House committee to hear physician negotiations bill
The U.S. House Judiciary Committee is scheduled to
hold a hearing June 9 on the Quality Health Care Coalition Act
(H.R. 1304) which would allow physicians to enter into negotiations
with health care plans and other payers and receive the same exemption
from antitrust laws that unions now receive, without having to
join a trade union. As of May 21, the bill had almost 90 sponsors,
16 of whom are members of the House Judiciary Committee. By the
time you read this, the Texas legislature will have decided whether
to approve a bill giving similar rights to independently practicing
physicians to ask for the state's attorney's office for permission
to collectively negotiate with health care plans. The bill was
approved by the Texas Senate and was to be discussed in the House
as the May 31 adjournment neared.
NIAMS offers grants for research on chondroprotection
The National Institute of Arthritis and Musculoskeletal
and Skin Diseases (NIAMS) has invited applications for research
on mechanisms of chondroprotection. The applications may be for
individual research projects or for exploratory/developmental
grants. The research should be specifically targeted towards identification
and evaluation of chondroprotective agents to prevent cartilage
destruction and/or facilitate it's repair in such conditions as
rheumatoid arthritis, juvenile rheumatoid arthritis and osteoarthritis
where there is a decline in the structural integrity of the articular
cartilage. The deadline for a letter of intent is Aug. 1, 1999.
Application deadline is Sept. 8, 1999. Send a letter of intent
to Tommy L. Broadwater, PhD, scientific review branch, NIAMS,
Natcher Building, Room 5AS-25U, 45 Center Dr., MSC 6500, Bethesda,
Legislation would require use of devices to stop needlesticks
Rep. Pete Stark (D-Calif.) and Rep. Marge Roukema
(R-N.J.) have introduced the Health Care Worker Needlestick Prevention
Act which would require the use of needle-less systems or other
engineered safety mechanisms designed to reduce the estimated
800,000 needlestick injuries to healthcare workers each year.
The bill would establish a National Clearinghouse on Safer Needle
Technology that would collect data on new safety technology and
create model training curricula for employers and health care
MedPAC discusses using business model to pay for DGME
The June report of the Medicare Payment Advisory
Commission (MedPAC) may include further discussion of a proposal
to recognize costs traditionally categorized as Direct Medical
Education (DGME) as similar to other costs in the business community
such as on-the-job training. Thus, like other businesses, the
cost associated with resident training would be a necessary cost
in producing a teaching hospital's output, which is patient care,
says Joseph Newhouse, MedPAC vice chairman, who proposed the concept.
Since the indirect medical education (IME) adjustment is also
associated with patient care costs, he said it would be more appropriate
to incorporate the DGME costs into the IME financing mechanism.
The rationale is that because teaching hospitals produce a "product"
that is different and more costly than nonteaching hospitals,
Medicare should recognize and pay for it accordingly. MedPAC is
manadated by the Balanced Budget Act of 1997 to issue a report
on GME and other issues by Aug. 4, 1999.
Sen. Lott expects managed care bill debate in June
Senate Majority Leader Trent Lott (R-Miss.) wants
to bring managed care legislation to the floor in June. The Senate
Finance Committee is considering patient protection legislation
that will mandate internal and external reviews, a ban on "gag"
clauses, require emergency room visits and increase doctors' authority
in making medical judgments. Rep. Charles Norwood (R-Ga.) and
Rep. Tom Coburn (R-Okla.) have delivered drafts of two "consensus"
health care bills to House Speaker J. Dennis Hastert (R-Ill.)
and House Commerce Committee Chairman Thomas Bliley Jr. (R-Va.).
A patient protection bill includes expanded liability for plans,
external appeals and a mandatory point-of-service provision, according
to an aide to Rep. Norwood. An access to affordable care bill
creates local and national insurance pools, gives the same tax
treatment to businesses and individuals that purchase insurance
and sets up "measures that begin the process of returning
full legal authority over the health insurance industry from the
federal government to the states."