Mary Ellen Schneider

New health plans will soon be required to offer a range of recommended preventive health services to patients free of charge under the Affordable Care Act.

The requirements will affect new private health plans in the individual and group markets starting with plan years that begin on or after Sept. 23.

The Health and Human Services department estimates that in 2011, the rules will impact about 30 million people in group health plans and another 10 million in individual market plans. The rules do not apply to grandfathered plans.

The administration released an interim final regulation detailing the new requirements on July 14.

Under the final rule, health plans may not collect copayments, coinsurance, or deductibles for a number of recommended preventive services. However, they may collect fees for the associated office visit if the preventive service wasn't the primary purpose of the visit. Patients may also incur cost sharing if they go out of network for the recommended screenings.

The covered services include those given an evidence rating of “A” or “B” from the U.S. Preventive Services Task Force. Those services include breast and colon cancer screenings, diabetes screenings, blood pressure and cholesterol testing, and screening for vitamin deficiencies during pregnancy. Tobacco cessation counseling is also given a high evidence rating by the U.S. Preventive Services Task Force and would be covered under the new rule.

Health plans will have some extra time to begin covering newly recommended services. For recommendations that have been in effect for less than a year, plans will have 1 year to comply after the effective date, according to the interim final rule.

Health plans will also be required to cover the list of adult and childhood vaccines recommended by the Advisory Committee on Immunization Practices.

For children, the rule also requires health plans to cover all preventive care recommended under the Bright Futures guidelines. The guidelines include screenings, developmental assessments, immunizations, and regular well-child visits from birth to age 21 years. These guidelines were developed jointly by the Health Resources and Services Administration and the American Academy of Pediatrics.

A list of the recommended preventive services is available online at www.healthcare.gov/center/regulations/prevention/recommendations.html

New health plans will soon be required to offer a range of recommended preventive health services to patients free of charge under the Affordable Care Act.

The requirements will affect new private health plans in the individual and group markets starting with plan years that begin on or after Sept. 23.

The Health and Human Services department estimates that in 2011, the rules will impact about 30 million people in group health plans and another 10 million in individual market plans. The rules do not apply to grandfathered plans.

The administration released an interim final regulation detailing the new requirements on July 14.

Under the final rule, health plans may not collect copayments, coinsurance, or deductibles for a number of recommended preventive services. However, they may collect fees for the associated office visit if the preventive service wasn't the primary purpose of the visit. Patients may also incur cost sharing if they go out of network for the recommended screenings.

The covered services include those given an evidence rating of “A” or “B” from the U.S. Preventive Services Task Force. Those services include breast and colon cancer screenings, diabetes screenings, blood pressure and cholesterol testing, and screening for vitamin deficiencies during pregnancy. Tobacco cessation counseling is also given a high evidence rating by the U.S. Preventive Services Task Force and would be covered under the new rule.

Health plans will have some extra time to begin covering newly recommended services. For recommendations that have been in effect for less than a year, plans will have 1 year to comply after the effective date, according to the interim final rule.

Health plans will also be required to cover the list of adult and childhood vaccines recommended by the Advisory Committee on Immunization Practices.

For children, the rule also requires health plans to cover all preventive care recommended under the Bright Futures guidelines. The guidelines include screenings, developmental assessments, immunizations, and regular well-child visits from birth to age 21 years. These guidelines were developed jointly by the Health Resources and Services Administration and the American Academy of Pediatrics.

A list of the recommended preventive services is available online at www.healthcare.gov/center/regulations/prevention/recommendations.html

New health plans will soon be required to offer a range of recommended preventive health services to patients free of charge under the Affordable Care Act.

The requirements will affect new private health plans in the individual and group markets starting with plan years that begin on or after Sept. 23.

The Health and Human Services department estimates that in 2011, the rules will impact about 30 million people in group health plans and another 10 million in individual market plans. The rules do not apply to grandfathered plans.

The administration released an interim final regulation detailing the new requirements on July 14.

Under the final rule, health plans may not collect copayments, coinsurance, or deductibles for a number of recommended preventive services. However, they may collect fees for the associated office visit if the preventive service wasn't the primary purpose of the visit. Patients may also incur cost sharing if they go out of network for the recommended screenings.

The covered services include those given an evidence rating of “A” or “B” from the U.S. Preventive Services Task Force. Those services include breast and colon cancer screenings, diabetes screenings, blood pressure and cholesterol testing, and screening for vitamin deficiencies during pregnancy. Tobacco cessation counseling is also given a high evidence rating by the U.S. Preventive Services Task Force and would be covered under the new rule.

Health plans will have some extra time to begin covering newly recommended services. For recommendations that have been in effect for less than a year, plans will have 1 year to comply after the effective date, according to the interim final rule.

Health plans will also be required to cover the list of adult and childhood vaccines recommended by the Advisory Committee on Immunization Practices.

For children, the rule also requires health plans to cover all preventive care recommended under the Bright Futures guidelines. The guidelines include screenings, developmental assessments, immunizations, and regular well-child visits from birth to age 21 years. These guidelines were developed jointly by the Health Resources and Services Administration and the American Academy of Pediatrics.

A list of the recommended preventive services is available online at www.healthcare.gov/center/regulations/prevention/recommendations.html

Accountable care organizations are garnering a lot of attention as a way to reform how health care is paid for in the United States, but just about the only thing that experts can agree on right now is that the ACO concept is still in its infancy.

"This is sort of an evolving area of health policy, and it's not exactly clear that, when people are talking about ACOs, [everyone] has the same thing in mind," said Dr. Francis J. Crosson, senior fellow in the Kaiser Permanente Institute for Health Policy in Oakland, Calif., and a member of a task force on ACOs that was recently convened by the National Committee for Quality Assurance (NCQA).

In general, ACOs would allow primary care physicians, specialists, and hospitals to form a partnership to provide care to a group of patients. The idea is that all the providers would work together to improve quality and manage costs, and that they would share in any savings that were produced as a result. A few models already exist for both pediatric and adult populations.

While many hospitals are still just contemplating their potential role in an ACO, Nationwide Children's Hospital in Columbus, Ohio, is billing itself as the country's largest pediatric ACO. It offers one model for how to pursue this concept in the care of children.

Starting about 5 years ago, Nationwide officials partnered with the state of Ohio to assume financial risk in treating children who were covered by the Medicaid managed care program in central and southeast Ohio. To help run the program, they formed a nonprofit physician-hospital organization called Partners for Kids that includes not only Nationwide-employed physicians but also other physicians working in the community. Under the arrangement, Partners for Kids receives a capitated fee to care for about 285,000 pediatric Medicaid recipients.

The organization contracts with three Medicaid managed care plans that retain a percentage of the Medicaid premium to provide claims processing, member relations, and other medical management functions. The hospital and physicians assume the business risk for clinical and financial outcomes.

The idea was to move away from the conventional fee-for-service model while improving access for children who might otherwise have difficulty finding a physician, said Dr. Steve Allen, chief executive officer for Nationwide. For example, Partners for Kids pays primary care physicians in rural areas an increased fee to keep their panels open for these Medicaid patients.

"We saw this as an opportunity to change the paradigm so that we could improve access," Dr. Allen said.

Officials at Nationwide Children's Hospital have conducted an analysis of the current ACO landscape and found that about a dozen institutions around the country are planning to develop or have launched some type of a pediatric ACO, with sizes ranging from 30,000 patients to Nationwide's high of 285,000. Most of the more developed models are among integrated delivery systems, he said.

One integrated system looking to become an ACO is University Hospitals in northeast Ohio, which includes the Rainbow Babies and Children's Hospital.

Participating in an ACO will mean shifting the system's focus from an acute, episodic care model to a prevention and wellness model, according to Dr. Eric Bieber, chief medical officer at University Hospitals Case Medical Center and Rainbow Babies and Children's Hospital.

"Health care in its present design is highly episodic. It doesn't relate one piece to the other," he said. Switching to an ACO model "is a transformational change in how care is going to be delivered."

There has been a lot of buzz around ACOs since the passage of the Affordable Care Act. The massive health reform law includes three sections with implications for forming ACOs. The section that has received the most attention is the Medicare shared-savings program, which will allow groups of providers to work together in treating patients and to share in any potential savings they achieve. That program is set to launch in January 2012.

ACOs may also end up being part of testing performed by the Center for Medicare and Medicaid Innovation, a new office created under the law. The innovation center has broad authority to test new payment ideas and will launch in January 2011. Finally, the Affordable Care Act includes a pediatric ACO demonstration project that allows states to recognize pediatric medical providers as ACOs and to award incentive payments through Medicaid. That project is also expected to launch in January 2012.

Since the passage of the Affordable Care Act, there's been a "flurry of activity" going on around the country, similar to what happened in the early 1990s around the growth of HMOs and capitation, said Dr. Crosson of the Kaiser Permanente Institute, who is also a pediatrician.

In the near term, there is likely to be a range of ACO models, Dr. Crosson predicted. Some will be tightly constructed around integrated delivery systems in which physicians and hospitals are part of the same economic entity. Other will be looser models that bring together a group of physicians and hospitals that are financially separate from one another, he said. The real question, Dr. Crosson noted, is not whether various models can be designed, but which ones will work best.

But he added that pediatricians will have a role, especially if they have had success in transitioning to a patient-centered medical home practice. The type of care coordination that happens at the individual practice level is the same type of capability a physician will need to be successful within an ACO. "I think there's room in this for virtually everyone to be in the game and try to get it to work."

As the ACO concept develops, pediatricians may find that they are getting a lot more attention from hospitals that are interested in developing closer, more collaborative relationships with them, said Dr. Allen of Nationwide Children's Hospital. "I think [pediatricians] are going to find themselves to be incredibly popular."

Naseem S. Miller contributed to this report.

Accountable care organizations are garnering a lot of attention as a way to reform how health care is paid for in the United States, but just about the only thing that experts can agree on right now is that the ACO concept is still in its infancy.

