Mary Ellen Schneider

The Health and Human Services department has released the much-anticipated requirements for how physicians and hospitals can qualify for tens of thousands of dollars in incentive payments to adopt and use electronic health records.

The final rule on the meaningful use of electronic health records (EHRs) eases many of the requirements that officials in HHS had outlined in a January proposal. Physician organizations had objected to that proposal, saying that it asked doctors, especially those in small practices, to do too much too quickly. Physicians were also critical of the all-or-nothing framework, which required them to meet all 25 objectives for meaningful use or lose out on incentive payments.

Federal officials aimed to address those concerns in the final rule by requiring physicians to first meet a core set of 15 requirements and then meet any 5 of 10 additional requirements. The core set includes requirements such as recording patient demographics and vital signs in the EHR, maintaining an up-to-date problem list and an active list of medications and allergies, and transmitting permissible prescriptions electronically.

“We very much want well-intentioned providers to become meaningful users,” Dr. David Blumenthal, National Coordinator for Health Information Technology at HHS, said during a press briefing to announce the final rule.

HHS officials also relaxed some of the thresholds related to the requirements. For example, under the proposed rule, physicians would have had to generate and transmit 75% of their permissible prescriptions electronically to meet the e-prescribing requirement. Under the final rule, the threshold has been lowered to more than 40% of permissible prescriptions, Dr. Blumenthal said.

The final rule also creates an easier path for physicians to meet meaningful use requirements on electronic reporting of quality data. Under the final rule, physicians will need to report data on blood pressure, tobacco status, and adult weight screening, and follow-up in 2011 and 2012, in order to qualify. Alternatives are available if those measures do not apply to their practices. Physicians will also have to choose three other quality measures to report on through their EHRs.

The final rule outlines the steps physicians must take in 2011 and 2012 to quality for the maximum incentive payments through the Medicare and Medicaid programs. The incentives were mandated by the Health Information Technology for Economic and Clinical Health Act (HITECH), a part of 2009's American Recovery Act.

Starting in 2011, physicians who demonstrate meaningful use of certified EHRs can receive payments of up to $18,000 from Medicare. Those bonuses continue for 5 years, with physicians eligible to earn up to $44,000 in total incentives. Physicians can still receive bonuses if they begin their meaningful use of the technology later, but they must start before 2013 to get all the available incentives. A similar program is in place under the Medicaid program, with physicians eligible to receive up to $64,000 over 6 years for the adoption and use of certified EHRs.

Technical Requirements For EHRs Released

Further to the 'meaningul use' rule for electronic health records, HHS has published regulations last month that will allow for temporary certification of electronic health records—the first step in helping physicians and other providers get the software and hardware required to be eligible for bonus payments under federal health programs.

According to the Office of the National Coordinator for Health Information Technology (ONC), the rule “establishes processes that organizations will need to follow in order to be authorized by the National Coordinator to test and certify [electronic health record] technology.”

“We hope that all [health information technology] stakeholders view this rule as the federal government's commitment to reduce uncertainty in the health IT marketplace and advance the successful implementation of EHR incentive programs,” said Dr. Blumenthal in a statement.

Certification means that the EHR package has been tested and includes the required capabilities to meet the meaningful use standards issued by ONC. Hospitals and physicians will have the assurance that the certified EHRs can help them improve the quality of care and qualify for bonus payments under Medicare or Medicaid.

“By purchasing certified EHR technology, hospitals and eligible professionals and hospitals will be able to make EHR purchasing decisions knowing that the technology will allow them to become meaningful users of electronic health records, qualify for the payment incentives, and begin to use EHRs in a way that will improve quality and efficiency in our health care system,” Dr. Blumenthal said.

The July rule was for a temporary certification program. A final rule on permanent certification of EHRs will be issued in the fall.

—Alicia Ault

The Health and Human Services department has released the much-anticipated requirements for how physicians and hospitals can qualify for tens of thousands of dollars in incentive payments to adopt and use electronic health records.

The final rule on the meaningful use of electronic health records (EHRs) eases many of the requirements that officials in HHS had outlined in a January proposal. Physician organizations had objected to that proposal, saying that it asked doctors, especially those in small practices, to do too much too quickly. Physicians were also critical of the all-or-nothing framework, which required them to meet all 25 objectives for meaningful use or lose out on incentive payments.

Federal officials aimed to address those concerns in the final rule by requiring physicians to first meet a core set of 15 requirements and then meet any 5 of 10 additional requirements. The core set includes requirements such as recording patient demographics and vital signs in the EHR, maintaining an up-to-date problem list and an active list of medications and allergies, and transmitting permissible prescriptions electronically.

“We very much want well-intentioned providers to become meaningful users,” Dr. David Blumenthal, National Coordinator for Health Information Technology at HHS, said during a press briefing to announce the final rule.

HHS officials also relaxed some of the thresholds related to the requirements. For example, under the proposed rule, physicians would have had to generate and transmit 75% of their permissible prescriptions electronically to meet the e-prescribing requirement. Under the final rule, the threshold has been lowered to more than 40% of permissible prescriptions, Dr. Blumenthal said.

The final rule also creates an easier path for physicians to meet meaningful use requirements on electronic reporting of quality data. Under the final rule, physicians will need to report data on blood pressure, tobacco status, and adult weight screening, and follow-up in 2011 and 2012, in order to qualify. Alternatives are available if those measures do not apply to their practices. Physicians will also have to choose three other quality measures to report on through their EHRs.

The final rule outlines the steps physicians must take in 2011 and 2012 to quality for the maximum incentive payments through the Medicare and Medicaid programs. The incentives were mandated by the Health Information Technology for Economic and Clinical Health Act (HITECH), a part of 2009's American Recovery Act.

Starting in 2011, physicians who demonstrate meaningful use of certified EHRs can receive payments of up to $18,000 from Medicare. Those bonuses continue for 5 years, with physicians eligible to earn up to $44,000 in total incentives. Physicians can still receive bonuses if they begin their meaningful use of the technology later, but they must start before 2013 to get all the available incentives. A similar program is in place under the Medicaid program, with physicians eligible to receive up to $64,000 over 6 years for the adoption and use of certified EHRs.

Technical Requirements For EHRs Released

Further to the 'meaningul use' rule for electronic health records, HHS has published regulations last month that will allow for temporary certification of electronic health records—the first step in helping physicians and other providers get the software and hardware required to be eligible for bonus payments under federal health programs.

According to the Office of the National Coordinator for Health Information Technology (ONC), the rule “establishes processes that organizations will need to follow in order to be authorized by the National Coordinator to test and certify [electronic health record] technology.”

“We hope that all [health information technology] stakeholders view this rule as the federal government's commitment to reduce uncertainty in the health IT marketplace and advance the successful implementation of EHR incentive programs,” said Dr. Blumenthal in a statement.

Certification means that the EHR package has been tested and includes the required capabilities to meet the meaningful use standards issued by ONC. Hospitals and physicians will have the assurance that the certified EHRs can help them improve the quality of care and qualify for bonus payments under Medicare or Medicaid.

“By purchasing certified EHR technology, hospitals and eligible professionals and hospitals will be able to make EHR purchasing decisions knowing that the technology will allow them to become meaningful users of electronic health records, qualify for the payment incentives, and begin to use EHRs in a way that will improve quality and efficiency in our health care system,” Dr. Blumenthal said.

The July rule was for a temporary certification program. A final rule on permanent certification of EHRs will be issued in the fall.

—Alicia Ault

The Health and Human Services department has released the much-anticipated requirements for how physicians and hospitals can qualify for tens of thousands of dollars in incentive payments to adopt and use electronic health records.

The final rule on the meaningful use of electronic health records (EHRs) eases many of the requirements that officials in HHS had outlined in a January proposal. Physician organizations had objected to that proposal, saying that it asked doctors, especially those in small practices, to do too much too quickly. Physicians were also critical of the all-or-nothing framework, which required them to meet all 25 objectives for meaningful use or lose out on incentive payments.

Federal officials aimed to address those concerns in the final rule by requiring physicians to first meet a core set of 15 requirements and then meet any 5 of 10 additional requirements. The core set includes requirements such as recording patient demographics and vital signs in the EHR, maintaining an up-to-date problem list and an active list of medications and allergies, and transmitting permissible prescriptions electronically.

“We very much want well-intentioned providers to become meaningful users,” Dr. David Blumenthal, National Coordinator for Health Information Technology at HHS, said during a press briefing to announce the final rule.

HHS officials also relaxed some of the thresholds related to the requirements. For example, under the proposed rule, physicians would have had to generate and transmit 75% of their permissible prescriptions electronically to meet the e-prescribing requirement. Under the final rule, the threshold has been lowered to more than 40% of permissible prescriptions, Dr. Blumenthal said.

The final rule also creates an easier path for physicians to meet meaningful use requirements on electronic reporting of quality data. Under the final rule, physicians will need to report data on blood pressure, tobacco status, and adult weight screening, and follow-up in 2011 and 2012, in order to qualify. Alternatives are available if those measures do not apply to their practices. Physicians will also have to choose three other quality measures to report on through their EHRs.

