From pottsbri@yahoo.com Mon Feb 2 17:06:28 2004 From: pottsbri@yahoo.com (CAL/AAEM News Service) Date: Mon, 2 Feb 2004 09:06:28 -0800 (PST) Subject: CMS Releases National Provider Identifier Rule Message-ID: <20040202170628.96498.qmail@web41310.mail.yahoo.com> --0-1101419778-1075741588=:95804 Content-Type: text/plain; charset=us-ascii -----Original Message----- From: cma_alert@cmanews.org [mailto:cma_alert@cmanews.org] Sent: Thursday, January 29, 2004 2:58 PM 4. CMS Releases National Provider Identifier Rule The Centers for Medicare & Medicaid Services (CMS) last week announced that the National Provider Identifier (NPI) will become the standard unique identifier for health care providers on May 23, 2007. This national provider identification system-mandated by the Health Insurance Portability and Accountability Act of 1996 (HIPAA)-will eliminate the need for physicians to keep track of and use multiple identification numbers assigned to them by health plans. Providers will still, however, need to provide their taxpayer identification number to plans for tax reporting purposes. Providers who are not "covered entities" under HIPAA do not have to obtain an NPI, but they may do so if they wish. Physicians who are covered by HIPAA will need these identifiers to submit HIPAA-compliant claims. There is nothing physicians can do to apply for NPIs at this time. The final rule governing NPIs, published January 23 in the Federal Register, establishes a timeline for implementation of this new national provider identification system. According to the rule, CMS will begin accepting NPI applications on May 23, 2005. Physicians will be required to use their assigned number in dealings with health plans and other business partners by May 23, 2007. For more information, click here . Additional HIPAA information is available at in the California Physician HIPAA Help Center . Brian Potts Managing Editor, CAL/AAEM News Service MS-IV, UC-Irvine --------------------------------- Do you Yahoo!? Yahoo! SiteBuilder - Free web site building tool. Try it! --0-1101419778-1075741588=:95804 Content-Type: text/html; charset=us-ascii

-----Original Message-----

From: cma_alert@cmanews.org [mailto:cma_alert@cmanews.org]

Sent: Thursday, January 29, 2004 2:58 PM

4. CMS Releases National Provider Identifier Rule

The Centers for Medicare & Medicaid Services (CMS) last week announced that the National Provider Identifier (NPI) will become the standard unique identifier for health care providers on May 23, 2007. This national provider identification system-mandated by the Health Insurance Portability and Accountability Act of 1996 (HIPAA)-will eliminate the need for physicians to keep track of and use multiple identification numbers assigned to them by health plans. Providers will still, however, need to provide their taxpayer identification number to plans for tax reporting purposes.

Providers who are not "covered entities" under HIPAA do not have to obtain an NPI, but they may do so if they wish. Physicians who are covered by HIPAA will need these identifiers to submit HIPAA-compliant claims.

There is nothing physicians can do to apply for NPIs at this time. The final rule governing NPIs, published January 23 in the Federal Register, establishes a timeline for implementation of this new national provider identification system. According to the rule, CMS will begin accepting NPI applications on May 23, 2005. Physicians will be required to use their assigned number in dealings with health plans and other business partners by May 23, 2007.

For more information, click here <http://www.calphys.org/html/bb486.asp>. Additional HIPAA information is available

at in the California Physician HIPAA Help Center <http://www.calphys.org/html/hipaa_help.asp> .



Brian Potts
Managing Editor, CAL/AAEM News Service
MS-IV, UC-Irvine

Do you Yahoo!?
Yahoo! SiteBuilder - Free web site building tool. Try it! --0-1101419778-1075741588=:95804-- From DrWest4218@aol.com Wed Feb 4 23:11:02 2004 From: DrWest4218@aol.com (DrWest4218@aol.com) Date: Wed, 4 Feb 2004 18:11:02 EST Subject: Team Health ? Message-ID: --part1_da.295de03.2d52d606_boundary Content-Type: text/plain; charset="US-ASCII" Content-Transfer-Encoding: 7bit Do any of the readers out there know the style ( name of the parties) for the Qui Tan case that was filed in Texas against Team Health for fraudulent billing practices ? Thanks and let me know if anyone has anything on it. Robert V. West M.D. F.A.A.E.M. --part1_da.295de03.2d52d606_boundary Content-Type: text/html; charset="US-ASCII" Content-Transfer-Encoding: quoted-printable
Do any of the readers out there know the style ( name of the parties) for th= e Qui Tan case that was filed in Texas against Team Health for fraudulent bi= lling practices ?

Thanks and let me know if anyone has anything on it.

Robert V. West M.D. F.A.A.E.M. --part1_da.295de03.2d52d606_boundary-- From pottsbri@yahoo.com Thu Feb 5 02:17:26 2004 From: pottsbri@yahoo.com (CAL/AAEM News Service) Date: Wed, 4 Feb 2004 18:17:26 -0800 (PST) Subject: HMO profits jumped 60% in first-quarter 2003, rating agency reports, -AND- Physicians: Watch Out for Abusive Clauses in Managed Care Contracts Message-ID: <20040205021726.29742.qmail@web41307.mail.yahoo.com> --0-1169205609-1075947446=:29203 Content-Type: text/plain; charset=us-ascii =============================== AHA NEWS NOW The Daily Report for Health Care Executives www.ahanews.com =================================== Tuesday, Jan. 20, 2004 1) HMO profits jumped 60% in first-quarter 2003, rating agency reports The nation's HMOs recorded a $2.3 billion profit for the first three months of 2003, a 60% increase over first-quarter 2002, rating agency Weiss Ratings Inc. reported today. In addition, the number of HMOs earning a profit climbed to 80.2% from 61.6% in 2001, Weiss said. The analysis is based on 451 HMOs rated by Weiss, including Medicare HMOs. "HMOs continue to thrive as a result of ongoing premium increases and effective cost-cutting measures," said Melissa Gannon, Weiss vice president. She said she expects the rate hikes to eventually wane, giving consumers "some much needed relief." For more, see the announcement at http://www.weissratings.com/News/Ins_HMO/. ================================== Copyright 2004 by the American Hospital Association. All rights reserved. For republication rights, contact Craig Webb. AHA News is a registered trademark of the American Hospital Association. The opinions expressed in AHA News Now are not necessarily those of the American Hospital Association. =================================================== -----Original Message----- From: cma_alert@cmanews.org [mailto:cma_alert@cmanews.org] Sent: Thursday, January 29, 2004 2:58 PM 1. Physicians: Watch Out for Abusive Clauses in Managed Care Contracts Physicians should vigilantly check any managed care contract before signing it to ensure that it does not contain improper or otherwise abusive conditions. In particular, physicians should beware of contract terms that bind them to lengthy contractual periods. For example, some contracts require physicians to notify a health plan of their intent to terminate a contract at least 120 days prior to the anniversary date of the agreement and also require the physician to continue providing care under the agreement for at least 60 days after the anniversary date. If you signed such a contract, you would be obligated to provide care under the terms of the agreement for a total of 5 months after sending a timely notice of termination. If you missed the 4-month preanniversary notice deadline, you would be bound for more than a year. CMA urges physicians to negotiate such clauses out of any contract before signing. If you have already signed a contract containing such terms, CMA attorneys believe that you still have the right to terminate the contract, if the payor has breached the contract by, for example, failing to pay claims in accordance with the terms of the agreement. (CMA legal counsel believes this to be true even if the contract does not contain a termination-for-cause clause.) For more information, visit CMA's ON-CALL library, which contains thousands of pages of medicolegal, regulatory, and reimbursement information. ON-CALL documents are available free to members at CMA's members-only website . Nonmembers can purchase ON-CALL documents for $2 per page at the CMA Bookstore. For step by step instructions on how to access the ON-CALL system, click here . Brian Potts Managing Editor, CAL/AAEM News Service MS-IV, UC-Irvine --------------------------------- Do you Yahoo!? Yahoo! Finance: Get your refund fast by filing online --0-1169205609-1075947446=:29203 Content-Type: text/html; charset=us-ascii

===============================

AHA NEWS NOW

The Daily Report for Health Care Executives

www.ahanews.com

===================================

Tuesday, Jan. 20, 2004

1) HMO profits jumped 60% in first-quarter 2003, rating agency reports

The nation's HMOs recorded a $2.3 billion profit for the first three months of 2003, a 60% increase over first-quarter 2002, rating agency Weiss Ratings Inc. reported today. In addition, the number of HMOs earning a profit climbed to 80.2% from 61.6% in 2001, Weiss said. The analysis is based on 451 HMOs rated by Weiss, including Medicare HMOs. "HMOs continue to thrive as a result of ongoing premium increases and effective cost-cutting measures," said Melissa Gannon, Weiss vice president. She said she expects the rate hikes to eventually wane, giving consumers "some much needed relief." For more, see the announcement at http://www.weissratings.com/News/Ins_HMO/.

==================================

Copyright 2004 by the American Hospital Association. All rights reserved. For republication rights, contact Craig Webb. AHA News is a registered trademark of the American Hospital Association. The opinions expressed in AHA News Now are not necessarily those of the American Hospital Association.

===================================================

-----Original Message-----

From: cma_alert@cmanews.org [mailto:cma_alert@cmanews.org]

Sent: Thursday, January 29, 2004 2:58 PM

1. Physicians: Watch Out for Abusive Clauses in Managed Care Contracts

Physicians should vigilantly check any managed care contract before signing it to ensure that it does not contain improper or otherwise abusive conditions. In particular, physicians should beware of contract terms that bind them to lengthy contractual periods.

For example, some contracts require physicians to notify a health plan of their intent to terminate a contract at least 120 days prior to the anniversary date of the agreement and also require the physician to continue providing care under the agreement for at least 60 days after the anniversary date. If you signed such a contract, you would be obligated to provide care under the terms of the agreement for a total of 5 months after sending a timely notice of termination. If you missed the 4-month preanniversary notice deadline, you would be bound for more than a year.

CMA urges physicians to negotiate such clauses out of any contract before signing. If you have already signed a contract containing such terms, CMA attorneys believe that you still have the right to terminate the contract, if the payor has breached the contract by, for example, failing to pay claims in accordance with the terms of the agreement. (CMA legal counsel believes this to be true even if the contract does not contain a termination-for-cause clause.)

For more information, visit CMA's ON-CALL library, which contains thousands of pages of medicolegal, regulatory, and reimbursement information. ON-CALL documents are available free to members at CMA's members-only website <http://www.cmanet.org/logon> . Nonmembers can purchase ON-CALL documents for $2 per page at the <http://www.cmanet.org/bookstore> CMA Bookstore. For step by step instructions on how to access the ON-CALL system, click here <http://www.calphys.org/html/bb483.asp> .