"This is sort of an evolving area of health policy, and it's not exactly clear that, when people are talking about ACOs, [everyone] has the same thing in mind," said Dr. Francis J. Crosson, senior fellow in the Kaiser Permanente Institute for Health Policy in Oakland, Calif., and a member of a task force on ACOs that was recently convened by the National Committee for Quality Assurance (NCQA).

In general, ACOs would allow primary care physicians, specialists, and hospitals to form a partnership to provide care to a group of patients. The idea is that all the providers would work together to improve quality and manage costs, and that they would share in any savings that were produced as a result. A few models already exist for both pediatric and adult populations.

While many hospitals are still just contemplating their potential role in an ACO, Nationwide Children's Hospital in Columbus, Ohio, is billing itself as the country's largest pediatric ACO. It offers one model for how to pursue this concept in the care of children.

Starting about 5 years ago, Nationwide officials partnered with the state of Ohio to assume financial risk in treating children who were covered by the Medicaid managed care program in central and southeast Ohio. To help run the program, they formed a nonprofit physician-hospital organization called Partners for Kids that includes not only Nationwide-employed physicians but also other physicians working in the community. Under the arrangement, Partners for Kids receives a capitated fee to care for about 285,000 pediatric Medicaid recipients.

The organization contracts with three Medicaid managed care plans that retain a percentage of the Medicaid premium to provide claims processing, member relations, and other medical management functions. The hospital and physicians assume the business risk for clinical and financial outcomes.

The idea was to move away from the conventional fee-for-service model while improving access for children who might otherwise have difficulty finding a physician, said Dr. Steve Allen, chief executive officer for Nationwide. For example, Partners for Kids pays primary care physicians in rural areas an increased fee to keep their panels open for these Medicaid patients.

"We saw this as an opportunity to change the paradigm so that we could improve access," Dr. Allen said.

Officials at Nationwide Children's Hospital have conducted an analysis of the current ACO landscape and found that about a dozen institutions around the country are planning to develop or have launched some type of a pediatric ACO, with sizes ranging from 30,000 patients to Nationwide's high of 285,000. Most of the more developed models are among integrated delivery systems, he said.

One integrated system looking to become an ACO is University Hospitals in northeast Ohio, which includes the Rainbow Babies and Children's Hospital.

Participating in an ACO will mean shifting the system's focus from an acute, episodic care model to a prevention and wellness model, according to Dr. Eric Bieber, chief medical officer at University Hospitals Case Medical Center and Rainbow Babies and Children's Hospital.

"Health care in its present design is highly episodic. It doesn't relate one piece to the other," he said. Switching to an ACO model "is a transformational change in how care is going to be delivered."

There has been a lot of buzz around ACOs since the passage of the Affordable Care Act. The massive health reform law includes three sections with implications for forming ACOs. The section that has received the most attention is the Medicare shared-savings program, which will allow groups of providers to work together in treating patients and to share in any potential savings they achieve. That program is set to launch in January 2012.

ACOs may also end up being part of testing performed by the Center for Medicare and Medicaid Innovation, a new office created under the law. The innovation center has broad authority to test new payment ideas and will launch in January 2011. Finally, the Affordable Care Act includes a pediatric ACO demonstration project that allows states to recognize pediatric medical providers as ACOs and to award incentive payments through Medicaid. That project is also expected to launch in January 2012.

Since the passage of the Affordable Care Act, there's been a "flurry of activity" going on around the country, similar to what happened in the early 1990s around the growth of HMOs and capitation, said Dr. Crosson of the Kaiser Permanente Institute, who is also a pediatrician.

In the near term, there is likely to be a range of ACO models, Dr. Crosson predicted. Some will be tightly constructed around integrated delivery systems in which physicians and hospitals are part of the same economic entity. Other will be looser models that bring together a group of physicians and hospitals that are financially separate from one another, he said. The real question, Dr. Crosson noted, is not whether various models can be designed, but which ones will work best.

But he added that pediatricians will have a role, especially if they have had success in transitioning to a patient-centered medical home practice. The type of care coordination that happens at the individual practice level is the same type of capability a physician will need to be successful within an ACO. "I think there's room in this for virtually everyone to be in the game and try to get it to work."

As the ACO concept develops, pediatricians may find that they are getting a lot more attention from hospitals that are interested in developing closer, more collaborative relationships with them, said Dr. Allen of Nationwide Children's Hospital. "I think [pediatricians] are going to find themselves to be incredibly popular."

Naseem S. Miller contributed to this report.

Accountable care organizations are garnering a lot of attention as a way to reform how health care is paid for in the United States, but just about the only thing that experts can agree on right now is that the ACO concept is still in its infancy.

"This is sort of an evolving area of health policy, and it's not exactly clear that, when people are talking about ACOs, [everyone] has the same thing in mind," said Dr. Francis J. Crosson, senior fellow in the Kaiser Permanente Institute for Health Policy in Oakland, Calif., and a member of a task force on ACOs that was recently convened by the National Committee for Quality Assurance (NCQA).

In general, ACOs would allow primary care physicians, specialists, and hospitals to form a partnership to provide care to a group of patients. The idea is that all the providers would work together to improve quality and manage costs, and that they would share in any savings that were produced as a result. A few models already exist for both pediatric and adult populations.

While many hospitals are still just contemplating their potential role in an ACO, Nationwide Children's Hospital in Columbus, Ohio, is billing itself as the country's largest pediatric ACO. It offers one model for how to pursue this concept in the care of children.

Starting about 5 years ago, Nationwide officials partnered with the state of Ohio to assume financial risk in treating children who were covered by the Medicaid managed care program in central and southeast Ohio. To help run the program, they formed a nonprofit physician-hospital organization called Partners for Kids that includes not only Nationwide-employed physicians but also other physicians working in the community. Under the arrangement, Partners for Kids receives a capitated fee to care for about 285,000 pediatric Medicaid recipients.

The organization contracts with three Medicaid managed care plans that retain a percentage of the Medicaid premium to provide claims processing, member relations, and other medical management functions. The hospital and physicians assume the business risk for clinical and financial outcomes.

The idea was to move away from the conventional fee-for-service model while improving access for children who might otherwise have difficulty finding a physician, said Dr. Steve Allen, chief executive officer for Nationwide. For example, Partners for Kids pays primary care physicians in rural areas an increased fee to keep their panels open for these Medicaid patients.

"We saw this as an opportunity to change the paradigm so that we could improve access," Dr. Allen said.

Officials at Nationwide Children's Hospital have conducted an analysis of the current ACO landscape and found that about a dozen institutions around the country are planning to develop or have launched some type of a pediatric ACO, with sizes ranging from 30,000 patients to Nationwide's high of 285,000. Most of the more developed models are among integrated delivery systems, he said.

One integrated system looking to become an ACO is University Hospitals in northeast Ohio, which includes the Rainbow Babies and Children's Hospital.

Participating in an ACO will mean shifting the system's focus from an acute, episodic care model to a prevention and wellness model, according to Dr. Eric Bieber, chief medical officer at University Hospitals Case Medical Center and Rainbow Babies and Children's Hospital.

"Health care in its present design is highly episodic. It doesn't relate one piece to the other," he said. Switching to an ACO model "is a transformational change in how care is going to be delivered."

There has been a lot of buzz around ACOs since the passage of the Affordable Care Act. The massive health reform law includes three sections with implications for forming ACOs. The section that has received the most attention is the Medicare shared-savings program, which will allow groups of providers to work together in treating patients and to share in any potential savings they achieve. That program is set to launch in January 2012.

ACOs may also end up being part of testing performed by the Center for Medicare and Medicaid Innovation, a new office created under the law. The innovation center has broad authority to test new payment ideas and will launch in January 2011. Finally, the Affordable Care Act includes a pediatric ACO demonstration project that allows states to recognize pediatric medical providers as ACOs and to award incentive payments through Medicaid. That project is also expected to launch in January 2012.

Since the passage of the Affordable Care Act, there's been a "flurry of activity" going on around the country, similar to what happened in the early 1990s around the growth of HMOs and capitation, said Dr. Crosson of the Kaiser Permanente Institute, who is also a pediatrician.

In the near term, there is likely to be a range of ACO models, Dr. Crosson predicted. Some will be tightly constructed around integrated delivery systems in which physicians and hospitals are part of the same economic entity. Other will be looser models that bring together a group of physicians and hospitals that are financially separate from one another, he said. The real question, Dr. Crosson noted, is not whether various models can be designed, but which ones will work best.

But he added that pediatricians will have a role, especially if they have had success in transitioning to a patient-centered medical home practice. The type of care coordination that happens at the individual practice level is the same type of capability a physician will need to be successful within an ACO. "I think there's room in this for virtually everyone to be in the game and try to get it to work."

As the ACO concept develops, pediatricians may find that they are getting a lot more attention from hospitals that are interested in developing closer, more collaborative relationships with them, said Dr. Allen of Nationwide Children's Hospital. "I think [pediatricians] are going to find themselves to be incredibly popular."

Naseem S. Miller contributed to this report.

Patients could gain greater access to their health information and have more power to limit disclosures of certain personal information to health plans under a new proposal from the Health and Human Services department.

The new requirements, which were announced in July, are aimed at beefing up privacy and security, as the Obama administration pushes to get more physicians using electronic health records over the next few years.

“The benefits of health IT can only be fully realized if patients and providers are confident that electronic health information is kept private and secure at all times,” Georgina Verdugo, director of the HHS Office for Civil Rights, said in a statement. “This proposed rule strengthens the privacy and security of health information, and is an integral piece of the administration's efforts to broaden the use of health information technology in health care today.”

The proposal alters the Health Insurance Portability and Accountability Act (HIPAA) rules by setting new limits on the use of disclosure of protected health information for marketing and fundraising and by requiring business associates of HIPAA-covered entities to follow most of the same rules that covered entities follow.

The proposal would also bar the sale of protected health information without explicit authorization from the patient.

