June 1999 Bulletin


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, Md. 20892-6500.

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 workers.

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."

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