Policy & Practice


California to Vote on Parental Notice

Voters in California will once again consider whether to mandate parental notification prior to a minor's receiving an abortion. California ballots next month will include an initiative to amend the state constitution to require parental notification 48 hours in advance of minors receiving abortions. In the case of reported parental abuse, another adult family member can be notified. The minor can also seek a waiver of parental notice from a judge. The initiative, Proposition 4, includes an exemption of parental notification in the case of a medical emergency. Supporters say that parental notification would help stop sexual predators from covering up their sexual exploitation of minors through secret abortions. In contrast, opponents of the measure say that parental notification is ineffective and jeopardizes the health of young women. The initiative is being opposed by the American College of Obstetricians and Gynecologists, the California Medical Association, and the California District of the American Academy of Pediatrics. Similar ballot initiatives were defeated in California in 2005 and 2006.

Inconsistent Contraceptive Use

Some women may be using contraceptives inconsistently because they are ambivalent about getting pregnant or fantasize about the idea of a pregnancy, according to a study published in the September issue of Perspectives on Sexual and Reproductive Health. The researchers conducted in-depth interviews with 24 women and 12 men from the metropolitan Atlanta area to gauge their attitudes about unprotected sex and their experiences with unintended pregnancy. The qualitative analysis found that some individuals had greater sexual arousal at the idea of conception, others had a romantic fantasy about the idea of pregnancy, and others considered an accidental pregnancy as a way to escape a bad family situation or poverty. While the study had a small sample size, the researchers said it was useful in identifying some of the factors affecting inconsistent contraceptive use. The investigators also called on other researchers to include men in these types of studies to figure out how men's attitudes can affect the use of contraceptives.

HIV Rate Highest in Black Women

Among women, African Americans bear a heavier burden of HIV/AIDS than do other ethnic groups, according to a new analysis by researchers at the Centers for Disease Control and Prevention. The HIV incidence rate for African American women was 55.7 per 100,000 population in 2006, nearly 15 times as high as the incidence rate for white women and nearly 4 times as high as the incidence for Hispanic women. The disproportionate rates of HIV infection among African Americans in the United States could be linked to a number of factors, including poverty, stigma, limited access to health care, higher rates of other sexually transmitted diseases, and drug use, according to the CDC. The analysis was published last month in the CDC's Morbidity and Mortality Weekly Report. The results are based on extrapolations from a total of 33,802 HIV diagnoses in 2006 among individuals aged 13 years and older that were reported to the CDC from 22 states.

Stem Cell Guidelines Revised

An expert committee convened by the Institute of Medicine and the National Research Council recently revised guidelines for conducting research involving human embryonic stem cells. The guidelines, which offer national ethical standards, amend guidelines issued by the standing committee in 2005 and 2007. They were revised in part to provide guidance on the use of new human stem cells called “induced pluripotent cells.” These cells were developed recently and are derived by reprogramming nonembryonic adult cells. While these stem cells do not use embryos, many of the ethical and policy concerns are similar to those involving human embryonic stem cells, according to the Human Embryonic Stem Cell Research Advisory Committee. The revised guidelines also recommend that institutions that are conducting stem cell research notify the public about the types of research being pursued. The report was sponsored by the Ellison Medical Foundation, the Greenwall Foundation, and the Howard Hughes Medical Institute.

CMS Alters Overpayment Policy

Officials at the Centers for Medicare and Medicaid Services are changing the procedures for recovering certain overpayments made to physicians. The CMS will no longer seek payment from a physician for an overpayment while the physician is seeking a reconsideration of the overpayment determination by a qualified independent contractor. Under the new policy, which was mandated by the 2003 Medicare Modernization Act, the CMS can only seek to recoup the payment after a decision has been made on the reconsideration. The changes, which went into effect on Sept. 29, will apply to all Part A and Part B claims for which a demand letter has been issued. However, a number of claims have been excluded, including Part A cost reports, Hospice Caps calculations, provider initiated adjustments, Home Health Agency Requests for Anticipated Payment, Accelerated/Advanced Payments, and certain other claims adjustments. The changes do not affect the appeal process or the normal debt collection and referral process, according to the CMS.

Next Article: