Vermont Bans Most Pharma Gifts
Vermont Gov. Jim Douglas (R) has signed into law a bill that prohibits manufacturers of drugs, medical devices, and biologics from providing free gifts, including meals and travel, to physicians and other health care providers. The legislation, which is the toughest of its kind in the nation, also requires disclosure of any allowed gifts or payments, regardless of their value. In 2002, a Vermont law required disclosure of gifts or payments of $25 or more. Under the stronger law, manufacturers can give physicians only gifts such as samples intended for patients, “reasonable quantities” of medical device evaluation or demonstration units, and copies of peer-reviewed articles. The companies still can provide scholarships or other support for medical students, residents, and fellows to attend educational events held by professional associations, as long as the association selects the scholarship recipient.
Obama: Give MedPAC More Clout
President Obama's administration wants to give the Medicare Payment Advisory Commission greater influence. In a June 2 letter to Sen. Ted Kennedy (D-Mass.) and Sen. Max Baucus (D-Mont.), President Obama said he supported giving each MedPAC recommendation the force of law unless it is opposed by a joint resolution of Congress. This appeared to embrace the approach in the MedPAC Reform Act of 2009, which Sen. Jay Rockefeller (D-W.Va.) introduced in May. Currently, MedPAC advises Congress, which then decides whether to act on the recommendations. At a Brookings Institution conference in mid-June, White House Office of Management and Budget Director Peter Orszag reiterated support for giving MedPAC more teeth. Mr. Orszag said the administration wanted to “take the MedPAC recommendations and, rather than having them sit on a shelf somewhere, have them protected in a fast track procedure, voted up or down as a package, and considered within a limited period of time so they become much more relevant.”
ED Overcrowding Continues
The emergency department wait time to see a physician for emergent patients—those who should be seen in 1-14 minutes—averaged 37 minutes in 2006. Half of such patients waited longer than recommended, the Government Accountability Office said in a report. In addition, patients who should have been seen immediately waited an average of 28 minutes, and about three-fourths had to wait to be seen. Hospitals performed better with urgent cases: Those patients, who should be seen in 15-60 minutes, waited an average of 50 minutes, and about 20% waited longer than recommended, the report indicated. Lack of inpatient beds continues to be the main driver of emergency department overcrowding. ED boarding of patients who are waiting for an inpatient bed continues to be a problem, the GAO noted. The American College of Emergency Physicians warned that overcrowding and wait times will only get worse as the population ages. “People age 65 and older represent the fastest growing segment of the population and the group whose visits to the emergency department are increasing the fastest,” Dr. Nicholas Jouriles, president of ACEP, indicated in a statement.
Crossover Claims Investigated
Reports that crossover claims from Medicare to Medicaid are not being automatically filed in several states are being examined by the Physicians Regulatory Issues Team. The PRIT works with health care providers to address Medicare payment issues. According to Dr. William Rogers, director, the Healthcare Billing and Management Association and the Medical Group Management Association have been receiving complaints from members alleging that crossover claims from Medicare to Medicaid are not automatically being completed, as they should be. And “if you have to handle any paperwork to bill Medicaid for the copay, you've already burned up any revenue you might have generated” from the Medicaid claim, said Dr. Rogers. The states under investigation include New York, North Carolina, Louisiana, Nevada, South Carolina, Georgia, Kentucky, and Texas. Dr. Rogers said that physicians who believe their state Medicaid program is not accepting automatic crossover claims from Medicare should contact the Medical Group Management Association or Healthcare Billing and Management Asssociation, or e-mail Dr. Rogers at