Brian Potts
Managing Editor, CAL/AAEM News Service
MS-IV, UC-Irvine

Do you Yahoo!?
Yahoo! Finance: Get your refund fast by filing online --0-1169205609-1075947446=:29203-- From pottsbri@yahoo.com Fri Feb 6 07:06:14 2004 From: pottsbri@yahoo.com (CAL/AAEM News Service) Date: Thu, 5 Feb 2004 23:06:14 -0800 (PST) Subject: Tenet Healthcare To Announce Plans To Sell 27 Hospitals, 19 in California; -AND- Department of Health Services Director Diana Bonta Resigns Message-ID: <20040206070614.9531.qmail@web41308.mail.yahoo.com> --0-1123960169-1076051174=:8140 Content-Type: text/plain; charset=us-ascii -----Original Message----- From: California Healthline [mailto:CALIFORNIAHEALTHLINE@ADVISORY.COM] Tenet Healthcare To Announce Plans To Sell 27 Hospitals, 19 in California 01/28/2004 Santa Barbara-based Tenet Healthcare on Wednesday will announce that the company intends to sell 27 -- more than 25% -- of its hospitals, CEO Trevor Fetter said Tuesday, the New York Times reports (Pollack, New York Times, 1/28). Tenet is the nation's second-largest hospital chain and owns 100 hospitals in 15 states. Tenet began downsizing last year, when it announced plans to sell or divest 14 facilities as part of an ongoing cost-cutting effort. However, unlike last year's sales, which focused largely on noncore markets, the hospitals in the upcoming sales will include a number in larger markets ( http://www.californiahealthline.org/members/basecontent.asp?contentid=50776&collectionid=3&program=1 California Healthline, 1/27). Of the hospitals Tenet plans to sell, 19 are in California, the company's largest market. The other facilities are in Louisiana, Massachusetts, Missouri and Texas. Fetter said that the sales are necessary under current ma! rket conditions, saying, "The strongest hospitals have always subsidized the weaker hospitals, but when the whole group is challenged economically, we need to devote resources from the strong hospitals back into those hospitals" (Rundle, Wall Street Journal, 1/28). Tenet officials said they expect to complete the sales by the end of the year and realize net profits of about $600 million (New York Times, 1/28). The sales are estimated to result in a $1.4 billion fourth-quarter charge that will lead to net losses for 2003 and 2004 (Wall Street Journal, 1/28). Fetter said, "By getting smaller, we will be able to accelerate the time it takes for a turnaround" (New York Times, 1/28). Financial Review, Investigations The decision follows a three-month financial review that "exposed weaknesses" at some facilities, the Journal reports. The hospitals are "struggling to adjust to a sharp reduction" in Medicare outlier payments -- which reimburse for unusually expensive care -- after agreeing to reduce such charges last year. The company's bad debt expense has increased, in part because of greater numbers of uninsured patients seeking treatment at the hospitals and more patients whose health benefits have been reduced. According to the Journal, the company is experiencing "revenue softness" because of "smaller-than-expected" payment increases from managed care plans. The downsizing also comes after "a series of crises" during the past 15 months, the Journal reports (Wall Street Journal, 1/28). Tenet faces separate probes by the Senate Finance Committee , the Department of Health Services, the Securities and Excha! nge Commission, the HHS Office of Inspector General , the Justice Department and the Federal Trade Commission related to alleged Medicare fraud and other issues. The company also faces an investigation by the Florida Medicaid Fraud Control Unit http://myfloridalegal.com/pages.nsf/0/ebc480598bbf32d885256cc6005b54d1?OpenDocument and the U.S. attorney's office in Los Angeles (California Healthline, 1/27). California Fetter said that Tenet is selling some facilities in California partly to save money on state-mandated seismic safety upgrades http://www.californiahealthline.org/members/basecontent.asp?contentid=50706&collectionid=3&program=1 , which must be completed by the end of 2007. Company officials estimate that it would cost about $1.6 billion to upgrade the 19 facilities that it plans to sell, compared with about $300 million to upgrade the 17 facilities that it is keeping (Wall Street Journal, 1/28). The upgrade costs for the facilities it is selling are higher primarily because they are older and larger, the Los Angeles Times reports. In addition, seismic upgrade requirements and a new state nurse-to-patient ratio http://www.californiahealthline.org/members/basecontent.asp?contentid=50785&collectionid=3&contentarea=40849 rule that took effect Jan. 1 may make the California hospitals "a very tough sell -- even at fire-sa! le prices," the Los Angeles Times reports. Tenet officials expect to take a loss on the sale of most of the California facilities. Health officials in Southern California are particularly concerned about the effects of the hospital sales because all but one of the California hospitals to be sold is in Los Angeles County or Orange County. John Edelston, a health care consultant and former chair of the Los Angeles County Emergency Medical Services Commission, said, "This is not good news. If hospitals close, it will mean less access and longer waits than there already are" (Girion/Lee, Los Angeles Times, 1/28). -----Original Message----- From: California Healthline [mailto:CALIFORNIAHEALTHLINE@ADVISORY.COM] Department of Health Services Director Diana Bonta Resigns 01/28/2004 Department of Health Services Director Diana Bonta last week resigned from her position, the Los Angeles Times reports. Bonta, who was appointed to the position in 1999 by former Gov. Gray Davis (D), has been expected to resign since Gov. Arnold Schwarzenegger (R) was elected in October, according to the Times. As DHS director, Bonta oversaw one of the largest departments in the state and helped lead the state's anti-smoking campaign, response to severe acute respiratory syndrome and bioterrorism preparedness efforts. DHS administers Medi-Cal , licensing programs for nursing homes, hospitals and clinics and other programs. Bonta's last day on the job was Thursday. A replacement has not yet been named (Reiterman, Los Angeles Times, 1/28). Brian Potts Managing Editor, CAL/AAEM News Service MS-IV, UC-Irvine --------------------------------- Do you Yahoo!? Yahoo! Finance: Get your refund fast by filing online --0-1123960169-1076051174=:8140 Content-Type: text/html; charset=us-ascii

-----Original Message-----

From: California Healthline [mailto:CALIFORNIAHEALTHLINE@ADVISORY.COM]

Tenet Healthcare To Announce Plans To Sell 27 Hospitals, 19 in California

01/28/2004

Santa Barbara-based Tenet Healthcare <http://www.tenethealth.com/> on Wednesday will announce that the company intends to sell 27 -- more than 25% -- of its hospitals, CEO Trevor Fetter said Tuesday, the New York Times reports (Pollack, New York Times, 1/28). Tenet is the nation's second-largest hospital chain and owns 100 hospitals in 15 states. Tenet began downsizing last year, when it announced plans to sell or divest 14 facilities as part of an ongoing cost-cutting effort. However, unlike last year's sales, which focused largely on noncore markets, the hospitals in the upcoming sales will include a number in larger markets ( http://www.californiahealthline.org/members/basecontent.asp?contentid=50776&collectionid=3&program=1 California Healthline, 1/27). Of the hospitals Tenet plans to sell, 19 are in California, the company's largest market. The other facilities are in Louisiana, Massachusetts, Missouri and Texas. Fetter said that the sales are necessary under current market conditions, saying, "The strongest hospitals have always subsidized the weaker hospitals, but when the whole group is challenged economically, we need to devote resources from the strong hospitals back into those hospitals" (Rundle, Wall Street Journal, 1/28). Tenet officials said they expect to complete the sales by the end of the year and realize net profits of about $600 million (New York Times, 1/28). The sales are estimated to result in a $1.4 billion fourth-quarter! charge that will lead to net losses for 2003 and 2004 (Wall Street Journal, 1/28). Fetter said, "By getting smaller, we will be able to accelerate the time it takes for a turnaround" (New York Times, 1/28).

Financial Review, Investigations

The decision follows a three-month financial review that "exposed weaknesses" at some facilities, the Journal reports. The hospitals are "struggling to adjust to a sharp reduction" in Medicare outlier payments -- which reimburse for unusually expensive care -- after agreeing to reduce such charges last year. The company's bad debt expense has increased, in part because of greater numbers of uninsured patients seeking treatment at the hospitals and more patients whose health benefits have been reduced. According to the Journal, the company is experiencing "revenue softness" because of "smaller-than-expected" payment increases from managed care plans. The downsizing also comes after "a series of crises" during the past 15 months, the Journal reports (Wall Street Journal, 1/28). Tenet faces separate probes by the Senate Finance Committee <http://finance.senate.gov/> , ! the Department of Health <http://www.dhs.cahwnet.gov/> Services, the Securities <http://www.sec.gov/> and Exchange Commission, the HHS Office of Inspector General <http://oig.hhs.gov/> , the Justice Department <http://www.usdoj.gov/> and the Federal Trade Commission <http://www.ftc.gov/> related to alleged Medicare fraud and other issues. The company also faces an investigation by the Florida Medicaid Fraud Control Unit http://myfloridalegal.com/pages.nsf/0/ebc480598bbf32d885256cc6005b54d1?OpenDocument and the U.S. attorney's office in Los Angeles (California Healthline, 1/27).

California

Fetter said that Tenet is selling some facilities in California partly to save money on state-mandated seismic safety upgrades http://www.californiahealthline.org/members/basecontent.asp?contentid=50706&collectionid=3&program=1 , which must be completed by the end of 2007. Company officials estimate that it would cost about $1.6 billion to upgrade the 19 facilities that it plans to sell, compared with about $300 million to upgrade the 17 facilities that it is keeping (Wall Street Journal, 1/28). The upgrade costs for the facilities it is selling are higher primarily because they are older and larger, the <http://www.latimes.com/la-fi-tenet28jan28,1,2233557.story> Los Angeles Times reports. In addition, seismic upgrade requirements and a new state nurse-to-patient ratio http://www.californiahealthline.org/members/basecontent.asp?contentid=50785&collectionid=3&contentarea=40849 rule that took effect Jan. 1 may make the California hospitals "a very tough sell -- even at fire-sale prices," the Los Angeles Times reports. Tenet officials expect to take a loss on the sale of most of the California facilities. Health officials in Southern California are particularly concerned about the effects of the hospital sales because all but one of the California hospitals to! be sold is in Los Angeles County or Orange County. John Edelston, a health care consultant and former chair of the Los Angeles County Emergency Medical Services Commission, said, "This is not good news. If hospitals close, it will mean less access and longer waits than there already are" (Girion/Lee, Los Angeles Times, 1/28).

 

-----Original Message-----

From: California Healthline [mailto:CALIFORNIAHEALTHLINE@ADVISORY.COM]

Department of Health Services Director Diana Bonta Resigns

01/28/2004

Department of Health <http://www.dhs.cahwnet.gov/> Services Director Diana Bonta last week resigned from her position, the <http://www.latimes.com/news/local/la-me-bonta28jan28,1,3575698.story> Los Angeles Times reports. Bonta, who was appointed to the position in 1999 by former Gov. Gray Davis (D), has been expected to resign since Gov. Arnold Schwarzenegger (R) was elected in October, according to the Times. As DHS director, Bonta oversaw one of the largest departments in the state and helped lead the state's anti-smoking campaign, response to severe acute respiratory syndrome and bioterrorism preparedness efforts. DHS administers Medi-Cal <http://www.medi-cal.ca.gov/> , licensing programs for nursing homes, hospitals and clinics and other programs. Bonta's last day on the job was Thursday. A replacement has not yet been named (Reiterman, Los Angeles Times, 1/28).



