Jane Anderson

Part D Premiums for 2009

Medicare beneficiaries can expect to pay an average of about $28 per month for standard Part D prescription drug coverage next year. The estimates from the Centers for Medicare and Medicaid Services are based on bids submitted for both prescription drug plans and Medicare Advantage drug plans. The estimated monthly premiums are about $3 higher than the average monthly premium costs this year, but are 37% lower than projections that were made when the Medicare prescription drug benefit was created in 2003. The $3 increase is based in part on rising drug costs in general and higher costs for catastrophic drug coverage. In some cases, price increases could be significant, said Kerry Weems, CMS acting administrator, during a teleconference to announce the premium estimates. However, he noted that most beneficiaries will have the option to switch to a prescription drug plan with premiums that are the same or lower than this year. Open enrollment for the fourth year of the Medicare Part D program is set to begin in November.

GAO: Part D Problems Continue

Almost 3 years after the Medicare Part D drug program went into effect, the Centers for Medicare and Medicaid Services still face continuing problems resolving beneficiaries' complaints and grievances, a Government Accountability Office report found. GAO said that there have been 630,000 complaints filed with CMS against drug plans since Part D went into effect, most involving problems of enrollment and disenrollment. Although GAO found that the number of complaints, and the time to resolve them, had declined in the first 2 years of the program, it also found that “a substantial proportion of the most critical complaints—those filed when beneficiaries were at risk of exhausting their medications—were not resolved within CMS's applicable time frames.”

Health Searches Level Off

The number of adults going online for health information has plateaued or declined, according to a Harris Interactive poll. According to the pollster, a total of 150 million people—66% of all adults and 81% of those who have online access—said they obtained health information from the Internet in 2008. That represents a slight drop from 2007, when the poll found that 160 million people reported obtaining health information online. The researchers who conducted the poll noted that the slight differences from 2007 to 2008 are within the possible sampling error. But they pointed out that, as opposed to other years, it appears that there has been no increase in the total number of people with Internet access or in the number of people searching for health information—those the poll calls “cybercondriacs”—indicating that a plateau or even a slight decline was underway. Just under half of cybercondriacs said that they had discussed the information they obtained online with their doctors, and 49% had gone online to look for information as a result of discussions with their doctors, the survey found.

Calif. Stops Cancellation Practice

California's Gov. Arnold Schwarzenegger (R) has signed legislation banning health insurance companies from rewarding employees for canceling or limiting a patient's health insurance. According to the bill's sponsor, Assemblyman Ted Lieu (D-Torrance), the law was introduced in response to reports that insurers used applications for individual health insurance that potentially could trick people into making mistakes that later could be used to cancel their coverage. Once policyholders became ill and incurred significant medical bills, the insurance companies would look for an undisclosed condition or symptom that could be used to justify cancellation of the policy, Mr. Lieu said, adding that some companies used bonuses to reward employees for canceling coverage. “Patients should not have to worry about losing their health insurance simply because an employee can make some extra bonus money,” he said in a statement.

Laws Won't Help Uninsured

New legislation in Florida and Georgia—states in which the percentage of uninsured is well above the national average of 18%—is unlikely to reduce the ranks of the uninsured, according to a report from the Center on Budget and Policy Priorities. In 2008, Georgia created new tax breaks for high-deductible health plans, while Florida's new law will allow private insurance companies to sell “bare-bones” policies with limited benefits. However, neither approach provides a targeted subsidy to help low-income people, who make up the bulk of the uninsured, according to the center's report. The report also said that many people who do get coverage through these initiatives will be underinsured and therefore could face high out-of-pocket costs and have problems paying their medical bills.

Grants Aimed at Risk Pools

CMS has awarded more than $49 million in grants to 30 states that provide health insurance to residents who cannot get conventional health coverage because of their health status. The grants will be used by the states to offset losses from the operation of their high-risk pools, which are typically state-created nonprofit associations that offer health coverage to individuals with serious medical conditions. Grant funds also provide support for disease management of chronic conditions and premium subsidies for individuals with lower incomes. More than 200,000 individuals are enrolled in state high-risk pools, according to CMS. Funds were allocated based on the number of uninsured individuals in each state and the number of people enrolled in each pool, CMS said.

Part D Premiums for 2009

Medicare beneficiaries can expect to pay an average of about $28 per month for standard Part D prescription drug coverage next year. The estimates from the Centers for Medicare and Medicaid Services are based on bids submitted for both prescription drug plans and Medicare Advantage drug plans. The estimated monthly premiums are about $3 higher than the average monthly premium costs this year, but are 37% lower than projections that were made when the Medicare prescription drug benefit was created in 2003. The $3 increase is based in part on rising drug costs in general and higher costs for catastrophic drug coverage. In some cases, price increases could be significant, said Kerry Weems, CMS acting administrator, during a teleconference to announce the premium estimates. However, he noted that most beneficiaries will have the option to switch to a prescription drug plan with premiums that are the same or lower than this year. Open enrollment for the fourth year of the Medicare Part D program is set to begin in November.

GAO: Part D Problems Continue

Almost 3 years after the Medicare Part D drug program went into effect, the Centers for Medicare and Medicaid Services still face continuing problems resolving beneficiaries' complaints and grievances, a Government Accountability Office report found. GAO said that there have been 630,000 complaints filed with CMS against drug plans since Part D went into effect, most involving problems of enrollment and disenrollment. Although GAO found that the number of complaints, and the time to resolve them, had declined in the first 2 years of the program, it also found that “a substantial proportion of the most critical complaints—those filed when beneficiaries were at risk of exhausting their medications—were not resolved within CMS's applicable time frames.”

Health Searches Level Off

The number of adults going online for health information has plateaued or declined, according to a Harris Interactive poll. According to the pollster, a total of 150 million people—66% of all adults and 81% of those who have online access—said they obtained health information from the Internet in 2008. That represents a slight drop from 2007, when the poll found that 160 million people reported obtaining health information online. The researchers who conducted the poll noted that the slight differences from 2007 to 2008 are within the possible sampling error. But they pointed out that, as opposed to other years, it appears that there has been no increase in the total number of people with Internet access or in the number of people searching for health information—those the poll calls “cybercondriacs”—indicating that a plateau or even a slight decline was underway. Just under half of cybercondriacs said that they had discussed the information they obtained online with their doctors, and 49% had gone online to look for information as a result of discussions with their doctors, the survey found.

Calif. Stops Cancellation Practice

California's Gov. Arnold Schwarzenegger (R) has signed legislation banning health insurance companies from rewarding employees for canceling or limiting a patient's health insurance. According to the bill's sponsor, Assemblyman Ted Lieu (D-Torrance), the law was introduced in response to reports that insurers used applications for individual health insurance that potentially could trick people into making mistakes that later could be used to cancel their coverage. Once policyholders became ill and incurred significant medical bills, the insurance companies would look for an undisclosed condition or symptom that could be used to justify cancellation of the policy, Mr. Lieu said, adding that some companies used bonuses to reward employees for canceling coverage. “Patients should not have to worry about losing their health insurance simply because an employee can make some extra bonus money,” he said in a statement.

Laws Won't Help Uninsured

New legislation in Florida and Georgia—states in which the percentage of uninsured is well above the national average of 18%—is unlikely to reduce the ranks of the uninsured, according to a report from the Center on Budget and Policy Priorities. In 2008, Georgia created new tax breaks for high-deductible health plans, while Florida's new law will allow private insurance companies to sell “bare-bones” policies with limited benefits. However, neither approach provides a targeted subsidy to help low-income people, who make up the bulk of the uninsured, according to the center's report. The report also said that many people who do get coverage through these initiatives will be underinsured and therefore could face high out-of-pocket costs and have problems paying their medical bills.

Grants Aimed at Risk Pools

CMS has awarded more than $49 million in grants to 30 states that provide health insurance to residents who cannot get conventional health coverage because of their health status. The grants will be used by the states to offset losses from the operation of their high-risk pools, which are typically state-created nonprofit associations that offer health coverage to individuals with serious medical conditions. Grant funds also provide support for disease management of chronic conditions and premium subsidies for individuals with lower incomes. More than 200,000 individuals are enrolled in state high-risk pools, according to CMS. Funds were allocated based on the number of uninsured individuals in each state and the number of people enrolled in each pool, CMS said.

Part D Premiums for 2009

Medicare beneficiaries can expect to pay an average of about $28 per month for standard Part D prescription drug coverage next year. The estimates from the Centers for Medicare and Medicaid Services are based on bids submitted for both prescription drug plans and Medicare Advantage drug plans. The estimated monthly premiums are about $3 higher than the average monthly premium costs this year, but are 37% lower than projections that were made when the Medicare prescription drug benefit was created in 2003. The $3 increase is based in part on rising drug costs in general and higher costs for catastrophic drug coverage. In some cases, price increases could be significant, said Kerry Weems, CMS acting administrator, during a teleconference to announce the premium estimates. However, he noted that most beneficiaries will have the option to switch to a prescription drug plan with premiums that are the same or lower than this year. Open enrollment for the fourth year of the Medicare Part D program is set to begin in November.

GAO: Part D Problems Continue

Almost 3 years after the Medicare Part D drug program went into effect, the Centers for Medicare and Medicaid Services still face continuing problems resolving beneficiaries' complaints and grievances, a Government Accountability Office report found. GAO said that there have been 630,000 complaints filed with CMS against drug plans since Part D went into effect, most involving problems of enrollment and disenrollment. Although GAO found that the number of complaints, and the time to resolve them, had declined in the first 2 years of the program, it also found that “a substantial proportion of the most critical complaints—those filed when beneficiaries were at risk of exhausting their medications—were not resolved within CMS's applicable time frames.”

Health Searches Level Off

The number of adults going online for health information has plateaued or declined, according to a Harris Interactive poll. According to the pollster, a total of 150 million people—66% of all adults and 81% of those who have online access—said they obtained health information from the Internet in 2008. That represents a slight drop from 2007, when the poll found that 160 million people reported obtaining health information online. The researchers who conducted the poll noted that the slight differences from 2007 to 2008 are within the possible sampling error. But they pointed out that, as opposed to other years, it appears that there has been no increase in the total number of people with Internet access or in the number of people searching for health information—those the poll calls “cybercondriacs”—indicating that a plateau or even a slight decline was underway. Just under half of cybercondriacs said that they had discussed the information they obtained online with their doctors, and 49% had gone online to look for information as a result of discussions with their doctors, the survey found.

Calif. Stops Cancellation Practice

California's Gov. Arnold Schwarzenegger (R) has signed legislation banning health insurance companies from rewarding employees for canceling or limiting a patient's health insurance. According to the bill's sponsor, Assemblyman Ted Lieu (D-Torrance), the law was introduced in response to reports that insurers used applications for individual health insurance that potentially could trick people into making mistakes that later could be used to cancel their coverage. Once policyholders became ill and incurred significant medical bills, the insurance companies would look for an undisclosed condition or symptom that could be used to justify cancellation of the policy, Mr. Lieu said, adding that some companies used bonuses to reward employees for canceling coverage. “Patients should not have to worry about losing their health insurance simply because an employee can make some extra bonus money,” he said in a statement.

Laws Won't Help Uninsured

New legislation in Florida and Georgia—states in which the percentage of uninsured is well above the national average of 18%—is unlikely to reduce the ranks of the uninsured, according to a report from the Center on Budget and Policy Priorities. In 2008, Georgia created new tax breaks for high-deductible health plans, while Florida's new law will allow private insurance companies to sell “bare-bones” policies with limited benefits. However, neither approach provides a targeted subsidy to help low-income people, who make up the bulk of the uninsured, according to the center's report. The report also said that many people who do get coverage through these initiatives will be underinsured and therefore could face high out-of-pocket costs and have problems paying their medical bills.

Grants Aimed at Risk Pools

CMS has awarded more than $49 million in grants to 30 states that provide health insurance to residents who cannot get conventional health coverage because of their health status. The grants will be used by the states to offset losses from the operation of their high-risk pools, which are typically state-created nonprofit associations that offer health coverage to individuals with serious medical conditions. Grant funds also provide support for disease management of chronic conditions and premium subsidies for individuals with lower incomes. More than 200,000 individuals are enrolled in state high-risk pools, according to CMS. Funds were allocated based on the number of uninsured individuals in each state and the number of people enrolled in each pool, CMS said.

Access to care has declined significantly since 2003, with 42% of all working-age adults either uninsured or underinsured in 2007, according to a national health system scorecard from The Commonwealth Fund, which found that health care system performance in the United States has worsened slightly overall since 2006.

According to the scorecard report, the United States on average continues to fall far short on key indicators of health outcomes and quality. U.S. scores are particularly low on efficiency, compared with top performers inside the country—states, regions, hospitals, health plans, or other providers—and internationally.