The final rule outlines the steps physicians must take in 2011 and 2012 to quality for the maximum incentive payments through the Medicare and Medicaid programs. The incentives were mandated by the Health Information Technology for Economic and Clinical Health Act (HITECH), a part of 2009's American Recovery Act.

Starting in 2011, physicians who demonstrate meaningful use of certified EHRs can receive payments of up to $18,000 from Medicare. Those bonuses continue for 5 years, with physicians eligible to earn up to $44,000 in total incentives. Physicians can still receive bonuses if they begin their meaningful use of the technology later, but they must start before 2013 to get all the available incentives. A similar program is in place under the Medicaid program, with physicians eligible to receive up to $64,000 over 6 years for the adoption and use of certified EHRs.

Technical Requirements For EHRs Released

Further to the 'meaningul use' rule for electronic health records, HHS has published regulations last month that will allow for temporary certification of electronic health records—the first step in helping physicians and other providers get the software and hardware required to be eligible for bonus payments under federal health programs.

According to the Office of the National Coordinator for Health Information Technology (ONC), the rule “establishes processes that organizations will need to follow in order to be authorized by the National Coordinator to test and certify [electronic health record] technology.”

“We hope that all [health information technology] stakeholders view this rule as the federal government's commitment to reduce uncertainty in the health IT marketplace and advance the successful implementation of EHR incentive programs,” said Dr. Blumenthal in a statement.

Certification means that the EHR package has been tested and includes the required capabilities to meet the meaningful use standards issued by ONC. Hospitals and physicians will have the assurance that the certified EHRs can help them improve the quality of care and qualify for bonus payments under Medicare or Medicaid.

“By purchasing certified EHR technology, hospitals and eligible professionals and hospitals will be able to make EHR purchasing decisions knowing that the technology will allow them to become meaningful users of electronic health records, qualify for the payment incentives, and begin to use EHRs in a way that will improve quality and efficiency in our health care system,” Dr. Blumenthal said.

The July rule was for a temporary certification program. A final rule on permanent certification of EHRs will be issued in the fall.

—Alicia Ault

The Federal Trade Commission has again postponed enforcement of the “Red Flags” rule, giving physicians until the end of 2010 before they must implement identity-theft prevention programs in their practices.

Enforcement of the rule had been scheduled to begin on June 1. In late May, the FTC announced that it was delaying enforcement to give Congress time to consider pending legislation that would exclude some small physician practices and small businesses from the rule.

Last year, the House passed a bill (H.R. 3763) that would have exempted physician practices with 20 or fewer employees from having to comply with the Red Flags rule, but that legislation has failed to gain traction in the Senate. FTC officials urged lawmakers to act quickly to clarify what groups should be covered by the regulation. “As an agency we're charged with enforcing the law, and endless extensions delay enforcement,” FTC chairman Jon Leibowitz said in a statement.

The Red Flags rule was written to implement provisions of the Fair and Accurate Credit Transactions Act, which calls on creditors and financial institutions to address the risk of identity theft. The rule requires creditors to develop formal identity-theft prevention programs that would allow an organization to identify, detect, and respond to any suspicious practices, or “red flags,” that could indicate identity theft. The rule became effective on Jan. 1, 2008, with an original enforcement deadline of Nov. 1, 2008. However, the FTC has delayed enforcement of the rule several times, first to give organizations more time to get familiar with the requirements and later at the request of members of Congress.

The rule has been controversial in the medical community because many physicians believe their practices don't fit into the definition of a “creditor.” However, the FTC has continued to insist that physicians are creditors because they allow their patients to defer payments over time.

The agency also has tried to assure physicians that the requirements should not be a burden and that small practices can come into compliance by implementing simple steps.

The American Medical Association and other physician groups have been lobbying to get physicians excluded completely from the requirements. On May 21, the AMA joined the American Osteopathic Association and the Medical Society of the District Columbia in a federal lawsuit that seeks to prevent the FTC from applying the Red Flags rule to physicians.

These groups contend that not only are physicians not creditors, but that the rules would be burdensome and duplicate requirements already in place under the Health Insurance Portability and Accountability Act. “Physicians are already ethically and legally responsible for ensuring the confidentiality and security of patients' medical information,” said Dr. Peter E. Lavine, president of the Medical Society of the District of Columbia, said in a statement. “It is unnecessary to add to the existing web of federal security regulations physicians must follow.”

The Federal Trade Commission has again postponed enforcement of the “Red Flags” rule, giving physicians until the end of 2010 before they must implement identity-theft prevention programs in their practices.

Enforcement of the rule had been scheduled to begin on June 1. In late May, the FTC announced that it was delaying enforcement to give Congress time to consider pending legislation that would exclude some small physician practices and small businesses from the rule.

Last year, the House passed a bill (H.R. 3763) that would have exempted physician practices with 20 or fewer employees from having to comply with the Red Flags rule, but that legislation has failed to gain traction in the Senate. FTC officials urged lawmakers to act quickly to clarify what groups should be covered by the regulation. “As an agency we're charged with enforcing the law, and endless extensions delay enforcement,” FTC chairman Jon Leibowitz said in a statement.

The Red Flags rule was written to implement provisions of the Fair and Accurate Credit Transactions Act, which calls on creditors and financial institutions to address the risk of identity theft. The rule requires creditors to develop formal identity-theft prevention programs that would allow an organization to identify, detect, and respond to any suspicious practices, or “red flags,” that could indicate identity theft. The rule became effective on Jan. 1, 2008, with an original enforcement deadline of Nov. 1, 2008. However, the FTC has delayed enforcement of the rule several times, first to give organizations more time to get familiar with the requirements and later at the request of members of Congress.

The rule has been controversial in the medical community because many physicians believe their practices don't fit into the definition of a “creditor.” However, the FTC has continued to insist that physicians are creditors because they allow their patients to defer payments over time.

The agency also has tried to assure physicians that the requirements should not be a burden and that small practices can come into compliance by implementing simple steps.

The American Medical Association and other physician groups have been lobbying to get physicians excluded completely from the requirements. On May 21, the AMA joined the American Osteopathic Association and the Medical Society of the District Columbia in a federal lawsuit that seeks to prevent the FTC from applying the Red Flags rule to physicians.

These groups contend that not only are physicians not creditors, but that the rules would be burdensome and duplicate requirements already in place under the Health Insurance Portability and Accountability Act. “Physicians are already ethically and legally responsible for ensuring the confidentiality and security of patients' medical information,” said Dr. Peter E. Lavine, president of the Medical Society of the District of Columbia, said in a statement. “It is unnecessary to add to the existing web of federal security regulations physicians must follow.”

The Federal Trade Commission has again postponed enforcement of the “Red Flags” rule, giving physicians until the end of 2010 before they must implement identity-theft prevention programs in their practices.

Enforcement of the rule had been scheduled to begin on June 1. In late May, the FTC announced that it was delaying enforcement to give Congress time to consider pending legislation that would exclude some small physician practices and small businesses from the rule.

Last year, the House passed a bill (H.R. 3763) that would have exempted physician practices with 20 or fewer employees from having to comply with the Red Flags rule, but that legislation has failed to gain traction in the Senate. FTC officials urged lawmakers to act quickly to clarify what groups should be covered by the regulation. “As an agency we're charged with enforcing the law, and endless extensions delay enforcement,” FTC chairman Jon Leibowitz said in a statement.

The Red Flags rule was written to implement provisions of the Fair and Accurate Credit Transactions Act, which calls on creditors and financial institutions to address the risk of identity theft. The rule requires creditors to develop formal identity-theft prevention programs that would allow an organization to identify, detect, and respond to any suspicious practices, or “red flags,” that could indicate identity theft. The rule became effective on Jan. 1, 2008, with an original enforcement deadline of Nov. 1, 2008. However, the FTC has delayed enforcement of the rule several times, first to give organizations more time to get familiar with the requirements and later at the request of members of Congress.

The rule has been controversial in the medical community because many physicians believe their practices don't fit into the definition of a “creditor.” However, the FTC has continued to insist that physicians are creditors because they allow their patients to defer payments over time.

The agency also has tried to assure physicians that the requirements should not be a burden and that small practices can come into compliance by implementing simple steps.

The American Medical Association and other physician groups have been lobbying to get physicians excluded completely from the requirements. On May 21, the AMA joined the American Osteopathic Association and the Medical Society of the District Columbia in a federal lawsuit that seeks to prevent the FTC from applying the Red Flags rule to physicians.

These groups contend that not only are physicians not creditors, but that the rules would be burdensome and duplicate requirements already in place under the Health Insurance Portability and Accountability Act. “Physicians are already ethically and legally responsible for ensuring the confidentiality and security of patients' medical information,” said Dr. Peter E. Lavine, president of the Medical Society of the District of Columbia, said in a statement. “It is unnecessary to add to the existing web of federal security regulations physicians must follow.”

President Obama on June 25 signed into law a bill that replaces the 21% Medicare physician payment cut with a 2.2% pay raise for 6 months.