Brian Potts
Managing Editor, CAL/AAEM News Service
MS-IV, UC-Irvine

Do you Yahoo!?
Yahoo! Finance: Get your refund fast by filing online --0-1123960169-1076051174=:8140-- From pottsbri@yahoo.com Sat Feb 7 23:41:59 2004 From: pottsbri@yahoo.com (CAL/AAEM News Service) Date: Sat, 7 Feb 2004 15:41:59 -0800 (PST) Subject: Malpractice debate, 3 articles:Practicing without Malpractice Insurance, Bush calls for Caps, CBO Report on Caps Message-ID: <20040207234159.71710.qmail@web41305.mail.yahoo.com> --0-892297931-1076197319=:70085 Content-Type: text/plain; charset=us-ascii -----Original Message----- From: California Healthline [mailto:CALIFORNIAHEALTHLINE@ADVISORY.COM] Wall Street Journal Examines Physicians Who Practice Without Malpractice Insurance 01/28/2004 The Wall Street Journal on Wednesday examined the "growing number" of physicians that are practicing medicine without malpractice insurance, known as "going bare." Doctors who go without malpractice insurance are self-insured and are personally responsible for judgments, settlements and legal fees if they are sued, possibly resulting in less money for a patient that is suing for malpractice, the Journal reports. It is unknown how many doctors nationally are without malpractice insurance, and many states do not require doctors to have malpractice insurance to practice. In Florida, which "consistently has some of the highest malpractice insurance rates in the country," 5% of physicians are self-insured, up from 4% last year, and in Miami-Dade County, 20% are self-insured, the Journal reports. The American Medical Association in December 2002 eliminated its malpractice insurance policy, which recommended that physicians carry "sufficient malpractice i! nsurance to protect themselves and their patients"; the AMA now "leave[s] the decision to doctors," according to the Journal. Marc Singer, of Singer Xenos Wealth Management, says that patients who sue self-insured doctors for malpractice "often settle for less and do so more quickly" because a doctor can file for bankruptcy, according to the Journal (Silverman, Wall Street Journal, 1/28). ================================================ From: California Healthline [mailto:CALIFORNIAHEALTHLINE@ADVISORY.COM] President Bush Calls for Cap on Medical Malpractice Awards in Arkansas Speech 01/27/2004 Speaking at a political stop at Baptist Health Medical Center in Little Rock, Ark., on Monday, President Bush called for a cap on medical malpractice awards, saying that costs associated with "frivolous" medical malpractice lawsuits are driving up physicians' liability premiums, forcing many to practice defensive medicine or abandon their practices, the Arkansas Democrat-Gazette reports (Smith/Oman, Arkansas Democrat-Gazette, 1/27). Bush added that "junk" lawsuits increase costs to taxpayers by increasing government health care costs by $28 billion each year, but he did not "define precisely" what would constitute a lawsuit without merit, the AP/Boston Globe reports (AP/Boston Globe, 1/26). "The health care system looks like a giant lottery, ... and somehow the trial lawyers always hold the winning ticket," Bush said (Sherman, http://www.lasvegassun.com/sunbin/stories/bw-wh/2004/jan/26/012606492.html AP/Las Vegas Sun, 1/26). The president is ! working to revive a bill to institute a cap that the House approved last year but was stalled in the Senate. The legislation would have capped at $250,000 noneconomic damages in medical malpractice cases and would have limited punitive damages to $250,000 or twice the patient's actual financial loss, whichever is higher. The bill also would have limited lawyers' fees and the amount of time patients have to file a medical malpractice lawsuit. Bush's effort is part of a five-part plan for confronting the issue of the uninsured that he outlined in his State of the Union address last week ( http://www.californiahealthline.org/members/%20/members/basecontent.asp?contentid=50765&collectionid=3&program=1 California Healthline, 1/26). Reaction In a prepared statement, the American Medical Association praised Bush's renewed effort, saying that the United States' "broken liability system is severely jeopardizing patients' access to care" (AP/Boston Globe, 1/26). However, Rep. Vic Snyder (D-Ark.) said that he is "concern[ed]" about Bush's plan because it "federalizes what has always been the right and responsibility of state legislatures to resolve," adding that it "is usually a mistake to comprehensively preempt state laws passed by state legislatures." Sen. Blanche Lincoln (D-Ark.) said that she agrees with Bush on the need for tort reform measures, "but only as part of a broader effort to lower health care costs," the Democrat-Gazette reports. Lincoln said that capping noneconomic damages could help reduce health care costs and improve access to care, but she added that "it's not the be-all, end-all solution" (Arkansas Democrat-Gazette, 1/27). ================================================ -----Original Message----- From: California Healthline [mailto:CALIFORNIAHEALTHLINE@ADVISORY.COM] Congressional Budget Office Report Questions Impact of Caps on Damages in Medical Malpractice Lawsuits 01/14/2004 Legislation to cap damages in medical malpractice lawsuits would "do little to hold down health care spending" or eliminate the practice of "defensive medicine," according to a Congressional Budget Office report released last week, CongressDaily reports (CongressDaily, 1/13). The report found that malpractice insurance premiums have increased in recent years in part because insurers have experienced increases in claims costs as the amounts of damage awards in malpractice lawsuits have increased. However, the report found, malpractice insurance premiums also have increased because of reduced income from insurer investments and short-term factors in the insurance market. The report also found that although malpractice insurance premiums are lower in states with caps on damages in malpractice lawsuits, "even large savings in premiums" would have a small impact on total health care spending because malpractice insurance costs account for less than 2% of spe! nding (CBO report, 1/8). In addition, the report said that a cap on damages in malpractice lawsuits would not likely end the practice of "defensive medicine" -- in which physicians order more procedures and tests than are medically necessary to avoid malpractice lawsuits -- because "physicians who practice defensive medicine may do so less because they fear liability than to generate more income," CongressDaily reports (CongressDaily, 1/13). The report did not reach a conclusion on whether caps on damages in malpractice lawsuits affect access to health care. According to the report, although the General Accounting Office confirmed cases in which access to emergency surgery and newborn delivery was reduced in "scattered, often rural areas where providers identified other long-standing factors that affect the availability of services," the GAO also found that many reported shortages of health care services "could not be substantiated" or "did not widely affect access to health care! " (CBO report, 1/8). Medical Errors The CBO report also found no evidence that the current medical liability system prevents medical errors, a claim that some opponents of caps on damages in malpractice lawsuits have made (CongressDaily, 1/13). The report said that the medical liability system may not prevent medical errors because health care providers are "generally not exposed to the financial cost of their own malpractice" and because "very few medical injuries ever become the subject of a tort claim" (CBO report, 1/8). The report is available online . Note: You must have Adobe Acrobat Reader to view the report. Brian Potts Managing Editor, CAL/AAEM News Service MS-IV, UC-Irvine --------------------------------- Do you Yahoo!? Yahoo! Finance: Get your refund fast by filing online --0-892297931-1076197319=:70085 Content-Type: text/html; charset=us-ascii

-----Original Message-----

From: California Healthline [mailto:CALIFORNIAHEALTHLINE@ADVISORY.COM]

 

Wall Street Journal Examines Physicians Who Practice Without Malpractice Insurance

01/28/2004

The Wall Street Journal on Wednesday examined the "growing number" of physicians that are practicing medicine without malpractice insurance, known as "going bare." Doctors who go without malpractice insurance are self-insured and are personally responsible for judgments, settlements and legal fees if they are sued, possibly resulting in less money for a patient that is suing for malpractice, the Journal reports. It is unknown how many doctors nationally are without malpractice insurance, and many states do not require doctors to have malpractice insurance to practice. In Florida, which "consistently has some of the highest malpractice insurance rates in the country," 5% of physicians are self-insured, up from 4% last year, and in Miami-Dade County, 20% are self-insured, the Journal reports. The American <http://www.ama-assn.org/> Medical Association in December 2002 e! liminated its malpractice insurance policy, which recommended that physicians carry "sufficient malpractice insurance to protect themselves and their patients"; the AMA now "leave[s] the decision to doctors," according to the Journal. Marc Singer, of Singer <http://www.singerxenos.com/new/singerxenos/default.asp> Xenos Wealth Management, says that patients who sue self-insured doctors for malpractice "often settle for less and do so more quickly" because a doctor can file for bankruptcy, according to the Journal (Silverman, Wall Street Journal, 1/28).

================================================

From: California Healthline [mailto:CALIFORNIAHEALTHLINE@ADVISORY.COM]

 

President Bush Calls for Cap on Medical Malpractice Awards in Arkansas Speech

01/27/2004

Speaking at a political stop at Baptist <http://www.baptist-health.com/> Health Medical Center in Little Rock, Ark., on Monday, President Bush called for a cap on medical malpractice awards, saying that costs associated with "frivolous" medical malpractice lawsuits are driving up physicians' liability premiums, forcing many to practice defensive medicine or abandon their practices, the Arkansas Democrat-Gazette reports (Smith/Oman, Arkansas Democrat-Gazette, 1/27). Bush added that "junk" lawsuits increase costs to taxpayers by increasing government health care costs by $28 billion each year, but he did not "define precisely" what would constitute a lawsuit without merit, the AP/Boston Globe reports (AP/Boston Globe, 1/26). "The health care system looks like a giant lottery, ... and somehow the trial lawyers always hold the winning ticket," Bush said (Sherman, http://www.lasvegassun.com/sunbin/stories/bw-wh/2004/jan/26/012606492.html AP/Las Vegas Sun, 1/26). The president is working to revive a bill to institute a cap that the House approved last year but was stalled in the Senate. The legislation would have capped at $250,000 noneconomic damages in medical malpractice cases and would have limited punitive damages to $250,000 or twice the patient's actual financial loss, whichever is higher. The bill also would have limited lawyers' fees and the amount of time patients have to file a medical malpractice lawsuit. Bush's effort is part of a five-part plan for confronting the issue of the uninsured that he outlined in his State of the Union address last week ( http://www.californiahealthline.org/members/%20/members/basecontent.asp?contentid=50765&collectionid=3&program=1 California Healthline, 1/26).

Reaction

In a prepared statement, the American <http://www.ama-assn.org/> Medical Association praised Bush's renewed effort, saying that the United States' "broken liability system is severely jeopardizing patients' access to care" (AP/Boston Globe, 1/26). However, Rep. Vic Snyder (D-Ark.) said that he is "concern[ed]" about Bush's plan because it "federalizes what has always been the right and responsibility of state legislatures to resolve," adding that it "is usually a mistake to comprehensively preempt state laws passed by state legislatures." Sen. Blanche Lincoln (D-Ark.) said that she agrees with Bush on the need for tort reform measures, "but only as part of a broader effort to lower health care costs," the Democrat-Gazette reports. Lincoln said that capping noneconomic damages could help reduce health care costs and improve access to care, but she added that "it's not ! the be-all, end-all solution" (Arkansas Democrat-Gazette, 1/27).

================================================

-----Original Message-----

From: California Healthline [mailto:CALIFORNIAHEALTHLINE@ADVISORY.COM]

 

Congressional Budget Office Report Questions Impact of Caps on Damages in Medical Malpractice Lawsuits

01/14/2004

Legislation to cap damages in medical malpractice lawsuits would "do little to hold down health care spending" or eliminate the practice of "defensive medicine," according to a Congressional <http://www.cbo.gov/> Budget Office report released last week, CongressDaily reports (CongressDaily, 1/13). The report found that malpractice insurance premiums have increased in recent years in part because insurers have experienced increases in claims costs as the amounts of damage awards in malpractice lawsuits have increased. However, the report found, malpractice insurance premiums also have increased because of reduced income from insurer investments and short-term factors in the insurance market. The report also found that although malpractice insurance premiums are lower in states with caps on damages in malpractice lawsuits, "even large savings in premiums" would have a small ! impact on total health care spending because malpractice insurance costs account for less than 2% of spending (CBO report, 1/8). In addition, the report said that a cap on damages in malpractice lawsuits would not likely end the practice of "defensive medicine" -- in which physicians order more procedures and tests than are medically necessary to avoid malpractice lawsuits -- because "physicians who practice defensive medicine may do so less because they fear liability than to generate more income," CongressDaily reports (CongressDaily, 1/13). The report did not reach a conclusion on whether caps on damages in malpractice lawsuits affect access to health care. According to the report, although the General Accounting Office confirmed cases in which access to emergency surgery and newborn delivery was reduced in "scattered, often rural areas where providers identified other long-standing factors that affect the availability of services," the GAO also found that many reported shortages ! of health care services "could not be substantiated" or "did not widely affect access to health care" (CBO report, 1/8).

