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Am Fam Physician. 2002;65(2):159-161

HIPAA Administrative Transaction Standards Requirements Delayed

Legislation passed by the U.S. House of Representatives in December would delay the administrative transaction standards of the Health Insurance Portability and Accountability Act (HIPAA) until October 2003. The measure stipulates that health care plans and providers submit a plan by October 2002, explaining why they are not in compliance with the requirements and offer a plan and a timeframe for compliance. The provision offers relief for many in the industry struggling to meet the regulatory requirements. However, the delay does not affect the privacy regulations, only those governing electronic transfer mechanisms that use patient information. Guidelines for the privacy regulations are scheduled to be published by the Department of Health and Human Services in early 2002, with an anticipated April 2003 compliance deadline.

ACIP Updates Vaccine Recommendations for Children

Continued supply shortages led the Advisory Committee on Immunization Practices (ACIP) to temporarily revise its childhood immunization recommendations from September 2001 to limit pneumococcal conjugate vaccine (PCV) use until supplies are adequate. About 1.2 million doses of the vaccine will be distributed every month through March 2002, but 1.5 million doses are needed every month. The ACIP revised recommendations include the following: (1) high-risk children younger than five years should continue to be vaccinated as recommended by the ACIP in October 2000; (2) healthy infants and children younger than 24 months should receive a decreased number of pneumococcal conjugate doses based on the age at which vaccination is initiated and the provider's estimate of vaccine supply in their practice; (3) further studies should be done to evaluate the immune response to a pneumococcal polysaccharide vaccine booster dose among children ages 12 to 15 months; and (4) providers should maintain a list of children for whom PCV-7 has been deferred so that the vaccine can be administered when the supply situation improves. The shortage of the vaccine was caused by a rapid increase in demand and manufacturing problems that have prevented the manufacturer from producing at full capacity. Depending on compliance with these revised recommendations, the shortage is expected to continue through mid-2002. The ACIP made no changes to the previous Centers for Disease Control and Prevention recommendations for providers who had insufficient quantities of the acellular pertussis (DTaP) vaccine, which suggested that physicians prioritize vaccinating infants with the initial three DTaP doses and, if necessary, defer the fourth DTaP dose. If deferring the fourth DtaP dose does not provide enough vaccine to vaccinate infants with three DTaP doses, the fifth DtaP dose can be deferred. For more information on the ACIP recommendations, visit

Overweight and Obesity Threaten Recent Gains in U.S. Health

Surgeon General David Satcher recently released strategies to help communities reduce the prevalence of overweight and obesity and the various health problems associated with these conditions. The report, entitled “The Surgeon General's Call to Action to Prevent and Decrease Overweight and Obesity,” includes the following community-based strategies: ensure daily, quality physical education for all school grades; ensure that more food options are available on school campuses and at school events, including foods low in fat and calories, fruits, vegetables, whole grains, and low-fat or nonfat dairy products; make community facilities available for physical activity for all persons; create more opportunities for physical activity at work sites; reduce time spent watching television and in other sedentary activities; educate all expectant parents about the benefits of breastfeeding; change the perception of obesity so that health becomes the main concern rather than personal appearance; increase research on the behavioral and biologic causes of overweight and obesity; and educate health care professionals and health profession students on the prevention and treatment of overweight and obesity across the patient's lifespan. Each year, approximately 300,000 deaths are associated with overweight and obesity, and these conditions accounted for health-related costs of $117 billion in the year 2000. In 1999, 61 percent of adults and 13 percent of children and adolescents in the United States were overweight. Since 1980, obesity has doubled among adults and tripled among adolescents. Only 3 percent of all Americans meet at least four of the five federal Food Guide Pyramid recommendations for food intake, and less than one third meet the federal recommendations to participate in at least 30 minutes of moderate physical activity at least five days a week. The Surgeon General's call to action is available at

Rural Health Agencies Need More Nurses, Educators, Scientists

According to results of research by the National Association of County and City Health Officials and the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services, local public health agencies need more nurses, health educators, and environmental scientists. The researchers also found that large and small towns in rural areas are similar in terms of services offered and needed, and that rural, local public health agencies provide more traditional services such as obstetric, gynecologic, and well-child care than urban agencies. These conclusions were based on a comparison of rural and urban data contained in a 1999–2000 survey of local health department officials. For more information on the HRSA's Office of Rural Health Policy, visit

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Copyright © 2002 by the American Academy of Family Physicians.

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