The legislation (H.R. 3962) provides physicians with a 2.2% increase in their Medicare payments through Nov. 30. The change is retroactive to June 1, the date that the 21% cut officially went into effect. Officials at the Centers for Medicare and Medicaid Services held claims from June 1 to June 18 to give Congress time to reverse the cuts, but has been paying physicians at the lower rate since then.

Now that the pay cuts have been reversed, CMS has directed its contractors to stop processing claims at the lower rates and temporarily hold all claims for services provided on or after June 1. This delay will give contractors time to adjust their claims processing systems. CMS said it expects to begin processing claims at the increased pay rate no later than July 1.

Medicare will also begin reprocessing any June claims that were paid under the 21% cut. Physicians should not resubmit those claims, but may need to contact their local Medicare contractor to request an adjustment, according to CMS. Under the law, Medicare must pay physicians the lower of either their submitted charge or the Medicare Physician Fee Schedule amount. Claims with submitted charges at or above the new 2.2% increased rate will be automatically reprocessed.

While physicians welcomed the temporary reprieve, they remain dissatisfied with the lack of congressional action on a permanent solution to the recurring Medicare payment cuts. The American Medical Association noted that without further action from Congress, physicians will face a 23% cut in December that will increase to nearly 30% in January 2011.

“Congress is playing a dangerous game of Russian roulette with seniors' health care. Sick patients can't wait. Congress must replace the broken payment system before the damage is done and cannot be reversed,” Dr. Cecil B. Wilson, AMA president, said in a statement. “The baby boomers begin entering Medicare in 6 months, and if the physician payment problem isn't fixed, these new Medicare patients won't be able to find a doctor to treat them.”

The instability of the current payment system doesn't just affect Medicare, but will have a significant impact on the future success of health reform, according to the American Academy of Family Physicians. The Affordable Care Act calls on physicians to change their practices through the adoption of health information technology and new practice models, both of which require time and money to implement. “Physicians can't invest in change if they can't count on payment for their services,” Dr. Lori Heim, AAFP president, said in a statement.

President Obama is also urging Congress to come up with a permanent replacement for the Medicare physician payment formula.

Before signing the bill, the President released a statement saying that the practice of temporary payment patches was “untenable” and must end. On June 24, the House of Representatives passed H.R. 3962 by a vote of 417-1. The Senate approved the measure on June 18.

President Obama on June 25 signed into law a bill that replaces the 21% Medicare physician payment cut with a 2.2% pay raise for 6 months.

The legislation (H.R. 3962) provides physicians with a 2.2% increase in their Medicare payments through Nov. 30. The change is retroactive to June 1, the date that the 21% cut officially went into effect. Officials at the Centers for Medicare and Medicaid Services held claims from June 1 to June 18 to give Congress time to reverse the cuts, but has been paying physicians at the lower rate since then.

Now that the pay cuts have been reversed, CMS has directed its contractors to stop processing claims at the lower rates and temporarily hold all claims for services provided on or after June 1. This delay will give contractors time to adjust their claims processing systems. CMS said it expects to begin processing claims at the increased pay rate no later than July 1.

Medicare will also begin reprocessing any June claims that were paid under the 21% cut. Physicians should not resubmit those claims, but may need to contact their local Medicare contractor to request an adjustment, according to CMS. Under the law, Medicare must pay physicians the lower of either their submitted charge or the Medicare Physician Fee Schedule amount. Claims with submitted charges at or above the new 2.2% increased rate will be automatically reprocessed.

While physicians welcomed the temporary reprieve, they remain dissatisfied with the lack of congressional action on a permanent solution to the recurring Medicare payment cuts. The American Medical Association noted that without further action from Congress, physicians will face a 23% cut in December that will increase to nearly 30% in January 2011.

“Congress is playing a dangerous game of Russian roulette with seniors' health care. Sick patients can't wait. Congress must replace the broken payment system before the damage is done and cannot be reversed,” Dr. Cecil B. Wilson, AMA president, said in a statement. “The baby boomers begin entering Medicare in 6 months, and if the physician payment problem isn't fixed, these new Medicare patients won't be able to find a doctor to treat them.”

The instability of the current payment system doesn't just affect Medicare, but will have a significant impact on the future success of health reform, according to the American Academy of Family Physicians. The Affordable Care Act calls on physicians to change their practices through the adoption of health information technology and new practice models, both of which require time and money to implement. “Physicians can't invest in change if they can't count on payment for their services,” Dr. Lori Heim, AAFP president, said in a statement.

President Obama is also urging Congress to come up with a permanent replacement for the Medicare physician payment formula.

Before signing the bill, the President released a statement saying that the practice of temporary payment patches was “untenable” and must end. On June 24, the House of Representatives passed H.R. 3962 by a vote of 417-1. The Senate approved the measure on June 18.

President Obama on June 25 signed into law a bill that replaces the 21% Medicare physician payment cut with a 2.2% pay raise for 6 months.

The legislation (H.R. 3962) provides physicians with a 2.2% increase in their Medicare payments through Nov. 30. The change is retroactive to June 1, the date that the 21% cut officially went into effect. Officials at the Centers for Medicare and Medicaid Services held claims from June 1 to June 18 to give Congress time to reverse the cuts, but has been paying physicians at the lower rate since then.

Now that the pay cuts have been reversed, CMS has directed its contractors to stop processing claims at the lower rates and temporarily hold all claims for services provided on or after June 1. This delay will give contractors time to adjust their claims processing systems. CMS said it expects to begin processing claims at the increased pay rate no later than July 1.

Medicare will also begin reprocessing any June claims that were paid under the 21% cut. Physicians should not resubmit those claims, but may need to contact their local Medicare contractor to request an adjustment, according to CMS. Under the law, Medicare must pay physicians the lower of either their submitted charge or the Medicare Physician Fee Schedule amount. Claims with submitted charges at or above the new 2.2% increased rate will be automatically reprocessed.

While physicians welcomed the temporary reprieve, they remain dissatisfied with the lack of congressional action on a permanent solution to the recurring Medicare payment cuts. The American Medical Association noted that without further action from Congress, physicians will face a 23% cut in December that will increase to nearly 30% in January 2011.

“Congress is playing a dangerous game of Russian roulette with seniors' health care. Sick patients can't wait. Congress must replace the broken payment system before the damage is done and cannot be reversed,” Dr. Cecil B. Wilson, AMA president, said in a statement. “The baby boomers begin entering Medicare in 6 months, and if the physician payment problem isn't fixed, these new Medicare patients won't be able to find a doctor to treat them.”

The instability of the current payment system doesn't just affect Medicare, but will have a significant impact on the future success of health reform, according to the American Academy of Family Physicians. The Affordable Care Act calls on physicians to change their practices through the adoption of health information technology and new practice models, both of which require time and money to implement. “Physicians can't invest in change if they can't count on payment for their services,” Dr. Lori Heim, AAFP president, said in a statement.

President Obama is also urging Congress to come up with a permanent replacement for the Medicare physician payment formula.

Before signing the bill, the President released a statement saying that the practice of temporary payment patches was “untenable” and must end. On June 24, the House of Representatives passed H.R. 3962 by a vote of 417-1. The Senate approved the measure on June 18.

Call to Cover Contraception

Federal officials should make contraception one of the preventive services that private health plans will have to cover free of charge under health reform, says the Guttmacher Institute. The Affordable Care Act mandates that, starting in September, all new private health plans must provide preventive care and screening for women, without copayments or other cost sharing. The law states that the preventive services will be determined by the Health Resources and Services Administration. Adam Sonfield, senior public policy associate at the Guttmacher Institute, made the case that including contraceptive services will reduce unintended pregnancies, maternal illness, and the number of babies being born at low birth weights. He argues that every $1 invested in contraceptive services saves Medicaid $3.74. The mandate “must include coverage for the full range of contraceptive drugs and devices, related services such as insertion and removal of devices, and counseling and patient education,” Mr. Sonfield said in a statement.

Report: Federal Funds Aid Abortions

Six organizations that support the right of women to have abortions got hundreds of millions in federal dollars between 2002 and 2009, according to a report from the Government Accountability Office. The funding was primarily for services in family planning, reproductive health, and HIV/AIDS. In total, the Department of Health and Human Services and the U.S. Agency for International Development distributed more than $500 million to Advocates for Youth, the Guttmacher Institute, the International Planned Parenthood Federation, the Planned Parenthood Federation of America, the Population Council, and the Sexuality Information and Education Council of the United States. With additional federal grants channeled through states, the six groups reported spending about $967 million in federal funds over the 8 years. The report was requested by Republicans in Congress. “By funding Planned Parenthood and their allies, we are unwittingly supporting an abortion organization and everything they do,” Ken Blackwell, of the antiabortion Family Research Council, said in a statement.

Bill Pushes Risk Warnings

Proposed legislation aims to increase information on pregnancy-risk information. The “Birth Defects Prevention, Risk Reduction, and Awareness Act” (H.R. 5462/S. 3479) has bipartisan support and endorsements from the American Academy of Pediatrics and the March of Dimes. The bill calls for a national media campaign to make physicians and patients aware of the information services. “Unfortunately, research shows that up to half of pregnant women are not counseled by their health care providers about the potential risks of medications they may be taking, and programs to provide this information have been closing due to state and local budget cuts,” Rep. Rosa DeLauro (D.-Conn.), one of the bill's sponsors, said in a statement.