The proposal also implements elements of the 2009 Health Information Technology for Economic and Clinical Health (HITECH) Act, which requires physicians and other covered entities to grant patient requests to restrict certain information from their health plans.

For example, the proposed rule states that patients must be allowed to restrict protected health information if that information is related only to a service for which the patient paid in full and the information is not otherwise required by law to be reported.

Individuals can provide comments on the rule for a period of 60 days, which began on July 14. Along with the release of the proposed regulation, HHS has also launched a new Web site (http://www.hhs.gov/healthprivacy/index.html

Patients could gain greater access to their health information and have more power to limit disclosures of certain personal information to health plans under a new proposal from the Health and Human Services department.

The new requirements, which were announced in July, are aimed at beefing up privacy and security, as the Obama administration pushes to get more physicians using electronic health records over the next few years.

“The benefits of health IT can only be fully realized if patients and providers are confident that electronic health information is kept private and secure at all times,” Georgina Verdugo, director of the HHS Office for Civil Rights, said in a statement. “This proposed rule strengthens the privacy and security of health information, and is an integral piece of the administration's efforts to broaden the use of health information technology in health care today.”

The proposal alters the Health Insurance Portability and Accountability Act (HIPAA) rules by setting new limits on the use of disclosure of protected health information for marketing and fundraising and by requiring business associates of HIPAA-covered entities to follow most of the same rules that covered entities follow.

The proposal would also bar the sale of protected health information without explicit authorization from the patient.

The proposal also implements elements of the 2009 Health Information Technology for Economic and Clinical Health (HITECH) Act, which requires physicians and other covered entities to grant patient requests to restrict certain information from their health plans.

For example, the proposed rule states that patients must be allowed to restrict protected health information if that information is related only to a service for which the patient paid in full and the information is not otherwise required by law to be reported.

Individuals can provide comments on the rule for a period of 60 days, which began on July 14. Along with the release of the proposed regulation, HHS has also launched a new Web site (http://www.hhs.gov/healthprivacy/index.html

Patients could gain greater access to their health information and have more power to limit disclosures of certain personal information to health plans under a new proposal from the Health and Human Services department.

The new requirements, which were announced in July, are aimed at beefing up privacy and security, as the Obama administration pushes to get more physicians using electronic health records over the next few years.

“The benefits of health IT can only be fully realized if patients and providers are confident that electronic health information is kept private and secure at all times,” Georgina Verdugo, director of the HHS Office for Civil Rights, said in a statement. “This proposed rule strengthens the privacy and security of health information, and is an integral piece of the administration's efforts to broaden the use of health information technology in health care today.”

The proposal alters the Health Insurance Portability and Accountability Act (HIPAA) rules by setting new limits on the use of disclosure of protected health information for marketing and fundraising and by requiring business associates of HIPAA-covered entities to follow most of the same rules that covered entities follow.

The proposal would also bar the sale of protected health information without explicit authorization from the patient.

The proposal also implements elements of the 2009 Health Information Technology for Economic and Clinical Health (HITECH) Act, which requires physicians and other covered entities to grant patient requests to restrict certain information from their health plans.

For example, the proposed rule states that patients must be allowed to restrict protected health information if that information is related only to a service for which the patient paid in full and the information is not otherwise required by law to be reported.

Individuals can provide comments on the rule for a period of 60 days, which began on July 14. Along with the release of the proposed regulation, HHS has also launched a new Web site (http://www.hhs.gov/healthprivacy/index.html

Dr. Lori Heim is anything but a typical hospitalist. She came to the field after working for many years as a family physician in the outpatient arena, and she now enjoys the chance to focus on quality and have time for interests outside of her own practice. And when Dr. Heim isn't in the hospital, she's likely at the airport, on her way to another meeting with lawmakers or physicians to discuss health reform, workforce issues, or the Medicare payment formula. As the current president of the American Academy of Family Physicians, Dr. Heim brings a unique perspective to her Laurinburg, N.C., hospital.

Dr. Heim is the first family physician to join the new hospital medicine program at Scotland Memorial Hospital. Currently, she practices alongside four internists and two family nurse practitioners as part of the growing program. Nationwide, family physicians are a minority in the hospitalist community. The Society of Hospital Medicine reports that fewer than 4% of hospitalists are trained in family medicine, compared with more than 80% of practicing hospitalists who were trained in general internal medicine. Similarly, only about 4% of AAFP members were working as hospitalists in 2009. Whether that indicates a lack of interest by hospitals or family physicians is unclear. But Dr. Heim said hospital medicine can be a good option for family physicians, even if it's not a career-long choice.

For some, it is simply a love of hospital medicine that drives the career choice. For others, it may represent a chance to get away from the administrative issues that plague many family physicians in private practice. And for others, it is a pragmatic way to get a better balance in their work and family lives, she said.

“I think what this shows is the incredible opportunity that [physicians] have within family medicine to tailor different parts of medicine, different focuses, at different times of their career,” she said.

For their part, family physicians can bring additional skills to the hospital medicine world. For example, hospital medicine groups with family physicians can expand the care they provide to children. And Dr. Heim said that when she is called to a medicine consult with obstetric and gynecology patients, she is glad for her broad-based training.

“I've dealt with a lot of the complications with regard to pregnancy and women's issues,” she said. “It's very familiar territory given our training.”

Dr. Heim said her own experience as a hospitalist over the last 18 months has really opened her eyes to systemwide issues that can result in poor outcomes for patients. Although family physicians often do a good job during the face-to-face visit, there aren't good systems to help patients outside that encounter, she said. And patients who can't get an appointment to see their regular doctor, or who don't have a regular physician, often end up hospitalized or readmitted.

But Dr. Heim is using her position as AAFP president to draw attention to some of these gaps in care. She tells lawmakers and the media about her firsthand experiences in the hospital, highlighting how conditions that can be cheaply and easily treated in the primary care setting, such as hypertension, can become expensive complications by the time they reach her in the hospital.

After her official leadership role with AAFP wraps up in a few years, Dr. Heim said she hopes to bring some of the innovative solutions she's seen while traveling around the country back to her North Carolina hospital. She looks forward to taking concrete steps on concepts like the medical home neighborhood, which envisions more coordinated patient care with roles for the hospital, the hospitalist, the primary care physician, subspecialists, and the community.

Hospital medicine can be a good option for family physicians, even if it's not a career-long choice.

Source Dr. Heim

Dr. Lori Heim is anything but a typical hospitalist. She came to the field after working for many years as a family physician in the outpatient arena, and she now enjoys the chance to focus on quality and have time for interests outside of her own practice. And when Dr. Heim isn't in the hospital, she's likely at the airport, on her way to another meeting with lawmakers or physicians to discuss health reform, workforce issues, or the Medicare payment formula. As the current president of the American Academy of Family Physicians, Dr. Heim brings a unique perspective to her Laurinburg, N.C., hospital.

Dr. Heim is the first family physician to join the new hospital medicine program at Scotland Memorial Hospital. Currently, she practices alongside four internists and two family nurse practitioners as part of the growing program. Nationwide, family physicians are a minority in the hospitalist community. The Society of Hospital Medicine reports that fewer than 4% of hospitalists are trained in family medicine, compared with more than 80% of practicing hospitalists who were trained in general internal medicine. Similarly, only about 4% of AAFP members were working as hospitalists in 2009. Whether that indicates a lack of interest by hospitals or family physicians is unclear. But Dr. Heim said hospital medicine can be a good option for family physicians, even if it's not a career-long choice.

For some, it is simply a love of hospital medicine that drives the career choice. For others, it may represent a chance to get away from the administrative issues that plague many family physicians in private practice. And for others, it is a pragmatic way to get a better balance in their work and family lives, she said.

“I think what this shows is the incredible opportunity that [physicians] have within family medicine to tailor different parts of medicine, different focuses, at different times of their career,” she said.

For their part, family physicians can bring additional skills to the hospital medicine world. For example, hospital medicine groups with family physicians can expand the care they provide to children. And Dr. Heim said that when she is called to a medicine consult with obstetric and gynecology patients, she is glad for her broad-based training.

“I've dealt with a lot of the complications with regard to pregnancy and women's issues,” she said. “It's very familiar territory given our training.”

Dr. Heim said her own experience as a hospitalist over the last 18 months has really opened her eyes to systemwide issues that can result in poor outcomes for patients. Although family physicians often do a good job during the face-to-face visit, there aren't good systems to help patients outside that encounter, she said. And patients who can't get an appointment to see their regular doctor, or who don't have a regular physician, often end up hospitalized or readmitted.

But Dr. Heim is using her position as AAFP president to draw attention to some of these gaps in care. She tells lawmakers and the media about her firsthand experiences in the hospital, highlighting how conditions that can be cheaply and easily treated in the primary care setting, such as hypertension, can become expensive complications by the time they reach her in the hospital.

After her official leadership role with AAFP wraps up in a few years, Dr. Heim said she hopes to bring some of the innovative solutions she's seen while traveling around the country back to her North Carolina hospital. She looks forward to taking concrete steps on concepts like the medical home neighborhood, which envisions more coordinated patient care with roles for the hospital, the hospitalist, the primary care physician, subspecialists, and the community.

Hospital medicine can be a good option for family physicians, even if it's not a career-long choice.

Source Dr. Heim

Dr. Lori Heim is anything but a typical hospitalist. She came to the field after working for many years as a family physician in the outpatient arena, and she now enjoys the chance to focus on quality and have time for interests outside of her own practice. And when Dr. Heim isn't in the hospital, she's likely at the airport, on her way to another meeting with lawmakers or physicians to discuss health reform, workforce issues, or the Medicare payment formula. As the current president of the American Academy of Family Physicians, Dr. Heim brings a unique perspective to her Laurinburg, N.C., hospital.