Medical Errors

The CBO report also found no evidence that the current medical liability system prevents medical errors, a claim that some opponents of caps on damages in malpractice lawsuits have made (CongressDaily, 1/13). The report said that the medical liability system may not prevent medical errors because health care providers are "generally not exposed to the financial cost of their own malpractice" and because "very few medical injuries ever become the subject of a tort claim" (CBO report, 1/8). The report is available online <ftp://ftp.cbo.gov/49xx/doc4968/01-08-MedicalMalpractice.pdf> . Note: You must have Adobe Acrobat Reader to view the report.



Brian Potts
Managing Editor, CAL/AAEM News Service
MS-IV, UC-Irvine

Do you Yahoo!?
Yahoo! Finance: Get your refund fast by filing online --0-892297931-1076197319=:70085-- From pottsbri@yahoo.com Sun Feb 8 17:14:51 2004 From: pottsbri@yahoo.com (CAL/AAEM News Service) Date: Sun, 8 Feb 2004 09:14:51 -0800 (PST) Subject: Bush Releases FY 2005 Budget Message-ID: <20040208171451.15258.qmail@web41305.mail.yahoo.com> --0-1803667152-1076260491=:15252 Content-Type: text/plain; charset=us-ascii -----Original Message----- From: Jonathan Fishburn [mailto:jfishburn@aamc.org] AAMC WASHINGTON HEADLINES Legislative and Regulatory News from the Association of American Medical Colleges February 6, 2004 Bush Releases FY 2005 Budget February 6, 2004 - President Bush Feb 2 submitted the details of his FY 2005 budget proposal to Congress. The $2.4 trillion spending plan calls for calls for $818 billion in discretionary spending in FY 2005, an increase of $31 billion (3.9 percent). Defense spending is increased by 7.1 percent and homeland security grows by 9.7 percent. Other domestic discretionary spending is slated to increase by 0.5 percent to $386 billion. The president's budget also proposes new budget enforcement mechanisms, including statutory controls to limit the growth of both discretionary and mandatory spending. Discretionary spending within the Department of Health and Human Services is decreased by $1.1 billion (1.6 percent) to $68.2 billion. As in previous budgets, the Administration proposes increases for a few priority programs, calls for the elimination of several programs, and freezes funding for the majority of discretionary health programs. The following summarizes the budget proposals for programs of interest to medical schools and teaching hospitals. National Institutes of Health (PDF, 12 pages): The president's budget includes $28.6 billion for NIH, an increase of $729 million (2.6 percent). This includes $80 million to be appropriated through the VA-HUD appropriations subcommittee, but does not includes $150 million for Type I diabetes research appropriated by Public Law 107-360 and $47 million for research in radiological and nuclear countermeasures appropriated through the Public Health and Social Services Emergency Fund. If these latter items are added, the program level for NIH is $28.8 billion, an increase of $763 million (2.7 percent) over the comparable total in FY 2004. The Biomedical Research and Development Price Index (BRDPI) for FY 2005 is projected at 3.5 percent [see related article]. The president's budget would fund a total of 39,986 research project grants (RPGs) in FY 2005, an increase of 558 over the current year. This includes 10,393 new and competing renewal RPGs, an increase of 258. NIH estimates this would provide for a success rate of 27 percent in FY 2005, equal to the projected FY 2004 success rate. However, the grants numbers are sustained by smaller than usual increases in the average cost of the grants. The budget calls for an aggregate 1.3 percent increase in average cost of RPGs. NIH will provide average cost increases of 1.9 percent for direct recurring costs in noncompeting continuation awards; competing RPGs will receive an average cost of 1 percent. Stipends for pre-doctoral and post-doctoral recipients of the Ruth L. Kirschstein National Research Service Awards will remain at FY 2004 levels. A total of $764 million is included for research training, a $15 million (2 percent) increase. Once again, the budget proposes to reduce the cap on salaries on extramural grants from Executive Level I ($174,500 in 2004) to Executive Level II ($157,000). The budget does not include funds for extramural research facilities grants through the National Center for Research Resources, which was funded at $119 million in FY 2004. HHS notes that $633 million has been appropriated for non-biodefense extramural construction projects over the past 10 years. The budget does propose $150 million to fund the construction of an additional 20 BSL-3 laboratories for biodefense research in metropolitan areas across the country. Funding for the NIH Roadmap in FY 2005 is set at $237 million, an increase of $109 million over the current year. Health Professions Programs: Similar to last year, the president's budget proposes $11 million for the Title VII health professions programs within HRSA, a 96 percent cut below FY 2004. Of this total, $10 million is for Scholarships for Disadvantaged Students (79 percent cut) and $1 million for health workforce information and analysis (39 percent increase). The budget provides $147 million for Title VIII nurse training programs, $5 million more than FY 2004. This includes $42 million for basic nurse education and retention, $10 million more than FY04; $21 million for diversity, a $5 million increase; $44 million for advanced nursing, a $15 million cut; $32 million for loan repayments and scholarships, a $5 million increase; and $8 million for geriatric education and faculty loan repayment, about level with last year. National Health Service Corps: The president's budget includes $205 million for the NHSC, an increase of $35 million (20.6 percent). Other HRSA Programs: The budget includes $303 million for Children's Hospitals Graduate Medical Education, the same funding as in FY 2004. The $35 million increase in the $2.08 billion Ryan White AIDS FY 2005 budget is directed for the AIDS Drug Assistance Programs, bringing it to $784 million. Rural health programs are cut by $91 million (63 percent) to $52 million in FY 2005, with the budget document citing the $9 billion in rural health resources provided in the Medicare reform bill as balancing this cut. The budget includes $10 million (a $94 million cut) for the Community Access Program (CAP), a program that seeks to enhance access through collaborative networks of providers. The traumatic brain injury ($9 million), poison control ($44 million) and telehealth programs ($4 million) are slated to receive flat funding in FY 2005. Agency for Healthcare Research and Quality: The budget provides level funding for AHRQ at $303.7 million, with all monies derived from transfers from other agencies. Funding designated for patient safety research is increased from $80 million to $84 million Bioterrorism Preparedness: The HRSA Bioterrorism Hospital Preparedness program receives $476 million in the president's FY 2005 budget, a $39 million (7.5 percent) cut below FY 2004 funding. The bioterrorism curriculum development grants are allotted $28 million in the budget, level with current funding. The budget also includes $1.1 billion for the state preparedness programs administered by the Centers for Disease Control and Prevention (CDC), the same level as current funding. The president's new $274 million surveillance initiative - coordinated by the CDC, the Department of Homeland Security (DHS), the Food and Drug Administration, and the Department of Agriculture - is designed to enhance surveillance in human health, hospital preparedness, state and local preparedness, vaccine research and procurement, animal health, food and agriculture safety and environmental monitoring. Provided under the DHS FY 2005 budget is new money for Project Bioshield, the administration's plan for stockpiling vaccines to counter a biological or chemical attack. It is proposed to receive $2.5 billion in FY 2005, three times the $890 million provided by Congress in FY 2004. VA Research: As in the president's FY 2004 proposal, the budget request for FY 2005 combines the direct and indirect costs of the VA research program into one appropriations line item. For FY 2005, the president's budget request proposes $770 million, a $50 million decrease (6.1 percent) from the comparable FY 2004 number. This figure is reportedly evenly split between the direct and indirect costs, which works out to a decrease of $20.6 million (5.1 percent) for the direct costs of research. The budget request also notes that the VA research program received a rating of "Results Not Demonstrated" as part of the Program Assessment Rating Tool (PART) evaluation. The Office of Management and Budget has directed the VA to develop meaningful and useful performance measures for the research program. VA Medical Care: The FY 2005 budget proposal recommends an appropriation of $27.05 billion for VA medical care, an increase of $510 million (1.9 percent) over FY 2004. At a Feb. 4 hearing of the House Veterans Affairs Committee, VA Secretary Anthony Principi stated that this request was $1.2 billion less than his agency had requested from the Office of Management and Budget (OMB). National Science Foundation: The president's FY 2005 budget proposal includes $5.75 billion for the NSF, an increase of $170 million (3.1 percent). This includes $4.45 billion for NSF research, an increase of $200 million (4.7 percent). Information: Dave Moore, Associate Vice President AAMC Office of Governmental Relations dbmoore@aamc.org (202) 828-0525 Jonathan Fishburn, Director, Research, Education and Veterans' Legislative Affairs AAMC Office of Governmental Relations jfishburn@aamc.org (202) 828-0525 Erica Froyd, Senior Legislative Analyst AAMC Office of Governmental Relations efroyd@aamc.org (202) 828-0525 This area contains documents in Portable Document Format (PDF). The Adobe Acrobat(r) Reader(r) is required to view PDF documents. Download Acrobat(r) Reader(r). ********************************************** To Subscribe to Washington Headlines Send an e-mail to typing only the words "subscribe aamcwash" in the body of the message -- not in the subject line. You will be notified when your request has been fulfilled. To Unsubscribe from Washington Headlines Send an e-mail to typing only the words "unsubscribe aamcwash" in the body of the message -- not in the subject line. =================================== AHA NEWS NOW The Daily Report for Health Care Executives www.ahanews.com =================================== Monday, Feb. 2, 2004 1) President releases budget; no Medicare, Medicaid cuts President Bush today offered a budget plan for fiscal year 2005 that refrains from cuts in Medicare funding, thereby supporting current law providing hospitals a full inpatient update if they submit 10 quality indicators to the Centers for Medicare & Medicaid Services. All spending would be subject to a pay-as-you-go proposal that would require additional spending to be offset by reductions elsewhere. The budget proposes two user fees affecting duplicate claims and appeals, and abandons the administration's Medicaid reform plan, meaning no proposed cuts for that program. However, it calls for increased scrutiny into the use of intergovernmental transfers and upper payment limits as a means of drawing federal dollars into state Medicaid programs, and encourages state flexibility through the use of Medicaid waivers. The budget proposes a reduction of $39 million for hospital preparedness, to $476 million from the $515 million appropriated in FY04; recommends FY2004's level of ! $303 million for Children's Graduate Medical Education; cuts health professions spending from FY04's level of $294 million to $11 million; recommends an increase of $35 million for the National Health Service Corps to $205 million; reduces funding for HRSA Rural Health Programs by $91 million while increasing funding for rural health outreach and state offices of rural health; and requests a total of $147 million for nursing education programs, including provisions of the Nurse Reinvestment Act. ============================================================= Copyright 2004 by the American Hospital Association. All rights reserved. For republication rights, contact Craig Webb. AHA News is a registered trademark of the American Hospital Association. The opinions expressed in AHA News Now are not necessarily those of the American Hospital Association. Brian Potts Managing Editor, CAL/AAEM News Service MS-IV, UC-Irvine --------------------------------- Do you Yahoo!? Yahoo! Finance: Get your refund fast by filing online --0-1803667152-1076260491=:15252 Content-Type: text/html; charset=us-ascii

-----Original Message-----

From: Jonathan Fishburn [mailto:jfishburn@aamc.org]

AAMC WASHINGTON HEADLINES

Legislative and Regulatory News from the Association of American Medical Colleges

February 6, 2004

Bush Releases FY 2005 Budget

February 6, 2004 - President Bush Feb 2 submitted the details of his FY 2005 budget proposal to Congress. The $2.4 trillion spending plan calls for calls for $818 billion in discretionary spending in FY 2005, an increase of $31 billion (3.9 percent). Defense spending is increased by 7.1 percent and homeland security grows by 9.7 percent. Other domestic discretionary spending is slated to increase by 0.5 percent to $386 billion. The president's budget also proposes new budget enforcement mechanisms, including statutory controls to limit the growth of both discretionary and mandatory spending.

Discretionary spending within the Department of Health and Human Services is decreased by $1.1 billion (1.6 percent) to $68.2 billion. As in previous budgets, the Administration proposes increases for a few priority programs, calls for the elimination of several programs, and freezes funding for the majority of discretionary health programs.