ART Called Heavily Regulated

When a California woman gave birth to octuplets last year, some people cried out for a clampdown on assisted reproductive medicine in the United States. But the American Society for Reproductive Medicine reports that assisted reproductive technology (ART) is already one of the most highly regulated practices in all of medicine. For example, ART falls under the purview of three federal agencies, the Centers for Disease Control and Prevention, the Food and Drug Administration, and the Centers for Medicare and Medicaid Services. These agencies are responsible for collecting data on ART, regulating drugs and devices and tests of eggs and sperm, and ensuring the quality of laboratories. Self-regulation includes a reproductive-laboratory accreditation program and ethics and practice guidelines. However, the report concedes that oversight could be improved if health plans would agree to cover ART services. Then health plans could require that physicians comply with the ethics and practice guidelines as a condition of payment.

Doctors Retract 'Nick' Policy

The American Academy of Pediatrics, under fire for its position on female genital cutting, has withdrawn the statement and reiterated its “strong opposition” to the practice. In April, the journal Pediatrics published an AAP statement suggesting that physicians in certain immigrant communities might substitute a pinprick of the clitoral skin for ritual genital cutting in order to satisfy cultural requirements. The statement warned that parents still might send their daughters out of the country to get the full procedure or have it done in the United States by someone not medically trained. But the AAP said in its new statement that it does not endorse the practice of offering a “clitoral nick,” which is forbidden by federal law. Said AAP President Judith Palfrey, “We retracted that policy because it is important that the world health community understands the AAP is totally opposed to all forms of female genital cutting, both here in the U.S. and anywhere else in the world.”

Call to Cover Contraception

Federal officials should make contraception one of the preventive services that private health plans will have to cover free of charge under health reform, says the Guttmacher Institute. The Affordable Care Act mandates that, starting in September, all new private health plans must provide preventive care and screening for women, without copayments or other cost sharing. The law states that the preventive services will be determined by the Health Resources and Services Administration. Adam Sonfield, senior public policy associate at the Guttmacher Institute, made the case that including contraceptive services will reduce unintended pregnancies, maternal illness, and the number of babies being born at low birth weights. He argues that every $1 invested in contraceptive services saves Medicaid $3.74. The mandate “must include coverage for the full range of contraceptive drugs and devices, related services such as insertion and removal of devices, and counseling and patient education,” Mr. Sonfield said in a statement.

Report: Federal Funds Aid Abortions

Six organizations that support the right of women to have abortions got hundreds of millions in federal dollars between 2002 and 2009, according to a report from the Government Accountability Office. The funding was primarily for services in family planning, reproductive health, and HIV/AIDS. In total, the Department of Health and Human Services and the U.S. Agency for International Development distributed more than $500 million to Advocates for Youth, the Guttmacher Institute, the International Planned Parenthood Federation, the Planned Parenthood Federation of America, the Population Council, and the Sexuality Information and Education Council of the United States. With additional federal grants channeled through states, the six groups reported spending about $967 million in federal funds over the 8 years. The report was requested by Republicans in Congress. “By funding Planned Parenthood and their allies, we are unwittingly supporting an abortion organization and everything they do,” Ken Blackwell, of the antiabortion Family Research Council, said in a statement.

Bill Pushes Risk Warnings

Proposed legislation aims to increase information on pregnancy-risk information. The “Birth Defects Prevention, Risk Reduction, and Awareness Act” (H.R. 5462/S. 3479) has bipartisan support and endorsements from the American Academy of Pediatrics and the March of Dimes. The bill calls for a national media campaign to make physicians and patients aware of the information services. “Unfortunately, research shows that up to half of pregnant women are not counseled by their health care providers about the potential risks of medications they may be taking, and programs to provide this information have been closing due to state and local budget cuts,” Rep. Rosa DeLauro (D.-Conn.), one of the bill's sponsors, said in a statement.

ART Called Heavily Regulated

When a California woman gave birth to octuplets last year, some people cried out for a clampdown on assisted reproductive medicine in the United States. But the American Society for Reproductive Medicine reports that assisted reproductive technology (ART) is already one of the most highly regulated practices in all of medicine. For example, ART falls under the purview of three federal agencies, the Centers for Disease Control and Prevention, the Food and Drug Administration, and the Centers for Medicare and Medicaid Services. These agencies are responsible for collecting data on ART, regulating drugs and devices and tests of eggs and sperm, and ensuring the quality of laboratories. Self-regulation includes a reproductive-laboratory accreditation program and ethics and practice guidelines. However, the report concedes that oversight could be improved if health plans would agree to cover ART services. Then health plans could require that physicians comply with the ethics and practice guidelines as a condition of payment.

Doctors Retract 'Nick' Policy

The American Academy of Pediatrics, under fire for its position on female genital cutting, has withdrawn the statement and reiterated its “strong opposition” to the practice. In April, the journal Pediatrics published an AAP statement suggesting that physicians in certain immigrant communities might substitute a pinprick of the clitoral skin for ritual genital cutting in order to satisfy cultural requirements. The statement warned that parents still might send their daughters out of the country to get the full procedure or have it done in the United States by someone not medically trained. But the AAP said in its new statement that it does not endorse the practice of offering a “clitoral nick,” which is forbidden by federal law. Said AAP President Judith Palfrey, “We retracted that policy because it is important that the world health community understands the AAP is totally opposed to all forms of female genital cutting, both here in the U.S. and anywhere else in the world.”

Call to Cover Contraception

Federal officials should make contraception one of the preventive services that private health plans will have to cover free of charge under health reform, says the Guttmacher Institute. The Affordable Care Act mandates that, starting in September, all new private health plans must provide preventive care and screening for women, without copayments or other cost sharing. The law states that the preventive services will be determined by the Health Resources and Services Administration. Adam Sonfield, senior public policy associate at the Guttmacher Institute, made the case that including contraceptive services will reduce unintended pregnancies, maternal illness, and the number of babies being born at low birth weights. He argues that every $1 invested in contraceptive services saves Medicaid $3.74. The mandate “must include coverage for the full range of contraceptive drugs and devices, related services such as insertion and removal of devices, and counseling and patient education,” Mr. Sonfield said in a statement.

Report: Federal Funds Aid Abortions

Six organizations that support the right of women to have abortions got hundreds of millions in federal dollars between 2002 and 2009, according to a report from the Government Accountability Office. The funding was primarily for services in family planning, reproductive health, and HIV/AIDS. In total, the Department of Health and Human Services and the U.S. Agency for International Development distributed more than $500 million to Advocates for Youth, the Guttmacher Institute, the International Planned Parenthood Federation, the Planned Parenthood Federation of America, the Population Council, and the Sexuality Information and Education Council of the United States. With additional federal grants channeled through states, the six groups reported spending about $967 million in federal funds over the 8 years. The report was requested by Republicans in Congress. “By funding Planned Parenthood and their allies, we are unwittingly supporting an abortion organization and everything they do,” Ken Blackwell, of the antiabortion Family Research Council, said in a statement.

Bill Pushes Risk Warnings

Proposed legislation aims to increase information on pregnancy-risk information. The “Birth Defects Prevention, Risk Reduction, and Awareness Act” (H.R. 5462/S. 3479) has bipartisan support and endorsements from the American Academy of Pediatrics and the March of Dimes. The bill calls for a national media campaign to make physicians and patients aware of the information services. “Unfortunately, research shows that up to half of pregnant women are not counseled by their health care providers about the potential risks of medications they may be taking, and programs to provide this information have been closing due to state and local budget cuts,” Rep. Rosa DeLauro (D.-Conn.), one of the bill's sponsors, said in a statement.

ART Called Heavily Regulated

When a California woman gave birth to octuplets last year, some people cried out for a clampdown on assisted reproductive medicine in the United States. But the American Society for Reproductive Medicine reports that assisted reproductive technology (ART) is already one of the most highly regulated practices in all of medicine. For example, ART falls under the purview of three federal agencies, the Centers for Disease Control and Prevention, the Food and Drug Administration, and the Centers for Medicare and Medicaid Services. These agencies are responsible for collecting data on ART, regulating drugs and devices and tests of eggs and sperm, and ensuring the quality of laboratories. Self-regulation includes a reproductive-laboratory accreditation program and ethics and practice guidelines. However, the report concedes that oversight could be improved if health plans would agree to cover ART services. Then health plans could require that physicians comply with the ethics and practice guidelines as a condition of payment.

Doctors Retract 'Nick' Policy

The American Academy of Pediatrics, under fire for its position on female genital cutting, has withdrawn the statement and reiterated its “strong opposition” to the practice. In April, the journal Pediatrics published an AAP statement suggesting that physicians in certain immigrant communities might substitute a pinprick of the clitoral skin for ritual genital cutting in order to satisfy cultural requirements. The statement warned that parents still might send their daughters out of the country to get the full procedure or have it done in the United States by someone not medically trained. But the AAP said in its new statement that it does not endorse the practice of offering a “clitoral nick,” which is forbidden by federal law. Said AAP President Judith Palfrey, “We retracted that policy because it is important that the world health community understands the AAP is totally opposed to all forms of female genital cutting, both here in the U.S. and anywhere else in the world.”