Dr. Heim is the first family physician to join the new hospital medicine program at Scotland Memorial Hospital. Currently, she practices alongside four internists and two family nurse practitioners as part of the growing program. Nationwide, family physicians are a minority in the hospitalist community. The Society of Hospital Medicine reports that fewer than 4% of hospitalists are trained in family medicine, compared with more than 80% of practicing hospitalists who were trained in general internal medicine. Similarly, only about 4% of AAFP members were working as hospitalists in 2009. Whether that indicates a lack of interest by hospitals or family physicians is unclear. But Dr. Heim said hospital medicine can be a good option for family physicians, even if it's not a career-long choice.

For some, it is simply a love of hospital medicine that drives the career choice. For others, it may represent a chance to get away from the administrative issues that plague many family physicians in private practice. And for others, it is a pragmatic way to get a better balance in their work and family lives, she said.

“I think what this shows is the incredible opportunity that [physicians] have within family medicine to tailor different parts of medicine, different focuses, at different times of their career,” she said.

For their part, family physicians can bring additional skills to the hospital medicine world. For example, hospital medicine groups with family physicians can expand the care they provide to children. And Dr. Heim said that when she is called to a medicine consult with obstetric and gynecology patients, she is glad for her broad-based training.

“I've dealt with a lot of the complications with regard to pregnancy and women's issues,” she said. “It's very familiar territory given our training.”

Dr. Heim said her own experience as a hospitalist over the last 18 months has really opened her eyes to systemwide issues that can result in poor outcomes for patients. Although family physicians often do a good job during the face-to-face visit, there aren't good systems to help patients outside that encounter, she said. And patients who can't get an appointment to see their regular doctor, or who don't have a regular physician, often end up hospitalized or readmitted.

But Dr. Heim is using her position as AAFP president to draw attention to some of these gaps in care. She tells lawmakers and the media about her firsthand experiences in the hospital, highlighting how conditions that can be cheaply and easily treated in the primary care setting, such as hypertension, can become expensive complications by the time they reach her in the hospital.

After her official leadership role with AAFP wraps up in a few years, Dr. Heim said she hopes to bring some of the innovative solutions she's seen while traveling around the country back to her North Carolina hospital. She looks forward to taking concrete steps on concepts like the medical home neighborhood, which envisions more coordinated patient care with roles for the hospital, the hospitalist, the primary care physician, subspecialists, and the community.

Hospital medicine can be a good option for family physicians, even if it's not a career-long choice.

Source Dr. Heim

The American College of Obstetricians and Gynecologists has endorsed federal recommendations to routinely vaccinate girls 11-12 years old against the human papillomavirus using either the quadrivalent or bivalent vaccines.

Echoing the advice of the Advisory Committee on Immunization Practices, ACOG officials said the vaccine can be given to girls as young as 9 years old and that catch-up vaccination should be offered through age 26 years. ACOG outlined its position in the September issue of Obstetrics & Gynecology (2010;116:800-3).

Although ob.gyns. are unlikely to care for girls in the initial vaccination group, ACOG said that ob.gyns. should offer the vaccine to girls in the catch-up group and routinely document human papillomavirus (HPV) vaccine status in the patient’s record.

Two HPV vaccines are currently licensed by the Food and Drug Administration for sale in the United States. Merck’s Gardasil, which is offered as a three-dose course, is a quadrivalent vaccine that provides protection against cervical cancer, cervical dysplasias, vulvar and vaginal dysplasias, and genital warts associated with HPV genotypes 6, 11, 16, and 18.

Last year, the FDA approved the bivalent HPV vaccine Cervarix. This new vaccine, marketed by GlaxoSmithKline, is also offered as a three-dose course and is thought to provide protection similar to that of Gardasil for infections caused by the HPV genotypes 16 and 18. About 70% of all cervical cancer cases are associated with HPV genotypes 16 and 18, and about 90% of genital warts are associated with the HPV genotypes 6 and 11, according to the Centers for Disease Control and Prevention.

In the policy statement issued by ACOG’s Committee on Adolescent Health Care, the organization urged girls to get vaccinated before they are sexually active. “The ideal time for girls to receive the HPV vaccination is before they become sexually active and become exposed to HPV,” Dr. Diane F. Merritt, chair of the committee, said in a statement. “For those already sexually active, we also recommend the HPV vaccination for adolescents and young women up to age 26.”

Dr. Merritt said physicians should counsel patients that the HPV vaccine may be less effective if they have already been exposed to the virus.

ACOG does not recommend that girls and women be tested for HPV before they are vaccinated. Serologic assays to test for HPV DNA are unreliable and aren’t currently commercially available, according to the organization. “More importantly, it’s unlikely that someone would have been exposed to all of the HPV strains that the vaccines protect against, so testing is somewhat pointless,” Dr. Merritt said.

But women should have routine cervical cytology screening, according to ACOG. The organization said cervical cancer screening is needed in all women aged 21 years and older, even if they received the HPV vaccine before becoming sexually active.

HPV vaccination is not recommended during pregnancy, but physicians do not need to routinely perform pregnancy testing before giving the vaccine, according to ACOG. Instead, ACOG officials advised physicians to remind their patients to use contraception while they are receiving the vaccine series. If a woman becomes pregnant while receiving the vaccine, the series should be delayed until the end of the pregnancy. The vaccine is safe for breast-feeding women, ACOG said, because the virus it contains is inactive.

The American College of Obstetricians and Gynecologists has endorsed federal recommendations to routinely vaccinate girls 11-12 years old against the human papillomavirus using either the quadrivalent or bivalent vaccines.

Echoing the advice of the Advisory Committee on Immunization Practices, ACOG officials said the vaccine can be given to girls as young as 9 years old and that catch-up vaccination should be offered through age 26 years. ACOG outlined its position in the September issue of Obstetrics & Gynecology (2010;116:800-3).

Although ob.gyns. are unlikely to care for girls in the initial vaccination group, ACOG said that ob.gyns. should offer the vaccine to girls in the catch-up group and routinely document human papillomavirus (HPV) vaccine status in the patient’s record.

Two HPV vaccines are currently licensed by the Food and Drug Administration for sale in the United States. Merck’s Gardasil, which is offered as a three-dose course, is a quadrivalent vaccine that provides protection against cervical cancer, cervical dysplasias, vulvar and vaginal dysplasias, and genital warts associated with HPV genotypes 6, 11, 16, and 18.

Last year, the FDA approved the bivalent HPV vaccine Cervarix. This new vaccine, marketed by GlaxoSmithKline, is also offered as a three-dose course and is thought to provide protection similar to that of Gardasil for infections caused by the HPV genotypes 16 and 18. About 70% of all cervical cancer cases are associated with HPV genotypes 16 and 18, and about 90% of genital warts are associated with the HPV genotypes 6 and 11, according to the Centers for Disease Control and Prevention.

In the policy statement issued by ACOG’s Committee on Adolescent Health Care, the organization urged girls to get vaccinated before they are sexually active. “The ideal time for girls to receive the HPV vaccination is before they become sexually active and become exposed to HPV,” Dr. Diane F. Merritt, chair of the committee, said in a statement. “For those already sexually active, we also recommend the HPV vaccination for adolescents and young women up to age 26.”

Dr. Merritt said physicians should counsel patients that the HPV vaccine may be less effective if they have already been exposed to the virus.

ACOG does not recommend that girls and women be tested for HPV before they are vaccinated. Serologic assays to test for HPV DNA are unreliable and aren’t currently commercially available, according to the organization. “More importantly, it’s unlikely that someone would have been exposed to all of the HPV strains that the vaccines protect against, so testing is somewhat pointless,” Dr. Merritt said.

But women should have routine cervical cytology screening, according to ACOG. The organization said cervical cancer screening is needed in all women aged 21 years and older, even if they received the HPV vaccine before becoming sexually active.

HPV vaccination is not recommended during pregnancy, but physicians do not need to routinely perform pregnancy testing before giving the vaccine, according to ACOG. Instead, ACOG officials advised physicians to remind their patients to use contraception while they are receiving the vaccine series. If a woman becomes pregnant while receiving the vaccine, the series should be delayed until the end of the pregnancy. The vaccine is safe for breast-feeding women, ACOG said, because the virus it contains is inactive.

The American College of Obstetricians and Gynecologists has endorsed federal recommendations to routinely vaccinate girls 11-12 years old against the human papillomavirus using either the quadrivalent or bivalent vaccines.

Echoing the advice of the Advisory Committee on Immunization Practices, ACOG officials said the vaccine can be given to girls as young as 9 years old and that catch-up vaccination should be offered through age 26 years. ACOG outlined its position in the September issue of Obstetrics & Gynecology (2010;116:800-3).

Although ob.gyns. are unlikely to care for girls in the initial vaccination group, ACOG said that ob.gyns. should offer the vaccine to girls in the catch-up group and routinely document human papillomavirus (HPV) vaccine status in the patient’s record.

Two HPV vaccines are currently licensed by the Food and Drug Administration for sale in the United States. Merck’s Gardasil, which is offered as a three-dose course, is a quadrivalent vaccine that provides protection against cervical cancer, cervical dysplasias, vulvar and vaginal dysplasias, and genital warts associated with HPV genotypes 6, 11, 16, and 18.

Last year, the FDA approved the bivalent HPV vaccine Cervarix. This new vaccine, marketed by GlaxoSmithKline, is also offered as a three-dose course and is thought to provide protection similar to that of Gardasil for infections caused by the HPV genotypes 16 and 18. About 70% of all cervical cancer cases are associated with HPV genotypes 16 and 18, and about 90% of genital warts are associated with the HPV genotypes 6 and 11, according to the Centers for Disease Control and Prevention.

In the policy statement issued by ACOG’s Committee on Adolescent Health Care, the organization urged girls to get vaccinated before they are sexually active. “The ideal time for girls to receive the HPV vaccination is before they become sexually active and become exposed to HPV,” Dr. Diane F. Merritt, chair of the committee, said in a statement. “For those already sexually active, we also recommend the HPV vaccination for adolescents and young women up to age 26.”