"These findings were very disturbing, considering the resources the U.S. spends on health care," Dr. Karen Davis, president of The Commonwealth Fund, said in a briefing on the report, adding that the nation spends more on health care than any other in the industrialized world.

In the report, "Why Not the Best? Results From the National Scorecard on U.S. Health System Performance, 2008," the United States scored an average of 65 out of a possible 100—slightly below the 67 scored in 2006 in the first scorecard released—across 37 key indicators of health outcomes, quality, access, efficiency, and equity.

"We need to change direction," Dr. Davis said. "This latest scorecard demonstrates that we are in fact losing ground."

The report found that the number of uninsured and underinsured Americans continues to rise: As of 2007, 42% of all working-age adults were either uninsured or underinsured—up from 35% in 2003.

In addition, the report said that the United States failed to keep up with improvements made in other countries, and fell from 15th place to dead last among 19 industrialized nations in premature deaths that could have been prevented by timely access to effective health care.

Rates for basic preventive care, such as cancer screening, failed to improve from 2005 to 2007, the report said.

In addition, "scores on efficiency are particularly low, pulled down by fragmented, poorly coordinated care," along with lack of access to care and high administrative costs, said Cathy Schoen, senior vice president of The Commonwealth Fund.

In 2007, for example, as in 2005, patients in the United States were three to four times more likely than patients in other countries to report having had duplicate tests or to report that medical records or test results were not available at the time of their appointment. And, although primary care physicians in the United States used electronic medical records (EMRs) increasingly from 2001 to 2006—17% to 28%—the United States lags far behind leading countries, where EMRs now are used by nearly all physicians (98%) to improve care, the scorecard reported.

Still, "there are some bright spots," Ms. Schoen said. The report found evidence that focusing on specific areas through targeted initiatives can yield substantial improvement.

For example, the report found that hospital standardized mortality ratios, a key indicator of patient safety, improved by 19% over 5 years, following broad public and private efforts to assess and improve hospital safety. Also, chronic care and acute hospital care quality metrics that have been the focus of public reporting, pay for performance, and improvement efforts also showed significant progress.

"We find that what gets attention gets improved," Ms. Schoen said. "But to date we have focused too narrowly. Current initiatives often fail to encourage more effective or more efficient care."

Dr. Davis pointed out that, with a new president and administration next year, the nation has a real opportunity to refocus and rebuild its health care system. "The most important thing is extending health insurance to all," she said. "There were 75 million American adults uninsured at some point in the year."

Access to care has declined significantly since 2003, with 42% of all working-age adults either uninsured or underinsured in 2007, according to a national health system scorecard from The Commonwealth Fund, which found that health care system performance in the United States has worsened slightly overall since 2006.

According to the scorecard report, the United States on average continues to fall far short on key indicators of health outcomes and quality. U.S. scores are particularly low on efficiency, compared with top performers inside the country—states, regions, hospitals, health plans, or other providers—and internationally.

"These findings were very disturbing, considering the resources the U.S. spends on health care," Dr. Karen Davis, president of The Commonwealth Fund, said in a briefing on the report, adding that the nation spends more on health care than any other in the industrialized world.

In the report, "Why Not the Best? Results From the National Scorecard on U.S. Health System Performance, 2008," the United States scored an average of 65 out of a possible 100—slightly below the 67 scored in 2006 in the first scorecard released—across 37 key indicators of health outcomes, quality, access, efficiency, and equity.

"We need to change direction," Dr. Davis said. "This latest scorecard demonstrates that we are in fact losing ground."

The report found that the number of uninsured and underinsured Americans continues to rise: As of 2007, 42% of all working-age adults were either uninsured or underinsured—up from 35% in 2003.

In addition, the report said that the United States failed to keep up with improvements made in other countries, and fell from 15th place to dead last among 19 industrialized nations in premature deaths that could have been prevented by timely access to effective health care.

Rates for basic preventive care, such as cancer screening, failed to improve from 2005 to 2007, the report said.

In addition, "scores on efficiency are particularly low, pulled down by fragmented, poorly coordinated care," along with lack of access to care and high administrative costs, said Cathy Schoen, senior vice president of The Commonwealth Fund.

In 2007, for example, as in 2005, patients in the United States were three to four times more likely than patients in other countries to report having had duplicate tests or to report that medical records or test results were not available at the time of their appointment. And, although primary care physicians in the United States used electronic medical records (EMRs) increasingly from 2001 to 2006—17% to 28%—the United States lags far behind leading countries, where EMRs now are used by nearly all physicians (98%) to improve care, the scorecard reported.

Still, "there are some bright spots," Ms. Schoen said. The report found evidence that focusing on specific areas through targeted initiatives can yield substantial improvement.

For example, the report found that hospital standardized mortality ratios, a key indicator of patient safety, improved by 19% over 5 years, following broad public and private efforts to assess and improve hospital safety. Also, chronic care and acute hospital care quality metrics that have been the focus of public reporting, pay for performance, and improvement efforts also showed significant progress.

"We find that what gets attention gets improved," Ms. Schoen said. "But to date we have focused too narrowly. Current initiatives often fail to encourage more effective or more efficient care."

Dr. Davis pointed out that, with a new president and administration next year, the nation has a real opportunity to refocus and rebuild its health care system. "The most important thing is extending health insurance to all," she said. "There were 75 million American adults uninsured at some point in the year."

Access to care has declined significantly since 2003, with 42% of all working-age adults either uninsured or underinsured in 2007, according to a national health system scorecard from The Commonwealth Fund, which found that health care system performance in the United States has worsened slightly overall since 2006.

According to the scorecard report, the United States on average continues to fall far short on key indicators of health outcomes and quality. U.S. scores are particularly low on efficiency, compared with top performers inside the country—states, regions, hospitals, health plans, or other providers—and internationally.

"These findings were very disturbing, considering the resources the U.S. spends on health care," Dr. Karen Davis, president of The Commonwealth Fund, said in a briefing on the report, adding that the nation spends more on health care than any other in the industrialized world.

In the report, "Why Not the Best? Results From the National Scorecard on U.S. Health System Performance, 2008," the United States scored an average of 65 out of a possible 100—slightly below the 67 scored in 2006 in the first scorecard released—across 37 key indicators of health outcomes, quality, access, efficiency, and equity.

"We need to change direction," Dr. Davis said. "This latest scorecard demonstrates that we are in fact losing ground."

The report found that the number of uninsured and underinsured Americans continues to rise: As of 2007, 42% of all working-age adults were either uninsured or underinsured—up from 35% in 2003.

In addition, the report said that the United States failed to keep up with improvements made in other countries, and fell from 15th place to dead last among 19 industrialized nations in premature deaths that could have been prevented by timely access to effective health care.

Rates for basic preventive care, such as cancer screening, failed to improve from 2005 to 2007, the report said.

In addition, "scores on efficiency are particularly low, pulled down by fragmented, poorly coordinated care," along with lack of access to care and high administrative costs, said Cathy Schoen, senior vice president of The Commonwealth Fund.

In 2007, for example, as in 2005, patients in the United States were three to four times more likely than patients in other countries to report having had duplicate tests or to report that medical records or test results were not available at the time of their appointment. And, although primary care physicians in the United States used electronic medical records (EMRs) increasingly from 2001 to 2006—17% to 28%—the United States lags far behind leading countries, where EMRs now are used by nearly all physicians (98%) to improve care, the scorecard reported.

Still, "there are some bright spots," Ms. Schoen said. The report found evidence that focusing on specific areas through targeted initiatives can yield substantial improvement.

For example, the report found that hospital standardized mortality ratios, a key indicator of patient safety, improved by 19% over 5 years, following broad public and private efforts to assess and improve hospital safety. Also, chronic care and acute hospital care quality metrics that have been the focus of public reporting, pay for performance, and improvement efforts also showed significant progress.

"We find that what gets attention gets improved," Ms. Schoen said. "But to date we have focused too narrowly. Current initiatives often fail to encourage more effective or more efficient care."

Dr. Davis pointed out that, with a new president and administration next year, the nation has a real opportunity to refocus and rebuild its health care system. "The most important thing is extending health insurance to all," she said. "There were 75 million American adults uninsured at some point in the year."

Feds Scrutinize Generic Maker

India's Ranbaxy Inc., one of the world's top 10 generic drug makers, is being investigated by various arms of the federal government for allegedly introducing “adulterated or misbranded products” into the U.S. market. The company's auditor, Parexel Consulting, is also under scrutiny. According to a subpoena for documents filed in the U.S. District Court for the District of Maryland by the federal Department of Justice and the U.S. Attorney's Office in Maryland, Ranbaxy submitted false information to the Food and Drug Administration on sterility and bioequivalence, covered up violations of good manufacturing practice, and defrauded Medicare. Rep. John Dingell (D-Mich.) and Rep. Bart Stupak (D-Mich.) said they will formally investigate the situation. “If these allegations are true, Ranbaxy has imperiled the safety of Americans in a manner similar to the generic drug scandal we uncovered 20 years ago,” said Rep. Dingell. “I would like to know whether FDA officials knew about these allegations and what, if any, action was taken.”

OIG Okays Gift Cards

The Health and Human Services Department has granted permission to an unnamed health care system to manage and resolve patient complaints by offering dissatisfied patients $10 gift cards. The health system, which includes three hospitals, 22 clinics, a skilled nursing facility, and a health plan, had asked the HHS Office of Inspector General if it could offer gift cards for local restaurants and theater chains, the OIG said. The health system had suggested using the gift cards to resolve complaints about excessive wait times; cancelled appointments; delayed meals; excess noise; housekeeping or dietary concerns; equipment problems in hospital rooms; or loss of personal items. The OIG said in its opinion that the gift cards would not be considered illegal kickbacks.

Accreditation for Urgent Care

The Urgent Care Association said it will discontinue its own accreditation program and instead will partner with the Joint Commission on Accreditation of Healthcare Organizations, which currently provides an ambulatory care accreditation program. The groups also said they will collaborate on the development of quality standards specific to urgent care, which are targeted for introduction in 2010. Discontinuing its own program and instead providing support services through the JCAHO's ambulatory care accreditation program will allow the Urgent Care Association to focus on other quality assurance issues specific to urgent care, executive director Lou Ellen Horwitz said in a statement.

RACs Find Overpayments

The recovery audit contractors (RAC) pilot program is successfully identifying improper payments, according to a Centers for Medicare and Medicaid Services report. The findings also will help the CMS improve the program as it expands nationwide within 2 years, said the agency. The report showed that $693.6 million in improper Medicare payments were recovered between 2005 and March 2008. Of the overpayments, 85% were collected from inpatient hospital providers, 6% from inpatient rehabilitation facilities, 4% from outpatient hospital providers, and 2.5% from physicians. The remaining 2.5% were collected from ambulance services, skilled nursing facilities, and durable medical equipment suppliers. The program began in California, Florida, and New York in 2005 and expanded to Arizona, Massachusetts, and South Carolina in 2007.

Mass. Plans to Pay Clinics

Health plans in Massachusetts will join plans in two dozen other states in covering visits to urgent care clinics located in chain drugstores, said CVS Caremark Corp. spokeswoman Carolyn Castel in an interview. “We expect that both national and regional players in the state” will add MinuteClinics to their networks, she said. In January, the Massachusetts Public Health Council gave CVS Caremark permission to open the clinics. At the same time, the council ordered new regulations governing how the clinics are run in an effort to address concerns by physician groups that the clinics could, for some patients, replace an ongoing relationship with a physician. CVS Caremark intends to open 15-28 MinuteClinics in Massachusetts by the end of this year, and hopes to have 100 clinics operating in the state within 5 years, Ms. Castel said. The company is negotiating for coverage of clinic services with Blue Cross and Blue Shield of Massachusetts, the state's largest health insurer, she said.

Medicare Pay Favors Specialists

Incomes vary widely in the four medical specialties—geriatrics, hematology-oncology, nephrology, and rheumatology—that derive more than half of their revenues from government-run health insurance programs, a study showed. For example, geriatricians' incomes averaged $165,000 annually, compared with $504,000 for hematologists, even though the specialties require a similar amount of training, researchers from Harvard Medical School at Cambridge (Mass.) Health Alliance, wrote in a study published online in the Journal of General Internal Medicine. They analyzed data from the national Medical Expenditure Panel Survey. The income disparity fuels the shortage of primary care physicians, said lead author Dr. Karen Lasser. “It's no surprise that there is a shortage of primary care doctors when debt-burdened medical students have much more lucrative career options,” she said in a statement. “What is surprising is that government fee schedules are behind much of this income discrepancy.” In total, Medicare accounts for about 21% of payments to doctors, whereas Medicaid and other government programs account for 10%, according to the study.

Feds Scrutinize Generic Maker

India's Ranbaxy Inc., one of the world's top 10 generic drug makers, is being investigated by various arms of the federal government for allegedly introducing “adulterated or misbranded products” into the U.S. market. The company's auditor, Parexel Consulting, is also under scrutiny. According to a subpoena for documents filed in the U.S. District Court for the District of Maryland by the federal Department of Justice and the U.S. Attorney's Office in Maryland, Ranbaxy submitted false information to the Food and Drug Administration on sterility and bioequivalence, covered up violations of good manufacturing practice, and defrauded Medicare. Rep. John Dingell (D-Mich.) and Rep. Bart Stupak (D-Mich.) said they will formally investigate the situation. “If these allegations are true, Ranbaxy has imperiled the safety of Americans in a manner similar to the generic drug scandal we uncovered 20 years ago,” said Rep. Dingell. “I would like to know whether FDA officials knew about these allegations and what, if any, action was taken.”

OIG Okays Gift Cards

The Health and Human Services Department has granted permission to an unnamed health care system to manage and resolve patient complaints by offering dissatisfied patients $10 gift cards. The health system, which includes three hospitals, 22 clinics, a skilled nursing facility, and a health plan, had asked the HHS Office of Inspector General if it could offer gift cards for local restaurants and theater chains, the OIG said. The health system had suggested using the gift cards to resolve complaints about excessive wait times; cancelled appointments; delayed meals; excess noise; housekeeping or dietary concerns; equipment problems in hospital rooms; or loss of personal items. The OIG said in its opinion that the gift cards would not be considered illegal kickbacks.

Accreditation for Urgent Care

The Urgent Care Association said it will discontinue its own accreditation program and instead will partner with the Joint Commission on Accreditation of Healthcare Organizations, which currently provides an ambulatory care accreditation program. The groups also said they will collaborate on the development of quality standards specific to urgent care, which are targeted for introduction in 2010. Discontinuing its own program and instead providing support services through the JCAHO's ambulatory care accreditation program will allow the Urgent Care Association to focus on other quality assurance issues specific to urgent care, executive director Lou Ellen Horwitz said in a statement.

RACs Find Overpayments

The recovery audit contractors (RAC) pilot program is successfully identifying improper payments, according to a Centers for Medicare and Medicaid Services report. The findings also will help the CMS improve the program as it expands nationwide within 2 years, said the agency. The report showed that $693.6 million in improper Medicare payments were recovered between 2005 and March 2008. Of the overpayments, 85% were collected from inpatient hospital providers, 6% from inpatient rehabilitation facilities, 4% from outpatient hospital providers, and 2.5% from physicians. The remaining 2.5% were collected from ambulance services, skilled nursing facilities, and durable medical equipment suppliers. The program began in California, Florida, and New York in 2005 and expanded to Arizona, Massachusetts, and South Carolina in 2007.

Mass. Plans to Pay Clinics

Health plans in Massachusetts will join plans in two dozen other states in covering visits to urgent care clinics located in chain drugstores, said CVS Caremark Corp. spokeswoman Carolyn Castel in an interview. “We expect that both national and regional players in the state” will add MinuteClinics to their networks, she said. In January, the Massachusetts Public Health Council gave CVS Caremark permission to open the clinics. At the same time, the council ordered new regulations governing how the clinics are run in an effort to address concerns by physician groups that the clinics could, for some patients, replace an ongoing relationship with a physician. CVS Caremark intends to open 15-28 MinuteClinics in Massachusetts by the end of this year, and hopes to have 100 clinics operating in the state within 5 years, Ms. Castel said. The company is negotiating for coverage of clinic services with Blue Cross and Blue Shield of Massachusetts, the state's largest health insurer, she said.

Medicare Pay Favors Specialists

Incomes vary widely in the four medical specialties—geriatrics, hematology-oncology, nephrology, and rheumatology—that derive more than half of their revenues from government-run health insurance programs, a study showed. For example, geriatricians' incomes averaged $165,000 annually, compared with $504,000 for hematologists, even though the specialties require a similar amount of training, researchers from Harvard Medical School at Cambridge (Mass.) Health Alliance, wrote in a study published online in the Journal of General Internal Medicine. They analyzed data from the national Medical Expenditure Panel Survey. The income disparity fuels the shortage of primary care physicians, said lead author Dr. Karen Lasser. “It's no surprise that there is a shortage of primary care doctors when debt-burdened medical students have much more lucrative career options,” she said in a statement. “What is surprising is that government fee schedules are behind much of this income discrepancy.” In total, Medicare accounts for about 21% of payments to doctors, whereas Medicaid and other government programs account for 10%, according to the study.

Feds Scrutinize Generic Maker

India's Ranbaxy Inc., one of the world's top 10 generic drug makers, is being investigated by various arms of the federal government for allegedly introducing “adulterated or misbranded products” into the U.S. market. The company's auditor, Parexel Consulting, is also under scrutiny. According to a subpoena for documents filed in the U.S. District Court for the District of Maryland by the federal Department of Justice and the U.S. Attorney's Office in Maryland, Ranbaxy submitted false information to the Food and Drug Administration on sterility and bioequivalence, covered up violations of good manufacturing practice, and defrauded Medicare. Rep. John Dingell (D-Mich.) and Rep. Bart Stupak (D-Mich.) said they will formally investigate the situation. “If these allegations are true, Ranbaxy has imperiled the safety of Americans in a manner similar to the generic drug scandal we uncovered 20 years ago,” said Rep. Dingell. “I would like to know whether FDA officials knew about these allegations and what, if any, action was taken.”

OIG Okays Gift Cards

The Health and Human Services Department has granted permission to an unnamed health care system to manage and resolve patient complaints by offering dissatisfied patients $10 gift cards. The health system, which includes three hospitals, 22 clinics, a skilled nursing facility, and a health plan, had asked the HHS Office of Inspector General if it could offer gift cards for local restaurants and theater chains, the OIG said. The health system had suggested using the gift cards to resolve complaints about excessive wait times; cancelled appointments; delayed meals; excess noise; housekeeping or dietary concerns; equipment problems in hospital rooms; or loss of personal items. The OIG said in its opinion that the gift cards would not be considered illegal kickbacks.

Accreditation for Urgent Care

The Urgent Care Association said it will discontinue its own accreditation program and instead will partner with the Joint Commission on Accreditation of Healthcare Organizations, which currently provides an ambulatory care accreditation program. The groups also said they will collaborate on the development of quality standards specific to urgent care, which are targeted for introduction in 2010. Discontinuing its own program and instead providing support services through the JCAHO's ambulatory care accreditation program will allow the Urgent Care Association to focus on other quality assurance issues specific to urgent care, executive director Lou Ellen Horwitz said in a statement.

RACs Find Overpayments

The recovery audit contractors (RAC) pilot program is successfully identifying improper payments, according to a Centers for Medicare and Medicaid Services report. The findings also will help the CMS improve the program as it expands nationwide within 2 years, said the agency. The report showed that $693.6 million in improper Medicare payments were recovered between 2005 and March 2008. Of the overpayments, 85% were collected from inpatient hospital providers, 6% from inpatient rehabilitation facilities, 4% from outpatient hospital providers, and 2.5% from physicians. The remaining 2.5% were collected from ambulance services, skilled nursing facilities, and durable medical equipment suppliers. The program began in California, Florida, and New York in 2005 and expanded to Arizona, Massachusetts, and South Carolina in 2007.

Mass. Plans to Pay Clinics

Health plans in Massachusetts will join plans in two dozen other states in covering visits to urgent care clinics located in chain drugstores, said CVS Caremark Corp. spokeswoman Carolyn Castel in an interview. “We expect that both national and regional players in the state” will add MinuteClinics to their networks, she said. In January, the Massachusetts Public Health Council gave CVS Caremark permission to open the clinics. At the same time, the council ordered new regulations governing how the clinics are run in an effort to address concerns by physician groups that the clinics could, for some patients, replace an ongoing relationship with a physician. CVS Caremark intends to open 15-28 MinuteClinics in Massachusetts by the end of this year, and hopes to have 100 clinics operating in the state within 5 years, Ms. Castel said. The company is negotiating for coverage of clinic services with Blue Cross and Blue Shield of Massachusetts, the state's largest health insurer, she said.

Medicare Pay Favors Specialists

Incomes vary widely in the four medical specialties—geriatrics, hematology-oncology, nephrology, and rheumatology—that derive more than half of their revenues from government-run health insurance programs, a study showed. For example, geriatricians' incomes averaged $165,000 annually, compared with $504,000 for hematologists, even though the specialties require a similar amount of training, researchers from Harvard Medical School at Cambridge (Mass.) Health Alliance, wrote in a study published online in the Journal of General Internal Medicine. They analyzed data from the national Medical Expenditure Panel Survey. The income disparity fuels the shortage of primary care physicians, said lead author Dr. Karen Lasser. “It's no surprise that there is a shortage of primary care doctors when debt-burdened medical students have much more lucrative career options,” she said in a statement. “What is surprising is that government fee schedules are behind much of this income discrepancy.” In total, Medicare accounts for about 21% of payments to doctors, whereas Medicaid and other government programs account for 10%, according to the study.

RACs Find Overpayments

The recovery audit contractors (RAC) pilot program is successfully identifying improper payments, according to a report from the Centers for Medicare and Medicaid Services. The findings from the report will help the CMS improve the program as it expands nationwide within 2 years, the agency said. The report showed that $693.6 million in improper Medicare payments were recovered between 2005 and March 2008. Of the overpayments, 85% were collected from inpatient hospital providers, 6% from inpatient rehabilitation facilities, 4% from outpatient hospital providers, and 2.5% from physicians, the report said. The remaining 2.5% were collected from ambulance services, skilled nursing facilities, and durable medical equipment suppliers. The program began in California, Florida, and New York in 2005 and expanded to Arizona, Massachusetts, and South Carolina in 2007.

Mass. Plans to Pay Clinics

Massachusetts health plans in will join plans in two dozen other states in covering visits to urgent care clinics in chain drugstores, a CVS Caremark Corp. spokeswoman said. “We expect that both national and regional players in the state” will add MinuteClinics to their networks, spokeswoman Carolyn Castel said in an interview. In January, the Massachusetts Public Health Council gave CVS Caremark permission to open the clinics, and ordered new regulations governing how the clinics are run in response to concerns by physician groups that the clinics could, for some patients, replace an ongoing relationship with a physician. CVS Caremark intends to open 15-28 MinuteClinics in Massachusetts by the end of this year, and hopes to have 100 clinics operating in the state within 5 years, Ms. Castel said. The company is negotiating for coverage of clinic services with Blue Cross and Blue Shield of Massachusetts, the state's largest health insurer, she said.

Accreditation for Urgent Care

The Urgent Care Association said it will discontinue its own accreditation program and instead will partner with the Joint Commission on Accreditation of Healthcare Organizations, which currently provides an ambulatory care accreditation program. The two groups also said they will collaborate to develop quality standards specific to urgent care, for introduction in 2010. Discontinuing its own program and providing support services through the JCAHO's ambulatory care accreditation program will let the Urgent Care Association focus on other quality assurance issues specific to urgent care, executive director Lou Ellen Horwitz said in a statement. There are an estimated 8,000 urgent care centers in the United States, according to the association.

Medicare Pay Favors Specialists

Incomes vary widely among the four medical specialties—geriatrics, hematology-oncology, nephrology, and rheumatology—that derive more than half of their revenues from government-run health insurance programs, a study showed. For example, geriatricians' incomes averaged $165,000 annually, versus $504,000 for hematologists, even though the two specialties require a similar amount of training. The study, from Harvard Medical School researchers at Cambridge (Mass.) Health Alliance and published online in the Journal of General Internal Medicine, analyzed data from the national Medical Expenditure Panel Survey. The income disparity fuels the shortage of primary care physicians, lead author Dr. Karen Lasser said. “Debt-burdened medical students have much more lucrative career options,” Dr. Lasser said in a statement. “What is surprising is that government fee schedules are behind much of this income discrepancy.” In total, Medicare accounts for about 21% of payments to doctors, whereas Medicaid and other government programs account for 10%, according to the study.

Feds Scrutinize Generic Maker

India's Ranbaxy Inc., 1 of the top 10 generic drug makers in the world, is being investigated by various arms of the federal government for allegedly introducing “adulterated or misbranded products” into the U.S. market. The company's auditor, Parexel Consulting, is also under scrutiny. According to a subpoena for documents filed in the U.S. District Court for the District of Maryland by the federal Department of Justice and the U.S. Attorney's Office in Maryland, Ranbaxy submitted false information to the Food and Drug Administration on sterility and bioequivalence, covered up violations of good manufacturing practice, and defrauded Medicare. “If these allegations are true, Ranbaxy has imperiled the safety of Americans in a manner similar to the generic drug scandal we uncovered 20 years ago,” said Rep. John Dingell (D-Mich.). “I would like to know whether FDA officials knew about these allegations and what, if any, action was taken.”

OIG Okays Gift Cards

The Health and Human Services Department has granted permission to an unnamed health care system to manage and resolve patient complaints by offering dissatisfied patients $10 gift cards. The health system, which includes three hospitals, 22 clinics, a skilled nursing facility, and a health plan, had asked the HHS Office of Inspector General if it could offer gift cards for local restaurants and theater chains, the OIG said. The health system had suggested using the gift cards to resolve complaints about excessive wait times; cancelled appointments; delayed meals; excess noise; housekeeping or dietary concerns; equipment problems in hospital rooms; or loss of personal items, the OIG said. The OIG concluded in its opinion that the gift cards would not be considered illegal kickbacks to patients.

RACs Find Overpayments

The recovery audit contractors (RAC) pilot program is successfully identifying improper payments, according to a report from the Centers for Medicare and Medicaid Services. The findings from the report will help the CMS improve the program as it expands nationwide within 2 years, the agency said. The report showed that $693.6 million in improper Medicare payments were recovered between 2005 and March 2008. Of the overpayments, 85% were collected from inpatient hospital providers, 6% from inpatient rehabilitation facilities, 4% from outpatient hospital providers, and 2.5% from physicians, the report said. The remaining 2.5% were collected from ambulance services, skilled nursing facilities, and durable medical equipment suppliers. The program began in California, Florida, and New York in 2005 and expanded to Arizona, Massachusetts, and South Carolina in 2007.

Mass. Plans to Pay Clinics

Massachusetts health plans in will join plans in two dozen other states in covering visits to urgent care clinics in chain drugstores, a CVS Caremark Corp. spokeswoman said. “We expect that both national and regional players in the state” will add MinuteClinics to their networks, spokeswoman Carolyn Castel said in an interview. In January, the Massachusetts Public Health Council gave CVS Caremark permission to open the clinics, and ordered new regulations governing how the clinics are run in response to concerns by physician groups that the clinics could, for some patients, replace an ongoing relationship with a physician. CVS Caremark intends to open 15-28 MinuteClinics in Massachusetts by the end of this year, and hopes to have 100 clinics operating in the state within 5 years, Ms. Castel said. The company is negotiating for coverage of clinic services with Blue Cross and Blue Shield of Massachusetts, the state's largest health insurer, she said.

Accreditation for Urgent Care

The Urgent Care Association said it will discontinue its own accreditation program and instead will partner with the Joint Commission on Accreditation of Healthcare Organizations, which currently provides an ambulatory care accreditation program. The two groups also said they will collaborate to develop quality standards specific to urgent care, for introduction in 2010. Discontinuing its own program and providing support services through the JCAHO's ambulatory care accreditation program will let the Urgent Care Association focus on other quality assurance issues specific to urgent care, executive director Lou Ellen Horwitz said in a statement. There are an estimated 8,000 urgent care centers in the United States, according to the association.

Medicare Pay Favors Specialists

Incomes vary widely among the four medical specialties—geriatrics, hematology-oncology, nephrology, and rheumatology—that derive more than half of their revenues from government-run health insurance programs, a study showed. For example, geriatricians' incomes averaged $165,000 annually, versus $504,000 for hematologists, even though the two specialties require a similar amount of training. The study, from Harvard Medical School researchers at Cambridge (Mass.) Health Alliance and published online in the Journal of General Internal Medicine, analyzed data from the national Medical Expenditure Panel Survey. The income disparity fuels the shortage of primary care physicians, lead author Dr. Karen Lasser said. “Debt-burdened medical students have much more lucrative career options,” Dr. Lasser said in a statement. “What is surprising is that government fee schedules are behind much of this income discrepancy.” In total, Medicare accounts for about 21% of payments to doctors, whereas Medicaid and other government programs account for 10%, according to the study.

Feds Scrutinize Generic Maker

India's Ranbaxy Inc., 1 of the top 10 generic drug makers in the world, is being investigated by various arms of the federal government for allegedly introducing “adulterated or misbranded products” into the U.S. market. The company's auditor, Parexel Consulting, is also under scrutiny. According to a subpoena for documents filed in the U.S. District Court for the District of Maryland by the federal Department of Justice and the U.S. Attorney's Office in Maryland, Ranbaxy submitted false information to the Food and Drug Administration on sterility and bioequivalence, covered up violations of good manufacturing practice, and defrauded Medicare. “If these allegations are true, Ranbaxy has imperiled the safety of Americans in a manner similar to the generic drug scandal we uncovered 20 years ago,” said Rep. John Dingell (D-Mich.). “I would like to know whether FDA officials knew about these allegations and what, if any, action was taken.”

OIG Okays Gift Cards

The Health and Human Services Department has granted permission to an unnamed health care system to manage and resolve patient complaints by offering dissatisfied patients $10 gift cards. The health system, which includes three hospitals, 22 clinics, a skilled nursing facility, and a health plan, had asked the HHS Office of Inspector General if it could offer gift cards for local restaurants and theater chains, the OIG said. The health system had suggested using the gift cards to resolve complaints about excessive wait times; cancelled appointments; delayed meals; excess noise; housekeeping or dietary concerns; equipment problems in hospital rooms; or loss of personal items, the OIG said. The OIG concluded in its opinion that the gift cards would not be considered illegal kickbacks to patients.

RACs Find Overpayments

The recovery audit contractors (RAC) pilot program is successfully identifying improper payments, according to a report from the Centers for Medicare and Medicaid Services. The findings from the report will help the CMS improve the program as it expands nationwide within 2 years, the agency said. The report showed that $693.6 million in improper Medicare payments were recovered between 2005 and March 2008. Of the overpayments, 85% were collected from inpatient hospital providers, 6% from inpatient rehabilitation facilities, 4% from outpatient hospital providers, and 2.5% from physicians, the report said. The remaining 2.5% were collected from ambulance services, skilled nursing facilities, and durable medical equipment suppliers. The program began in California, Florida, and New York in 2005 and expanded to Arizona, Massachusetts, and South Carolina in 2007.

Mass. Plans to Pay Clinics

Massachusetts health plans in will join plans in two dozen other states in covering visits to urgent care clinics in chain drugstores, a CVS Caremark Corp. spokeswoman said. “We expect that both national and regional players in the state” will add MinuteClinics to their networks, spokeswoman Carolyn Castel said in an interview. In January, the Massachusetts Public Health Council gave CVS Caremark permission to open the clinics, and ordered new regulations governing how the clinics are run in response to concerns by physician groups that the clinics could, for some patients, replace an ongoing relationship with a physician. CVS Caremark intends to open 15-28 MinuteClinics in Massachusetts by the end of this year, and hopes to have 100 clinics operating in the state within 5 years, Ms. Castel said. The company is negotiating for coverage of clinic services with Blue Cross and Blue Shield of Massachusetts, the state's largest health insurer, she said.

Accreditation for Urgent Care

The Urgent Care Association said it will discontinue its own accreditation program and instead will partner with the Joint Commission on Accreditation of Healthcare Organizations, which currently provides an ambulatory care accreditation program. The two groups also said they will collaborate to develop quality standards specific to urgent care, for introduction in 2010. Discontinuing its own program and providing support services through the JCAHO's ambulatory care accreditation program will let the Urgent Care Association focus on other quality assurance issues specific to urgent care, executive director Lou Ellen Horwitz said in a statement. There are an estimated 8,000 urgent care centers in the United States, according to the association.

Medicare Pay Favors Specialists

Incomes vary widely among the four medical specialties—geriatrics, hematology-oncology, nephrology, and rheumatology—that derive more than half of their revenues from government-run health insurance programs, a study showed. For example, geriatricians' incomes averaged $165,000 annually, versus $504,000 for hematologists, even though the two specialties require a similar amount of training. The study, from Harvard Medical School researchers at Cambridge (Mass.) Health Alliance and published online in the Journal of General Internal Medicine, analyzed data from the national Medical Expenditure Panel Survey. The income disparity fuels the shortage of primary care physicians, lead author Dr. Karen Lasser said. “Debt-burdened medical students have much more lucrative career options,” Dr. Lasser said in a statement. “What is surprising is that government fee schedules are behind much of this income discrepancy.” In total, Medicare accounts for about 21% of payments to doctors, whereas Medicaid and other government programs account for 10%, according to the study.

Feds Scrutinize Generic Maker

India's Ranbaxy Inc., 1 of the top 10 generic drug makers in the world, is being investigated by various arms of the federal government for allegedly introducing “adulterated or misbranded products” into the U.S. market. The company's auditor, Parexel Consulting, is also under scrutiny. According to a subpoena for documents filed in the U.S. District Court for the District of Maryland by the federal Department of Justice and the U.S. Attorney's Office in Maryland, Ranbaxy submitted false information to the Food and Drug Administration on sterility and bioequivalence, covered up violations of good manufacturing practice, and defrauded Medicare. “If these allegations are true, Ranbaxy has imperiled the safety of Americans in a manner similar to the generic drug scandal we uncovered 20 years ago,” said Rep. John Dingell (D-Mich.). “I would like to know whether FDA officials knew about these allegations and what, if any, action was taken.”

OIG Okays Gift Cards

The Health and Human Services Department has granted permission to an unnamed health care system to manage and resolve patient complaints by offering dissatisfied patients $10 gift cards. The health system, which includes three hospitals, 22 clinics, a skilled nursing facility, and a health plan, had asked the HHS Office of Inspector General if it could offer gift cards for local restaurants and theater chains, the OIG said. The health system had suggested using the gift cards to resolve complaints about excessive wait times; cancelled appointments; delayed meals; excess noise; housekeeping or dietary concerns; equipment problems in hospital rooms; or loss of personal items, the OIG said. The OIG concluded in its opinion that the gift cards would not be considered illegal kickbacks to patients.

Without the American Medical Association program that lets physicians opt out of having their prescribing data sold to pharmaceutical companies, physicians would have no influence on how their data are used by sales people, the association told two senators who inquired about the program.

The Physician Data Restriction Program (PDRP) allows individual physicians to restrict pharmaceutical companies from disclosing their prescribing data to pharmaceutical sales representatives.

Sen. Herb Kohl (D-Wis.), chairman of the Special Committee on Aging, and Sen. Dick Durbin (D-Ill.), assistant majority leader, wrote to the AMA asking about the type of outreach and physician education the association does on the program, the number of physicians who participate, and how the AMA ensures pharmaceutical companies adhere to the program.

AMA Executive Vice President and CEO Michael Maves told the senators that the PDRP has been promoted in more than 70 periodicals, through e-mail “blasts,” and in the annual AMA physician census. “The AMA has done significant outreach and marketing to the physician community at large,” Dr. Maves said in the letter, adding that, as of April, some 13,000 physicians had chosen the program.

Physicians who believe their data have been used inappropriately can complain through the AMA; to date, only one such complaint has been received, Dr. Maves said.

“Upon AMA investigation, the pharmaceutical company found an error had been made during processing,” he told the senators. “The process error was immediately corrected and additional safeguards were put in place.”

The senators said they are considering legislation to create a federal academic detailing program, which could be an objective source of information on all prescription drugs.

Without the American Medical Association program that lets physicians opt out of having their prescribing data sold to pharmaceutical companies, physicians would have no influence on how their data are used by sales people, the association told two senators who inquired about the program.

The Physician Data Restriction Program (PDRP) allows individual physicians to restrict pharmaceutical companies from disclosing their prescribing data to pharmaceutical sales representatives.

Sen. Herb Kohl (D-Wis.), chairman of the Special Committee on Aging, and Sen. Dick Durbin (D-Ill.), assistant majority leader, wrote to the AMA asking about the type of outreach and physician education the association does on the program, the number of physicians who participate, and how the AMA ensures pharmaceutical companies adhere to the program.

AMA Executive Vice President and CEO Michael Maves told the senators that the PDRP has been promoted in more than 70 periodicals, through e-mail “blasts,” and in the annual AMA physician census. “The AMA has done significant outreach and marketing to the physician community at large,” Dr. Maves said in the letter, adding that, as of April, some 13,000 physicians had chosen the program.

Physicians who believe their data have been used inappropriately can complain through the AMA; to date, only one such complaint has been received, Dr. Maves said.

“Upon AMA investigation, the pharmaceutical company found an error had been made during processing,” he told the senators. “The process error was immediately corrected and additional safeguards were put in place.”

The senators said they are considering legislation to create a federal academic detailing program, which could be an objective source of information on all prescription drugs.

Without the American Medical Association program that lets physicians opt out of having their prescribing data sold to pharmaceutical companies, physicians would have no influence on how their data are used by sales people, the association told two senators who inquired about the program.