The following summarizes the budget proposals for programs of interest to medical schools and teaching hospitals.

National Institutes of Health (PDF, 12 pages): The president's budget includes $28.6 billion for NIH, an increase of $729 million (2.6 percent). This includes $80 million to be appropriated through the VA-HUD appropriations subcommittee, but does not includes $150 million for Type I diabetes research appropriated by Public Law 107-360 and $47 million for research in radiological and nuclear countermeasures appropriated through the Public Health and Social Services Emergency Fund. If these latter items are added, the program level for NIH is $28.8 billion, an increase of $763 million (2.7 percent) over the comparable total in FY 2004. The Biomedical Research and Development Price Index (BRDPI) for FY 2005 is projected at 3.5 percent [see related article].

The president's budget would fund a total of 39,986 research project grants (RPGs) in FY 2005, an increase of 558 over the current year. This includes 10,393 new and competing renewal RPGs, an increase of 258. NIH estimates this would provide for a success rate of 27 percent in FY 2005, equal to the projected FY 2004 success rate. However, the grants numbers are sustained by smaller than usual increases in the average cost of the grants. The budget calls for an aggregate 1.3 percent increase in average cost of RPGs. NIH will provide average cost increases of 1.9 percent for direct recurring costs in noncompeting continuation awards; competing RPGs will receive an average cost of 1 percent.

Stipends for pre-doctoral and post-doctoral recipients of the Ruth L. Kirschstein National Research Service Awards will remain at FY 2004 levels. A total of $764 million is included for research training, a $15 million (2 percent) increase.

Once again, the budget proposes to reduce the cap on salaries on extramural grants from Executive Level I ($174,500 in 2004) to Executive Level II ($157,000). The budget does not include funds for extramural research facilities grants through the National Center for Research Resources, which was funded at $119 million in FY 2004. HHS notes that $633 million has been appropriated for non-biodefense extramural construction projects over the past 10 years. The budget does propose $150 million to fund the construction of an additional 20 BSL-3 laboratories for biodefense research in metropolitan areas across the country. Funding for the NIH Roadmap in FY 2005 is set at $237 million, an increase of $109 million over the current year.

Health Professions Programs: Similar to last year, the president's budget proposes $11 million for the Title VII health professions programs within HRSA, a 96 percent cut below FY 2004. Of this total, $10 million is for Scholarships for Disadvantaged Students (79 percent cut) and $1 million for health workforce information and analysis (39 percent increase).

The budget provides $147 million for Title VIII nurse training programs, $5 million more than FY 2004. This includes $42 million for basic nurse education and retention, $10 million more than FY04; $21 million for diversity, a $5 million increase; $44 million for advanced nursing, a $15 million cut; $32 million for loan repayments and scholarships, a $5 million increase; and $8 million for geriatric education and faculty loan repayment, about level with last year.

National Health Service Corps: The president's budget includes $205 million for the NHSC, an increase of $35 million (20.6 percent).

Other HRSA Programs: The budget includes $303 million for Children's Hospitals Graduate Medical Education, the same funding as in FY 2004. The $35 million increase in the $2.08 billion Ryan White AIDS FY 2005 budget is directed for the AIDS Drug Assistance Programs, bringing it to $784 million. Rural health programs are cut by $91 million (63 percent) to $52 million in FY 2005, with the budget document citing the $9 billion in rural health resources provided in the Medicare reform bill as balancing this cut. The budget includes $10 million (a $94 million cut) for the Community Access Program (CAP), a program that seeks to enhance access through collaborative networks of providers. The traumatic brain injury ($9 million), poison control ($44 million) and telehealth programs ($4 million) are slated to receive flat funding in FY 2005.

Agency for Healthcare Research and Quality: The budget provides level funding for AHRQ at $303.7 million, with all monies derived from transfers from other agencies. Funding designated for patient safety research is increased from $80 million to $84 million

Bioterrorism Preparedness: The HRSA Bioterrorism Hospital Preparedness program receives $476 million in the president's FY 2005 budget, a $39 million (7.5 percent) cut below FY 2004 funding. The bioterrorism curriculum development grants are allotted $28 million in the budget, level with current funding.

The budget also includes $1.1 billion for the state preparedness programs administered by the Centers for Disease Control and Prevention (CDC), the same level as current funding. The president's new $274 million surveillance initiative - coordinated by the CDC, the Department of Homeland Security (DHS), the Food and Drug Administration, and the Department of Agriculture - is designed to enhance surveillance in human health, hospital preparedness, state and local preparedness, vaccine research and procurement, animal health, food and agriculture safety and environmental monitoring. Provided under the DHS FY 2005 budget is new money for Project Bioshield, the administration's plan for stockpiling vaccines to counter a biological or chemical attack. It is proposed to receive $2.5 billion in FY 2005, three times the $890 million provided by Congress in FY 2004.

VA Research: As in the president's FY 2004 proposal, the budget request for FY 2005 combines the direct and indirect costs of the VA research program into one appropriations line item. For FY 2005, the president's budget request proposes $770 million, a $50 million decrease (6.1 percent) from the comparable FY 2004 number. This figure is reportedly evenly split between the direct and indirect costs, which works out to a decrease of $20.6 million (5.1 percent) for the direct costs of research. The budget request also notes that the VA research program received a rating of "Results Not Demonstrated" as part of the Program Assessment Rating Tool (PART) evaluation. The Office of Management and Budget has directed the VA to develop meaningful and useful performance measures for the research program.

VA Medical Care: The FY 2005 budget proposal recommends an appropriation of $27.05 billion for VA medical care, an increase of $510 million (1.9 percent) over FY 2004. At a Feb. 4 hearing of the House Veterans Affairs Committee, VA Secretary Anthony Principi stated that this request was $1.2 billion less than his agency had requested from the Office of Management and Budget (OMB).

National Science Foundation: The president's FY 2005 budget proposal includes $5.75 billion for the NSF, an increase of $170 million (3.1 percent). This includes $4.45 billion for NSF research, an increase of $200 million (4.7 percent).

Information:

Dave Moore, Associate Vice President

AAMC Office of Governmental Relations

dbmoore@aamc.org

(202) 828-0525

Jonathan Fishburn, Director, Research, Education and Veterans' Legislative Affairs AAMC Office of Governmental Relations jfishburn@aamc.org

(202) 828-0525

Erica Froyd, Senior Legislative Analyst

AAMC Office of Governmental Relations

efroyd@aamc.org

(202) 828-0525

This area contains documents in Portable Document Format (PDF). The Adobe Acrobat(r) Reader(r) is required to view PDF documents. Download Acrobat(r) Reader(r).

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===================================

AHA NEWS NOW

The Daily Report for Health Care Executives

www.ahanews.com

===================================

Monday, Feb. 2, 2004

1) President releases budget; no Medicare, Medicaid cuts

President Bush today offered a budget plan for fiscal year 2005 that refrains from cuts in Medicare funding, thereby supporting current law providing hospitals a full inpatient update if they submit 10 quality indicators to the Centers for Medicare & Medicaid Services. All spending would be subject to a pay-as-you-go proposal that would require additional spending to be offset by reductions elsewhere. The budget proposes two user fees affecting duplicate claims and appeals, and abandons the administration's Medicaid reform plan, meaning no proposed cuts for that program. However, it calls for increased scrutiny into the use of intergovernmental transfers and upper payment limits as a means of drawing federal dollars into state Medicaid programs, and encourages state flexibility through the use of Medicaid waivers. The budget proposes a reduction of $39 million for hospital preparedness, to $476 million from the $515 million appropriated in FY04; recommends FY2004's le! vel of $303 million for Children's Graduate Medical Education; cuts health professions spending from FY04's level of $294 million to $11 million; recommends an increase of $35 million for the National Health Service Corps to $205 million; reduces funding for HRSA Rural Health Programs by $91 million while increasing funding for rural health outreach and state offices of rural health; and requests a total of $147 million for nursing education programs, including provisions of the Nurse Reinvestment Act.

=============================================================

Copyright 2004 by the American Hospital Association. All rights reserved. For republication rights, contact Craig Webb.

AHA News is a registered trademark of the American Hospital Association. The opinions expressed in AHA News Now are not necessarily those of the American Hospital Association.



Brian Potts
Managing Editor, CAL/AAEM News Service
MS-IV, UC-Irvine

Do you Yahoo!?
Yahoo! Finance: Get your refund fast by filing online --0-1803667152-1076260491=:15252-- From pottsbri@yahoo.com Mon Feb 9 16:55:43 2004 From: pottsbri@yahoo.com (CAL/AAEM News Service) Date: Mon, 9 Feb 2004 08:55:43 -0800 (PST) Subject: New California staffing regs forcing many hospitals to divert ambulances Message-ID: <20040209165543.49059.qmail@web41310.mail.yahoo.com> --0-1259332863-1076345743=:48791 Content-Type: text/plain; charset=us-ascii =================================== AHA NEWS NOW The Daily Report for Health Care Executives www.ahanews.com =================================== Friday, Jan. 30, 2004 1) New California staffing regs forcing many hospitals to divert ambulances Nearly nine out of 10 California hospitals surveyed by the California Healthcare Foundation this month indicated they have been out of compliance with the state's new nurse-to-patient staffing ratios at some time, forcing many hospitals to divert ambulances to other facilities. State regulators have held that hospitals must be in continuous compliance with the prescribed staffing levels at all times of the day and night, a requirement CHA is challenging in court. Of 229 hospitals surveyed, 86% reported they have been unable to comply with the regulations at times, and nearly 50% said they have had to divert ambulances from their emergency rooms as a result. Jan Emerson, CHA spokesperson, said the rigidity of the new rules make it nearly impossible for hospitals to meet them "every minute, every shift." The CHA survey was conducted over a two-week period. For more on the staffing requirements, go to http://www.calhealth.org/public/press/node1.asp?ID=1. ================================== Copyright 2004 by the American Hospital Association. All rights reserved. For republication rights, contact Craig Webb. AHA News is a registered trademark of the American Hospital Association. The opinions expressed in AHA News Now are not necessarily those of the American Hospital Association. ============================================ -----Original Message----- From: California Healthline [mailto:CALIFORNIAHEALTHLINE@ADVISORY.COM] Nurse-to-Patient Ratio Rules Cause Emergency Rooms To Divert Ambulances, Survey Says 01/27/2004 Nearly half of hospital emergency rooms have diverted ambulances because they have not been in compliance with staffing regulations established by new nurse-to-patient ratio rules that took effect Jan. 1, according to an informal survey by the California Healthcare Association, the San Jose Mercury News reports. The survey of 150 hospitals also found that about 90% of hospitals said they have been out of compliance with the new staffing rules at some point (Feder Ostrov, San Jose Mercury News, 1/27). Under the new staffing rules, nurses will not have to care for more than eight patients at a time. The rules also call for one nurse per five patients in medical-surgical units by 2005, as well as one nurse per four patients in specialty care and telemetry units and one nurse per three patients in step-down units by 2008. In addition, the regulations state that licensed vocational nurses can comprise no more than 50% of the licensed nurses assigned to! patient care and that only registered nurses can care for critical trauma patients. The rules also require at least one registered nurse to serve as a triage nurse in ERs ( http://www.californiahealthline.org/members/basecontent.asp?contentid=50694&collectionid=3&program=1 California Healthline, 1/15). The Mercury News reports that ERs in Santa Clara County diverted ambulances for a total of 243 hours between Jan. 3 and Jan. 16, "more than double" the amount of time that ERs diverted ambulances during the same two-week period a year earlier. According to the Santa Clara County Emergency Medical Services Authority, hospitals attributed more than 40% of the 2004 period's diversion hours to the new nurse-to-patient ratio rules. Reaction CHA spokesperson Jan Emerson said that ER doctors and nurses must "either provide the care and be in violation of the law, or they make the very difficult decision of turning patients away and not violating the law." Chuck Idelson, a California Nurses Association spokesperson, said, "A large part of this is political. There've been diversions for years due to inadequate staffing" (San Jose Mercury News, 1/27). Brian Potts Managing Editor, CAL/AAEM News Service MS-IV, UC-Irvine --------------------------------- Do you Yahoo!? Yahoo! Finance: Get your refund fast by filing online --0-1259332863-1076345743=:48791 Content-Type: text/html; charset=us-ascii

===================================

AHA NEWS NOW

The Daily Report for Health Care Executives

www.ahanews.com

===================================

Friday, Jan. 30, 2004

1) New California staffing regs forcing many hospitals to divert ambulances

Nearly nine out of 10 California hospitals surveyed by the California Healthcare Foundation this month indicated they have been out of compliance with the state's new nurse-to-patient staffing ratios at some time, forcing many hospitals to divert ambulances to other facilities. State regulators have held that hospitals must be in continuous compliance with the prescribed staffing levels at all times of the day and night, a requirement CHA is challenging in court. Of 229 hospitals surveyed, 86% reported they have been unable to comply with the regulations at times, and nearly 50% said they have had to divert ambulances from their emergency rooms as a result. Jan Emerson, CHA spokesperson, said the rigidity of the new rules make it nearly impossible for hospitals to meet them "every minute, every shift." The CHA survey was conducted over a two-week period. For more on the staffing requirements, go to http://www.calhealth.org/public/press/node1.asp?ID=1.