The Agency for Healthcare Research and Quality has awarded $25 million in grants to states and health systems to test various approaches to medical liability reform.

The grant awards follow through on a 2009 promise made by President Obama. In a speech to Congress last September, the president pledged to fund demonstration projects that would look at malpractice reforms that also improve patient safety.

The focus on patient safety is critical, said Dr. Carolyn Clancy, director of AHRQ, because when physicians fear being sued, they are less likely to be open about potential errors, near misses, and avoidable harms, and that's a major hurdle to improving patient safety in any organization.

“If you're fearful and you're worried about being sued, that has a very chilling effect on people's willingness to step forward and say 'we have a problem and we need to do something about it,'” Dr. Clancy said during a press briefing.

The awards, which were announced on June 11, include 3-year grants to states and health systems of as much as $3 million. The $25 million pool also includes 1-year planning grants of as much as $300,000, and a $2 million grant to JBA/RAND Corp. to evaluate the various projects.

Many of the demonstration grants will focus on early disclosure of errors and early offers of compensation, Dr. Clancy said. The aim with early offers is not to short-circuit the system, she added, but to give both physicians and patients relief from a process that often drags on. Another common theme among the grants is to promote better communication among providers, patients, and families.

The results of these tests could lay the groundwork for the additional medical malpractice studies called for under the Affordable Care Act, which authorizes an additional $50 million over 5 years to fund more studies, Dr. Clancy said.

A list of the projects is available at www.ahrq.gov/qual/liability/demogrants.htmwww.ahrq.gov/qual/liability/planninggrants.htm

The Agency for Healthcare Research and Quality has awarded $25 million in grants to states and health systems to test various approaches to medical liability reform.

The grant awards follow through on a 2009 promise made by President Obama. In a speech to Congress last September, the president pledged to fund demonstration projects that would look at malpractice reforms that also improve patient safety.

The focus on patient safety is critical, said Dr. Carolyn Clancy, director of AHRQ, because when physicians fear being sued, they are less likely to be open about potential errors, near misses, and avoidable harms, and that's a major hurdle to improving patient safety in any organization.

“If you're fearful and you're worried about being sued, that has a very chilling effect on people's willingness to step forward and say 'we have a problem and we need to do something about it,'” Dr. Clancy said during a press briefing.

The awards, which were announced on June 11, include 3-year grants to states and health systems of as much as $3 million. The $25 million pool also includes 1-year planning grants of as much as $300,000, and a $2 million grant to JBA/RAND Corp. to evaluate the various projects.

Many of the demonstration grants will focus on early disclosure of errors and early offers of compensation, Dr. Clancy said. The aim with early offers is not to short-circuit the system, she added, but to give both physicians and patients relief from a process that often drags on. Another common theme among the grants is to promote better communication among providers, patients, and families.

The results of these tests could lay the groundwork for the additional medical malpractice studies called for under the Affordable Care Act, which authorizes an additional $50 million over 5 years to fund more studies, Dr. Clancy said.

A list of the projects is available at www.ahrq.gov/qual/liability/demogrants.htmwww.ahrq.gov/qual/liability/planninggrants.htm

The Agency for Healthcare Research and Quality has awarded $25 million in grants to states and health systems to test various approaches to medical liability reform.

The grant awards follow through on a 2009 promise made by President Obama. In a speech to Congress last September, the president pledged to fund demonstration projects that would look at malpractice reforms that also improve patient safety.

The focus on patient safety is critical, said Dr. Carolyn Clancy, director of AHRQ, because when physicians fear being sued, they are less likely to be open about potential errors, near misses, and avoidable harms, and that's a major hurdle to improving patient safety in any organization.

“If you're fearful and you're worried about being sued, that has a very chilling effect on people's willingness to step forward and say 'we have a problem and we need to do something about it,'” Dr. Clancy said during a press briefing.

The awards, which were announced on June 11, include 3-year grants to states and health systems of as much as $3 million. The $25 million pool also includes 1-year planning grants of as much as $300,000, and a $2 million grant to JBA/RAND Corp. to evaluate the various projects.

Many of the demonstration grants will focus on early disclosure of errors and early offers of compensation, Dr. Clancy said. The aim with early offers is not to short-circuit the system, she added, but to give both physicians and patients relief from a process that often drags on. Another common theme among the grants is to promote better communication among providers, patients, and families.

The results of these tests could lay the groundwork for the additional medical malpractice studies called for under the Affordable Care Act, which authorizes an additional $50 million over 5 years to fund more studies, Dr. Clancy said.

A list of the projects is available at www.ahrq.gov/qual/liability/demogrants.htmwww.ahrq.gov/qual/liability/planninggrants.htm

The Federal Trade Commission has again postponed enforcement of the “Red Flags” rule, giving physicians until the end of 2010 before they must implement identity-theft prevention programs in their practices.

Enforcement of the rule had been scheduled to begin on June 1. In a statement issued on May 28, the FTC said it was delaying enforcement to give Congress time to consider pending legislation that would exclude some small physician practices and small businesses from the rule. Last year, the House passed a bill (H.R. 3763) that would have exempted physician practices with 20 or fewer employees from having to comply with the Red Flags rule, but that legislation has failed to gain traction in the Senate.

FTC officials urged lawmakers to act quickly to clarify what groups should be covered by the regulation. “As an agency we're charged with enforcing the law, and endless extensions delay enforcement,” FTC chairman Jon Leibowitz said in a statement.

The Red Flags rule was written to implement provisions of the Fair and Accurate Credit Transactions Act, which calls on creditors and financial institutions to address the risk of identity theft. The rule requires creditors to develop formal identity-theft prevention programs that would allow an organization to identify, detect, and respond to any suspicious practices, or “red flags,” that could indicate identity theft. The rule became effective on Jan. 1, 2008, with an original enforcement deadline of Nov. 1, 2008.

However, the FTC has delayed enforcement of the rule several times, first to give organizations more time to get familiar with the requirements and later at the request of members of Congress.

The rule has been controversial in the medical community because many physicians believe their practices don't fit into the definition of a “creditor.” However, the FTC has continued to insist that physicians are in fact “creditors” because they allow their patients to defer payments over time.

The agency also has tried to assure physicians that the requirements should not be a burden and that small practices can come into compliance by implementing simple steps. For example, in low-risk settings, practice staff can ask patients for photo identification when they come in for an appointment.

The American Medical Association and other physician groups have been lobbying to get physicians excluded completely from the requirements.

On May 21, the AMA joined the American Osteopathic Association and the Medical Society of the District of Columbia in a federal lawsuit that seeks to prevent the FTC from applying the Red Flags rule to physicians. The groups contend that not only are physicians not creditors, but that the rules would be burdensome and duplicate requirements already in place under the Health Insurance Portability and Accountability Act.

The Federal Trade Commission has again postponed enforcement of the “Red Flags” rule, giving physicians until the end of 2010 before they must implement identity-theft prevention programs in their practices.

Enforcement of the rule had been scheduled to begin on June 1. In a statement issued on May 28, the FTC said it was delaying enforcement to give Congress time to consider pending legislation that would exclude some small physician practices and small businesses from the rule. Last year, the House passed a bill (H.R. 3763) that would have exempted physician practices with 20 or fewer employees from having to comply with the Red Flags rule, but that legislation has failed to gain traction in the Senate.

FTC officials urged lawmakers to act quickly to clarify what groups should be covered by the regulation. “As an agency we're charged with enforcing the law, and endless extensions delay enforcement,” FTC chairman Jon Leibowitz said in a statement.

The Red Flags rule was written to implement provisions of the Fair and Accurate Credit Transactions Act, which calls on creditors and financial institutions to address the risk of identity theft. The rule requires creditors to develop formal identity-theft prevention programs that would allow an organization to identify, detect, and respond to any suspicious practices, or “red flags,” that could indicate identity theft. The rule became effective on Jan. 1, 2008, with an original enforcement deadline of Nov. 1, 2008.

However, the FTC has delayed enforcement of the rule several times, first to give organizations more time to get familiar with the requirements and later at the request of members of Congress.

The rule has been controversial in the medical community because many physicians believe their practices don't fit into the definition of a “creditor.” However, the FTC has continued to insist that physicians are in fact “creditors” because they allow their patients to defer payments over time.

The agency also has tried to assure physicians that the requirements should not be a burden and that small practices can come into compliance by implementing simple steps. For example, in low-risk settings, practice staff can ask patients for photo identification when they come in for an appointment.

The American Medical Association and other physician groups have been lobbying to get physicians excluded completely from the requirements.

On May 21, the AMA joined the American Osteopathic Association and the Medical Society of the District of Columbia in a federal lawsuit that seeks to prevent the FTC from applying the Red Flags rule to physicians. The groups contend that not only are physicians not creditors, but that the rules would be burdensome and duplicate requirements already in place under the Health Insurance Portability and Accountability Act.