Dr. Merritt said physicians should counsel patients that the HPV vaccine may be less effective if they have already been exposed to the virus.

ACOG does not recommend that girls and women be tested for HPV before they are vaccinated. Serologic assays to test for HPV DNA are unreliable and aren’t currently commercially available, according to the organization. “More importantly, it’s unlikely that someone would have been exposed to all of the HPV strains that the vaccines protect against, so testing is somewhat pointless,” Dr. Merritt said.

But women should have routine cervical cytology screening, according to ACOG. The organization said cervical cancer screening is needed in all women aged 21 years and older, even if they received the HPV vaccine before becoming sexually active.

HPV vaccination is not recommended during pregnancy, but physicians do not need to routinely perform pregnancy testing before giving the vaccine, according to ACOG. Instead, ACOG officials advised physicians to remind their patients to use contraception while they are receiving the vaccine series. If a woman becomes pregnant while receiving the vaccine, the series should be delayed until the end of the pregnancy. The vaccine is safe for breast-feeding women, ACOG said, because the virus it contains is inactive.

Some researchers studying human embryonic stem cells are surprised, disappointed, and even angry after a federal judge temporarily blocked the federal government from funding research using the cells.

The ruling, which was handed down on Aug. 23, bars the use of federal funds for any research involving human embryonic stem cells. As a result of the temporary injunction, the National Institutes of Health has stopped accepting submissions of information on human embryonic stem cell lines for NIH review and has also suspended all review of embryonic stem cell lines. It had not been confirmed at press time whether the Obama administration would appeal the court decision.

Last year, President Obama greatly expanded opportunities to receive federal funding for embryonic stem cell research when he issued an executive order that eliminated many of the restrictions placed funding during the George W. Bush administration. The NIH followed with guidelines that allowed research to be conducted on embryonic stem cells derived from embryos created through in vitro fertilization and donated for research.

With the recent court decision, some researchers worry that the development of therapies that use embryonic stem cells will be set back and that the loss of federal funding will have a chilling effect on newly minted researchers who are considering whether to enter the field.

The Coalition for the Advancement of Medical Research, which advocates for stem cell funding, called the injunction a “blow to the hopes of millions of patients and their families suffering from fatal and chronic diseases and disorders.”

The halt on funding for research using embryonic stem cells has implications on all types of stem cell research, said Alan Trounson, Ph.D., president of the California Institute for Regenerative Medicine, which issues grants to researchers in California who use state funds. “The decision is a deplorable brake on all stem cell research,” he said in a statement. “Many discoveries with other cell types, notably the so-called reprogrammed [induced Pluripotent Stem] cells, would not happen without ongoing research in human embryonic stem cells.”

Dr. Trounson said the California institute’s funding plans would not be affected by the federal court decision. Institutions that have obtained private funding for their stem cell work will also be able to continue their work.

However, even those with deep pockets are concerned that private funding alone is not enough. “It’s a blow to us,” said B.D. Colen, a spokesman for the Harvard Stem Cell Institute. “It’s a blow to the field.”

The institute, a collaborative of stem cell researchers from around Massachusetts, has raised about $120 million in private funds since its founding 2004, but those sources are not unlimited, Mr. Colen said. The loss of federal funding that was expected to go to the institute’s researchers will be disruptive, he said, and the impact will be worse for those researchers who do not have private funding sources to fall back on.

Another source of concern for researchers has to do with the legal issues involved in the case. An earlier lawsuit challenging the Obama stem cell guidelines had been dismissed after the court ruled that the plaintiffs had no standing to challenge it. However, the recent injunction came about after the court decided that two researchers who work with adult stem cells could challenge the guidelines because funding of embryonic stem cell research was harming their chances for receiving federal funds for adult stem cells.

“This judge opens the door for every scientist who ever has a grant request rejected on the merits to sue the federal government,” the American Society for Reproductive Medicine said in a statement condemning the court decision.

In granting the temporary injunction, Judge Royce C. Lamberth, the chief judge in the U.S. District Court for the District of Columbia, said the NIH guidelines violated the intent of Congress to bar the use of federal funds for research in which human embryos are destroyed. He said the rules violated the Dickey-Wicker amendment, a rider generally attached to health spending bills each year. It prohibits the use of federal funds for the creation of a human embryo or embryos for research purposes or research in which a human embryo or embryos are destroyed or discarded. However, the Obama administration has argued that the amendment doesn’t apply because federal funds are used for research on the embryonic stem cell lines, not in the destruction of the embryos.

Judge Lamberth did not find the argument persuasive. “[Embryonic stem cell] research is clearly research in which an embryo is destroyed,” he wrote in the order. “Despite defendants’ attempt to separate the derivation of [embryonic stem cells] from research on the [embryonic stem cells], the two cannot be separated.”

Some researchers studying human embryonic stem cells are surprised, disappointed, and even angry after a federal judge temporarily blocked the federal government from funding research using the cells.

The ruling, which was handed down on Aug. 23, bars the use of federal funds for any research involving human embryonic stem cells. As a result of the temporary injunction, the National Institutes of Health has stopped accepting submissions of information on human embryonic stem cell lines for NIH review and has also suspended all review of embryonic stem cell lines. It had not been confirmed at press time whether the Obama administration would appeal the court decision.

Last year, President Obama greatly expanded opportunities to receive federal funding for embryonic stem cell research when he issued an executive order that eliminated many of the restrictions placed funding during the George W. Bush administration. The NIH followed with guidelines that allowed research to be conducted on embryonic stem cells derived from embryos created through in vitro fertilization and donated for research.

With the recent court decision, some researchers worry that the development of therapies that use embryonic stem cells will be set back and that the loss of federal funding will have a chilling effect on newly minted researchers who are considering whether to enter the field.

The Coalition for the Advancement of Medical Research, which advocates for stem cell funding, called the injunction a “blow to the hopes of millions of patients and their families suffering from fatal and chronic diseases and disorders.”

The halt on funding for research using embryonic stem cells has implications on all types of stem cell research, said Alan Trounson, Ph.D., president of the California Institute for Regenerative Medicine, which issues grants to researchers in California who use state funds. “The decision is a deplorable brake on all stem cell research,” he said in a statement. “Many discoveries with other cell types, notably the so-called reprogrammed [induced Pluripotent Stem] cells, would not happen without ongoing research in human embryonic stem cells.”

Dr. Trounson said the California institute’s funding plans would not be affected by the federal court decision. Institutions that have obtained private funding for their stem cell work will also be able to continue their work.

However, even those with deep pockets are concerned that private funding alone is not enough. “It’s a blow to us,” said B.D. Colen, a spokesman for the Harvard Stem Cell Institute. “It’s a blow to the field.”

The institute, a collaborative of stem cell researchers from around Massachusetts, has raised about $120 million in private funds since its founding 2004, but those sources are not unlimited, Mr. Colen said. The loss of federal funding that was expected to go to the institute’s researchers will be disruptive, he said, and the impact will be worse for those researchers who do not have private funding sources to fall back on.

Another source of concern for researchers has to do with the legal issues involved in the case. An earlier lawsuit challenging the Obama stem cell guidelines had been dismissed after the court ruled that the plaintiffs had no standing to challenge it. However, the recent injunction came about after the court decided that two researchers who work with adult stem cells could challenge the guidelines because funding of embryonic stem cell research was harming their chances for receiving federal funds for adult stem cells.

“This judge opens the door for every scientist who ever has a grant request rejected on the merits to sue the federal government,” the American Society for Reproductive Medicine said in a statement condemning the court decision.

In granting the temporary injunction, Judge Royce C. Lamberth, the chief judge in the U.S. District Court for the District of Columbia, said the NIH guidelines violated the intent of Congress to bar the use of federal funds for research in which human embryos are destroyed. He said the rules violated the Dickey-Wicker amendment, a rider generally attached to health spending bills each year. It prohibits the use of federal funds for the creation of a human embryo or embryos for research purposes or research in which a human embryo or embryos are destroyed or discarded. However, the Obama administration has argued that the amendment doesn’t apply because federal funds are used for research on the embryonic stem cell lines, not in the destruction of the embryos.

Judge Lamberth did not find the argument persuasive. “[Embryonic stem cell] research is clearly research in which an embryo is destroyed,” he wrote in the order. “Despite defendants’ attempt to separate the derivation of [embryonic stem cells] from research on the [embryonic stem cells], the two cannot be separated.”

Some researchers studying human embryonic stem cells are surprised, disappointed, and even angry after a federal judge temporarily blocked the federal government from funding research using the cells.

The ruling, which was handed down on Aug. 23, bars the use of federal funds for any research involving human embryonic stem cells. As a result of the temporary injunction, the National Institutes of Health has stopped accepting submissions of information on human embryonic stem cell lines for NIH review and has also suspended all review of embryonic stem cell lines. It had not been confirmed at press time whether the Obama administration would appeal the court decision.

Last year, President Obama greatly expanded opportunities to receive federal funding for embryonic stem cell research when he issued an executive order that eliminated many of the restrictions placed funding during the George W. Bush administration. The NIH followed with guidelines that allowed research to be conducted on embryonic stem cells derived from embryos created through in vitro fertilization and donated for research.

With the recent court decision, some researchers worry that the development of therapies that use embryonic stem cells will be set back and that the loss of federal funding will have a chilling effect on newly minted researchers who are considering whether to enter the field.

The Coalition for the Advancement of Medical Research, which advocates for stem cell funding, called the injunction a “blow to the hopes of millions of patients and their families suffering from fatal and chronic diseases and disorders.”

The halt on funding for research using embryonic stem cells has implications on all types of stem cell research, said Alan Trounson, Ph.D., president of the California Institute for Regenerative Medicine, which issues grants to researchers in California who use state funds. “The decision is a deplorable brake on all stem cell research,” he said in a statement. “Many discoveries with other cell types, notably the so-called reprogrammed [induced Pluripotent Stem] cells, would not happen without ongoing research in human embryonic stem cells.”

