Policy & Practice


CDC Proposes New Vaccine Criteria

The Centers for Disease Control and Prevention is proposing new criteria for setting vaccination requirements for U.S. immigrants. Currently, those seeking entry to the country or wishing to change their legal status must receive vaccinations recommended by the Advisory Committee on Immunization Practices. This system created controversy last summer when the ACIP recommended vaccination against the human papillomavirus (HPV). Many groups, including the American College of Obstetricians and Gynecologists, objected that the vaccine is prohibitively expensive at $360 for the three-dose series. ACOG also argued that unlike other infectious diseases on the vaccination list, HPV doesn't pose an immediate threat to public health. Under the criteria proposed by CDC, a required vaccine must be age appropriate and recommended for the general U.S. population by ACIP. It also must protect against a disease meeting at least one of the following criteria: has the potential to cause an outbreak, has been eliminated in the United States, or is in the process of being eliminated here. CDC would continue to require that immigrants be vaccinated against mumps, measles, rubella, polio, tetanus, diphtheria, pertussis, Haemophilus influenzae type B, and hepatitis—but not HPV.

Bill Backs Better Biomarkers

Federal lawmakers have reintroduced legislation aimed at improving ovarian cancer screening. The Ovarian Cancer Biomarker Research Act (H.R. 1816 and S. 755) would authorize $100 million over 4 years for research into biomarkers that detect or indicate a woman's risk of ovarian cancer, fallopian tube cancer, and primary peritoneal cancer. The research would be conducted at centers of excellence around the country. The bill would also establish a committee to help design a large clinical trial of such biomarkers. The bill is sponsored by Rep. Howard L. Berman (D-Calif.) in the House and Sen. Barbara Boxer (D-Calif.) in the Senate.

HIV Bill Would Expand Medicaid

House Speaker Nancy Pelosi (D-Calif.) and a bipartisan group of representatives are seeking to allow low-income individuals with HIV to enroll earlier in Medicaid. Rep. Pelosi, Rep. Eliot Engel (D-N.Y.), and Rep. Ileana Ros-Lehtinen (R-Fla.) recently reintroduced the Early Treatment for HIV Act (H.R. 1616). The bill is modeled after a law that provides early access to Medicaid for women with breast or cervical cancer. The HIV bill failed to make it out of committee in the previous Congress. But the chances for success for greater this time around, according to Speaker Pelosi, given the bipartisan support for the legislation and President Obama's support of the concept.

Bill Seeks Payment Floor for Tests

Ob.gyns., rheumatologists, endocrinologists, and others are throwing their support behind federal legislation that would establish a payment floor for dual-energy x-ray absorptiometry (DXA) and vertebral fracture assessment (VFA). The “Medicare Fracture Prevention and Osteoporosis Testing Act of 2009” (S. 769, H.R. 1894), would mandate payments not less than the 2006 Medicare rates for these services (CPT codes 77080 and 77082, respectively). The legislation would counteract deep Medicare payment cuts for the services that began in 2007. The new bill is supported by the DXA Task Force, which includes ACOG, the National Osteoporosis Foundation, the American Association of Clinical Endocrinologists, and the American College of Rheumatology.

Awareness Campaign Targets AIDS

The federal government plans to spend $45 million over the next 5 years on a new public-awareness campaign to fight growing complacency about HIV/AIDS in the United States. The effort, called Act Against AIDS, will include public service announcements, online communications, and targeted messages to African Americans, Latinos, and other groups that are disproportionately affected by HIV/AIDS. “Act Against AIDS seeks to put the HIV crisis back on the national radar screen,” Melody Barnes, director of the White House Domestic Policy Council, said in a statement. “Our goal is to remind Americans that HIV/AIDS continues to pose a serious health threat in the United States and encourage them to get the facts they need to take action for themselves and their communities.” More information on the campaign is available at

EHR Applications Rise

By a March 31 deadline, 64 companies applied for certification of their electronic health record (EHR) products, one-third more than applied by the same time last year, the Certification Commission for Healthcare Information Technology reported. In addition, nearly 40% of the applications were for new EHR products, rather than renewals, according to the federally recognized commission. Nearly two-thirds of the applicants qualified as small businesses, the commission noted. The biggest category of applications, including 26, was for EMR products concerning health records for children. Other applications covered cardiovascular medicine, emergency departments, and inpatient records. So far, 25 of the products have been certified, the commission said.

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