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Am Fam Physician. 2006;74(3):367-368

CMS to Offer Beneficiaries Health Savings Account Plan Option

A demonstration program allowing Medicare Advantage organizations to offer more flexible accounts will give beneficiaries the option of coverage with features similar to health savings accounts (HSAs), the Centers for Medicare and Medicaid Services (CMS) announced. HSA-type plans have not previously been available to Medicare beneficiaries, but the increased popularity of these plans has created market interest for vendors. Medicare's payments to HSA-type plans would be the same as for the existing medical savings account plan coverage, in which Medicare pays for a high-deductible health insurance plan and puts money into the beneficiary's health care account. However, the new plans would offer more flexible features, including a minimum deductible and a separate limit on out-of pocket expenditures, with cost-sharing permitted; coverage of services after the deductible is met before the out-of-pocket cap is reached, with cost-sharing permitted; and coverage for preventive services. Bids for the demonstration are due by August 10. For more information, visit

AAFP Objects to Proposed Medicare Hospital Discharge Procedure

In a letter to the CMS administrator, the American Academy of Family Physicians (AAFP) objected to a proposed two-step notification procedure for Medicare hospital discharge published in the April 5 Federal Register ( The rule fails to address the current discharge process and would place an undue burden on family physicians, the AAFP said. In the new process, the hospital would be required to deliver a standardized notice of noncoverage to Medicare beneficiaries as soon as the attending physician approved the discharge; if the beneficiary were to dispute the discharge, delivery of an individualized, detailed notice would be required. The initial notice would have to be delivered the day before the discharge occurred. According to the AAFP, the proposal presumes the day of discharge will always be known in advance, whereas patients sometimes are admitted and discharged on the same day or are discharged earlier than expected. The proposal thus could extend the length of stay for many Medicare beneficiaries by at least one day. In addition, the AAFP stated, the burden of much of the paperwork would often fall to the attending physician, especially in small and rural community hospitals. The AAFP asked CMS to rescind the proposed rule and revise the current discharge notification document. For more information, visit

HHS Collaboration Aims to Improve Health of Older Americans

The U.S. Department of Health and Human Services (HHS) is collaborating with the Atlantic Philanthropies to improve the health and quality of life of older Americans. HHS research has created a body of evidence supporting low-cost interventions that help older persons improve their health through management of chronic diseases, attention to diet and exercise, and avoidance of injuries. Through the new partnership, led by the Administration on Aging with involvement from many public and private organizations, the HHS will spend $15 million over three years to support the delivery of community-level, evidence-based programs for seniors in up to 12 states. Programs will be delivered by nonprofit service providers for the aging such as senior centers, nutrition programs, senior-housing projects, and faith-based organizations. At least 30 communities are expected to have programs running within one year. For more information and the program announcement, visit, or call 202-357-0136.

AHRQ Provides State Leaders with Asthma Care Resource Guide

The Agency for Healthcare Research and Quality (AHRQ), in partnership with the Council of State Governments, has released an asthma care quality improvement resource guide for state leaders. The guide and its companion workbook are designed to help state leaders identify measures of asthma care quality, assemble asthma care data, assess areas in need of improvement, learn about action other states have taken, and develop a plan for improving quality of care in their own states. Nearly 20 million persons reported having asthma in 2003, and in 2004 asthma care cost $27.6 million. By providing policymakers with good data and best practice information, the AHRQ hopes to facilitate improvements in asthma care that will impact quality of life, prevent avoidable hospitalization, and reduce costs. The guide and workbook are available at, or by calling 800-358-9295.

Study Finds Increased Survival Rate for Infants with Down Syndrome

A study examining the survival of 645 infants with Down syndrome in the Atlanta area found an increase in survival rates between 1979 and 1998. Nearly 93 percent of infants with Down syndrome now live to one year, and nearly 90 percent survive for 10 years, the study showed. Racial disparities persisted, however: blacks with Down syndrome are more than seven times as likely as whites with the condition to die by age 20 years. The findings that children with Down syndrome are living longer indicate that appropriate medical, residential, social, and community services must be made available for adults with Down syndrome, said Dr. José Cordero, director of the Centers for Disease Control and Prevention's (CDC's) National Center on Birth Defects and Developmental Disabilities. The CDC is conducting a similar study in other states to see whether the findings are comparable. Results from the study were published in the June 2006 issue of the Journal of Pediatrics. For more information, go to

HHS Publishes Privacy Rule Decision Tool for Emergency Planners

The HHS published a new Web-based interactive decision tool designed to help emergency preparedness and recovery planners determine how to access and use health information consistent with the Health Insurance Portability and Accountability Act (HIPAA) privacy rule. Initially, the purpose of the tool was focused on emergency planning for persons with disabilities, but it can be applied to most emergency planning efforts, the HHS said. It guides planners through questions about the application of the HIPAA privacy rule to particular disclosures, focusing on the source of the information, the person to whom it is being disclosed, and the purpose of the disclosure. The tool was demonstrated for the first time at a joint HHS and Department of Homeland Security conference on emergency management, individuals with disabilities, and the elderly, in Washington, D.C., and is available from the Office for Civil Rights Web site at

AMA Says Secondhand Smoke Report Findings Are a Wake-up Call

The American Medical Association (AMA) said the findings of the U.S. Surgeon General's report on the health consequences of involuntary exposure to tobacco smoke were a wake-up call to lawmakers to enact comprehensive clean indoor air laws prohibiting smoking in all indoor public places and work environments. The report, which was released in June, concluded that there is no risk-free level of exposure to secondhand smoke and that even brief secondhand smoke exposure can cause immediate harm, stating that the only way to protect nonsmokers from secondhand smoke is to eliminate smoking indoors. In June the AMA adopted new policy supporting the elimination of smoking in all public places and workplaces at national, state, and local levels. The full report and fact sheets are available at For the AMA's statement, visit

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Copyright © 2006 by the American Academy of Family Physicians.

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