Dr. Trounson said the California institute’s funding plans would not be affected by the federal court decision. Institutions that have obtained private funding for their stem cell work will also be able to continue their work.

However, even those with deep pockets are concerned that private funding alone is not enough. “It’s a blow to us,” said B.D. Colen, a spokesman for the Harvard Stem Cell Institute. “It’s a blow to the field.”

The institute, a collaborative of stem cell researchers from around Massachusetts, has raised about $120 million in private funds since its founding 2004, but those sources are not unlimited, Mr. Colen said. The loss of federal funding that was expected to go to the institute’s researchers will be disruptive, he said, and the impact will be worse for those researchers who do not have private funding sources to fall back on.

Another source of concern for researchers has to do with the legal issues involved in the case. An earlier lawsuit challenging the Obama stem cell guidelines had been dismissed after the court ruled that the plaintiffs had no standing to challenge it. However, the recent injunction came about after the court decided that two researchers who work with adult stem cells could challenge the guidelines because funding of embryonic stem cell research was harming their chances for receiving federal funds for adult stem cells.

“This judge opens the door for every scientist who ever has a grant request rejected on the merits to sue the federal government,” the American Society for Reproductive Medicine said in a statement condemning the court decision.

In granting the temporary injunction, Judge Royce C. Lamberth, the chief judge in the U.S. District Court for the District of Columbia, said the NIH guidelines violated the intent of Congress to bar the use of federal funds for research in which human embryos are destroyed. He said the rules violated the Dickey-Wicker amendment, a rider generally attached to health spending bills each year. It prohibits the use of federal funds for the creation of a human embryo or embryos for research purposes or research in which a human embryo or embryos are destroyed or discarded. However, the Obama administration has argued that the amendment doesn’t apply because federal funds are used for research on the embryonic stem cell lines, not in the destruction of the embryos.

Judge Lamberth did not find the argument persuasive. “[Embryonic stem cell] research is clearly research in which an embryo is destroyed,” he wrote in the order. “Despite defendants’ attempt to separate the derivation of [embryonic stem cells] from research on the [embryonic stem cells], the two cannot be separated.”

The heat is a serious hazard for teenage athletes that each year results in more than 9,000 illnesses nationwide, according to a heat illness analysis from the Centers for Disease Control and Prevention.

Nearly 71% of those heat-related illnesses occurred among high school football players. They experienced time-loss heat illness – dehydration, heat exhaustion, or heat stroke that resulted in at least 1 day of missed sports – about 4.5 times per 100,000 athlete exposures. That rate is 10 times greater than the average rate for eight other common high school sports. Football players also were more likely to experience a heat-related illness if they were overweight or obese. About 37% of high school football players who were affected by the heat were overweight, and nearly 28% were obese, according to the CDC.

The study, which is the first to report national estimates for time-loss heat illness among high school athletes, was published Aug. 19 in the Morbidity and Mortality Weekly Report (MMWR 2010; 59:1009-13). The researchers used information from the National High School Sports-Related Injury Surveillance Study and specifically analyzed data on 100 high schools from 2005 to 2009. The researchers used those data to produce national estimates.

Many high schools begin preseason sports training in August, which appeared to be the worst month for heat-related illnesses among teen athletes: 66% of illnesses occurring in that month. Time-loss heat illnesses also were more likely to occur during practice than competition, although that is likely because teams spend more time practicing in August, the researchers noted.

The heat-loss illness estimates are conservative and might underestimate the risk to teenage athletes, the investigators said, because the data don’t include heat illnesses in which an athlete was cleared to return to practice the next day. The study also was limited to nine sports and included only schools with certified athletic trainers who were affiliated with the National Athletic Trainers’ Association (NATA).

The researchers urged athletes and coaches to heed existing recommendations from NATA for preventing and treating heat-related illnesses. Those include providing a 14-day acclimatization period during warm-weather sports training, in which the frequency, duration, and intensity of training is increased gradually.

NATA also recommends that athletes be educated about heat-related illnesses and the need for proper hydration before, during, and after sports.

The heat is a serious hazard for teenage athletes that each year results in more than 9,000 illnesses nationwide, according to a heat illness analysis from the Centers for Disease Control and Prevention.

Nearly 71% of those heat-related illnesses occurred among high school football players. They experienced time-loss heat illness – dehydration, heat exhaustion, or heat stroke that resulted in at least 1 day of missed sports – about 4.5 times per 100,000 athlete exposures. That rate is 10 times greater than the average rate for eight other common high school sports. Football players also were more likely to experience a heat-related illness if they were overweight or obese. About 37% of high school football players who were affected by the heat were overweight, and nearly 28% were obese, according to the CDC.

The study, which is the first to report national estimates for time-loss heat illness among high school athletes, was published Aug. 19 in the Morbidity and Mortality Weekly Report (MMWR 2010; 59:1009-13). The researchers used information from the National High School Sports-Related Injury Surveillance Study and specifically analyzed data on 100 high schools from 2005 to 2009. The researchers used those data to produce national estimates.

Many high schools begin preseason sports training in August, which appeared to be the worst month for heat-related illnesses among teen athletes: 66% of illnesses occurring in that month. Time-loss heat illnesses also were more likely to occur during practice than competition, although that is likely because teams spend more time practicing in August, the researchers noted.

The heat-loss illness estimates are conservative and might underestimate the risk to teenage athletes, the investigators said, because the data don’t include heat illnesses in which an athlete was cleared to return to practice the next day. The study also was limited to nine sports and included only schools with certified athletic trainers who were affiliated with the National Athletic Trainers’ Association (NATA).

The researchers urged athletes and coaches to heed existing recommendations from NATA for preventing and treating heat-related illnesses. Those include providing a 14-day acclimatization period during warm-weather sports training, in which the frequency, duration, and intensity of training is increased gradually.

NATA also recommends that athletes be educated about heat-related illnesses and the need for proper hydration before, during, and after sports.

The heat is a serious hazard for teenage athletes that each year results in more than 9,000 illnesses nationwide, according to a heat illness analysis from the Centers for Disease Control and Prevention.

Nearly 71% of those heat-related illnesses occurred among high school football players. They experienced time-loss heat illness – dehydration, heat exhaustion, or heat stroke that resulted in at least 1 day of missed sports – about 4.5 times per 100,000 athlete exposures. That rate is 10 times greater than the average rate for eight other common high school sports. Football players also were more likely to experience a heat-related illness if they were overweight or obese. About 37% of high school football players who were affected by the heat were overweight, and nearly 28% were obese, according to the CDC.

The study, which is the first to report national estimates for time-loss heat illness among high school athletes, was published Aug. 19 in the Morbidity and Mortality Weekly Report (MMWR 2010; 59:1009-13). The researchers used information from the National High School Sports-Related Injury Surveillance Study and specifically analyzed data on 100 high schools from 2005 to 2009. The researchers used those data to produce national estimates.

Many high schools begin preseason sports training in August, which appeared to be the worst month for heat-related illnesses among teen athletes: 66% of illnesses occurring in that month. Time-loss heat illnesses also were more likely to occur during practice than competition, although that is likely because teams spend more time practicing in August, the researchers noted.

The heat-loss illness estimates are conservative and might underestimate the risk to teenage athletes, the investigators said, because the data don’t include heat illnesses in which an athlete was cleared to return to practice the next day. The study also was limited to nine sports and included only schools with certified athletic trainers who were affiliated with the National Athletic Trainers’ Association (NATA).

The researchers urged athletes and coaches to heed existing recommendations from NATA for preventing and treating heat-related illnesses. Those include providing a 14-day acclimatization period during warm-weather sports training, in which the frequency, duration, and intensity of training is increased gradually.

NATA also recommends that athletes be educated about heat-related illnesses and the need for proper hydration before, during, and after sports.

Provisions of the new Affordable Care Act, coupled with other payment changes, will save Medicare nearly $8 billion over 2 years and extend the solvency of the Medicare Trust Funds by 12 years, according to a new report from the Centers for Medicare and Medicaid Services.

The immediate savings come from cuts to Medicare Advantage payments, competitive bidding for durable medical equipment, changes to how Medicare pays for advanced imaging services, productivity improvements in the hospital, and efforts to reduce waste, fraud, and abuse. These changes are expected to save $7.8 billion for the Medicare program by the end of next year.

The report, issued Aug. 2, analyzes cost-cutting provisions that CMS has already implemented or will be implementing soon.

“For too long, we’ve paid too much for health care, gotten too little in return, and watched the situation get worse each and every year,” Health and Human Services Secretary Kathleen Sebelius said at a press conference to release the report. “The Affordable Care Act is already putting our health care system on a new course, bringing down costs while improving the quality of care and giving all Americans more value for their dollars.”

Ms. Sebelius noted that the new law will protect Medicare beneficiaries by maintaining current benefits and adding new ones such as free preventive care and the eventually closing the Medicare Part D prescription drug doughnut hole.

Over the long-term, CMS officials estimate that Medicare savings will exceed $418 billion by 2019. Some of those savings will come from reducing hospital readmissions and hospital-acquired infections, bundling payments for end-stage renal disease care, promoting Accountable Care Organizations, and improving quality reporting by physicians. CMS also expects the establishment of the Independent Payment Advisory Board, which will recommend payment changes aimed at slowing growth in Medicare spending, to contribute to those savings by cutting Medicare costs by about $23 billion by 2019.

Ms. Sebelius said she expects private insurers to follow the federal government’s lead in implementing some of these payment changes as they prove effective in the Medicare program.

Provisions of the new Affordable Care Act, coupled with other payment changes, will save Medicare nearly $8 billion over 2 years and extend the solvency of the Medicare Trust Funds by 12 years, according to a new report from the Centers for Medicare and Medicaid Services.