The Federal Trade Commission has again postponed enforcement of the “Red Flags” rule, giving physicians until the end of 2010 before they must implement identity-theft prevention programs in their practices.

Enforcement of the rule had been scheduled to begin on June 1. In a statement issued on May 28, the FTC said it was delaying enforcement to give Congress time to consider pending legislation that would exclude some small physician practices and small businesses from the rule. Last year, the House passed a bill (H.R. 3763) that would have exempted physician practices with 20 or fewer employees from having to comply with the Red Flags rule, but that legislation has failed to gain traction in the Senate.

FTC officials urged lawmakers to act quickly to clarify what groups should be covered by the regulation. “As an agency we're charged with enforcing the law, and endless extensions delay enforcement,” FTC chairman Jon Leibowitz said in a statement.

The Red Flags rule was written to implement provisions of the Fair and Accurate Credit Transactions Act, which calls on creditors and financial institutions to address the risk of identity theft. The rule requires creditors to develop formal identity-theft prevention programs that would allow an organization to identify, detect, and respond to any suspicious practices, or “red flags,” that could indicate identity theft. The rule became effective on Jan. 1, 2008, with an original enforcement deadline of Nov. 1, 2008.

However, the FTC has delayed enforcement of the rule several times, first to give organizations more time to get familiar with the requirements and later at the request of members of Congress.

The rule has been controversial in the medical community because many physicians believe their practices don't fit into the definition of a “creditor.” However, the FTC has continued to insist that physicians are in fact “creditors” because they allow their patients to defer payments over time.

The agency also has tried to assure physicians that the requirements should not be a burden and that small practices can come into compliance by implementing simple steps. For example, in low-risk settings, practice staff can ask patients for photo identification when they come in for an appointment.

The American Medical Association and other physician groups have been lobbying to get physicians excluded completely from the requirements.

On May 21, the AMA joined the American Osteopathic Association and the Medical Society of the District of Columbia in a federal lawsuit that seeks to prevent the FTC from applying the Red Flags rule to physicians. The groups contend that not only are physicians not creditors, but that the rules would be burdensome and duplicate requirements already in place under the Health Insurance Portability and Accountability Act.

The Agency for Healthcare Research and Quality has awarded $25 million in grants to states and health systems to test various approaches to medical liability reform.

The grant awards follow through on a 2009 promise made by President Obama. In a speech to Congress last September, the president pledged to fund demonstration projects that would look at malpractice reforms that also improve patient safety.

The focus on patient safety is critical, said Dr. Carolyn Clancy, director of AHRQ, because when physicians fear being sued, they are less likely to be open about potential errors, near misses, and avoidable harms, and that's a major hurdle to improving patient safety in any organization. “If you're fearful and you're worried about being sued, that has a very chilling effect on people's willingness to step forward and say 'we have a problem and we need to do something about it,'” Dr. Clancy said during a press briefing.

The awards, which were announced in June, include 3-year grants to states and health systems of as much as $3 million. The $25 million pool also includes 1-year planning grants of as much as $300,000 and a $2 million grant to JBA/RAND Corp. to evaluate the various projects.

Many of the demonstration grants will focus on early disclosure of errors and early offers of compensation, Dr. Clancy said. The aim with early offers is not to short-circuit the system, she added, but to give both physicians and patients relief from a process that often drags on. Another common theme among the grants is to promote better communication among providers, patients, and families.

None of the grants will examine the concept of health courts. Although health courts have been talked about for years and praised as a possible solution by President Obama, none of the grant applicants proposed studying that concept. One project, however, will look at a judge-directed negotiation program that is currently in use in New York in combination with an early disclosure and settlement model.

The results of these tests could lay the groundwork for the additional medical malpractice studies called for under the Affordable Care Act, which authorizes an additional $50 million over 5 years to fund more studies, Dr. Clancy said.

A list of the projects is available at www.ahrq.gov/qual/liability/demogrants.htmandwww.ahrq.gov/qual/liability/planninggrants.htm

The Agency for Healthcare Research and Quality has awarded $25 million in grants to states and health systems to test various approaches to medical liability reform.

The grant awards follow through on a 2009 promise made by President Obama. In a speech to Congress last September, the president pledged to fund demonstration projects that would look at malpractice reforms that also improve patient safety.

The focus on patient safety is critical, said Dr. Carolyn Clancy, director of AHRQ, because when physicians fear being sued, they are less likely to be open about potential errors, near misses, and avoidable harms, and that's a major hurdle to improving patient safety in any organization. “If you're fearful and you're worried about being sued, that has a very chilling effect on people's willingness to step forward and say 'we have a problem and we need to do something about it,'” Dr. Clancy said during a press briefing.

The awards, which were announced in June, include 3-year grants to states and health systems of as much as $3 million. The $25 million pool also includes 1-year planning grants of as much as $300,000 and a $2 million grant to JBA/RAND Corp. to evaluate the various projects.

Many of the demonstration grants will focus on early disclosure of errors and early offers of compensation, Dr. Clancy said. The aim with early offers is not to short-circuit the system, she added, but to give both physicians and patients relief from a process that often drags on. Another common theme among the grants is to promote better communication among providers, patients, and families.

None of the grants will examine the concept of health courts. Although health courts have been talked about for years and praised as a possible solution by President Obama, none of the grant applicants proposed studying that concept. One project, however, will look at a judge-directed negotiation program that is currently in use in New York in combination with an early disclosure and settlement model.

The results of these tests could lay the groundwork for the additional medical malpractice studies called for under the Affordable Care Act, which authorizes an additional $50 million over 5 years to fund more studies, Dr. Clancy said.

A list of the projects is available at www.ahrq.gov/qual/liability/demogrants.htmandwww.ahrq.gov/qual/liability/planninggrants.htm

The Agency for Healthcare Research and Quality has awarded $25 million in grants to states and health systems to test various approaches to medical liability reform.

The grant awards follow through on a 2009 promise made by President Obama. In a speech to Congress last September, the president pledged to fund demonstration projects that would look at malpractice reforms that also improve patient safety.

The focus on patient safety is critical, said Dr. Carolyn Clancy, director of AHRQ, because when physicians fear being sued, they are less likely to be open about potential errors, near misses, and avoidable harms, and that's a major hurdle to improving patient safety in any organization. “If you're fearful and you're worried about being sued, that has a very chilling effect on people's willingness to step forward and say 'we have a problem and we need to do something about it,'” Dr. Clancy said during a press briefing.

The awards, which were announced in June, include 3-year grants to states and health systems of as much as $3 million. The $25 million pool also includes 1-year planning grants of as much as $300,000 and a $2 million grant to JBA/RAND Corp. to evaluate the various projects.

Many of the demonstration grants will focus on early disclosure of errors and early offers of compensation, Dr. Clancy said. The aim with early offers is not to short-circuit the system, she added, but to give both physicians and patients relief from a process that often drags on. Another common theme among the grants is to promote better communication among providers, patients, and families.

None of the grants will examine the concept of health courts. Although health courts have been talked about for years and praised as a possible solution by President Obama, none of the grant applicants proposed studying that concept. One project, however, will look at a judge-directed negotiation program that is currently in use in New York in combination with an early disclosure and settlement model.

The results of these tests could lay the groundwork for the additional medical malpractice studies called for under the Affordable Care Act, which authorizes an additional $50 million over 5 years to fund more studies, Dr. Clancy said.

A list of the projects is available at www.ahrq.gov/qual/liability/demogrants.htmandwww.ahrq.gov/qual/liability/planninggrants.htm

The Federal Trade Commission has again postponed enforcement of the “Red Flags” rule, giving physicians until the end of 2010 before they must implement identity-theft prevention programs in their practices.

Enforcement of the rule had been scheduled to begin on June 1.

In a statement issued on May 28, the FTC said it was delaying enforcement to give Congress time to consider pending legislation that would exclude some small physician practices and small businesses from the rule.

Last year, the House passed a bill (H.R. 3763) that would have exempted physician practices that have 20 or fewer employees from having to comply with the Red Flags rule, but that legislation has failed to gain traction in the Senate.

FTC officials urged lawmakers to act quickly to clarify what groups should be covered by the regulation. “As an agency we're charged with enforcing the law, and endless extensions delay enforcement,” FTC chairman Jon Leibowitz said in a statement.

The Red Flags rule was written to implement provisions of the Fair and Accurate Credit Transactions Act, which calls on creditors and financial institutions to address the risk of identity theft.

The rule requires creditors to develop formal identity-theft prevention programs that would allow an organization to identify, detect, and respond to any suspicious practices, or “red flags,” that could indicate identity theft.

The rule became effective on Jan. 1, 2008, with an original enforcement deadline of Nov. 1, 2008.

However, the FTC has delayed enforcement of the rule several times, first to give organizations more time to get familiar with the requirements, and later to comply with requests from members of Congress.

The rule has been controversial in the medical community because many physicians believe their practices don't fit into the definition of a “creditor.”

However, the FTC has continued to insist that physicians are in fact “creditors” because they allow their patients to defer payments over time.

