Policy & Practice


Bill Halts 4.4% Medicare Cut

Congress' long-awaited passage of the budget reconciliation package put a freeze on a 4.4% cut Medicare physicians experienced in the month of January. While the congressional action stopped any further reductions to payments, it did not increase Medicare physician pay for 2006. The Centers for Medicare and Medicaid Services will reimburse physicians retroactively for the reductions experienced in January, and has instructed its contractors to automatically reprocess claims. But work on this issue is far from over, Dr. J. Edward Hill, president of the American Medical Association, said in a statement. “With 6 years of cuts still scheduled to come as practice costs continue to rise, we fear more physicians will make difficult practice decisions about treating Medicare patients. … We must build on the momentum and awareness raised in 2005 to make 2006 the year Congress permanently repeals the broken Medicare physician payment formula.” President Bush's fiscal year 2007 budget request to Congress briefly mentioned the impending cuts, although it expounded on CMS's efforts to expand pay-for-performance initiatives to “achieve better outcomes at a lower overall cost.”

President's Health Care Agenda

The federal government has a responsibility to provide health care for the poor and the elderly, as well as confront its rising costs, strengthen the doctor-patient relationship, and help people afford insurance coverage, President Bush said in his State of the Union Address. Medical associations praised the president for his pledge to make broader use of electronic health records and calling medical liability reform a priority. “America's medical liability insurance crisis is hurting the women of this country and limiting their access to the obstetrician-gynecologists who care for them,” Dr. Michael T. Mennuti, president of the American College of Obstetricians and Gynecologists, said in a statement. But Ron Pollack, executive director of the consumer group Families USA, noted that the president failed to mention the recent efforts by the White House and Congress to cut Medicaid funding. “These Medicaid cuts will drive many low-income seniors and children out of the system and leave millions of people without any health care coverage whatsoever.”

Courts Overturn Partial Birth Ban Again

Federal appeals courts in California and New York recently upheld lower court rulings that the “Partial Birth Abortion Ban Act of 2003” is unconstitutional. In the New York case, the court ruled that the ban must contain an exception for the health of the woman and asked for additional legal briefs. The California court struck down the ban. “We are pleased that both courts have recognized that this ban needs an exception to protect women's health,” Vicki Saporta, president and CEO of the National Abortion Federation, said in a statement. “Doctors and women should be able to make medical decisions free from interference by politicians.” Last year, a third appeal of the statute also was struck down. That case has been sent to the Supreme Court. At press time, there was no word on whether the court would agree to hear the case.

Kansas Court Backs Abortion Privacy

Reproductive rights groups are claiming victory in Kansas after the state's Supreme Court ruled that all patient-identifying information must be removed before medical records can be reviewed by a local district court as part of an investigation launched by the state's attorney general. Kansas Attorney General Phill Kline had been seeking the full patient files of 90 girls and women who obtained abortions at two women's health clinics in 2003 as part of an investigation aimed at uncovering alleged unjustified late-term abortions and possible unreported child abuse. The two clinics that are targets of Mr. Kline's investigation—Comprehensive Health of Planned Parenthood and Wichita's Women's Health Services—have been fighting the subpoena, saying that it violates the privacy of their patients.

CVD Awareness by Women Rises

More women are aware of cardiovascular disease, and that knowledge is causing them to take positive preventive health steps for themselves and family members, according to a recent study published in the journal Circulation. A survey of more than 1,000 women aged 25 and older found that awareness has nearly doubled since 1997. Among the women who completed the full survey in July 2005, 55% said that heart disease/heart attack is the leading cause of death. This is up from 30% in 1997. More than 80% of women surveyed said they had seen, heard, or read information about heart disease in the last year. The researchers reported that those women were “significantly more likely to increase their physical activity, decrease their intake of unhealthy food, and lose weight.”

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