The Physician Data Restriction Program (PDRP) allows individual physicians to restrict pharmaceutical companies from disclosing their prescribing data to pharmaceutical sales representatives.

Sen. Herb Kohl (D-Wis.), chairman of the Special Committee on Aging, and Sen. Dick Durbin (D-Ill.), assistant majority leader, wrote to the AMA asking about the type of outreach and physician education the association does on the program, the number of physicians who participate, and how the AMA ensures pharmaceutical companies adhere to the program.

AMA Executive Vice President and CEO Michael Maves told the senators that the PDRP has been promoted in more than 70 periodicals, through e-mail “blasts,” and in the annual AMA physician census. “The AMA has done significant outreach and marketing to the physician community at large,” Dr. Maves said in the letter, adding that, as of April, some 13,000 physicians had chosen the program.

Physicians who believe their data have been used inappropriately can complain through the AMA; to date, only one such complaint has been received, Dr. Maves said.

“Upon AMA investigation, the pharmaceutical company found an error had been made during processing,” he told the senators. “The process error was immediately corrected and additional safeguards were put in place.”

The senators said they are considering legislation to create a federal academic detailing program, which could be an objective source of information on all prescription drugs.

Newborn Hearing Screening Urged

All newborn infants should be screened for congenital hearing loss that is present at birth, the U.S. Preventive Services Task Force has recommended. The task force gave screening a B recommendation, meaning that, “there is moderate certainty that the net benefit is moderate to substantial.” Congenital hearing loss occurs in approximately 1-3 infants/1,000; infants at high risk include those who have spent more than 2 days in a neonatal ICU, those diagnosed with certain syndromes, and those with a family history of childhood hearing loss, according to the task force. However, half of infants with hearing loss have no identifiable risk factors. Children whose hearing is impaired at birth, during infancy, or in early childhood can have problems with verbal and nonverbal communication and social skills, increased behavioral problems, and lower academic achievement, compared with children who have normal hearing, according to the task force. “Screening at birth allows for hearing loss to be detected early and is associated with better outcomes for infants who test positive,” said Dr. Ned Calonge, task force chairman.

Some Tween Web Use Risky

More than one in five “tweens” (children aged 8-12 years) post personal information online, including pictures, their hometown, and their age, according to a survey on Internet safety by cable company Cox Communications and the National Center for Missing and Exploited Children. In addition, 27% of tweens aged 11-12 years admit to posting a fake age online, 28% of tweens have been contacted over the Internet by someone they don't know, and 11% have responded and chatted with an unknown person online, the survey found. Still, the poll found that most parents are discussing Internet safety with their children: 73% of the 1,015 tweens contacted said their parents had talked to them “a lot” about online safety. Children whose parents have discussed online safety are more likely to perceive posting personal information as unsafe, and also to tell their parents if they are contacted by a stranger, the survey found.

SCHIP Reporting Bill Introduced

Rep. Charles W. Boustany Jr. (R-La.) has introduced legislation that would require states to report how many children enrolled in the State Children's Health Insurance Plan actually receive a primary care visit each year. In addition, the legislation would encourage states to survey patients to determine if enrolled children are getting needed care in a timely manner. “Congress has a duty to ensure SCHIP coverage actually delivers timely care to enrolled children,” said Rep. Boustany, a cardiovascular surgeon, in a statement. “Studies show children with Medicaid or SCHIP receive fewer recommended checkups and fewer visits with primary care providers than [do] those with private coverage.” The bill also would require states to report their plans to target enrollment outreach to needy children who don't already have private coverage.

Child Skin Infections Rise

Children aged 4 years and younger were hospitalized with skin infections more than 34,000 times in 2006, a 150% increase from 2000, according to data from the Agency for Healthcare Research and Quality. The AHRQ analysis of hospitalization trends in children shows skin infections ranked as the 8th most common reason for child hospitalizations in 2006, up from 17th in 2000. Reasons for the increase were unclear but may be linked in part to increasing resistance to antibiotics, according to AHRQ. Meanwhile, respiratory diseases remained the top reason for child hospitalization, while other leading admissions of children in 2006 included gastritis; intestinal infections and other digestive disorders; meningitis, epilepsy, and other nervous system disorders; adolescent pregnancy; diabetes, nutritional deficiencies, and other metabolic or endocrine disorders; and depression, bipolar disease, and other mental disorders, according to AHRQ.

Patients Rate Own MDs Higher

Parents believe that their children's pediatricians always or almost always listen carefully to them and explain things in a way that is easy to understand, but they don't rate physicians and nurses in the same practice quite as highly, according to the second patient experience survey conducted by Massachusetts Health Quality Partners. The nonprofit coalition of physicians, patients, insurers, and hospitals asked 51,000 patients at 400 practices about their satisfaction on such issues as getting timely appointments, how well doctors know their patients, and how efficiently doctors coordinate care. More than 95% of parents responding said their child's doctor always or almost always listened to them and explained issues carefully, giving clear instructions about what to do about symptoms. But only about 85% of parents rated other doctors and nurses in the same practice as highly.

Most Drink Fluoridated Water

Nearly 70% of U.S. residents who get water from community water systems now receive fluoridated water, according to a study published in the July 11 issue of Morbidity and Mortality Weekly Report. The CDC found that the proportion of the U.S. population receiving fluoridated water, about 184 million people, increased from about 62% in 1992 to 69% in 2006. The percentage of people served by community water systems with optimal levels of fluoridated water ranged from less than 9% in Hawaii to 100% in the District of Columbia, the report said.

Newborn Hearing Screening Urged

All newborn infants should be screened for congenital hearing loss that is present at birth, the U.S. Preventive Services Task Force has recommended. The task force gave screening a B recommendation, meaning that, “there is moderate certainty that the net benefit is moderate to substantial.” Congenital hearing loss occurs in approximately 1-3 infants/1,000; infants at high risk include those who have spent more than 2 days in a neonatal ICU, those diagnosed with certain syndromes, and those with a family history of childhood hearing loss, according to the task force. However, half of infants with hearing loss have no identifiable risk factors. Children whose hearing is impaired at birth, during infancy, or in early childhood can have problems with verbal and nonverbal communication and social skills, increased behavioral problems, and lower academic achievement, compared with children who have normal hearing, according to the task force. “Screening at birth allows for hearing loss to be detected early and is associated with better outcomes for infants who test positive,” said Dr. Ned Calonge, task force chairman.

Some Tween Web Use Risky

More than one in five “tweens” (children aged 8-12 years) post personal information online, including pictures, their hometown, and their age, according to a survey on Internet safety by cable company Cox Communications and the National Center for Missing and Exploited Children. In addition, 27% of tweens aged 11-12 years admit to posting a fake age online, 28% of tweens have been contacted over the Internet by someone they don't know, and 11% have responded and chatted with an unknown person online, the survey found. Still, the poll found that most parents are discussing Internet safety with their children: 73% of the 1,015 tweens contacted said their parents had talked to them “a lot” about online safety. Children whose parents have discussed online safety are more likely to perceive posting personal information as unsafe, and also to tell their parents if they are contacted by a stranger, the survey found.

SCHIP Reporting Bill Introduced

Rep. Charles W. Boustany Jr. (R-La.) has introduced legislation that would require states to report how many children enrolled in the State Children's Health Insurance Plan actually receive a primary care visit each year. In addition, the legislation would encourage states to survey patients to determine if enrolled children are getting needed care in a timely manner. “Congress has a duty to ensure SCHIP coverage actually delivers timely care to enrolled children,” said Rep. Boustany, a cardiovascular surgeon, in a statement. “Studies show children with Medicaid or SCHIP receive fewer recommended checkups and fewer visits with primary care providers than [do] those with private coverage.” The bill also would require states to report their plans to target enrollment outreach to needy children who don't already have private coverage.

Child Skin Infections Rise

Children aged 4 years and younger were hospitalized with skin infections more than 34,000 times in 2006, a 150% increase from 2000, according to data from the Agency for Healthcare Research and Quality. The AHRQ analysis of hospitalization trends in children shows skin infections ranked as the 8th most common reason for child hospitalizations in 2006, up from 17th in 2000. Reasons for the increase were unclear but may be linked in part to increasing resistance to antibiotics, according to AHRQ. Meanwhile, respiratory diseases remained the top reason for child hospitalization, while other leading admissions of children in 2006 included gastritis; intestinal infections and other digestive disorders; meningitis, epilepsy, and other nervous system disorders; adolescent pregnancy; diabetes, nutritional deficiencies, and other metabolic or endocrine disorders; and depression, bipolar disease, and other mental disorders, according to AHRQ.

Patients Rate Own MDs Higher

Parents believe that their children's pediatricians always or almost always listen carefully to them and explain things in a way that is easy to understand, but they don't rate physicians and nurses in the same practice quite as highly, according to the second patient experience survey conducted by Massachusetts Health Quality Partners. The nonprofit coalition of physicians, patients, insurers, and hospitals asked 51,000 patients at 400 practices about their satisfaction on such issues as getting timely appointments, how well doctors know their patients, and how efficiently doctors coordinate care. More than 95% of parents responding said their child's doctor always or almost always listened to them and explained issues carefully, giving clear instructions about what to do about symptoms. But only about 85% of parents rated other doctors and nurses in the same practice as highly.

Most Drink Fluoridated Water

Nearly 70% of U.S. residents who get water from community water systems now receive fluoridated water, according to a study published in the July 11 issue of Morbidity and Mortality Weekly Report. The CDC found that the proportion of the U.S. population receiving fluoridated water, about 184 million people, increased from about 62% in 1992 to 69% in 2006. The percentage of people served by community water systems with optimal levels of fluoridated water ranged from less than 9% in Hawaii to 100% in the District of Columbia, the report said.

Newborn Hearing Screening Urged

All newborn infants should be screened for congenital hearing loss that is present at birth, the U.S. Preventive Services Task Force has recommended. The task force gave screening a B recommendation, meaning that, “there is moderate certainty that the net benefit is moderate to substantial.” Congenital hearing loss occurs in approximately 1-3 infants/1,000; infants at high risk include those who have spent more than 2 days in a neonatal ICU, those diagnosed with certain syndromes, and those with a family history of childhood hearing loss, according to the task force. However, half of infants with hearing loss have no identifiable risk factors. Children whose hearing is impaired at birth, during infancy, or in early childhood can have problems with verbal and nonverbal communication and social skills, increased behavioral problems, and lower academic achievement, compared with children who have normal hearing, according to the task force. “Screening at birth allows for hearing loss to be detected early and is associated with better outcomes for infants who test positive,” said Dr. Ned Calonge, task force chairman.

Some Tween Web Use Risky

More than one in five “tweens” (children aged 8-12 years) post personal information online, including pictures, their hometown, and their age, according to a survey on Internet safety by cable company Cox Communications and the National Center for Missing and Exploited Children. In addition, 27% of tweens aged 11-12 years admit to posting a fake age online, 28% of tweens have been contacted over the Internet by someone they don't know, and 11% have responded and chatted with an unknown person online, the survey found. Still, the poll found that most parents are discussing Internet safety with their children: 73% of the 1,015 tweens contacted said their parents had talked to them “a lot” about online safety. Children whose parents have discussed online safety are more likely to perceive posting personal information as unsafe, and also to tell their parents if they are contacted by a stranger, the survey found.

SCHIP Reporting Bill Introduced

Rep. Charles W. Boustany Jr. (R-La.) has introduced legislation that would require states to report how many children enrolled in the State Children's Health Insurance Plan actually receive a primary care visit each year. In addition, the legislation would encourage states to survey patients to determine if enrolled children are getting needed care in a timely manner. “Congress has a duty to ensure SCHIP coverage actually delivers timely care to enrolled children,” said Rep. Boustany, a cardiovascular surgeon, in a statement. “Studies show children with Medicaid or SCHIP receive fewer recommended checkups and fewer visits with primary care providers than [do] those with private coverage.” The bill also would require states to report their plans to target enrollment outreach to needy children who don't already have private coverage.

Child Skin Infections Rise

Children aged 4 years and younger were hospitalized with skin infections more than 34,000 times in 2006, a 150% increase from 2000, according to data from the Agency for Healthcare Research and Quality. The AHRQ analysis of hospitalization trends in children shows skin infections ranked as the 8th most common reason for child hospitalizations in 2006, up from 17th in 2000. Reasons for the increase were unclear but may be linked in part to increasing resistance to antibiotics, according to AHRQ. Meanwhile, respiratory diseases remained the top reason for child hospitalization, while other leading admissions of children in 2006 included gastritis; intestinal infections and other digestive disorders; meningitis, epilepsy, and other nervous system disorders; adolescent pregnancy; diabetes, nutritional deficiencies, and other metabolic or endocrine disorders; and depression, bipolar disease, and other mental disorders, according to AHRQ.

