August 2000 Bulletin


HCFA publishes Medicare Fee Schedule for 2001

The Health Care Financing Administration published its proposed rule on revisions to the Medicare Fee Schedule for calendar year 2001 in the July 17, 2000Federal Register. Much of the proposal is devoted to discussion on refinements to the new resource-based practice expense relative values. Next year will be the third year of a four-year transition from charge-based practice expense payments to a resource-based system. Practice expense relative value units in 2001 will be 25 percent charge-based and 75 percent resource-based. HCFA also proposes to make refinements to the resource-based malpractice relative value units, the geographic practice cost indices (GPCIs) and the physician work RVUs for critical care services. In addition, HCFA briefly outlines its efforts to collect physician time data as part of the five-year review of physician work RVUs. The AAOS is currently analyzing the proposed rule and will submit comments to HCFA. The public comment period closes Sept. 15, 2000. The proposed rule in theFederal Register is at Scroll down to Health Care Financing Administration.

Agency to convene national summit on medical errors

The first National Summit on Medical Errors and Patient Safety Research will be held by the Agency for Healthcare Research and Quality and the Quality Interagency Coordination Task Force on Sept. 11, 2000 in Washington, D.C. The summit, open to the public and media, will focus on the key research questions that need to be answered to foster improvements in patient safety throughout the nation’s health care system, and approaches that should be taken to answer the questions.

Massachusetts approves major HMO reform bill

After two years of debate, the Massachusetts state legislature approved a sweeping managed care reform bill that was signed into law by Gov. Paul Cellucci on July 21. The law requires HMOs to pay for procedures deemed necessary by physicians, make it harder for nonprofit hospitals to become for-profit, create a committee to develop a plan to achieve universal care, prevent HMOs from offering doctors financial incentives for cutting health care costs, allow women to get prenatal services without a primary care physician’s referral and allow people with chronic illnesses to obtain standing referrals to specialists. The law takes effect in 2001.

Academy posts model compliance plan on AAOS home page

The Office of General Counsel of the Academy has prepared a model compliance program and manual for orthopaedic surgeons. It is designed to serve as a starting point from which orthopaedic surgeons can develop compliance programs and plans for their own offices. The material includes discussions of the Medicare fraud and abuse laws, elements of acceptable medical office compliance plans, as well as a model plan for consideration and adaptation by orthopaedic surgeons. It is located on the AAOS website, Developed at the request of many orthopaedic surgeons and the Board of Councilors, the Academy’s model compliance program and manual reflects the practice in the field as well as the Draft Compliance Program Guidance for Individual and Small Group Physician Practices, released by the Office of the Inspector General of the Department of Health and Human Services on June 7, 2000.

Healthcare workers face greater risk of HCV than HIV

Healthcare workers’ risk of becoming infected with Hepatitis C (HCV) following an accidental needle stick is 20 to 40 times greater than their risk of HIV infection, according to data presented at a meeting of the Centers for Disease Control and Prevention and the American Society of Microbiology. Data from 53 hospitals in South Carolina revealed that 1,668 healthcare workers had been exposed to either HCV or HIV. The source patient (SP) seropositive rate for HCV was 5.2 percent and for HIV, 2.3 percent, which is significantly higher than the general public at 1.5 percent and 0.3%, respectively.

Irwin Feinberg, MD, right center, greets delegates from state legislatures at the AAOS exhibit during the National Conference of State Legislatures in Chicago last month.

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