The immediate savings come from cuts to Medicare Advantage payments, competitive bidding for durable medical equipment, changes to how Medicare pays for advanced imaging services, productivity improvements in the hospital, and efforts to reduce waste, fraud, and abuse. These changes are expected to save $7.8 billion for the Medicare program by the end of next year.

The report, issued Aug. 2, analyzes cost-cutting provisions that CMS has already implemented or will be implementing soon.

“For too long, we’ve paid too much for health care, gotten too little in return, and watched the situation get worse each and every year,” Health and Human Services Secretary Kathleen Sebelius said at a press conference to release the report. “The Affordable Care Act is already putting our health care system on a new course, bringing down costs while improving the quality of care and giving all Americans more value for their dollars.”

Ms. Sebelius noted that the new law will protect Medicare beneficiaries by maintaining current benefits and adding new ones such as free preventive care and the eventually closing the Medicare Part D prescription drug doughnut hole.

Over the long-term, CMS officials estimate that Medicare savings will exceed $418 billion by 2019. Some of those savings will come from reducing hospital readmissions and hospital-acquired infections, bundling payments for end-stage renal disease care, promoting Accountable Care Organizations, and improving quality reporting by physicians. CMS also expects the establishment of the Independent Payment Advisory Board, which will recommend payment changes aimed at slowing growth in Medicare spending, to contribute to those savings by cutting Medicare costs by about $23 billion by 2019.

Ms. Sebelius said she expects private insurers to follow the federal government’s lead in implementing some of these payment changes as they prove effective in the Medicare program.

Provisions of the new Affordable Care Act, coupled with other payment changes, will save Medicare nearly $8 billion over 2 years and extend the solvency of the Medicare Trust Funds by 12 years, according to a new report from the Centers for Medicare and Medicaid Services.

The immediate savings come from cuts to Medicare Advantage payments, competitive bidding for durable medical equipment, changes to how Medicare pays for advanced imaging services, productivity improvements in the hospital, and efforts to reduce waste, fraud, and abuse. These changes are expected to save $7.8 billion for the Medicare program by the end of next year.

The report, issued Aug. 2, analyzes cost-cutting provisions that CMS has already implemented or will be implementing soon.

“For too long, we’ve paid too much for health care, gotten too little in return, and watched the situation get worse each and every year,” Health and Human Services Secretary Kathleen Sebelius said at a press conference to release the report. “The Affordable Care Act is already putting our health care system on a new course, bringing down costs while improving the quality of care and giving all Americans more value for their dollars.”

Ms. Sebelius noted that the new law will protect Medicare beneficiaries by maintaining current benefits and adding new ones such as free preventive care and the eventually closing the Medicare Part D prescription drug doughnut hole.

Over the long-term, CMS officials estimate that Medicare savings will exceed $418 billion by 2019. Some of those savings will come from reducing hospital readmissions and hospital-acquired infections, bundling payments for end-stage renal disease care, promoting Accountable Care Organizations, and improving quality reporting by physicians. CMS also expects the establishment of the Independent Payment Advisory Board, which will recommend payment changes aimed at slowing growth in Medicare spending, to contribute to those savings by cutting Medicare costs by about $23 billion by 2019.

Ms. Sebelius said she expects private insurers to follow the federal government’s lead in implementing some of these payment changes as they prove effective in the Medicare program.

Provisions of the new Affordable Care Act, coupled with other payment changes, will save Medicare nearly $8 billion over 2 years and extend the solvency of the Medicare Trust Funds by 12 years, according to a new report from the Centers for Medicare and Medicaid Services.

The immediate savings come from cuts to Medicare Advantage payments, competitive bidding for durable medical equipment, changes to how Medicare pays for advanced imaging services, productivity improvements in the hospital, and efforts to reduce waste, fraud, and abuse. These changes are expected to save $7.8 billion for the Medicare program by the end of next year.

The report, issued Aug. 2, analyzes cost-cutting provisions that CMS has already implemented or will be implementing soon.

"For too long, we’ve paid too much for health care, gotten too little in return, and watched the situation get worse each and every year," Health and Human Services Secretary Kathleen Sebelius said at a press conference to release the report. "The Affordable Care Act is already putting our health care system on a new course, bringing down costs while improving the quality of care and giving all Americans more value for their dollars."

Ms. Sebelius noted that the new law will protect Medicare beneficiaries by maintaining current benefits and adding new ones such as free preventive care and the eventually closing the Medicare Part D prescription drug doughnut hole.

Over the long-term, CMS officials estimate that Medicare savings will exceed $418 billion by 2019. Some of those savings will come from reducing hospital readmissions and hospital-acquired infections, bundling payments for end-stage renal disease care, promoting Accountable Care Organizations, and improving quality reporting by physicians.

CMS also expects the establishment of the Independent Payment Advisory Board, which will recommend payment changes aimed at slowing growth in Medicare spending, to contribute to those savings by cutting Medicare costs by about $23 billion by 2019.

Ms. Sebelius said she expects private insurers to follow the federal government’s lead in implementing some of these payment changes as they prove effective in the Medicare program.

Provisions of the new Affordable Care Act, coupled with other payment changes, will save Medicare nearly $8 billion over 2 years and extend the solvency of the Medicare Trust Funds by 12 years, according to a new report from the Centers for Medicare and Medicaid Services.

The immediate savings come from cuts to Medicare Advantage payments, competitive bidding for durable medical equipment, changes to how Medicare pays for advanced imaging services, productivity improvements in the hospital, and efforts to reduce waste, fraud, and abuse. These changes are expected to save $7.8 billion for the Medicare program by the end of next year.

The report, issued Aug. 2, analyzes cost-cutting provisions that CMS has already implemented or will be implementing soon.

"For too long, we’ve paid too much for health care, gotten too little in return, and watched the situation get worse each and every year," Health and Human Services Secretary Kathleen Sebelius said at a press conference to release the report. "The Affordable Care Act is already putting our health care system on a new course, bringing down costs while improving the quality of care and giving all Americans more value for their dollars."

Ms. Sebelius noted that the new law will protect Medicare beneficiaries by maintaining current benefits and adding new ones such as free preventive care and the eventually closing the Medicare Part D prescription drug doughnut hole.

Over the long-term, CMS officials estimate that Medicare savings will exceed $418 billion by 2019. Some of those savings will come from reducing hospital readmissions and hospital-acquired infections, bundling payments for end-stage renal disease care, promoting Accountable Care Organizations, and improving quality reporting by physicians.

CMS also expects the establishment of the Independent Payment Advisory Board, which will recommend payment changes aimed at slowing growth in Medicare spending, to contribute to those savings by cutting Medicare costs by about $23 billion by 2019.

Ms. Sebelius said she expects private insurers to follow the federal government’s lead in implementing some of these payment changes as they prove effective in the Medicare program.

Provisions of the new Affordable Care Act, coupled with other payment changes, will save Medicare nearly $8 billion over 2 years and extend the solvency of the Medicare Trust Funds by 12 years, according to a new report from the Centers for Medicare and Medicaid Services.

The immediate savings come from cuts to Medicare Advantage payments, competitive bidding for durable medical equipment, changes to how Medicare pays for advanced imaging services, productivity improvements in the hospital, and efforts to reduce waste, fraud, and abuse. These changes are expected to save $7.8 billion for the Medicare program by the end of next year.

The report, issued Aug. 2, analyzes cost-cutting provisions that CMS has already implemented or will be implementing soon.

"For too long, we’ve paid too much for health care, gotten too little in return, and watched the situation get worse each and every year," Health and Human Services Secretary Kathleen Sebelius said at a press conference to release the report. "The Affordable Care Act is already putting our health care system on a new course, bringing down costs while improving the quality of care and giving all Americans more value for their dollars."

Ms. Sebelius noted that the new law will protect Medicare beneficiaries by maintaining current benefits and adding new ones such as free preventive care and the eventually closing the Medicare Part D prescription drug doughnut hole.

Over the long-term, CMS officials estimate that Medicare savings will exceed $418 billion by 2019. Some of those savings will come from reducing hospital readmissions and hospital-acquired infections, bundling payments for end-stage renal disease care, promoting Accountable Care Organizations, and improving quality reporting by physicians.

CMS also expects the establishment of the Independent Payment Advisory Board, which will recommend payment changes aimed at slowing growth in Medicare spending, to contribute to those savings by cutting Medicare costs by about $23 billion by 2019.

Ms. Sebelius said she expects private insurers to follow the federal government’s lead in implementing some of these payment changes as they prove effective in the Medicare program.

States Seek to Restrict Abortion

During the first half of 2010, lawmakers had introduced measures in 18 states to limit insurance coverage of abortion, according to an analysis by the Guttmacher Institute. In those states, five new laws were enacted. The laws either restrict abortion coverage in private health insurance policies written in a state, limit coverage in policies to be included in state-based health insurance exchanges created under health reform, or restrict coverage in policies offered to state employees. Additionally, a separate list of 18 states saw proposals to make ultrasounds part of abortion procedures. Some measures would require physicians to offer women ultrasounds before abortions, others would require that any ultrasound images made be shown or made available to women seeking abortions, and others would mandate an ultrasound before any abortion. So far this year, new abortion-ultrasound laws have been enacted in six states, the institute reported.

Bill Aims for Better Maternity

New federal legislation would make childbirth in the United States safer by promoting evidence-based maternity practices and discouraging the overuse of cesarean sections and scheduled inductions of labor. Introduced by Rep. Lucille Roybal-Allard (D-Calif.), H.R. 5807 would create an interagency committee to promote proven medical practices such as prenatal smoking cessation programs and group prenatal care. It would also expand federal research on best maternity practices and authorize data collection to identify the parts of the country with shortages of maternity care providers.

Grants Will Be Mothers' Helpers

Officials at the Department of Health and Human Services are awarding $25 million this year to help states and Native American tribes better support pregnant teens and women, as well as women already raising children. The competitive grant program, which will offer $25 million in funding each year through 2019, was mandated by the Affordable Care Act. HHS expects to award up to 25 grants per year in amounts ranging from $500,000 to $2 million. The program, called the Pregnancy Assistance Fund, is designed to connect teens and women with services to help them complete school and access health care, child care, and housing.