Patients Rate Own MDs Higher

Parents believe that their children's pediatricians always or almost always listen carefully to them and explain things in a way that is easy to understand, but they don't rate physicians and nurses in the same practice quite as highly, according to the second patient experience survey conducted by Massachusetts Health Quality Partners. The nonprofit coalition of physicians, patients, insurers, and hospitals asked 51,000 patients at 400 practices about their satisfaction on such issues as getting timely appointments, how well doctors know their patients, and how efficiently doctors coordinate care. More than 95% of parents responding said their child's doctor always or almost always listened to them and explained issues carefully, giving clear instructions about what to do about symptoms. But only about 85% of parents rated other doctors and nurses in the same practice as highly.

Most Drink Fluoridated Water

Nearly 70% of U.S. residents who get water from community water systems now receive fluoridated water, according to a study published in the July 11 issue of Morbidity and Mortality Weekly Report. The CDC found that the proportion of the U.S. population receiving fluoridated water, about 184 million people, increased from about 62% in 1992 to 69% in 2006. The percentage of people served by community water systems with optimal levels of fluoridated water ranged from less than 9% in Hawaii to 100% in the District of Columbia, the report said.

CMS Issues PQRI Payments

Physicians who successfully reported quality measures to Medicare in 2007 as part of the Physician Quality Reporting Initiative should be receiving their bonus payments this month. Officials at the Centers for Medicare and Medicaid Services announced that they had paid out more than $36 million in bonuses to physicians and other health professionals as part of the PQRI. Of the approximately 109,000 health professionals who reported data on Medicare services provided during July-December 2007, more than 56,700 met the reporting requirements and will be receiving bonus checks. The average bonus paid to an individual provider was more than $600, and the average bonus for a group practice was more than $4,700, the CMS said. “These payments to physicians for participating in the PQRI are a first step toward improving how Medicare pays for health care services,” Kerry Weems, acting administrator, said in a statement. Under the PQRI, physicians could earn bonus payments of up to 1.5% of their total allowed Medicare charges by successfully reporting quality data for Medicare services. Also, physicians and other health professionals can now access confidential feedback reports on their performance by registering with the Individuals Authorized Access to CMS Computer Services-Provider Community (IACS-PC). More information on the program is available at

www.cms.hhs.gov/PQRI

Drugs Easy to Get Online

Despite a decline in the number of Web sites advertising or selling prescriptions for controlled substances, 85% of sites selling such drugs in the past year did not require a prescription, according to a new report by the National Center on Addiction and Substance Abuse at Columbia University. Researchers found 365 sites advertising or selling controlled substances during searches that took place in the first 3 months of 2008, compared with 581 sites found during the same period in 2007. The decline in the number of sites offering controlled-substance prescriptions may reflect federal and state efforts to crack down on Internet drug trafficking, said Joseph A. Califano Jr., the center's chairman. Only 2 of the 365 sites found online in 2008 were certified by the National Association of Boards of Pharmacy as Verified Internet Pharmacy Practice Sites (VIPPS), the same number found certified in 2007. Of those sites not requiring prescriptions, 42% explicitly stated that no prescription was needed, 45% offered “online consultations,” which enable Internet users to get controlled substances online without a proper prescription, and 13% made no mention of a prescription.

Claims by Dead Doctors Paid

In the past 8 years, Medicare has paid more than $76.6 million in durable medical equipment claims that contained the Unique Physician Identification Numbers of dead physicians, according to a congressional subcommittee investigation. The probe, from the Senate Permanent Subcommittee on Investigations, found that from 2000 through 2007, Medicare paid for at least 478,500 claims that contained the UPINs of deceased doctors. Medicare was unable to stop the claims even though the CMS took steps in 2002 to reject claims using invalid or inactive UPINs, the report said. UPINs were replaced this year by National Provider Identifier numbers. The subcommittee recommended that the CMS strengthen procedures to deactivate NPIs after physician death, and initiate regular NPI registry and claim audits.

Pharmacies, PBMs Merge Networks

RxHub, founded in 2001 by the nation's three largest pharmacy benefit managers, and SureScripts, formed the same year by the National Association of Chain Drug Stores and the National Community Pharmacists Association, announced that they will consolidate their operations, forming a single, secure, nationwide network for e-prescriptions and the exchange of health information. “The combined strengths of the two organizations will enable the delivery of a single suite of services that will dramatically improve the safety, efficiency, and quality of one of the largest segments in health care,” said Bruce Roberts, executive vice president and CEO of the NCPA.

N.J. Expands Coverage

New Jersey Gov. Jon Corzine (D) has signed a bill that will require all children in the state to have health insurance within a year. The bill also expands coverage to more low-income parents. The legislation is the first step toward universal health care for New Jersey, Gov. Corzine said in a statement. The new law includes insurance reforms to increase affordability and stabilize enrollment for individuals and small businesses, and will make individual plans more affordable for younger people. “We're expanding our best-in-the-nation FamilyCare program to cover more working-class families and we're requiring health coverage for all children in New Jersey,” the governor said.

Infection Control Experts Renamed

Call them infection preventionists. In what it said was an effort to better articulate the expanding roles of its members, the Association for Professionals in Infection Control and Epidemiology has offered a new moniker for its members. The term joins the list of professional titles such as hospitalists, intensivists, and interventionists introduced by the health care industry over the past several years, the association said. Infection preventionists protect patients from health care-associated infections and related adverse events in clinical and other settings, the association said. They work with clinicians and administrators to improve patient- and systems-level outcomes.

CMS Issues PQRI Payments

Physicians who successfully reported quality measures to Medicare in 2007 as part of the Physician Quality Reporting Initiative should be receiving their bonus payments this month. Officials at the Centers for Medicare and Medicaid Services announced that they had paid out more than $36 million in bonuses to physicians and other health professionals as part of the PQRI. Of the approximately 109,000 health professionals who reported data on Medicare services provided during July-December 2007, more than 56,700 met the reporting requirements and will be receiving bonus checks. The average bonus paid to an individual provider was more than $600, and the average bonus for a group practice was more than $4,700, the CMS said. “These payments to physicians for participating in the PQRI are a first step toward improving how Medicare pays for health care services,” Kerry Weems, acting administrator, said in a statement. Under the PQRI, physicians could earn bonus payments of up to 1.5% of their total allowed Medicare charges by successfully reporting quality data for Medicare services. Also, physicians and other health professionals can now access confidential feedback reports on their performance by registering with the Individuals Authorized Access to CMS Computer Services-Provider Community (IACS-PC). More information on the program is available at

www.cms.hhs.gov/PQRI

Drugs Easy to Get Online

Despite a decline in the number of Web sites advertising or selling prescriptions for controlled substances, 85% of sites selling such drugs in the past year did not require a prescription, according to a new report by the National Center on Addiction and Substance Abuse at Columbia University. Researchers found 365 sites advertising or selling controlled substances during searches that took place in the first 3 months of 2008, compared with 581 sites found during the same period in 2007. The decline in the number of sites offering controlled-substance prescriptions may reflect federal and state efforts to crack down on Internet drug trafficking, said Joseph A. Califano Jr., the center's chairman. Only 2 of the 365 sites found online in 2008 were certified by the National Association of Boards of Pharmacy as Verified Internet Pharmacy Practice Sites (VIPPS), the same number found certified in 2007. Of those sites not requiring prescriptions, 42% explicitly stated that no prescription was needed, 45% offered “online consultations,” which enable Internet users to get controlled substances online without a proper prescription, and 13% made no mention of a prescription.

Claims by Dead Doctors Paid

In the past 8 years, Medicare has paid more than $76.6 million in durable medical equipment claims that contained the Unique Physician Identification Numbers of dead physicians, according to a congressional subcommittee investigation. The probe, from the Senate Permanent Subcommittee on Investigations, found that from 2000 through 2007, Medicare paid for at least 478,500 claims that contained the UPINs of deceased doctors. Medicare was unable to stop the claims even though the CMS took steps in 2002 to reject claims using invalid or inactive UPINs, the report said. UPINs were replaced this year by National Provider Identifier numbers. The subcommittee recommended that the CMS strengthen procedures to deactivate NPIs after physician death, and initiate regular NPI registry and claim audits.

Pharmacies, PBMs Merge Networks

RxHub, founded in 2001 by the nation's three largest pharmacy benefit managers, and SureScripts, formed the same year by the National Association of Chain Drug Stores and the National Community Pharmacists Association, announced that they will consolidate their operations, forming a single, secure, nationwide network for e-prescriptions and the exchange of health information. “The combined strengths of the two organizations will enable the delivery of a single suite of services that will dramatically improve the safety, efficiency, and quality of one of the largest segments in health care,” said Bruce Roberts, executive vice president and CEO of the NCPA.

N.J. Expands Coverage

New Jersey Gov. Jon Corzine (D) has signed a bill that will require all children in the state to have health insurance within a year. The bill also expands coverage to more low-income parents. The legislation is the first step toward universal health care for New Jersey, Gov. Corzine said in a statement. The new law includes insurance reforms to increase affordability and stabilize enrollment for individuals and small businesses, and will make individual plans more affordable for younger people. “We're expanding our best-in-the-nation FamilyCare program to cover more working-class families and we're requiring health coverage for all children in New Jersey,” the governor said.

Infection Control Experts Renamed

Call them infection preventionists. In what it said was an effort to better articulate the expanding roles of its members, the Association for Professionals in Infection Control and Epidemiology has offered a new moniker for its members. The term joins the list of professional titles such as hospitalists, intensivists, and interventionists introduced by the health care industry over the past several years, the association said. Infection preventionists protect patients from health care-associated infections and related adverse events in clinical and other settings, the association said. They work with clinicians and administrators to improve patient- and systems-level outcomes.

CMS Issues PQRI Payments

Physicians who successfully reported quality measures to Medicare in 2007 as part of the Physician Quality Reporting Initiative should be receiving their bonus payments this month. Officials at the Centers for Medicare and Medicaid Services announced that they had paid out more than $36 million in bonuses to physicians and other health professionals as part of the PQRI. Of the approximately 109,000 health professionals who reported data on Medicare services provided during July-December 2007, more than 56,700 met the reporting requirements and will be receiving bonus checks. The average bonus paid to an individual provider was more than $600, and the average bonus for a group practice was more than $4,700, the CMS said. “These payments to physicians for participating in the PQRI are a first step toward improving how Medicare pays for health care services,” Kerry Weems, acting administrator, said in a statement. Under the PQRI, physicians could earn bonus payments of up to 1.5% of their total allowed Medicare charges by successfully reporting quality data for Medicare services. Also, physicians and other health professionals can now access confidential feedback reports on their performance by registering with the Individuals Authorized Access to CMS Computer Services-Provider Community (IACS-PC). More information on the program is available at

www.cms.hhs.gov/PQRI

Drugs Easy to Get Online

Despite a decline in the number of Web sites advertising or selling prescriptions for controlled substances, 85% of sites selling such drugs in the past year did not require a prescription, according to a new report by the National Center on Addiction and Substance Abuse at Columbia University. Researchers found 365 sites advertising or selling controlled substances during searches that took place in the first 3 months of 2008, compared with 581 sites found during the same period in 2007. The decline in the number of sites offering controlled-substance prescriptions may reflect federal and state efforts to crack down on Internet drug trafficking, said Joseph A. Califano Jr., the center's chairman. Only 2 of the 365 sites found online in 2008 were certified by the National Association of Boards of Pharmacy as Verified Internet Pharmacy Practice Sites (VIPPS), the same number found certified in 2007. Of those sites not requiring prescriptions, 42% explicitly stated that no prescription was needed, 45% offered “online consultations,” which enable Internet users to get controlled substances online without a proper prescription, and 13% made no mention of a prescription.

Claims by Dead Doctors Paid

In the past 8 years, Medicare has paid more than $76.6 million in durable medical equipment claims that contained the Unique Physician Identification Numbers of dead physicians, according to a congressional subcommittee investigation. The probe, from the Senate Permanent Subcommittee on Investigations, found that from 2000 through 2007, Medicare paid for at least 478,500 claims that contained the UPINs of deceased doctors. Medicare was unable to stop the claims even though the CMS took steps in 2002 to reject claims using invalid or inactive UPINs, the report said. UPINs were replaced this year by National Provider Identifier numbers. The subcommittee recommended that the CMS strengthen procedures to deactivate NPIs after physician death, and initiate regular NPI registry and claim audits.

Pharmacies, PBMs Merge Networks

RxHub, founded in 2001 by the nation's three largest pharmacy benefit managers, and SureScripts, formed the same year by the National Association of Chain Drug Stores and the National Community Pharmacists Association, announced that they will consolidate their operations, forming a single, secure, nationwide network for e-prescriptions and the exchange of health information. “The combined strengths of the two organizations will enable the delivery of a single suite of services that will dramatically improve the safety, efficiency, and quality of one of the largest segments in health care,” said Bruce Roberts, executive vice president and CEO of the NCPA.

N.J. Expands Coverage

New Jersey Gov. Jon Corzine (D) has signed a bill that will require all children in the state to have health insurance within a year. The bill also expands coverage to more low-income parents. The legislation is the first step toward universal health care for New Jersey, Gov. Corzine said in a statement. The new law includes insurance reforms to increase affordability and stabilize enrollment for individuals and small businesses, and will make individual plans more affordable for younger people. “We're expanding our best-in-the-nation FamilyCare program to cover more working-class families and we're requiring health coverage for all children in New Jersey,” the governor said.

Infection Control Experts Renamed

Call them infection preventionists. In what it said was an effort to better articulate the expanding roles of its members, the Association for Professionals in Infection Control and Epidemiology has offered a new moniker for its members. The term joins the list of professional titles such as hospitalists, intensivists, and interventionists introduced by the health care industry over the past several years, the association said. Infection preventionists protect patients from health care-associated infections and related adverse events in clinical and other settings, the association said. They work with clinicians and administrators to improve patient- and systems-level outcomes.

Medical error studies that focus only on inpatient stays—not taking into account hospital readmissions and other patient care—may underestimate costs by up to 30%, according to an analysis of millions of health insurance claims.

William E. Encinosa, Ph.D., and Fred J. Hellinger, Ph.D., researchers at the Agency for Healthcare Research and Quality, examined a database of 5.6 million insurance claims for 14 potentially preventable adverse medical errors defined by the agency's Patient Safety Indicators (PSIs).

“Many hospitals are struggling to survive financially,” Dr. Encinosa said in a statement. “The point of our paper is that the cost savings from reducing medical errors are much larger than previously thought.”

A total of 2.6% of the 161,004 claims for major surgery in an adult included at least 1 of the 14 potentially preventable adverse medical errors; almost 6% of those claims had more than 1 error (Health Services Research 2008 July 25 [doi:10.1111/j.1475–6773.2008.00882.x]).

Total 90-day cost for surgery claims with one or more errors was $66,879 on average, compared with $18,284 for surgery claims without an error. In addition, surgeries with one or more errors averaged 21.5 inpatient days, with 5.3 of those days occurring on readmission, the researchers found. In contrast, surgeries without an error averaged 5.1 inpatient days, with just 1 day of readmission.

Errors associated with the postoperative acute respiratory failure PSI were the most expensive of the seven patient-safety event classes, costing an average of $106,370 over the 90-day period, along with the highest 90-day death rate (12%), according to the researchers. Readmission costs for the postoperative acute respiratory failure PSI averaged $12,274.

Medical error studies that focus only on inpatient stays—not taking into account hospital readmissions and other patient care—may underestimate costs by up to 30%, according to an analysis of millions of health insurance claims.

William E. Encinosa, Ph.D., and Fred J. Hellinger, Ph.D., researchers at the Agency for Healthcare Research and Quality, examined a database of 5.6 million insurance claims for 14 potentially preventable adverse medical errors defined by the agency's Patient Safety Indicators (PSIs).

“Many hospitals are struggling to survive financially,” Dr. Encinosa said in a statement. “The point of our paper is that the cost savings from reducing medical errors are much larger than previously thought.”

A total of 2.6% of the 161,004 claims for major surgery in an adult included at least 1 of the 14 potentially preventable adverse medical errors; almost 6% of those claims had more than 1 error (Health Services Research 2008 July 25 [doi:10.1111/j.1475–6773.2008.00882.x]).

Total 90-day cost for surgery claims with one or more errors was $66,879 on average, compared with $18,284 for surgery claims without an error. In addition, surgeries with one or more errors averaged 21.5 inpatient days, with 5.3 of those days occurring on readmission, the researchers found. In contrast, surgeries without an error averaged 5.1 inpatient days, with just 1 day of readmission.

Errors associated with the postoperative acute respiratory failure PSI were the most expensive of the seven patient-safety event classes, costing an average of $106,370 over the 90-day period, along with the highest 90-day death rate (12%), according to the researchers. Readmission costs for the postoperative acute respiratory failure PSI averaged $12,274.

Medical error studies that focus only on inpatient stays—not taking into account hospital readmissions and other patient care—may underestimate costs by up to 30%, according to an analysis of millions of health insurance claims.

William E. Encinosa, Ph.D., and Fred J. Hellinger, Ph.D., researchers at the Agency for Healthcare Research and Quality, examined a database of 5.6 million insurance claims for 14 potentially preventable adverse medical errors defined by the agency's Patient Safety Indicators (PSIs).

“Many hospitals are struggling to survive financially,” Dr. Encinosa said in a statement. “The point of our paper is that the cost savings from reducing medical errors are much larger than previously thought.”

A total of 2.6% of the 161,004 claims for major surgery in an adult included at least 1 of the 14 potentially preventable adverse medical errors; almost 6% of those claims had more than 1 error (Health Services Research 2008 July 25 [doi:10.1111/j.1475–6773.2008.00882.x]).

Total 90-day cost for surgery claims with one or more errors was $66,879 on average, compared with $18,284 for surgery claims without an error. In addition, surgeries with one or more errors averaged 21.5 inpatient days, with 5.3 of those days occurring on readmission, the researchers found. In contrast, surgeries without an error averaged 5.1 inpatient days, with just 1 day of readmission.

Errors associated with the postoperative acute respiratory failure PSI were the most expensive of the seven patient-safety event classes, costing an average of $106,370 over the 90-day period, along with the highest 90-day death rate (12%), according to the researchers. Readmission costs for the postoperative acute respiratory failure PSI averaged $12,274.

CMS Issues PQRI Payments

Physicians who successfully reported quality measures to Medicare in 2007 as part of the Physician Quality Reporting Initiative should be receiving their bonus payments this month. Officials at the Centers for Medicare and Medicaid Services announced that they had paid out more than $36 million in bonuses to physicians and other health professionals as part of the PQRI. Of the approximately 109,000 health professionals who reported data on Medicare services provided during July-December 2007, more than 56,700 met the reporting requirements and will be receiving bonus checks. The average bonus paid to an individual provider was more than $600, and the average bonus for a group practice was more than $4,700, CMS said. “These payments to physicians for participating in the PQRI are a first step toward improving how Medicare pays for health care services,” Kerry Weems, acting administrator, said in a statement. Under the PQRI, physicians could earn bonus payments of up to 1.5% of their total allowed Medicare charges by successfully reporting quality data for Medicare services. Also, physicians and other health professionals can now access confidential feedback reports on their performance by registering with the Individuals Authorized Access to CMS Computer Services-Provider Community (IACS-PC). More information on the program is available at

www.cms.hhs.gov/PQRI

Drugs Easy to Get Online

Despite a decline in the number of Web sites advertising or selling prescriptions for controlled substances, 85% of sites selling such drugs in the past year did not require a prescription, according to a new report by the National Center on Addiction and Substance Abuse at Columbia University. Researchers found 365 sites advertising or selling controlled substances during searches that took place in the first 3 months of 2008, compared with 581 sites found during the same period in 2007. The decline in the number of sites offering controlled-substance prescriptions may reflect federal and state efforts to crack down on Internet drug trafficking, said Joseph A. Califano Jr., the center's chairman. Only 2 of the 365 sites found online in 2008 were certified by the National Association of Boards of Pharmacy as Verified Internet Pharmacy Practice Sites (VIPPS), the same number found certified in 2007. Of those sites not requiring prescriptions, 42% explicitly stated that no prescription was needed; 45% offered “online consultations,” which enable Internet users to get controlled substances online without a proper prescription; and 13% made no mention of a prescription.

Claims by Dead Doctors Paid

In the past 8 years, Medicare has paid more than $76.6 million in durable medical equipment claims that contained the Unique Physician Identification Numbers of dead physicians, according to the Senate Permanent Subcommittee on Investigations. The probe found that from 2000 through 2007, Medicare paid for at least 478,500 claims that contained the UPINs of deceased doctors. Medicare was unable to stop the claims even though CMS took steps in 2002 to reject claims using invalid or inactive UPINs, the report said. UPINs were replaced this year by National Provider Identifier numbers. The subcommittee recommended that CMS strengthen procedures to deactivate NPIs after physician death, and initiate regular NPI registry and claim audits.

Pharmacies, PBMs Merge Networks

RxHub, founded in 2001 by the nation's three largest pharmacy benefit managers, and SureScripts, formed the same year by the National Association of Chain Drug Stores and the National Community Pharmacists Association, announced that they will consolidate their operations, forming a single, secure, nationwide network for e-prescriptions and the exchange of health information. “The combined strengths of the two organizations will enable the delivery of a single suite of services that will dramatically improve the safety, efficiency, and quality of one of the largest segments in health care,” said Bruce Roberts, executive vice president and CEO of the NCPA.

N.J. Expands Coverage

New Jersey Gov. Jon Corzine (D) has signed a bill that will require all children in the state to have health insurance within a year. The bill also expands coverage to more low-income parents. The legislation is the first step toward universal health care for New Jersey, Gov. Corzine said in a statement. The new law includes insurance reforms to increase affordability and stabilize enrollment for individuals and small businesses, and will make individual plans more affordable for younger people. “We're expanding our best-in-the-nation FamilyCare program to cover more working-class families and we're requiring health coverage for all children in New Jersey,” the governor said.

Infection Control Experts Renamed

Call them infection preventionists. In what it said was an effort to better articulate the expanding roles of its members, the Association for Professionals in Infection Control and Epidemiology has offered a new moniker for its members. The term joins the list of professional titles such as hospitalists, intensivists, and interventionists introduced by the health care industry over the past several years, the association said. Infection preventionists protect patients from health care-associated infections and related adverse events in clinical and other settings, the association said. They work with clinicians and administrators to improve patient- and systems-level outcomes.

CMS Issues PQRI Payments

Physicians who successfully reported quality measures to Medicare in 2007 as part of the Physician Quality Reporting Initiative should be receiving their bonus payments this month. Officials at the Centers for Medicare and Medicaid Services announced that they had paid out more than $36 million in bonuses to physicians and other health professionals as part of the PQRI. Of the approximately 109,000 health professionals who reported data on Medicare services provided during July-December 2007, more than 56,700 met the reporting requirements and will be receiving bonus checks. The average bonus paid to an individual provider was more than $600, and the average bonus for a group practice was more than $4,700, CMS said. “These payments to physicians for participating in the PQRI are a first step toward improving how Medicare pays for health care services,” Kerry Weems, acting administrator, said in a statement. Under the PQRI, physicians could earn bonus payments of up to 1.5% of their total allowed Medicare charges by successfully reporting quality data for Medicare services. Also, physicians and other health professionals can now access confidential feedback reports on their performance by registering with the Individuals Authorized Access to CMS Computer Services-Provider Community (IACS-PC). More information on the program is available at

www.cms.hhs.gov/PQRI

Drugs Easy to Get Online

Despite a decline in the number of Web sites advertising or selling prescriptions for controlled substances, 85% of sites selling such drugs in the past year did not require a prescription, according to a new report by the National Center on Addiction and Substance Abuse at Columbia University. Researchers found 365 sites advertising or selling controlled substances during searches that took place in the first 3 months of 2008, compared with 581 sites found during the same period in 2007. The decline in the number of sites offering controlled-substance prescriptions may reflect federal and state efforts to crack down on Internet drug trafficking, said Joseph A. Califano Jr., the center's chairman. Only 2 of the 365 sites found online in 2008 were certified by the National Association of Boards of Pharmacy as Verified Internet Pharmacy Practice Sites (VIPPS), the same number found certified in 2007. Of those sites not requiring prescriptions, 42% explicitly stated that no prescription was needed; 45% offered “online consultations,” which enable Internet users to get controlled substances online without a proper prescription; and 13% made no mention of a prescription.

Claims by Dead Doctors Paid

In the past 8 years, Medicare has paid more than $76.6 million in durable medical equipment claims that contained the Unique Physician Identification Numbers of dead physicians, according to the Senate Permanent Subcommittee on Investigations. The probe found that from 2000 through 2007, Medicare paid for at least 478,500 claims that contained the UPINs of deceased doctors. Medicare was unable to stop the claims even though CMS took steps in 2002 to reject claims using invalid or inactive UPINs, the report said. UPINs were replaced this year by National Provider Identifier numbers. The subcommittee recommended that CMS strengthen procedures to deactivate NPIs after physician death, and initiate regular NPI registry and claim audits.

