Congress Offers a Temporary Solution for Medicare Physician Payment Cuts

Congress has passed a temporary 0.5 percent Medicare payment increase as part of a bill to postpone a 10.1 percent rate reduction called for by the sustainable growth rate (SGR) formula; the cut would have been effective January 1, 2008. However, without further action, the payment cut will take place in July 2008, with another steep cut in 2009. AAFP President Jim King, MD, Selmer, Tenn., says that the temporary reprieve is not enough. He calls for a complete reevaluation of the Medicare payment system. The reprieve comes on the heels of two virtual rallies organized by AAFP and other physician organizations. The rallies mobilized physicians to persuade legislators to take action against the current payment system and SGR formula, which they consider flawed. These organizations urge physicians to continue to contact legislators during the six-month reprieve to encourage a more permanent fix to the problem. For more information, visit https://www.aafp.org/news-now/government-medicine/20071219medicarebill.html.

MedWatch: Merck Announces Voluntary Recall of 1 Million Hib Vaccine Doses

Merck has voluntarily recalled 10 lots of its Haemophilus influenzae type b (Hib) conjugate vaccine and two lots of its combination Hib/hepatitis B vaccine; both are used to vaccinate infants and children. The recall was issued after Bacillus cereus was detected on equipment used to manufacture the vaccines, although the vaccines themselves were not contaminated. Officials from the Centers for Disease Control and Prevention (CDC) say that there is no health threat; however, the recall is a major inconvenience for health care professionals. CDC Director Julie Gerberding, MD, said during a news conference that children who have already been vaccinated do not need to be revaccinated because the potency of the vaccines has not been affected. She also said that there is no immediate concern about invasive Hib disease. The CDC says that it will continue to work with Sanofi Pasteur, another Hib vaccine manufacturer, to evaluate and ensure an adequate supply. In response to the recall, the CDC has published interim guidelines on the use of Hib vaccines in the December 19, 2007, Morbidity and Mortality Weekly Report (http://www.cdc.gov/mmwr/preview/mmwrhtml/mm56d1219a1.htm). For more information, visit https://www.aafp.org/news-now/clinical-care-research/20071213hibvaccinefolo.html or the CDC's Current Vaccine Shortages and Delays Web site at http://www.cdc.gov/vaccines/vac-gen/shortages/default.htm.

Bipartisan Legislation Includes Mandatory E-Prescribing, Incentives for Physicians

Legislation in the House and Senate (S.B. 2408 and H.R. 4296) would require Medicare physicians to adopt electronic prescribing (e-prescribing) by 2011. Under the Medicare Electronic Medication and Safety Protection Act, physicians would receive financial incentives to use e-prescribing systems. Grants would help offset start-up costs, and physicians who use the technology would receive a 1 percent bonus for every claim that includes an e-prescription. Although temporary hardship waivers would be available, mainly to rural physicians, most physicians who do not comply by 2011 would face per-claim penalties. Although previous e-prescribing initiatives have failed, proponents say that there is broad bipartisan support for the current legislation. The Bush administration also has voiced support for health information technology initiatives. For more information, visit https://www.aafp.org/news-now/government-medicine/20071219eprescribing.html.

Bill Aims to Reinstate Hardship Deferment Plan that Assists with Medical School Debt

Legislation (S.B. 2303) has been introduced to reinstate the hardship student loan deferment plan commonly know as the 20/220 rule. The rule was eliminated with the recent passage of a new loan-reduction plan. In the meantime, the U.S. Department of Education has extended the 20/220 rule until November 2008 and has expanded its eligibility criteria. The 20/220 rule allows recipients, who qualify based on income, to defer student loan payments while avoiding interest for three years. The new plan, which is part of the College Cost Reduction and Access Act (H.R. 2669), implements two initiatives to reduce long-term debt: an income-based repayment program and a loan-forgiveness program for direct loans and loan consolidation. However, under the new plan, medical students would have to begin making loan payments immediately after graduation during their residencies or defer payment while interest accrues. The American Medical Association (AMA) strongly supports the legislation calling for permanent loan deferment eligibility for residents. In a recent statement, the AMA said that one of its top legislative priorities for 2008 is helping residents and young physicians finance their education and manage the burden of high debt. For more information, visit https://www.aafp.org/news-now/resident-student-focus/20071213hardshipdeferments.html.

