December 1999 Bulletin


Managed care, antitrust bills on Congress's agenda

The so-called "Campbell bill" (H.R. 1304) that offers antitrust relief for physicians negotiating collectively with insurers may be marked up in the House Judiciary Committee the first week that Congress returns to legislative session next year. It was scheduled to come before the committee in late October, but was pulled at the request of House Speaker Dennis Hastert (R-Ill.). Twenty of the 37 members of the committee support the bill. Next year, the House-Senate conference committee is expected to merge two bills on managed care reform. The House approved a bipartisan bill, supported by almost all Democrats and 68 Republicans, that guarantees patients a number of rights including the right to sue insurers; the Senate approved a bill that is more limited in scope and does not include the right-to-sue feature. Also, watch for possible hearings by the House Commerce Committee on opening to the public the National Practitioner Data Bank and information on malpractice suits against physicians.

Proposed rules for negotiating law are proving tough

Physicians in Texas may have been overjoyed when the state approved a new law that allows health care professionals to negotiate collectively with insurers on contract issues, but now reality has set in. The proposed ground rules which the state attorney general is developing are proving to be tough. The rules must be strong enough to protect physicians from violating federal antitrust rules and the attorney general must oversee the negotiations. Physicians must prove that they need to negotiate collectively. The state attorney general is expected to hold a public hearing on the rules in December.

HHS tells new 'safe harbors' for anti-kickback law

The Office of the Inspector General of Department of Health and Human Services announced eight new final regulatory "safe harbors" to the federal anti-kickback statue, which prohibits the knowing payment of anything of value to influence referral of federal health care program business, including Medicare and Medicaid. The new safe harbors, which protect certain arrangements from prosecution under the anti-kickback statute, address: investments in underserved areas; practitioner recruitment in underserved areas; obstetrical malpractice insurance subsidies for underserved areas; sales of physician practices to hospitals in underserved areas; investments in ambulatory surgical centers; investments in group practices; referral arrangements for specialty services; and cooperative hospital service organizations.

AAOS collaborates on falls guidelines

The Academy is collaborating with the American Geriatrics Society (AGS) and the British Geriatrics Society in developing the AGS Clinical Practice Guidelines on Approaching Falls and Fall Prevention in Older Adults. "As the baby boomers generation explodes into the millenium, the need for caregivers to gain an understanding of the needs of the elderly will be much greater than it is today," says Kenneth J. Koval, MD, project vice chair. The guidelines are expected to be available in January 2001.

Need volunteers to build playground

You can help build a lasting legacy of orthopaedists' support for a community and raise awareness of the specialty by helping to build a playground in Orlando, Fla. on March 14, 2000, the day before the Annual Meeting begins. Members of the Academy, state and specialty societies and their spouses will build the playground at a public school that serves students with mental, developmental and physical challenges. The day long project will end with ribbon-cutting ceremonies attended by local officials. For more information, contact Teena Austin, department of public and media relations, at (847) 346-2267, ext. 4031 or e-mail

FDA reclassifies PMMA bone cement

The Food and Drug Administration said it has reclassified from class III to class II polymethylmethacrylate (PMMA) bone cement that is intended for use in arthroplastic procedures of the hip, knee and other joints for the fixation of polymer or metallic prosthetic implants to living bone. The reclassification was reported in a letter to the Orthopedic Surgical Manufacturers Association at a meeting of the Orthopaedic Device Forum on Oct. 17. The reclassification order will be published in the Federal Register.

Need Y2K help? See AAOS homepage

If you're still looking for help to prevent Y2K problems, look at the "Y2K Alert for Orthopaedic Surgeons" in the "Members Services" section of the AAOS home page The Computer Link column in the June 1999 Bulletin in the "Library" section of the AAOS home page discusses how to get your home computer ready. To find out what other orthopaedic practices are doing to prevent computer problems, see the article, "BONES gets ready for Year 2000 glitches," also in the June Bulletin.

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