The agency also has tried to assure physicians that the requirements should not be a burden and that small practices can come into compliance by implementing simple steps. For example, in low-risk settings, practice staff can ask patients for photo identification when they come in for an appointment.

The American Medical Association and other physician groups have been lobbying to get physicians excluded completely from the requirements. On May 21, the AMA joined the American Osteopathic Association and the Medical Society of the District Columbia in a federal lawsuit that seeks to prevent the FTC from applying the Red Flags rule to physicians.

The groups contend that not only are physicians not creditors, but that the rules would be burdensome and duplicate requirements already in place under the Health Insurance Portability and Accountability Act.

“Physicians are already ethically and legally responsible for ensuring the confidentiality and security of patients' medical information,” said Dr. Peter E. Lavine, president of the Medical Society of the District of Columbia, said in a statement. “It is unnecessary to add to the existing web of federal security regulations physicians must follow.”

The Federal Trade Commission has again postponed enforcement of the “Red Flags” rule, giving physicians until the end of 2010 before they must implement identity-theft prevention programs in their practices.

Enforcement of the rule had been scheduled to begin on June 1.

In a statement issued on May 28, the FTC said it was delaying enforcement to give Congress time to consider pending legislation that would exclude some small physician practices and small businesses from the rule.

Last year, the House passed a bill (H.R. 3763) that would have exempted physician practices that have 20 or fewer employees from having to comply with the Red Flags rule, but that legislation has failed to gain traction in the Senate.

FTC officials urged lawmakers to act quickly to clarify what groups should be covered by the regulation. “As an agency we're charged with enforcing the law, and endless extensions delay enforcement,” FTC chairman Jon Leibowitz said in a statement.

The Red Flags rule was written to implement provisions of the Fair and Accurate Credit Transactions Act, which calls on creditors and financial institutions to address the risk of identity theft.

The rule requires creditors to develop formal identity-theft prevention programs that would allow an organization to identify, detect, and respond to any suspicious practices, or “red flags,” that could indicate identity theft.

The rule became effective on Jan. 1, 2008, with an original enforcement deadline of Nov. 1, 2008.

However, the FTC has delayed enforcement of the rule several times, first to give organizations more time to get familiar with the requirements, and later to comply with requests from members of Congress.

The rule has been controversial in the medical community because many physicians believe their practices don't fit into the definition of a “creditor.”

However, the FTC has continued to insist that physicians are in fact “creditors” because they allow their patients to defer payments over time.

The agency also has tried to assure physicians that the requirements should not be a burden and that small practices can come into compliance by implementing simple steps. For example, in low-risk settings, practice staff can ask patients for photo identification when they come in for an appointment.

The American Medical Association and other physician groups have been lobbying to get physicians excluded completely from the requirements. On May 21, the AMA joined the American Osteopathic Association and the Medical Society of the District Columbia in a federal lawsuit that seeks to prevent the FTC from applying the Red Flags rule to physicians.

The groups contend that not only are physicians not creditors, but that the rules would be burdensome and duplicate requirements already in place under the Health Insurance Portability and Accountability Act.

“Physicians are already ethically and legally responsible for ensuring the confidentiality and security of patients' medical information,” said Dr. Peter E. Lavine, president of the Medical Society of the District of Columbia, said in a statement. “It is unnecessary to add to the existing web of federal security regulations physicians must follow.”

The Federal Trade Commission has again postponed enforcement of the “Red Flags” rule, giving physicians until the end of 2010 before they must implement identity-theft prevention programs in their practices.

Enforcement of the rule had been scheduled to begin on June 1.

In a statement issued on May 28, the FTC said it was delaying enforcement to give Congress time to consider pending legislation that would exclude some small physician practices and small businesses from the rule.

Last year, the House passed a bill (H.R. 3763) that would have exempted physician practices that have 20 or fewer employees from having to comply with the Red Flags rule, but that legislation has failed to gain traction in the Senate.

FTC officials urged lawmakers to act quickly to clarify what groups should be covered by the regulation. “As an agency we're charged with enforcing the law, and endless extensions delay enforcement,” FTC chairman Jon Leibowitz said in a statement.

The Red Flags rule was written to implement provisions of the Fair and Accurate Credit Transactions Act, which calls on creditors and financial institutions to address the risk of identity theft.

The rule requires creditors to develop formal identity-theft prevention programs that would allow an organization to identify, detect, and respond to any suspicious practices, or “red flags,” that could indicate identity theft.

The rule became effective on Jan. 1, 2008, with an original enforcement deadline of Nov. 1, 2008.

However, the FTC has delayed enforcement of the rule several times, first to give organizations more time to get familiar with the requirements, and later to comply with requests from members of Congress.

The rule has been controversial in the medical community because many physicians believe their practices don't fit into the definition of a “creditor.”

However, the FTC has continued to insist that physicians are in fact “creditors” because they allow their patients to defer payments over time.

The agency also has tried to assure physicians that the requirements should not be a burden and that small practices can come into compliance by implementing simple steps. For example, in low-risk settings, practice staff can ask patients for photo identification when they come in for an appointment.

The American Medical Association and other physician groups have been lobbying to get physicians excluded completely from the requirements. On May 21, the AMA joined the American Osteopathic Association and the Medical Society of the District Columbia in a federal lawsuit that seeks to prevent the FTC from applying the Red Flags rule to physicians.

The groups contend that not only are physicians not creditors, but that the rules would be burdensome and duplicate requirements already in place under the Health Insurance Portability and Accountability Act.

“Physicians are already ethically and legally responsible for ensuring the confidentiality and security of patients' medical information,” said Dr. Peter E. Lavine, president of the Medical Society of the District of Columbia, said in a statement. “It is unnecessary to add to the existing web of federal security regulations physicians must follow.”

Check your mailbox. If you provided covered out-of-network services to patients insured by UnitedHealth Group between March 1994 and November 2009, you may be eligible to receive payments as part of a $350 million settlement reached last year.

The American Medical Association estimates that thousands of physicians will be eligible to be paid under the settlement. Notices with instructions for filing claims are being mailed this month.

The $350 million settlement comes after a nearly decade-long legal battle between UnitedHealth Group and several plaintiffs, including the AMA, the Medical Society of the State of New York, and the Missouri State Medical Association. The groups alleged that UnitedHealth Group conspired to systematically underpay physicians for out-of-network medical services by using an industry database of charges to justify lower reimbursements.

Last year, UnitedHealth Group reached a settlement with New York State Attorney General Andrew Cuomo to discontinue use of the database and the company committed $50 million to fund the development of a new, independent database that will determine the rates paid for out-of-network care.

In a separate settlement, the company agreed to pay $350 million to reimburse health plan members and out-of-network providers who were underpaid as a result of the flawed database calculations. Physicians and patients have until July 27, 2010, to opt out of the settlement. Claims for payments from the settlement fund are due by Oct. 5, 2010.

To be eligible to receive part of the settlement, physicians must have provided covered out-of-network services or supplies between March 15, 1994, and Nov. 18, 2009, to patients covered by a health plan that was either administered or insured by UnitedHealthcare, Oxford Health Plans, Metropolitan Life Insurance Companies, American Airlines, or one of their affiliates. In order to be eligible, physicians must have been given an assignment by the patient to bill the health plan.

Physicians billed via an assignment if they received a payment directly from the health plan, if they completed box 13 on the HCFA/CMS 1500 form, or if they marked yes in the benefits assignment indicator on an electronic health care claim, according to the AMA.

Physicians who are owed money by a patient for a covered out-of-network service or supply cannot file a claim through the settlement; however, they can contact the Settlement Claims Administrator to find out if any of their patients have submitted claims to the settlement fund.

For more information, contact the Berdon Claims Administration LLC at 800-443-1073 or unitedhealthcare@berdonclaimsllc.com

Check your mailbox. If you provided covered out-of-network services to patients insured by UnitedHealth Group between March 1994 and November 2009, you may be eligible to receive payments as part of a $350 million settlement reached last year.

The American Medical Association estimates that thousands of physicians will be eligible to be paid under the settlement. Notices with instructions for filing claims are being mailed this month.

The $350 million settlement comes after a nearly decade-long legal battle between UnitedHealth Group and several plaintiffs, including the AMA, the Medical Society of the State of New York, and the Missouri State Medical Association. The groups alleged that UnitedHealth Group conspired to systematically underpay physicians for out-of-network medical services by using an industry database of charges to justify lower reimbursements.

Last year, UnitedHealth Group reached a settlement with New York State Attorney General Andrew Cuomo to discontinue use of the database and the company committed $50 million to fund the development of a new, independent database that will determine the rates paid for out-of-network care.

In a separate settlement, the company agreed to pay $350 million to reimburse health plan members and out-of-network providers who were underpaid as a result of the flawed database calculations. Physicians and patients have until July 27, 2010, to opt out of the settlement. Claims for payments from the settlement fund are due by Oct. 5, 2010.

To be eligible to receive part of the settlement, physicians must have provided covered out-of-network services or supplies between March 15, 1994, and Nov. 18, 2009, to patients covered by a health plan that was either administered or insured by UnitedHealthcare, Oxford Health Plans, Metropolitan Life Insurance Companies, American Airlines, or one of their affiliates. In order to be eligible, physicians must have been given an assignment by the patient to bill the health plan.