==================================

Copyright 2004 by the American Hospital Association. All rights reserved. For republication rights, contact Craig Webb.

AHA News is a registered trademark of the American Hospital Association. The opinions expressed in AHA News Now are not necessarily those of the American Hospital Association.

============================================

-----Original Message-----

From: California Healthline [mailto:CALIFORNIAHEALTHLINE@ADVISORY.COM]

Nurse-to-Patient Ratio Rules Cause Emergency Rooms To Divert Ambulances, Survey Says

01/27/2004

Nearly half of hospital emergency rooms have diverted ambulances because they have not been in compliance with staffing regulations established by new nurse-to-patient ratio rules that took effect Jan. 1, according to an informal survey by the California Healthcare <http://www.calhealth.org/> Association, the San Jose Mercury News reports. The survey of 150 hospitals also found that about 90% of hospitals said they have been out of compliance with the new staffing rules at some point (Feder Ostrov, San Jose Mercury News, 1/27). Under the new staffing rules, nurses will not have to care for more than eight patients at a time. The rules also call for one nurse per five patients in medical-surgical units by 2005, as well as one nurse per four patients in specialty care and telemetry units and one nurse per three patients in step-down units by 2008. In addition, the regu! lations state that licensed vocational nurses can comprise no more than 50% of the licensed nurses assigned to patient care and that only registered nurses can care for critical trauma patients. The rules also require at least one registered nurse to serve as a triage nurse in ERs ( http://www.californiahealthline.org/members/basecontent.asp?contentid=50694&collectionid=3&program=1 California Healthline, 1/15). The Mercury News reports that ERs in Santa Clara County diverted ambulances for a total of 243 hours between Jan. 3 and Jan. 16, "more than double" the amount of time that ERs diverted ambulances during the same two-week period a year earlier. According to the Santa Clara County Emergency Medical Servi! ces Authority, hospitals attributed more than 40% of the 2004 period's diversion hours to the new nurse-to-patient ratio rules.

Reaction

CHA spokesperson Jan Emerson said that ER doctors and nurses must "either provide the care and be in violation of the law, or they make the very difficult decision of turning patients away and not violating the law." Chuck Idelson, a California Nurses Association <http://www.calnurse.org/> spokesperson, said, "A large part of this is political. There've been diversions for years due to inadequate staffing" (San Jose Mercury News, 1/27).



Brian Potts
Managing Editor, CAL/AAEM News Service
MS-IV, UC-Irvine

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Yahoo! Finance: Get your refund fast by filing online --0-1259332863-1076345743=:48791-- From pottsbri@yahoo.com Tue Feb 10 16:30:35 2004 From: pottsbri@yahoo.com (CAL/AAEM News Service) Date: Tue, 10 Feb 2004 08:30:35 -0800 (PST) Subject: Attend AAEM's Simulation Workshop in Miami - $75 discount Message-ID: <20040210163035.47755.qmail@web41310.mail.yahoo.com> --0-1867500296-1076430635=:47187 Content-Type: text/plain; charset=us-ascii -----Original Message----- From: AAEM [mailto:info@aaem.org] Sent: Friday, February 06, 2004 2:09 PM Subject: Attend AAEM's Simulation Workshop in Miami - $75 discount AAEM is now offering a $75 discount to attend the workshop titled "Simulation in the Clinical Teaching Setting". We feel that this course is worthy of your attention and that is why we are now offering this discount. Please consider attending this workshop on Thursday, February 19, 2004 at the Marriott Miami Biscayne Bay. On-line registration is still available on the website at www.aaem.org. Cost of the course is now $120.00. Full course description follows. Simulation in the Clinical Teaching Setting Course Description This course will introduce physicians to high-fidelity simulation and its use in clinical teaching. A combination of didactic instruction, demonstration, and hands-on simulation sessions will provide participants with the opportunity to learn about and experience an educational session with this cutting-edge training tool. The course will address the application of simulation to medicine, specifically including the potential for training in critical decision making, critical procedure performance, and teamwork improvement in high-stress scenarios. Training demonstrations will illustrate the educational potential of the high-fidelity simulators. The discussion will also analyze the evidence currently available that supports the use of simulation training in medical education. The course faculty are residency educators with three years of practical experience in simulation training. In order to increase the individualized attention to questions, the course is limited to no more than 40 participants. Credit Designation AAEM designates this educational activity for a maximum of 3.75 hours of Category 1 credit towards the AMA Physician's Recognition Award. Each physician should claim only those hours of credit he or she actually spends in the educational activity. Learning Objectives At the conclusion of this course participants will: 1. Discuss potential educational uses of simulator-based training 2. Understand the principles involved in the use of high-fidelity simulation and training. 3. Understand the basic tenets of simulator scenario development Course Schedule 8:00am to 8:50am Simulation in Medical Education - Overview, Background, Simulators, Scenarios (David Caro, MD) 8:50am to 9:45am Simulation in Medical Education - Practical Application (Andy Goodwin, MD) 9:45am to 10:00am Break 10:00am to 11:00am Scenario Demonstration (Caro/Goodwin) 11:00am to 12:00pm Hands-on Scenarios/Procedures (Caro/Goodwin) Course Directors: Andy Goodwin, MD Residency Director, Assistant Professor, University of Florida Health Science Center/Jacksonville David Caro, MD Associate Residency Director, Assistant Professor, University of Florida Health Science Center/Jacksonville American Academy of Emergency Medicine 611 E. Wells Street Milwaukee, WI 53202 800-884-2236 Fax: 414-276-3349 E-mail: info@aaem.org Website: www.aaem.org You have received this message because you have had previous contact with the American Academy of Emergency Medicine. If you do not wish to be included in our mailing list, please forward this message to info@aaem.org. Brian Potts Managing Editor, CAL/AAEM News Service MS-IV, UC-Irvine --------------------------------- Do you Yahoo!? Yahoo! Finance: Get your refund fast by filing online --0-1867500296-1076430635=:47187 Content-Type: text/html; charset=us-ascii

 

-----Original Message-----

From: AAEM [mailto:info@aaem.org]

Sent: Friday, February 06, 2004 2:09 PM

Subject: Attend AAEM's Simulation Workshop in Miami - $75 discount

AAEM is now offering a $75 discount to attend the workshop titled "Simulation in the Clinical Teaching Setting". We feel that this course is worthy of your attention and that is why we are now offering this discount. Please consider attending this workshop on Thursday,

February 19, 2004 at the Marriott Miami Biscayne Bay. On-line registration is still available on the website at www.aaem.org.

Cost of the course is now $120.00. Full course description follows.

Simulation in the Clinical Teaching Setting

Course Description

This course will introduce physicians to high-fidelity simulation and its use in clinical teaching. A combination of didactic instruction, demonstration, and hands-on simulation sessions will provide participants with the opportunity to learn about and experience an educational session with this cutting-edge training tool.

The course will address the application of simulation to medicine, specifically including the potential for training in critical decision making, critical procedure performance, and teamwork improvement in high-stress scenarios. Training demonstrations will illustrate the educational potential of the high-fidelity simulators. The discussion will also analyze the evidence currently available that supports the use of simulation training in medical education.

The course faculty are residency educators with three years of practical experience in simulation training. In order to increase the individualized attention to questions, the course is limited to no more than 40 participants.

Credit Designation

AAEM designates this educational activity for a maximum of 3.75 hours of Category 1 credit towards the AMA Physician's Recognition Award. Each physician should claim only those hours of credit he or she actually spends in the educational activity.

Learning Objectives

At the conclusion of this course participants will:

1. Discuss potential educational uses of simulator-based training 2. Understand the principles involved in the use of high-fidelity simulation and training. 3. Understand the basic tenets of simulator scenario development

Course Schedule

8:00am to 8:50am Simulation in Medical Education - Overview,

Background, Simulators, Scenarios (David Caro, MD)

8:50am to 9:45am Simulation in Medical Education - Practical

Application

(Andy Goodwin, MD)

9:45am to 10:00am Break

10:00am to 11:00am Scenario Demonstration (Caro/Goodwin)

11:00am to 12:00pm Hands-on Scenarios/Procedures (Caro/Goodwin)

Course Directors:

Andy Goodwin, MD

Residency Director, Assistant Professor, University of Florida Health Science Center/Jacksonville

David Caro, MD

Associate Residency Director, Assistant Professor, University of Florida Health Science Center/Jacksonville

American Academy of Emergency Medicine

611 E. Wells Street

Milwaukee, WI 53202

800-884-2236

Fax: 414-276-3349

E-mail: info@aaem.org

Website: www.aaem.org

You have received this message because you have had previous contact with the American Academy of Emergency Medicine. If you do not wish to be included in our mailing list, please forward this message to info@aaem.org.



