American College of Physicians: Internal Medicine — Doctors for Adults ®


Policy briefs

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

College gathers support for collective bargaining bill

The College is urging members of the House of Representatives to support legislation that would allow physicians to collectively negotiate with health plans without violating antitrust laws.

In an April 22 letter to Congress, College President Sara E. Walker, MACP, wrote that the Health Care Antitrust Improvements Act of 2002 would help level the playing field when physicians negotiate with health plans. Dr. Walker pointed out that physicians are now at a "distinct disadvantage" in those negotiations.

The bill would judge the legality of collective negotiations using the legal standard of reasonableness, coupled with other factors including patient access and quality of care.

The letter is online at


ACP-ASIM seeks further changes to privacy rule

The College has asked the federal government to further modify the privacy rule that is part of the Health Insurance Portability and Accountability Act (HIPAA). The rule is scheduled to take effect in April 2003.

In an April 26 letter to HHS Secretary Tommy G. Thompson, the College asked the administration to expand its recent HIPAA privacy rule modifications. The College asked HHS to do the following:

  • require covered entities to obtain consent, but in the least burdensome manner possible;
  • re-examine how the privacy rule should be applied to small and solo physician offices;
  • eliminate provisions that could make physicians liable for improper release of personal health information by business associates;
  • provide for the use of de-identified patient medical histories in quality improvement and research activities; and
  • give patients the right to restrict use of their information for marketing purposes.

The letter is online at

For more on the HIPAA privacy rule, see "Tips to comply with HIPAA's new privacy regulations" from the May ACP-ASIM Observer.


College recommends ways to head off nursing shortage

America needs to develop better incentives, recruitment programs and work environments to reverse a problematic nursing shortage that promises to worsen in coming years, according to a new College position paper.

In the paper, the College outlined recommendations to help hospitals improve nurses' working conditions. The paper also outlined legislation to provide more incentives for choosing a career in nursing.

ACP-ASIM recommendations include the following:

  • create a better work environment through more flexible scheduling and child care options, streamlined administrative duties and improved informatics;
  • support appropriate levels of staffing while opposing mandatory staffing ratios;
  • enact legislation to create tuition reimbursement and loan-repayment programs;
  • actively recruit males and minorities; and
  • form outreach programs that target teens and younger children.

The paper stated that more than 125,000 nursing positions are currently unfilled, a number that may soar as an aging nurse workforce retires and nursing school enrollment continues to fall.

The paper is online at


ACP-ASIM supports Medicare incentive program

The College has come out in support of draft legislation that would give physicians financial incentives to care for Medicare patients in medically underserved areas.

In an April 17 letter to Sen. Jeffrey Bingaman (D-N.M.), College President Sara E. Walker, MACP, applauded legislation backing the Medicare Incentive Payment (MIP) program. The plan would build on an existing program that pays a 10% bonus to physicians who care for Medicare patients in designated health professions shortage areas and helps underserved areas recruit and retain physicians.

Under the proposal, Medicare carriers, rather than individual physicians, would bear the burden of establishing who qualifies for the bonus. The proposal would also establish an MIP educational program for providers.

In the letter, Dr. Walker also noted that the bonus alone will not solve access problems in underserved areas as long as the flawed physician payment update formula that Medicare presently uses is in place.

The letter is online at


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