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Am Fam Physician. 2006;73(10):1691-1692

CMS to Cover Shortfalls in States' Children's Health Insurance Funds

To cover a shortfall in funds allocated to states' children's health insurance programs (SCHIPs), the Centers for Medicare and Medicaid Services (CMS) is making extra money available to those states whose funds are exhausted. States have three years to spend each year's allotment of SCHIP funds. Any unspent funds are then redistributed to states that exhausted their portion. However, surplus funds this year were only $173 million, less than half the $456 million needed to keep all SCHIPs running. Additional funds requested by the Bush Administration were granted as part of the Deficit Reduction Act, signed into law in February. CMS began distributing the grant funds to 12 states and territories in April. For more information and a list of the affected states, visit

Reports Find Costs Restrict Health Technology Implementation

A report released by the Healthcare Financial Management Association (HFMA) blames the lack of national standards and a national strategy to fund implementation for preventing many hospitals from integrating electronic health records (EHRs). Only one third of U.S. hospitals have begun implementing EHR systems, the report says, despite President Bush's call for universal adoption of EHRs by 2014. Larger, urban hospitals are further along in health technology implementation than smaller, rural facilities, with costs and the fear that universal standards could make some systems obsolete cited as prohibitive factors. Similarly, a report from the Agency for Healthcare Research and Quality (AHRQ) found that successful use of health technology systems has occurred primarily at larger sites, and that most health care providers need more information about how to implement these systems successfully. To help produce such information, the AHRQ is funding more than 100 health technology projects around the United States. The full report is available online at For information about the AHRQ projects, visit

Family Physician Gives Invited Testimony on EHR Difficulties

In April, family physician Christopher Normile, M.D., St. Charles, Mo., gave invited testimony to a House Small Business Committee subcommittee about the difficulties of buying, implementing, and maintaining an EHR system in a small office. On behalf of the American Academy of Family Physicians (AAFP), he asked Congress to ease the financial and time pressures that discourage small practices from introducing EHRs by providing financial incentives, establishing interoperability standards, and supporting technical assistance programs. For more information, visit

HHS and China Expand Cooperation in Health and Medical Science

An agreement between the U.S. Department of Health and Human Services (HHS) and the People's Republic of China Science and Technology Ministry (STM) has expanded cooperation on biomedical research. The agreement covers collaboration on scientific programs and research, exchanges and training of scientists and delegations, sharing of information supporting research, and sharing of best practices. Cooperation between the HHS and China has been expanding since 1977, said HHS Secretary Mike Leavitt. In 2005, the HHS and China's STM agreed to collaborate in work on new infectious diseases such as H5N1 influenza. The STM was instrumental in research efforts to develop a vaccine for severe acute respiratory syndrome and plays a crucial role in China's response to the threat of pandemic influenza. For more information, visit

FDA Adopts SNOMED as Standard Computerized Medical Vocabulary

The U.S. Food and Drug Administration (FDA) is adopting the systemized nomenclature of medicine (SNOMED) to code terms in the Highlights section of its new-format prescription drug labels, which will be required beginning June 30, 2006. SNOMED is a computerized medical vocabulary system developed by the College of American Pathologists to make clinical terminology readable across computer systems; it provides one code for clinical terms that may vary from site to site (e.g., “heart attack,” “myocardial infarction,” “infarct”). In May 2005, SNOMED was adopted by the HHS for the exchange of clinical information across the federal government. A licensing agreement allows U.S. health care professionals, hospitals, and other facilities to incorporate the terminology into their own systems, and the Problem List subset of codes to be used by the FDA will be available on the National Cancer Institute Web site ( For more information, visit

CMS Announces Home Health Demonstration Project

The CMS will implement a demonstration project encouraging home health agencies to partner with medical adult day care facilities to provide services to Medicare beneficiaries. Currently, Medicare beneficiaries pay out of pocket for medical adult day services or are reimbursed by a third-party payer. The Medical Adult Day Care Services Demonstration will assess whether provision of these services as part of the Medicare home health benefit would improve patient outcomes. Five home health agencies will participate in the three-year project, which is expected to begin in June 2006. Up to 15,000 beneficiaries will be eligible to enroll at any one time. For more information, visit the CMS Web site at

AHRQ Expands Therapeutics Education and Research Network

Four new Centers for Education and Research on Therapeutics (CERTs) are being established by the AHRQ to conduct research on treatments for mental health problems, medication use among older persons, help for patients taking prescription medications, and use of medical devices. The CERT program was authorized by Congress in 1997 to increase awareness of the benefits and risks of therapeutic products. The new centers are located at Rutgers, N.J.; the University of Iowa; Baylor College of Medicine, Tex.; and Weill Medical College, N.Y. Researchers at Rutgers will look at improving appropriate use of antidepressants and antipsychotics in children, as well as assessing Medicare pharmaceutical care for beneficiaries with mental illnesses. At the University of Iowa, researchers will test a model hypertension treatment program involving physician-pharmacist teams. The Baylor CERT will focus on health communication with English- and Spanish-speaking patients, and the Weill CERT will look at how best to use prosthetic orthopedic devices. The AHRQ is awarding $16 million over five years to finance the centers, bringing the total number of AHRQ-funded CERTs to 11. More information is available online at

AAFP President Discusses Medical Malpractice with Senators

As part of the AAFP's medical liability reform effort, AAFP President Larry Fields, M.D., Ashland, Ky., met with U.S. senators, White House staff, and legislative aides to discuss the impact of medical malpractice suits on patients' access to health care. The visit took place in anticipation of a federal proposal to limit noneconomic medical liability damages to $250,000 for any single health care provider. Several senators oppose the legislation because of fears that a federal law might undercut more stringent state laws, and that capping lawyer fees would be anticompetitive. A provision of the bill would preserve state rights, allowing future state laws to override federal limits. For more information, visit

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