December 1998 Bulletin


Legislators ask Clinton to declare bone, joint decade

Rep. Sherrod Brown, (D-Ohio); Rep. Steny H. Hoyer (D-Md.); and Rep. Frank Pallone Jr., (D-N.J.) have asked President Clinton to declare 2000-2010 "The Bone and Joint Decade." They informed Clinton in a letter that an international effort was launched in Lund, Sweden by orthopaedic surgeons, rheumatologists, physical therapists and representatives from worldwide medical and health associations "who are committed to improving health-related quality of life for people with bone and joint diseases and traumatic injuries. … Musculoskeletal injuries are the most common cause of severe long-term pain and physical disability, affecting hundreds of millions of people across the world, from birth to old age. …The implementation plan for 'The Bone and Joint Decade' identifies the most compelling musculoskeletal conditions and research issues in which the opportunity exists to make extraordinary practice advances within the next few years."

Academy, AMA review proposed E/M documentation

The Academy and the American Medical Association continue to review the proposed documentation guidelines for Evaluation and Management Services. The Academy is studying the musculoskeletal physical examination section of the guidelines which appears to be very general, compared to the physical examination sections for other specialties. The Academy's CPT Coding committee met in November to review the proposed guidelines and finalize comments to the AMA. Meanwhile, the AMA reviewed the proposed guidelines at a meeting of the CPT Advisory Committee and CPT Editorial Panel in November. The AMA is reviewing comments made by specialty societies on the AMA website and will meet again in February 1999.

NASS forms task force on ABSS issues

The North American Spine Society (NASS) has appointed a task force to study the issues presented by the formation of the American Board of Spine Surgery (ABSS) and proposed certification of spine surgeons. NASS has informed its members that it does not recognize any other accreditation agency than the Accreditation Council of Graduate Medical Education (ACGME). Steven Garfin, MD, immediate past president of NASS, is chairman of the task force. The Council of Spine Societies will meet Feb. 13, 1999; one of the items for discussion will be the issues presented by the ABSS.

Clinton to seek patient's bill passage in 1999

President Clinton and Democratic congressional leaders, meeting after the November election, agreed that the new Congress's first order of business in 1999 should be passing a patient's bill of rights.

HCFA publishes Medicare physician fee schedule

The Health Care Financing Administration published its 1999 Medicare physician fee schedule in the Federal Register Nov. 2, 1998. HCFA said the schedule will result in an annual 2.3% increase to physician fees for 1999. The Medicare physician fee schedule for the first time will relate payment for physician practice expenses to the actual resources used to provide medical services rather than physicians' historical charges. The comment period ends January 4, 1999. (A coalition of medical societies has filed a lawsuit against HCFA. See page 15.) HCFA also published a notice that the sustainable growth rate (SRG) for fiscal year 1999 will be -0.3 percent. The negative SRG is driven by a projected drop in Medicare fee-for-service enrollment, HCFA said. If the SRG target is not met, the appropriate fee schedule is adjusted up or down. The Academy is reviewing the two HCFA documents and will comment.

Law urges action on needle sticks

A new federal law urges Occupational Safety and Health Administration, U.S. Centers for Disease Control and Prevention and the Food and Drug Administration and other federal agencies to "make reduction of accidental needle sticks a priority by …taking all necessary actions to address this serious public health problem. " Congress also calls on the CDC and National Institute for Occupational Safety and Health to collect the numerous studies that have compared the performance of standard needles with that of safety needles. The law also asks the CDC to include in its hospital manual a recommendation for the use of needles and syringes with devices that protect against needle injuries.

NIH gets 14% hike in budget, NIAMS gets 12.4% increase

The $500 billion budget approved by Congress gives the National Institutes of Health a big infusion of extra money for the second consecutive year. The $2 billion expansion in funding for biomedical research at NIH, a 14 percent increase, comes on top of a $900 million increase last year. NIAMS will receive $308.2 million, 12.4 percent above 1998. Congress also funded the president's request to expand the administrative capacity of HCFA.

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