Brian Potts
Managing Editor, CAL/AAEM News Service
MS-IV, UC-Irvine

Do you Yahoo!?
Yahoo! Finance: Get your refund fast by filing online --0-1867500296-1076430635=:47187-- From pottsbri@yahoo.com Wed Feb 11 18:09:54 2004 From: pottsbri@yahoo.com (CAL/AAEM News Service) Date: Wed, 11 Feb 2004 10:09:54 -0800 (PST) Subject: NYT: The Shifting Burden of Emergency Care Message-ID: <20040211180954.47980.qmail@web41301.mail.yahoo.com> --0-871159851-1076522994=:47486 Content-Type: text/plain; charset=us-ascii Submission by Paul Windham ============================ February 3, 2004The Shifting Burden of Emergency CareBy REED ABELSON CA, the health care giant, has found itself, rather oddly, in the thick of the battle between full-service and specialty hospitals. The battle lines are familiar: full-service institutions, often with deep roots in communities, say that hospitals specializing in cardiac care, orthopedics and other lucrative areas siphon away profitable patients, but shirk the burden of providing emergency care. Specialty hospitals counter that their rivals merely fear competition. HCA, the nation's largest chain of for-profit hospitals, would seem an unlikely standard-bearer for community hospitals. But the company, which operates OU Medical Center in Oklahoma City, is in the same situation as other full-service hospitals competing with specialty operations. In Oklahoma, OU is the only hospital now providing care for the most critically injured trauma patients. The proliferation of specialty hospitals has worsened the shortage of specialists like neurosurgeons who are willing to cover emergency rooms, causing other hospitals to send more and more patients to OU. Roughly two-thirds of the time when ambulances in Oklahoma were diverted from a hospital's emergency room to another's, the reason was a lack of such physician coverage. With millions of dollars in losses from trauma care, OU threatened to stop providing those services in November. "We need more players," Jerry Maier, the chief executive of the hospital, said at a news conference at the time. OU executives declined to be interviewed. John Sacra, an emergency room physician who is advising Oklahoma on the problem, said, "It was going to be a disaster." State officials responded by temporarily requiring all hospitals to provide emergency care, make specialists available or contribute to a state fund for trauma care. The Legislature will take up the issue this spring, and OU has promised to keep its trauma center open until the end of June. While Congress has put a temporary ban on construction of specialty hospitals, full-service hospitals say that these hospitals, often owned by the doctors providing the lucrative care, remain a significant threat. Defenders of these hospitals say the only threat is healthy competition. "Specialty hospitals aren't doing anything to affect the trauma system," said Michael Lipomi, president of the American Surgical Hospital Association, who says his group is gearing up for many battles on the state level as well as the continuing push before Congress. "We, as a small association, are faced with the task of fighting the major lobbying groups," like the American Hospital Association, Mr. Lipomi said. But many hospital executives say they are providing important services that these competing hospitals do not. "We are the safety net," said Nancy Farber, chief executive of Washington Hospital Healthcare System in Fremont, Calif. "Our emergency room is the front door for people without insurance, the homeless, the underinsured," leaving the hospital with losses, she said. After pushing last year for legislation that would require new specialty hospitals in California to provide emergency care, Ms. Farber plans to bring it to the attention of lawmakers again this year. "This continues to be a pressing issue," agreed Carmela Coyle, an executive with the American Hospital Association, which helped win an 18-month moratorium on any new building, which was adopted as part of last year's Medicare bill. "It is on the top of the radar screen for many hospitals." The Federation of American Hospitals, which represents for-profit chains like HCA and Tenet Healthcare, has also weighed in with concerns about specialty hospitals and supported the moratorium on new hospitals. While there is no exact count, the General Accounting Office, the investigative arm of Congress, estimates that there are roughly 100 specialty hospitals open in the United States, largely in states where there is little oversight of new construction. The G.A.O. described these hospitals as "much less likely to have emergency departments" than full-service hospitals, with slightly fewer than half offering emergency care, compared with 92 percent of general hospitals. Other states are also feeling the shortage of specialists. "It's an increasing problem," said Darren Whitehurst, an executive at the Texas Hospital Association, who says some Texas hospitals have been unable to find neurosurgeons and other specialists to cover emergency rooms. Lawmakers have promised to take a close look at the issue, he said. To deflect some of these concerns, some specialty hospitals are offering emergency care. In Milwaukee, the two heart hospitals that have opened recently both offer a basic level of emergency services, although neither can treat trauma cases. MedCath, a for-profit chain of heart hospitals, which helped build the Heart Hospital of Milwaukee, says that all of its hospitals provide such care and that its doctors routinely cover emergency rooms at other hospitals. The other, the Wisconsin Heart Hospital, says it also plans to offer emergency services as soon as it can. "This would be another resource for the community," said Norma McCutcheon, president of the hospital, which is a joint venture between heart doctors and a community hospital system. The hospital has already worked out agreements with local hospitals that do handle trauma on how to transfer patients, she said. On the federal level, officials have promised to study the impact of specialty hospitals on full-service hospitals to determine whether more oversight or restrictions are needed. Ohio has a moratorium similar to the one enacted by Congress, said Scott Becker, a lawyer who represents the association of specialty hospitals, and numerous states are likely to weigh some sort of new laws, he said. Hospital groups "have more resources on the state level," he said. Mr. Becker also expects significant activity in various communities, as hospital groups push for local laws. In Oklahoma, he said, some communities are requiring additional review of new facilities to see how they might affect existing hospitals, and others are considering similar steps that will result in increased debate. "I think you'll have more and more of that," Mr. Becker said. Some hospital executives are also taking steps to combat the doctors who are forming these competing ventures. OhioHealth, a hospital network in Columbus, asked 17 doctors who are investors in New Albany Surgical Hospital, a new specialty institution, and who refer patients there to give up their privileges at OhioHealth by the end of January. The hospital says it believes that doctors should not have a financial interest in these facilities, said David Morehead, OhioHealth's chief medical officer. The system's board felt doctors "can't be competitors and partners at the same time,'' he said. Brian Potts Managing Editor, CAL/AAEM News Service MS-IV, UC-Irvine --------------------------------- Do you Yahoo!? Yahoo! Finance: Get your refund fast by filing online --0-871159851-1076522994=:47486 Content-Type: text/html; charset=us-ascii
Submission by Paul Windham
============================
The New York Times
 
 
February 3, 2004

The Shifting Burden of Emergency Care

By REED ABELSON

HCA, the health care giant, has found itself, rather oddly, in the thick of the battle between full-service and specialty hospitals.

The battle lines are familiar: full-service institutions, often with deep roots in communities, say that hospitals specializing in cardiac care, orthopedics and other lucrative areas siphon away profitable patients, but shirk the burden of providing emergency care. Specialty hospitals counter that their rivals merely fear competition.

HCA, the nation's largest chain of for-profit hospitals, would seem an unlikely standard-bearer for community hospitals. But the company, which operates OU Medical Center in Oklahoma City, is in the same situation as other full-service hospitals competing with specialty operations.

In Oklahoma, OU is the only hospital now providing care for the most critically injured trauma patients. The proliferation of specialty hospitals has worsened the shortage of specialists like neurosurgeons who are willing to cover emergency rooms, causing other hospitals to send more and more patients to OU. Roughly two-thirds of the time when ambulances in Oklahoma were diverted from a hospital's emergency room to another's, the reason was a lack of such physician coverage.

With millions of dollars in losses from trauma care, OU threatened to stop providing those services in November. "We need more players," Jerry Maier, the chief executive of the hospital, said at a news conference at the time. OU executives declined to be interviewed.

John Sacra, an emergency room physician who is advising Oklahoma on the problem, said, "It was going to be a disaster."

State officials responded by temporarily requiring all hospitals to provide emergency care, make specialists available or contribute to a state fund for trauma care. The Legislature will take up the issue this spring, and OU has promised to keep its trauma center open until the end of June.

While Congress has put a temporary ban on construction of specialty hospitals, full-service hospitals say that these hospitals, often owned by the doctors providing the lucrative care, remain a significant threat.

Defenders of these hospitals say the only threat is healthy competition. "Specialty hospitals aren't doing anything to affect the trauma system," said Michael Lipomi, president of the American Surgical Hospital Association, who says his group is gearing up for many battles on the state level as well as the continuing push before Congress.

"We, as a small association, are faced with the task of fighting the major lobbying groups," like the American Hospital Association, Mr. Lipomi said.

But many hospital executives say they are providing important services that these competing hospitals do not. "We are the safety net," said Nancy Farber, chief executive of Washington Hospital Healthcare System in Fremont, Calif. "Our emergency room is the front door for people without insurance, the homeless, the underinsured," leaving the hospital with losses, she said.

After pushing last year for legislation that would require new specialty hospitals in California to provide emergency care, Ms. Farber plans to bring it to the attention of lawmakers again this year.

"This continues to be a pressing issue," agreed Carmela Coyle, an executive with the American Hospital Association, which helped win an 18-month moratorium on any new building, which was adopted as part of last year's Medicare bill. "It is on the top of the radar screen for many hospitals."

The Federation of American Hospitals, which represents for-profit chains like HCA and Tenet Healthcare, has also weighed in with concerns about specialty hospitals and supported the moratorium on new hospitals.

While there is no exact count, the General Accounting Office, the investigative arm of Congress, estimates that there are roughly 100 specialty hospitals open in the United States, largely in states where there is little oversight of new construction. The G.A.O. described these hospitals as "much less likely to have emergency departments" than full-service hospitals, with slightly fewer than half offering emergency care, compared with 92 percent of general hospitals.

Other states are also feeling the shortage of specialists. "It's an increasing problem," said Darren Whitehurst, an executive at the Texas Hospital Association, who says some Texas hospitals have been unable to find neurosurgeons and other specialists to cover emergency rooms. Lawmakers have promised to take a close look at the issue, he said.

To deflect some of these concerns, some specialty hospitals are offering emergency care. In Milwaukee, the two heart hospitals that have opened recently both offer a basic level of emergency services, although neither can treat trauma cases. MedCath, a for-profit chain of heart hospitals, which helped build the Heart Hospital of Milwaukee, says that all of its hospitals provide such care and that its doctors routinely cover emergency rooms at other hospitals.

The other, the Wisconsin Heart Hospital, says it also plans to offer emergency services as soon as it can. "This would be another resource for the community," said Norma McCutcheon, president of the hospital, which is a joint venture between heart doctors and a community hospital system. The hospital has already worked out agreements with local hospitals that do handle trauma on how to transfer patients, she said.

On the federal level, officials have promised to study the impact of specialty hospitals on full-service hospitals to determine whether more oversight or restrictions are needed. Ohio has a moratorium similar to the one enacted by Congress, said Scott Becker, a lawyer who represents the association of specialty hospitals, and numerous states are likely to weigh some sort of new laws, he said. Hospital groups "have more resources on the state level," he said.

Mr. Becker also expects significant activity in various communities, as hospital groups push for local laws. In Oklahoma, he said, some communities are requiring additional review of new facilities to see how they might affect existing hospitals, and others are considering similar steps that will result in increased debate.

"I think you'll have more and more of that," Mr. Becker said.

Some hospital executives are also taking steps to combat the doctors who are forming these competing ventures. OhioHealth, a hospital network in Columbus, asked 17 doctors who are investors in New Albany Surgical Hospital, a new specialty institution, and who refer patients there to give up their privileges at OhioHealth by the end of January. The hospital says it believes that doctors should not have a financial interest in these facilities, said David Morehead, OhioHealth's chief medical officer. The system's board felt doctors "can't be competitors and partners at the same time,'' he said.



