employer or health plan applies to prescription drugs, devices and elective surgeries, those same provisions should apply to prescription contraceptive drugs and devices and to elective sterilization procedures. That's a new AAFP policy the delegates adopted Tuesday.
Medicare reform. The Congress issued a clarion call to revamp Medicare.
The delegates agreed, "The AAFP is gravely concerned about the viability, fairness and workability of the current Medicare program. Improvement is needed to keep pace with advances in the practice of medicine, changes in the demographics of the Medicare population and other developments in the health care system."
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