Policy & Practice


Bisphenol-A Is Focus Again

The Food and Drug Administration is conducting a new safety review of the chemical bisphenol-A in consumer products such as food containers. Rep. Henry Waxman (D-Calif.), chairman of the House Energy and Commerce Committee, recently wrote to the FDA to request that officials reevaluate the Bush administration's conclusion that the chemical is safe at current exposure levels, especially in light of the agency's reliance on industry studies. At a health subcommittee hearing in June, FDA Commissioner Dr. Margaret A. Hamburg told lawmakers that the agency's acting chief scientist, Dr. Jesse Goodman, would head up the review and that it could be completed by this fall. Rep. Waxman has called on the FDA to determine not only whether its interaction with industry groups during the review of bisphenol-A was appropriate, but also whether the agency's processes in such reviews need to be changed.

Abortion Discrimination Case Settled

The former head of an ob.gyn. residency program in Phoenix has reached a $1.4 million settlement with his former employer, Maricopa County, after alleging that he was discriminated against for supporting abortion training of residents. Dr. J. Christopher Carey claimed in a 2005 lawsuit that he was removed from his position at Maricopa Medical Center because he publicly opposed the county's plan to eliminate abortion training. He asserted that his first amendment rights had been violated and that officials had discriminated against him for his moral and religious beliefs. In a statement through the law firm representing him, Dr. Carey said, “I am extremely pleased with the settlement, but it's important to remember that the shortage of abortion providers in this country is extensive.” Although he settled with the county and its health care system, Dr. Carey's case remains open against two individuals with whom he worked.

CMS to Review Cervical PET Scans

Officials at the Centers for Medicare and Medicaid Services will evaluate whether to cover positron emission tomography more broadly for the staging of cervical cancer outside of clinical studies, the Gray Sheet reported. PET is covered without data collection requirements during the initial treatment phase for cervical cancer only if conventional imaging is negative for extrapelvic metastasis. The CMS already covers PET outside of clinical studies for some cervical cancer patients in subsequent treatment phases, such as in determining whether cancer treatments have been effective or whether post-treatment symptoms can be attributed to a recurrence. CMS plans to issue a proposed decision memo in November and a final ruling by February 2010. The Gray Sheet and OB.GYN. NEWS are both owned by Elsevier.

Fertility Bill Wins More Support

Legislation aimed at helping men and women with fertility problems access costly, high-tech treatments has a new champion in the Senate. Sen. Kirsten Gillibrand (D-N.Y.) has pledged to introduce The Family Building Act in the Senate. The bill was originally introduced in the House by Rep. Anthony Weiner (D-N.Y.). The House bill (H.R. 697) would expand coverage for fertility treatments by requiring insurance carriers to cover technologies such as in vitro fertilization, gamete intrafallopian transfer, and intracytoplasmic sperm injection. Sen. Gillibrand estimates that the legislation would help one in eight American couples affected by infertility.

Childbirth Injuries Drop Sharply

The number of potentially avoidable injuries to women during childbirth fell by more than 20% between 2000 and 2006, according to the Agency for Healthcare Research and Quality. The drop was 30% among mothers who gave birth vaginally without the use of forceps or other instruments. Overall in 2006, there were nearly 158,000 potentially avoidable childbirth injuries to mothers and newborns. The highest rate of obstetrical injuries occurred during vaginal births with instruments. Mothers with private insurance also had higher rates of obstetrical trauma than women with Medicaid coverage. Conversely, newborns covered by Medicaid had higher injury rates than those under private insurance. Blacks and Hispanics had lower newborn- and maternal-injury rates during vaginal deliveries than did whites. The findings are based on community hospital data from the Healthcare Cost and Utilization Project.

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