Pharmacies, PBMs Merge Networks

RxHub, founded in 2001 by the nation's three largest pharmacy benefit managers, and SureScripts, formed the same year by the National Association of Chain Drug Stores and the National Community Pharmacists Association, announced that they will consolidate their operations, forming a single, secure, nationwide network for e-prescriptions and the exchange of health information. “The combined strengths of the two organizations will enable the delivery of a single suite of services that will dramatically improve the safety, efficiency, and quality of one of the largest segments in health care,” said Bruce Roberts, executive vice president and CEO of the NCPA.

N.J. Expands Coverage

New Jersey Gov. Jon Corzine (D) has signed a bill that will require all children in the state to have health insurance within a year. The bill also expands coverage to more low-income parents. The legislation is the first step toward universal health care for New Jersey, Gov. Corzine said in a statement. The new law includes insurance reforms to increase affordability and stabilize enrollment for individuals and small businesses, and will make individual plans more affordable for younger people. “We're expanding our best-in-the-nation FamilyCare program to cover more working-class families and we're requiring health coverage for all children in New Jersey,” the governor said.

Infection Control Experts Renamed

Call them infection preventionists. In what it said was an effort to better articulate the expanding roles of its members, the Association for Professionals in Infection Control and Epidemiology has offered a new moniker for its members. The term joins the list of professional titles such as hospitalists, intensivists, and interventionists introduced by the health care industry over the past several years, the association said. Infection preventionists protect patients from health care-associated infections and related adverse events in clinical and other settings, the association said. They work with clinicians and administrators to improve patient- and systems-level outcomes.

CMS Issues PQRI Payments

Physicians who successfully reported quality measures to Medicare in 2007 as part of the Physician Quality Reporting Initiative should be receiving their bonus payments this month. Officials at the Centers for Medicare and Medicaid Services announced that they had paid out more than $36 million in bonuses to physicians and other health professionals as part of the PQRI. Of the approximately 109,000 health professionals who reported data on Medicare services provided during July-December 2007, more than 56,700 met the reporting requirements and will be receiving bonus checks. The average bonus paid to an individual provider was more than $600, and the average bonus for a group practice was more than $4,700, CMS said. “These payments to physicians for participating in the PQRI are a first step toward improving how Medicare pays for health care services,” Kerry Weems, acting administrator, said in a statement. Under the PQRI, physicians could earn bonus payments of up to 1.5% of their total allowed Medicare charges by successfully reporting quality data for Medicare services. Also, physicians and other health professionals can now access confidential feedback reports on their performance by registering with the Individuals Authorized Access to CMS Computer Services-Provider Community (IACS-PC). More information on the program is available at

www.cms.hhs.gov/PQRI

Drugs Easy to Get Online

Despite a decline in the number of Web sites advertising or selling prescriptions for controlled substances, 85% of sites selling such drugs in the past year did not require a prescription, according to a new report by the National Center on Addiction and Substance Abuse at Columbia University. Researchers found 365 sites advertising or selling controlled substances during searches that took place in the first 3 months of 2008, compared with 581 sites found during the same period in 2007. The decline in the number of sites offering controlled-substance prescriptions may reflect federal and state efforts to crack down on Internet drug trafficking, said Joseph A. Califano Jr., the center's chairman. Only 2 of the 365 sites found online in 2008 were certified by the National Association of Boards of Pharmacy as Verified Internet Pharmacy Practice Sites (VIPPS), the same number found certified in 2007. Of those sites not requiring prescriptions, 42% explicitly stated that no prescription was needed; 45% offered “online consultations,” which enable Internet users to get controlled substances online without a proper prescription; and 13% made no mention of a prescription.

Claims by Dead Doctors Paid

In the past 8 years, Medicare has paid more than $76.6 million in durable medical equipment claims that contained the Unique Physician Identification Numbers of dead physicians, according to the Senate Permanent Subcommittee on Investigations. The probe found that from 2000 through 2007, Medicare paid for at least 478,500 claims that contained the UPINs of deceased doctors. Medicare was unable to stop the claims even though CMS took steps in 2002 to reject claims using invalid or inactive UPINs, the report said. UPINs were replaced this year by National Provider Identifier numbers. The subcommittee recommended that CMS strengthen procedures to deactivate NPIs after physician death, and initiate regular NPI registry and claim audits.

Pharmacies, PBMs Merge Networks

RxHub, founded in 2001 by the nation's three largest pharmacy benefit managers, and SureScripts, formed the same year by the National Association of Chain Drug Stores and the National Community Pharmacists Association, announced that they will consolidate their operations, forming a single, secure, nationwide network for e-prescriptions and the exchange of health information. “The combined strengths of the two organizations will enable the delivery of a single suite of services that will dramatically improve the safety, efficiency, and quality of one of the largest segments in health care,” said Bruce Roberts, executive vice president and CEO of the NCPA.

N.J. Expands Coverage

New Jersey Gov. Jon Corzine (D) has signed a bill that will require all children in the state to have health insurance within a year. The bill also expands coverage to more low-income parents. The legislation is the first step toward universal health care for New Jersey, Gov. Corzine said in a statement. The new law includes insurance reforms to increase affordability and stabilize enrollment for individuals and small businesses, and will make individual plans more affordable for younger people. “We're expanding our best-in-the-nation FamilyCare program to cover more working-class families and we're requiring health coverage for all children in New Jersey,” the governor said.

Infection Control Experts Renamed

Call them infection preventionists. In what it said was an effort to better articulate the expanding roles of its members, the Association for Professionals in Infection Control and Epidemiology has offered a new moniker for its members. The term joins the list of professional titles such as hospitalists, intensivists, and interventionists introduced by the health care industry over the past several years, the association said. Infection preventionists protect patients from health care-associated infections and related adverse events in clinical and other settings, the association said. They work with clinicians and administrators to improve patient- and systems-level outcomes.

WASHINGTON — Although e-health activities are becoming commonplace, a variety of legal, financial, and logistical issues still must be addressed for the technology to realize its potential for physicians and patients, the American College of Physicians said in a position paper.

The challenges for effectively implementing e-health activities lie not only in the adoption of universal technical standards for the exchange of electronic health information, but also in the more fundamental concern of economic support for health information technology, the ACP said in its new position paper, which was released at the group's annual meeting and can be found at www.acponline.org

"ACP believes that patient portals and personal health records may provide the biggest benefits to patients when they are used collaboratively with physicians," said ACP President David Dale at a press briefing at the meeting.

But Dr. Dale added that, "the biggest single concern of physicians is the substantial cost in acquiring and maintaining the necessary technology, which averages $50,000 per physician."

The paper, "E-Health and Its Impact on Medical Practice," analyzes the benefits, technical and financial challenges, and legal issues related to adopting and implementing e-health activities for physicians and patients.

These issues include the privacy of medical records, financing and payment for physicians adopting electronic records and communication systems, computer literacy among patients, and telemedicine development and funding.

The ACP also recommends the creation of national standards for e-health Web site content.

Dr. Joel Levine, chairman of the ACP Board of Regents, said at the briefing that e-health initiatives have great potential to transform health care in the United States, especially as part of the development of the patient-centered medical home.

"ACP recommends ongoing investment in demonstration projects … within the context of the patient-centered medical home," Dr. Levine said.

However, Dr. Dale and Dr. Levine both said that payment policy reforms are needed to compensate physicians appropriately for their investment in and implementation of e-health services.

The new fee structures likely would include some sort of flat fee that would cover all communications with a patient, they said.

"This is the management of chronic health we're talking about—you can't do that by giving me 25 cents every time I click on my Blackberry," Dr. Levine commented.

In addition, confidentiality, privacy, and standardization are needed to create a trusted nationwide health information network, according to the ACP, as health care providers and individuals are likely to be reluctant to adopt e-health activities unless they are confident that the systems are secure and accurate.

In the paper, the ACP calls on technology developers and policy makers to support standards that address interoperability, functionality, security, privacy, content, and legal liability. In addition, it recommends the use of secure Web messaging infrastructure rather than standard e-mail to ensure the highest levels of confidentiality for electronic communications between physicians and patients.

Records of communication fall within the parameters of the Health Insurance Portability and Accountability Act and therefore must be protected according to HIPAA standards, the ACP said.

WASHINGTON — Although e-health activities are becoming commonplace, a variety of legal, financial, and logistical issues still must be addressed for the technology to realize its potential for physicians and patients, the American College of Physicians said in a position paper.

The challenges for effectively implementing e-health activities lie not only in the adoption of universal technical standards for the exchange of electronic health information, but also in the more fundamental concern of economic support for health information technology, the ACP said in its new position paper, which was released at the group's annual meeting and can be found at www.acponline.org

"ACP believes that patient portals and personal health records may provide the biggest benefits to patients when they are used collaboratively with physicians," said ACP President David Dale at a press briefing at the meeting.

But Dr. Dale added that, "the biggest single concern of physicians is the substantial cost in acquiring and maintaining the necessary technology, which averages $50,000 per physician."

The paper, "E-Health and Its Impact on Medical Practice," analyzes the benefits, technical and financial challenges, and legal issues related to adopting and implementing e-health activities for physicians and patients.

These issues include the privacy of medical records, financing and payment for physicians adopting electronic records and communication systems, computer literacy among patients, and telemedicine development and funding.

The ACP also recommends the creation of national standards for e-health Web site content.

Dr. Joel Levine, chairman of the ACP Board of Regents, said at the briefing that e-health initiatives have great potential to transform health care in the United States, especially as part of the development of the patient-centered medical home.

"ACP recommends ongoing investment in demonstration projects … within the context of the patient-centered medical home," Dr. Levine said.

However, Dr. Dale and Dr. Levine both said that payment policy reforms are needed to compensate physicians appropriately for their investment in and implementation of e-health services.

The new fee structures likely would include some sort of flat fee that would cover all communications with a patient, they said.

"This is the management of chronic health we're talking about—you can't do that by giving me 25 cents every time I click on my Blackberry," Dr. Levine commented.

In addition, confidentiality, privacy, and standardization are needed to create a trusted nationwide health information network, according to the ACP, as health care providers and individuals are likely to be reluctant to adopt e-health activities unless they are confident that the systems are secure and accurate.

In the paper, the ACP calls on technology developers and policy makers to support standards that address interoperability, functionality, security, privacy, content, and legal liability. In addition, it recommends the use of secure Web messaging infrastructure rather than standard e-mail to ensure the highest levels of confidentiality for electronic communications between physicians and patients.

Records of communication fall within the parameters of the Health Insurance Portability and Accountability Act and therefore must be protected according to HIPAA standards, the ACP said.

WASHINGTON — Although e-health activities are becoming commonplace, a variety of legal, financial, and logistical issues still must be addressed for the technology to realize its potential for physicians and patients, the American College of Physicians said in a position paper.

The challenges for effectively implementing e-health activities lie not only in the adoption of universal technical standards for the exchange of electronic health information, but also in the more fundamental concern of economic support for health information technology, the ACP said in its new position paper, which was released at the group's annual meeting and can be found at www.acponline.org

"ACP believes that patient portals and personal health records may provide the biggest benefits to patients when they are used collaboratively with physicians," said ACP President David Dale at a press briefing at the meeting.

But Dr. Dale added that, "the biggest single concern of physicians is the substantial cost in acquiring and maintaining the necessary technology, which averages $50,000 per physician."

The paper, "E-Health and Its Impact on Medical Practice," analyzes the benefits, technical and financial challenges, and legal issues related to adopting and implementing e-health activities for physicians and patients.

These issues include the privacy of medical records, financing and payment for physicians adopting electronic records and communication systems, computer literacy among patients, and telemedicine development and funding.

The ACP also recommends the creation of national standards for e-health Web site content.

Dr. Joel Levine, chairman of the ACP Board of Regents, said at the briefing that e-health initiatives have great potential to transform health care in the United States, especially as part of the development of the patient-centered medical home.

"ACP recommends ongoing investment in demonstration projects … within the context of the patient-centered medical home," Dr. Levine said.

However, Dr. Dale and Dr. Levine both said that payment policy reforms are needed to compensate physicians appropriately for their investment in and implementation of e-health services.

The new fee structures likely would include some sort of flat fee that would cover all communications with a patient, they said.

"This is the management of chronic health we're talking about—you can't do that by giving me 25 cents every time I click on my Blackberry," Dr. Levine commented.

In addition, confidentiality, privacy, and standardization are needed to create a trusted nationwide health information network, according to the ACP, as health care providers and individuals are likely to be reluctant to adopt e-health activities unless they are confident that the systems are secure and accurate.

In the paper, the ACP calls on technology developers and policy makers to support standards that address interoperability, functionality, security, privacy, content, and legal liability. In addition, it recommends the use of secure Web messaging infrastructure rather than standard e-mail to ensure the highest levels of confidentiality for electronic communications between physicians and patients.

Records of communication fall within the parameters of the Health Insurance Portability and Accountability Act and therefore must be protected according to HIPAA standards, the ACP said.