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Policy briefs

From the February ACP-ASIM Observer, copyright © 2002 by the American College of Physicians-American Society of Internal Medicine.

ACP-ASIM asks for review of immunization policies

The College, joined by 16 other medical organizations, urged the Centers for Medicare and Medicaid Services (CMS), formerly HCFA, to review its payment policy for administering immunizations.

In a Dec. 21 letter to Thomas A. Scully, CMS administrator, the College pointed out that while CMS has activated several CPT codes for administering immunizations, the government has declined to recognize the physician work component associated with these codes. Organized medicine has recommended that CMS reimburse physicians for their effort in immunizing patients.

The letter also asked CMS to simplify its coding requirements for immunizations. With the activation of CPT codes 90471 and 90472, physicians are unsure whether they should continue to use a separate set of G codes to bill Medicare for immunizations.

For more on the issue, see the letter online at


College to Congress: Fund Bioterror Defense Act

The College urged the House and Senate Defense Appropriations Conferees to include in the fiscal year 2002 budget adequate funding to improve the nation's preparedness for biological or chemical attack.

In a Dec. 13 letter, College President William J. Hall, FACP, explained that ACP-ASIM considers five funding initiatives essential to the legislation's success:

  • improving CDC's capacity and enhancing communication networks for local and state public health infrastructure;
  • improving training and education of health care professionals at all levels;
  • enhancing hospitals' preparedness by providing more training, equipment, medicine and surge capacity to handle mass casualties;
  • securing a sufficient national stockpile of smallpox vaccines; and
  • protecting the nation's food supply through more frequent inspection and better surveillance.

The letter is available online at


House rejects language identifying chiropractors as primary care providers

Thanks in part to ACP-ASIM's efforts, the House of Representatives deleted language from a bill that would have identified chiropractors as primary care physicians with the Veterans Health Administration.

The College had protested that language in the Disabled Veterans Service Dog and Health Care Improvement Act of 2001 (HR 2792) would have deprived the nation's veterans of the highest level of medical care.

"The College believes that primary care should be provided only by those who have the required skill and training," ACP-ASIM President William J. Hall, FACP, said in a statement. "Chiropractors do not have the necessary background and expertise to serve in this role."

Dr. Hall noted that the Institute of Medicine defines primary care as "integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health needs, especially as a first point of contact for undiagnosed symptoms." The accrediting body for chiropractic colleges, by comparison, describes chiropractic training in much narrower terms.

The House changed the language and passed the bill in early December. The Senate passed the bill in late December.

A College press release with more information is online at


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