Youth Breast Cancer Is Focus

The federal government is establishing a new advisory committee that will focus on early detection of breast cancer and support for young women coping with the disease. The Advisory Committee on Breast Cancer in Young Women, created by the Affordable Care Act, will provide advice to the secretary of HHS and the director of the Centers for Disease Control and Prevention. The new committee is being charged with creating a national education campaign of age-appropriate messages on breast health and risk factors related to family health, race, ethnicity, and cultural background.

Secondhand Smoke's Dangers

Getting pregnant women to not smoke may not be enough if they are exposed to secondhand smoke during their pregnancy, according to a study from researchers at the University of Pittsburgh. The researchers reported in the Open Pediatric Medicine Journal that newborn babies of mothers who don't smoke but were exposed to secondhand smoke during pregnancy had the same genetic mutations as those found in the babies of mothers who smoked. The mutations have the potential to affect survival, birth weight, and even susceptibility to cancer, according to the researchers.

Jailed for Reselling Fertility Drugs

A Massachusetts woman has been sentenced to 3 years in prison on charges that she fraudulently obtained fertility drugs and then sold them on the Internet. She will also have to repay more than $500,000 to Blue Cross/Blue Shield of Massachusetts, which was billed for the drugs. Heidi Benham, aged 44, was indeed a fertility patient, but she began calling pharmacies and fraudulently authorizing refills of various fertility medications by claiming that she worked for a physician, according to the U.S. Department of Justice. The government alleged that the scheme continued from February 2001 through October 2005 and that Ms. Benham received about $160,000 from the sale of the drugs.

FDA Drafts Transparency Rules

The Food and Drug Administration's Transparency Task Force has issued 21 draft proposals concerning public disclosure of FDA operations without compromising patents or companies' trade secrets. Part of the FDA's transparency initiative launched last summer, the proposals are aimed at helping consumers, stakeholders, and others understand how the agency makes decisions and enforces them. The FDA said that one of the draft proposals would support research into rare diseases by freeing the agency to discuss that a company has abandoned its application for an orphan drug. Once made public, this information could enable another drug manufacturer to pick up where the first one left off toward a potentially new therapy for a rare disease.

States Seek to Restrict Abortion

During the first half of 2010, lawmakers had introduced measures in 18 states to limit insurance coverage of abortion, according to an analysis by the Guttmacher Institute. In those states, five new laws were enacted. The laws either restrict abortion coverage in private health insurance policies written in a state, limit coverage in policies to be included in state-based health insurance exchanges created under health reform, or restrict coverage in policies offered to state employees. Additionally, a separate list of 18 states saw proposals to make ultrasounds part of abortion procedures. Some measures would require physicians to offer women ultrasounds before abortions, others would require that any ultrasound images made be shown or made available to women seeking abortions, and others would mandate an ultrasound before any abortion. So far this year, new abortion-ultrasound laws have been enacted in six states, the institute reported.

Bill Aims for Better Maternity

New federal legislation would make childbirth in the United States safer by promoting evidence-based maternity practices and discouraging the overuse of cesarean sections and scheduled inductions of labor. Introduced by Rep. Lucille Roybal-Allard (D-Calif.), H.R. 5807 would create an interagency committee to promote proven medical practices such as prenatal smoking cessation programs and group prenatal care. It would also expand federal research on best maternity practices and authorize data collection to identify the parts of the country with shortages of maternity care providers.

Grants Will Be Mothers' Helpers

Officials at the Department of Health and Human Services are awarding $25 million this year to help states and Native American tribes better support pregnant teens and women, as well as women already raising children. The competitive grant program, which will offer $25 million in funding each year through 2019, was mandated by the Affordable Care Act. HHS expects to award up to 25 grants per year in amounts ranging from $500,000 to $2 million. The program, called the Pregnancy Assistance Fund, is designed to connect teens and women with services to help them complete school and access health care, child care, and housing.

Youth Breast Cancer Is Focus

The federal government is establishing a new advisory committee that will focus on early detection of breast cancer and support for young women coping with the disease. The Advisory Committee on Breast Cancer in Young Women, created by the Affordable Care Act, will provide advice to the secretary of HHS and the director of the Centers for Disease Control and Prevention. The new committee is being charged with creating a national education campaign of age-appropriate messages on breast health and risk factors related to family health, race, ethnicity, and cultural background.

Secondhand Smoke's Dangers

Getting pregnant women to not smoke may not be enough if they are exposed to secondhand smoke during their pregnancy, according to a study from researchers at the University of Pittsburgh. The researchers reported in the Open Pediatric Medicine Journal that newborn babies of mothers who don't smoke but were exposed to secondhand smoke during pregnancy had the same genetic mutations as those found in the babies of mothers who smoked. The mutations have the potential to affect survival, birth weight, and even susceptibility to cancer, according to the researchers.

Jailed for Reselling Fertility Drugs

A Massachusetts woman has been sentenced to 3 years in prison on charges that she fraudulently obtained fertility drugs and then sold them on the Internet. She will also have to repay more than $500,000 to Blue Cross/Blue Shield of Massachusetts, which was billed for the drugs. Heidi Benham, aged 44, was indeed a fertility patient, but she began calling pharmacies and fraudulently authorizing refills of various fertility medications by claiming that she worked for a physician, according to the U.S. Department of Justice. The government alleged that the scheme continued from February 2001 through October 2005 and that Ms. Benham received about $160,000 from the sale of the drugs.

FDA Drafts Transparency Rules

The Food and Drug Administration's Transparency Task Force has issued 21 draft proposals concerning public disclosure of FDA operations without compromising patents or companies' trade secrets. Part of the FDA's transparency initiative launched last summer, the proposals are aimed at helping consumers, stakeholders, and others understand how the agency makes decisions and enforces them. The FDA said that one of the draft proposals would support research into rare diseases by freeing the agency to discuss that a company has abandoned its application for an orphan drug. Once made public, this information could enable another drug manufacturer to pick up where the first one left off toward a potentially new therapy for a rare disease.

States Seek to Restrict Abortion

During the first half of 2010, lawmakers had introduced measures in 18 states to limit insurance coverage of abortion, according to an analysis by the Guttmacher Institute. In those states, five new laws were enacted. The laws either restrict abortion coverage in private health insurance policies written in a state, limit coverage in policies to be included in state-based health insurance exchanges created under health reform, or restrict coverage in policies offered to state employees. Additionally, a separate list of 18 states saw proposals to make ultrasounds part of abortion procedures. Some measures would require physicians to offer women ultrasounds before abortions, others would require that any ultrasound images made be shown or made available to women seeking abortions, and others would mandate an ultrasound before any abortion. So far this year, new abortion-ultrasound laws have been enacted in six states, the institute reported.

Bill Aims for Better Maternity

New federal legislation would make childbirth in the United States safer by promoting evidence-based maternity practices and discouraging the overuse of cesarean sections and scheduled inductions of labor. Introduced by Rep. Lucille Roybal-Allard (D-Calif.), H.R. 5807 would create an interagency committee to promote proven medical practices such as prenatal smoking cessation programs and group prenatal care. It would also expand federal research on best maternity practices and authorize data collection to identify the parts of the country with shortages of maternity care providers.

Grants Will Be Mothers' Helpers

Officials at the Department of Health and Human Services are awarding $25 million this year to help states and Native American tribes better support pregnant teens and women, as well as women already raising children. The competitive grant program, which will offer $25 million in funding each year through 2019, was mandated by the Affordable Care Act. HHS expects to award up to 25 grants per year in amounts ranging from $500,000 to $2 million. The program, called the Pregnancy Assistance Fund, is designed to connect teens and women with services to help them complete school and access health care, child care, and housing.

Youth Breast Cancer Is Focus

The federal government is establishing a new advisory committee that will focus on early detection of breast cancer and support for young women coping with the disease. The Advisory Committee on Breast Cancer in Young Women, created by the Affordable Care Act, will provide advice to the secretary of HHS and the director of the Centers for Disease Control and Prevention. The new committee is being charged with creating a national education campaign of age-appropriate messages on breast health and risk factors related to family health, race, ethnicity, and cultural background.

Secondhand Smoke's Dangers

Getting pregnant women to not smoke may not be enough if they are exposed to secondhand smoke during their pregnancy, according to a study from researchers at the University of Pittsburgh. The researchers reported in the Open Pediatric Medicine Journal that newborn babies of mothers who don't smoke but were exposed to secondhand smoke during pregnancy had the same genetic mutations as those found in the babies of mothers who smoked. The mutations have the potential to affect survival, birth weight, and even susceptibility to cancer, according to the researchers.

Jailed for Reselling Fertility Drugs

A Massachusetts woman has been sentenced to 3 years in prison on charges that she fraudulently obtained fertility drugs and then sold them on the Internet. She will also have to repay more than $500,000 to Blue Cross/Blue Shield of Massachusetts, which was billed for the drugs. Heidi Benham, aged 44, was indeed a fertility patient, but she began calling pharmacies and fraudulently authorizing refills of various fertility medications by claiming that she worked for a physician, according to the U.S. Department of Justice. The government alleged that the scheme continued from February 2001 through October 2005 and that Ms. Benham received about $160,000 from the sale of the drugs.

FDA Drafts Transparency Rules

The Food and Drug Administration's Transparency Task Force has issued 21 draft proposals concerning public disclosure of FDA operations without compromising patents or companies' trade secrets. Part of the FDA's transparency initiative launched last summer, the proposals are aimed at helping consumers, stakeholders, and others understand how the agency makes decisions and enforces them. The FDA said that one of the draft proposals would support research into rare diseases by freeing the agency to discuss that a company has abandoned its application for an orphan drug. Once made public, this information could enable another drug manufacturer to pick up where the first one left off toward a potentially new therapy for a rare disease.