New AAFP Web site Gives Patients an Outlet to Advocate for Primary Care Issues

AAFP's new Family Health Advocate Web site informs patients about issues important to family physicians and their patients and to encourage patient advocacy for these issues. The Web site includes information about key topics, such as patient-centered medical homes, cost of health insurance, and preventive care. Visitors to the Web site will also have access to an electronic newsletter, resources for contacting legislators, and e-mail Action Alerts. For more information, visit https://www.aafp.org/news-now/inside-aafp/20071212famhealthadvoc.html or the Family Health Advocate Web site at http://www.familyhealthadvocate.org.

Change in Ownership Prevents Closure of the National Procedures Institute

On January 1, 2008, the American Academy of Family Physicians (AAFP), the Texas Academy of Family Physicians (TAFP), and the Society of Teachers of Family Medicine took ownership of the National Procedures Institute (NPI). The action ensures the continuation of the institute's continuing medical education (CME) courses on medical procedures for primary care physicians. Tom Banning, CEO and executive vice president of TAFP, says that the NPI is an important source for procedural training, and that its closure would have created a significant void in the CME market. For more information, visit https://www.aafp.org/news-now/inside-aafp/20071212npibuyout.html or the NPI Web site at http://www.npinstitute.com.

Study Shows that Many Americans Do Not Have a Regular Source of Health Care

A recent study by the CDC shows that 20 percent of Americans 18 to 64 years of age did not have a regular health care source between 2004 and 2005; this was most apparent in 18- to 24-year-olds. Because a regular source of health care has been shown to improve quality of care, these findings indicate that many Americans may not be receiving adequate care. The study findings were reported in Health, United States, 2007, an annual report on health trends in the United States. This was the first year that the report included a section on access to care. The CDC study also showed that 20 percent of adults could not afford health care services such as medical care, prescription drugs, mental health care, dental care, or eyeglasses. Nonfinancial factors shown to prevent regular health care include lack of transportation; travel time, especially in rural settings; communication barriers; and lack of patient knowledge about obtaining health care. For more information, visit https://www.aafp.org/news-now/health-of-the-public/20071218cdcstudy.html or the CDC Web site at http://www.cdc.gov/nchs/hus.htm.

AHRQ Develops Toolkits to Help Improve Patient Safety at the Point of Care

The Agency for Healthcare Research and Quality (AHRQ) has created 17 toolkits designed to help health care professionals and others reduce medical errors. The toolkits, which are adaptable to most health care settings, range from medication checklists to resources that help enhance physician-patient communication. Specifically, the toolkits provide resources on improving communication at hospital discharge, identifying risk factors for inaccurate medication reconciliation, and preventing thromboembolism in the hospital. Experts in patient safety research developed the toolkits based on the examination of best practices in a variety of health care settings. The toolkits also compliment the Joint Commission's National Patient Safety Goals. For more information, visit the AHRQ Web site at http://www.ahrq.gov/qual/pips.

Family Medicine Congressional Conference Now Open to More Primary Care Physicians

More family physicians will be able to attend the 2008 annual Family Medicine Congressional Conference than in previous years. For the first time, the conference is open to a limited number of attendees who are not sponsored by the AAFP or American Family Medicine Advocacy Alliance (AFMAA). The conference, hosted by AAFP and AFMAA, focuses on teaching physicians about legislative priorities for family medicine and on providing comprehensive training on how to successfully lobby federal legislators. The 2008 conference will be held in Washington, DC, in May. Registration ends in March. For more information, visit https://www.aafp.org/news-now/inside-aafp/20071205fyb-fmcc.html.

AFP and AAFP NEWS NOW staff