Physicians billed via an assignment if they received a payment directly from the health plan, if they completed box 13 on the HCFA/CMS 1500 form, or if they marked yes in the benefits assignment indicator on an electronic health care claim, according to the AMA.

Physicians who are owed money by a patient for a covered out-of-network service or supply cannot file a claim through the settlement; however, they can contact the Settlement Claims Administrator to find out if any of their patients have submitted claims to the settlement fund.

For more information, contact the Berdon Claims Administration LLC at 800-443-1073 or unitedhealthcare@berdonclaimsllc.com

Check your mailbox. If you provided covered out-of-network services to patients insured by UnitedHealth Group between March 1994 and November 2009, you may be eligible to receive payments as part of a $350 million settlement reached last year.

The American Medical Association estimates that thousands of physicians will be eligible to be paid under the settlement. Notices with instructions for filing claims are being mailed this month.

The $350 million settlement comes after a nearly decade-long legal battle between UnitedHealth Group and several plaintiffs, including the AMA, the Medical Society of the State of New York, and the Missouri State Medical Association. The groups alleged that UnitedHealth Group conspired to systematically underpay physicians for out-of-network medical services by using an industry database of charges to justify lower reimbursements.

Last year, UnitedHealth Group reached a settlement with New York State Attorney General Andrew Cuomo to discontinue use of the database and the company committed $50 million to fund the development of a new, independent database that will determine the rates paid for out-of-network care.

In a separate settlement, the company agreed to pay $350 million to reimburse health plan members and out-of-network providers who were underpaid as a result of the flawed database calculations. Physicians and patients have until July 27, 2010, to opt out of the settlement. Claims for payments from the settlement fund are due by Oct. 5, 2010.

To be eligible to receive part of the settlement, physicians must have provided covered out-of-network services or supplies between March 15, 1994, and Nov. 18, 2009, to patients covered by a health plan that was either administered or insured by UnitedHealthcare, Oxford Health Plans, Metropolitan Life Insurance Companies, American Airlines, or one of their affiliates. In order to be eligible, physicians must have been given an assignment by the patient to bill the health plan.

Physicians billed via an assignment if they received a payment directly from the health plan, if they completed box 13 on the HCFA/CMS 1500 form, or if they marked yes in the benefits assignment indicator on an electronic health care claim, according to the AMA.

Physicians who are owed money by a patient for a covered out-of-network service or supply cannot file a claim through the settlement; however, they can contact the Settlement Claims Administrator to find out if any of their patients have submitted claims to the settlement fund.

For more information, contact the Berdon Claims Administration LLC at 800-443-1073 or unitedhealthcare@berdonclaimsllc.com

Institutions that receive funding from the National Institutes of Health soon will have to publicly post information about any significant financial interests related to their government-funded research under proposed federal regulations published May 21.

The proposed regulation, which has been in the works for about a year, follows several high-profile cases in which NIH-funded researchers failed to disclose large amounts of industry funding.

Federal regulations on this subject have not been updated since 1995

In a commentary published online by JAMA on May 24, Dr. Francis S. Collins, the director of NIH, and Sally J. Rockey, Ph.D., the acting director of the NIH Office of Extramural Research, wrote that the 1995 regulations needed to be “clarified and strengthened” in order to maintain the public's trust in federally funded research (doi: 10.1001/jama.2010.774).

“The public may not always understand the intricacies of rigorous science, but most individuals quickly grasp the concept of bias,” Dr. Collins and Dr. Rockey wrote in JAMA.

“Plain and simple, Americans do not want financial conflicts of interest to influence the federally funded research they hope will yield better ways to fight disease and improve health.”

Under the proposed regulation, researchers would be required to make broader disclosures, and institutions are given greater responsibility for determining whether a disclosed financial interest would impact research.

Currently, individual researchers are required to report only significant financial interests that could affect their NIH-funded research or any significant financial interest they have in a company whose own monetary interests could affect the research.

The proposed rule would require researchers to report all significant financial interests. It would then be the institution's responsibility to determine whether those interests could reasonably appear to affect their NIH-funded research.

Additionally, the proposal would lower the threshold for reporting financial interests from $10,000 down to $5,000 for all equity interests and payments for services.

Along with evaluating potential financial conflicts, institutions also would be required to create a management plan for every identified financial conflict of interest.

Such management plans would be aimed at either reducing or eliminating the conflict, and institutions would have to report those management plans to the NIH.

The proposed rule also aims to improve transparency regarding financial conflicts of interest. Under the rule, NIH would require every institution that receives NIH funding to post information on potential conflicts of interest on a publicly accessible Web site. Institutions would be required to post the researcher's name, role in the study, nature of the financial interest, and the approximate dollar value.

The public may comment on the proposed federal regulation until July 20; the rule is expected to be made final before the end of the year.

Institutions that receive funding from the National Institutes of Health soon will have to publicly post information about any significant financial interests related to their government-funded research under proposed federal regulations published May 21.

The proposed regulation, which has been in the works for about a year, follows several high-profile cases in which NIH-funded researchers failed to disclose large amounts of industry funding.

Federal regulations on this subject have not been updated since 1995

In a commentary published online by JAMA on May 24, Dr. Francis S. Collins, the director of NIH, and Sally J. Rockey, Ph.D., the acting director of the NIH Office of Extramural Research, wrote that the 1995 regulations needed to be “clarified and strengthened” in order to maintain the public's trust in federally funded research (doi: 10.1001/jama.2010.774).

“The public may not always understand the intricacies of rigorous science, but most individuals quickly grasp the concept of bias,” Dr. Collins and Dr. Rockey wrote in JAMA.

“Plain and simple, Americans do not want financial conflicts of interest to influence the federally funded research they hope will yield better ways to fight disease and improve health.”

Under the proposed regulation, researchers would be required to make broader disclosures, and institutions are given greater responsibility for determining whether a disclosed financial interest would impact research.

Currently, individual researchers are required to report only significant financial interests that could affect their NIH-funded research or any significant financial interest they have in a company whose own monetary interests could affect the research.

The proposed rule would require researchers to report all significant financial interests. It would then be the institution's responsibility to determine whether those interests could reasonably appear to affect their NIH-funded research.

Additionally, the proposal would lower the threshold for reporting financial interests from $10,000 down to $5,000 for all equity interests and payments for services.

Along with evaluating potential financial conflicts, institutions also would be required to create a management plan for every identified financial conflict of interest.

Such management plans would be aimed at either reducing or eliminating the conflict, and institutions would have to report those management plans to the NIH.

The proposed rule also aims to improve transparency regarding financial conflicts of interest. Under the rule, NIH would require every institution that receives NIH funding to post information on potential conflicts of interest on a publicly accessible Web site. Institutions would be required to post the researcher's name, role in the study, nature of the financial interest, and the approximate dollar value.

The public may comment on the proposed federal regulation until July 20; the rule is expected to be made final before the end of the year.

Institutions that receive funding from the National Institutes of Health soon will have to publicly post information about any significant financial interests related to their government-funded research under proposed federal regulations published May 21.

The proposed regulation, which has been in the works for about a year, follows several high-profile cases in which NIH-funded researchers failed to disclose large amounts of industry funding.

Federal regulations on this subject have not been updated since 1995

In a commentary published online by JAMA on May 24, Dr. Francis S. Collins, the director of NIH, and Sally J. Rockey, Ph.D., the acting director of the NIH Office of Extramural Research, wrote that the 1995 regulations needed to be “clarified and strengthened” in order to maintain the public's trust in federally funded research (doi: 10.1001/jama.2010.774).

“The public may not always understand the intricacies of rigorous science, but most individuals quickly grasp the concept of bias,” Dr. Collins and Dr. Rockey wrote in JAMA.

“Plain and simple, Americans do not want financial conflicts of interest to influence the federally funded research they hope will yield better ways to fight disease and improve health.”

Under the proposed regulation, researchers would be required to make broader disclosures, and institutions are given greater responsibility for determining whether a disclosed financial interest would impact research.

Currently, individual researchers are required to report only significant financial interests that could affect their NIH-funded research or any significant financial interest they have in a company whose own monetary interests could affect the research.

The proposed rule would require researchers to report all significant financial interests. It would then be the institution's responsibility to determine whether those interests could reasonably appear to affect their NIH-funded research.

Additionally, the proposal would lower the threshold for reporting financial interests from $10,000 down to $5,000 for all equity interests and payments for services.

Along with evaluating potential financial conflicts, institutions also would be required to create a management plan for every identified financial conflict of interest.

Such management plans would be aimed at either reducing or eliminating the conflict, and institutions would have to report those management plans to the NIH.

The proposed rule also aims to improve transparency regarding financial conflicts of interest. Under the rule, NIH would require every institution that receives NIH funding to post information on potential conflicts of interest on a publicly accessible Web site. Institutions would be required to post the researcher's name, role in the study, nature of the financial interest, and the approximate dollar value.

The public may comment on the proposed federal regulation until July 20; the rule is expected to be made final before the end of the year.