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

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Policy briefs

From the April ACP Observer, copyright 2004 by the American College of Physicians.

College supports Senate action on changing fee update formula

In a letter sent last month to members of the Senate Budget Committee, the College supported an amendment to the fiscal year 2005 budget that expressed support for changing the formula used to update physician fees.

The letter pointed out that the current update, based on the sustainable growth rate formula, is deeply flawed. A new formula needs to be crafted, the letter said, that takes into account increased service costs and utilization.

The Committee approved the amendment to the budget resolution. While the sense of the Senate resolution is not binding, it will help College efforts to change the formula by putting Congress on record that there are serious problems with the current methods of determining physician payments.

ACP's letter is online.

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ACP calls on Senate to reject Medicaid cuts

In a March 9 letter sent to Senate members, ACP strongly opposed an administration proposal to cut $11 billion in Medicaid funds from the 2005 budget. The Senate later voted to reject the proposal.

The College signed the letter with 17 other medical associations. The letter noted that states will already face reduced Medicaid support when $10 billion in temporary state fiscal relief expires later this year.

The letter is online.

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College comments on 2004 Medicare payment changes

The College sent a letter to the acting administrator of the Centers for Medicare and Medicaid Services (CMS) last month, commenting on 2004 changes in Medicare payments for physician services related to outpatient drugs and in physician fee schedule payments.

The College urged the CMS to assign work relative value units to codes governing immunization and vaccine administration. Even though nurses often administer vaccines, the letter said, physicians spend time in counseling patients about immunization.

The letter also made several recommendations related to changes in the CMS' reimbursements for Part B drugs and their administration.

The letter is online.

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College supports Senate bill to reduce racial disparities

In a letter sent to several U.S. senators, the College expressed support for the Closing the Health Care Gap Act of 2004 (S. 2091), a bill that seeks to eliminate racial and ethnic health care disparities.

In his Feb. 26 letter, College President Munsey S. Wheby, FACP, said passage of the bill would help alleviate some of the problems faced by minorities, such as limited access to quality health care. The bill establishes priorities such as increasing access to care, improving the competence of providers and creating a more diversified medical workforce.

The College supports the creation of grants to educate minorities about health care options and encourage enrollment under Medicaid and SCHIP. However, legislation should go further and guarantee coverage to all low-income individuals to eliminate health care disparities, Dr. Wheby said.

The College's letter is online.

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ACP urges Senate passage of patient safety bill

The College last month joined close to 60 other professional societies and medical organizations in urging Senators to pass a bill to help boost patient safety.

The Patient Safety and Quality Improvement Act of 2003 (S. 720) would create a confidential, voluntary reporting system that physicians and hospitals would use to report error information. That information, which would be reported to patient safety organizations, would then be analyzed to provide feedback on ways to improve patient safety.

According to the letter, the bill would not preempt state requirements on error reporting.

The letter is online.

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ACP provides fee schedule recommendations

The College has provided the Practicing Physicians Advisory Council (PPAC)—which advises HHS about the Medicare program—a comprehensive statement of testimony on the Medicare 2005 physician fee schedule.

Among other recommendations, the College called for separate reimbursement for physician review of electronically transmitted data, a service that is now bundled. ACP also urged the council to recommend separate payment for anticoagulation monitoring. The lack of a separate payment, the statement said, may contribute to underutilization of anticoagulant drugs.

The College also made several recommendations to reduce physicians' documentation burden and improve the medical review process. Those recommendations included eliminating the use of detailed documentation guidelines and assessing the effectiveness of the current medical review process by conducting a cost-benefit analysis.

The College's statement to PPAC can be accessed online.

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