Brian Potts
Managing Editor, CAL/AAEM News Service
MS-IV, UC-Irvine

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Yahoo! Finance: Get your refund fast by filing online --0-871159851-1076522994=:47486-- From pottsbri@yahoo.com Thu Feb 12 17:04:38 2004 From: pottsbri@yahoo.com (CAL/AAEM News Service) Date: Thu, 12 Feb 2004 09:04:38 -0800 (PST) Subject: Court approves CIGNA settlement with physicians Message-ID: <20040212170438.33359.qmail@web41303.mail.yahoo.com> --0-766739904-1076605478=:32927 Content-Type: text/plain; charset=us-ascii =================================== AHA NEWS NOW The Daily Report for Health Care Executives www.ahanews.com =================================== Wednesday, Feb. 4, 2004 4) Court approves CIGNA settlement with physicians The U.S. District Court for the Southern District of Florida this week approved an agreement between CIGNA HealthCare and some 700,000 physicians involved in class-action lawsuits alleging several managed care companies improperly denied, delayed or reduced their reimbursement. The decision affirms a settlement reached in September in which the insurer agreed to offer multiple alternatives for monetary compensation to the physicians, simplify administrative requirements and procedures, and institute new business practices. The company also committed funds to create a foundation to foster public health improvement initiatives, and will establish a physician advisory committee. For more on the settlement, go to http://www.CIGNAPhysicianSettlement.com. ================================== Copyright 2004 by the American Hospital Association. All rights reserved. For republication rights, contact Craig Webb. AHA News is a registered trademark of the American Hospital Association. The opinions expressed in AHA News Now are not necessarily those of the American Hospital Association. Brian Potts Managing Editor, CAL/AAEM News Service MS-IV, UC-Irvine --------------------------------- Do you Yahoo!? Yahoo! Finance: Get your refund fast by filing online --0-766739904-1076605478=:32927 Content-Type: text/html; charset=us-ascii

===================================

AHA NEWS NOW

The Daily Report for Health Care Executives

www.ahanews.com

===================================

Wednesday, Feb. 4, 2004

4) Court approves CIGNA settlement with physicians

The U.S. District Court for the Southern District of Florida this week approved an agreement between CIGNA HealthCare and some 700,000 physicians involved in class-action lawsuits alleging several managed care companies improperly denied, delayed or reduced their reimbursement. The decision affirms a settlement reached in September in which the insurer agreed to offer multiple alternatives for monetary compensation to the physicians, simplify administrative requirements and procedures, and institute new business practices. The company also committed funds to create a foundation to foster public health improvement initiatives, and will establish a physician advisory committee. For more on the settlement, go to http://www.CIGNAPhysicianSettlement.com.

==================================

Copyright 2004 by the American Hospital Association. All rights reserved. For republication rights, contact Craig Webb.

AHA News is a registered trademark of the American Hospital Association. The opinions expressed in AHA News Now are not necessarily those of the American Hospital Association.



Brian Potts
Managing Editor, CAL/AAEM News Service
MS-IV, UC-Irvine

Do you Yahoo!?
Yahoo! Finance: Get your refund fast by filing online --0-766739904-1076605478=:32927-- From akazzi@uci.edu Sat Feb 14 18:54:19 2004 From: akazzi@uci.edu (Kazzi, A. Antoine) Date: Sat, 14 Feb 2004 10:54:19 -0800 Subject: FW: national committee/taskforce opportunity Message-ID: <59CDD9FF884EAE4AB86132E86110D72202E09F54@wicket.ndc.mc.uci.edu> Dear Members, Recently AAEM reorganized its Committee, Taskforce and Interest Group structure in order to more effectively advance the Academy's goals and interests. We are currently seeking volunteers to serve as a member or chairperson of one of the groups listed below. The ability of the Academy to influence and impact our membership and the specialty of EM is critically dependant upon the effectiveness and productivity of these groups. The Academy needs your talents and hard work to accomplish its goals. Please email us info@AAEM.org or give us a call if you are interested in joining a Committee, Taskforce and Interest Group. The goals of each of the Committees is listed on the AAEM website at www.aaem.org/committees . If you are interested in serving as a Committee or Taskforce Chairperson, please submit a letter of interest. You can also sign up by stopping by the AAEM registration desk at the Scientific Assembly next week. If you are still at the Scientific Assembly on Sunday, we plan to have short organizational meetings scheduled that day. Committees: Academic Affairs, Education, EMS, Ethics, By-Laws/Policy, Finance, Membership, Government/ National Affairs, Legal Affairs, EM Practice, Communications, Reimbursement, Practice Guidelines, International Taskforces: ED Overcrowding, Fairness in the Workplace, Rural EM, Industry Relations, Ultrasound Taskforce, Disaster Preparedness Interest Groups: Pediatrics, Trauma, Toxicology, Women in EM, Minorities in EM, Wellness Medical Informatics, Injury Prevention, International EM, Disaster Medicine American Academy of Emergency Medicine 611 E. Wells Street Milwaukee, WI 53202 800-884-2236 Fax: 414-276-3349 E-mail: info@aaem.org Website: www.aaem.org This e-mail/fax message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail/fax and destroy all copies of the original message. From pottsbri@yahoo.com Mon Feb 16 08:33:50 2004 From: pottsbri@yahoo.com (CAL/AAEM News Service) Date: Mon, 16 Feb 2004 00:33:50 -0800 (PST) Subject: Court approves CIGNA settlement with physicians, -AND- National Smallpox Vaccination Program a Failure, Democratic Staff for House Committee Say Message-ID: <20040216083350.99040.qmail@web41314.mail.yahoo.com> --0-242978678-1076920430=:96570 Content-Type: text/plain; charset=us-ascii =================================== AHA NEWS NOW The Daily Report for Health Care Executives www.ahanews.com =================================== Wednesday, Feb. 4, 2004 4) Court approves CIGNA settlement with physicians The U.S. District Court for the Southern District of Florida this week approved an agreement between CIGNA HealthCare and some 700,000 physicians involved in class-action lawsuits alleging several managed care companies improperly denied, delayed or reduced their reimbursement. The decision affirms a settlement reached in September in which the insurer agreed to offer multiple alternatives for monetary compensation to the physicians, simplify administrative requirements and procedures, and institute new business practices. The company also committed funds to create a foundation to foster public health improvement initiatives, and will establish a physician advisory committee. For more on the settlement, go to http://www.CIGNAPhysicianSettlement.com. Copyright 2004 by the American Hospital Association. All rights reserved. For republication rights, contact Craig Webb. AHA News is a registered trademark of the American Hospital Association. The opinions expressed in AHA News Now are not necessarily those of the American Hospital Association. ===================================== ---Original Message----- From: California Healthline [mailto:CALIFORNIAHEALTHLINE@ADVISORY.COM] Sent: Tuesday, February 03, 2004 10:23 AM National Smallpox Vaccination Program a Failure, Democratic Staff for House Committee Say 02/03/2004 A report released on Wednesday by the Democratic staff of the House Select Committee on Homeland Security called the national smallpox vaccination program a "failure," CongressDaily reports (Heil, CongressDaily, 1/30). Under the voluntary program, which began in January 2003, federal health officials hoped to vaccinate about 500,000 health care workers in the first few weeks and as many as 10 million emergency personnel, police and firefighters in the second phase of the program ( http://www.californiahealthline.org/members/basecontent.asp?contentid=49686&collectionid=3&program=1 California Healthline, 9/9/03). However, to date, fewer than 40,000 individuals have received the smallpox vaccine. The report said that the program has failed because of inadequate compensation for individuals who experience side effects from the vaccine, a lack of funds to implement the program and inadequate focus by the Bush administration on the threat of s! mallpox attacks. In addition, the report questioned whether health care workers who received the smallpox vaccine under the program are "properly positioned" to address large-scale smallpox outbreaks. "This program quickly ground to a halt and nothing has been done to fix it. Either the administration needs to tell the country that smallpox is not an urgent threat or it needs to take immediate action to get us prepared," Rep. Jim Turner (D-Texas), ranking member of the committee, said. Democrats on the committee have written a letter to HHS Secretary Tommy Thompson and Department of Homeland Security Secretary Tom Ridge to request their assessments of the program. Thompson said on Thursday that the program "may have stalled for now, but that doesn't mean we won't push" to vaccinate more health care workers in the future (CongressDaily, 1/30). Brian Potts Managing Editor, CAL/AAEM News Service MS-IV, UC-Irvine --------------------------------- Do you Yahoo!? Yahoo! Finance: Get your refund fast by filing online --0-242978678-1076920430=:96570 Content-Type: text/html; charset=us-ascii

===================================

AHA NEWS NOW

The Daily Report for Health Care Executives

www.ahanews.com

===================================

Wednesday, Feb. 4, 2004

4) Court approves CIGNA settlement with physicians

The U.S. District Court for the Southern District of Florida this week approved an agreement between CIGNA HealthCare and some 700,000 physicians involved in class-action lawsuits alleging several managed care companies improperly denied, delayed or reduced their reimbursement. The decision affirms a settlement reached in September in which the insurer agreed to offer multiple alternatives for monetary compensation to the physicians, simplify administrative requirements and procedures, and institute new business practices. The company also committed funds to create a foundation to foster public health improvement initiatives, and will establish a physician advisory committee. For more on the settlement, go to http://www.CIGNAPhysicianSettlement.com.

Copyright 2004 by the American Hospital Association. All rights reserved. For republication rights, contact Craig Webb.

AHA News is a registered trademark of the American Hospital Association. The opinions expressed in AHA News Now are not necessarily those of the American Hospital Association.

=====================================

---Original Message-----

From: California Healthline [mailto:CALIFORNIAHEALTHLINE@ADVISORY.COM]

Sent: Tuesday, February 03, 2004 10:23 AM

National Smallpox Vaccination Program a Failure, Democratic Staff for House Committee Say

02/03/2004

A report released on Wednesday by the Democratic staff of the House Select <http://www.house.gov/hsc/democrats/> Committee on Homeland Security called the national smallpox vaccination program a "failure," CongressDaily reports (Heil, CongressDaily, 1/30). Under the voluntary program, which began in January 2003, federal health officials hoped to vaccinate about 500,000 health care workers in the first few weeks and as many as 10 million emergency personnel, police and firefighters in the second phase of the program ( http://www.californiahealthline.org/members/basecontent.asp?contentid=49686&collectionid=3&program=1 California Healthline, 9/9/03). However, to date, fewer than 40,000 individuals have received the smallpox vaccine. The report said that the program has failed because of inadequate compensation for individuals who experience side effects from the vaccine, a lack of funds to implement the program and inadequate focus by the Bush administration on the threat of smallpox attacks. In addition, the report questioned whether health care workers who received the smallpox vaccine under the program are "properly positioned" to address large-scale smallpox outbreaks. "This program quickly ground to a halt and nothing has been done to fix it. Either the administration needs to tell the country that smallpox is not an urgent threat or it needs to take immediate action to get us prepared," Rep. Jim Turner (D-Texas), ranking member of the committee, said. Democrats on the committee have written a letter to HHS <http://www.hhs.gov/> Secretary Tommy Thompson and Department of <http://www.dhs.gov/dhspublic/> Homeland Security Secretary Tom Ridge to request their assessments of the program. Thompson said on Thursday that the program "may have stalled for now, but that doesn't mean we won't push" to vaccinate more health care workers in the future (CongressDaily, 1/30).



Brian Potts
Managing Editor, CAL/AAEM News Service
MS-IV, UC-Irvine

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Yahoo! Finance: Get your refund fast by filing online --0-242978678-1076920430=:96570-- From pottsbri@yahoo.com Tue Feb 17 16:30:07 2004 From: pottsbri@yahoo.com (CAL/AAEM News Service) Date: Tue, 17 Feb 2004 08:30:07 -0800 (PST) Subject: AAMC: No Additional Medicare Cuts to Teaching Hospitals and Academic Physicians Message-ID: <20040217163007.89303.qmail@web41302.mail.yahoo.com> --0-1524085731-1077035407=:88573 Content-Type: text/plain; charset=us-ascii -----Original Message----- From: Jonathan Fishburn [mailto:jfishburn@aamc.org] Sent: Friday, February 06, 2004 1:17 PM AAMC WASHINGTON HEADLINES Legislative and Regulatory News from the Association of American Medical Colleges February 6, 2004 *********************************************** President's Budget Devotes Attention to Implementing Prescription Drug Legislation; No Additional Medicare Cuts to Teaching Hospitals and Academic Physicians February 6, 2004 - The President's FY 2005 budget proposal identifies the implementation of the "Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA)" as a top priority of the Department of Health and Human Services (HHS) and Centers of Medicare and Medicaid Services (CMS). Because the Medicare budget assumes that providers will be reimbursed at levels set forth by the MMA, there are no additional proposals to cut reimbursements to teaching hospitals and academic physicians. However, the budget does include proposals to assess $205 million in provider user fees and change policies affecting durable medical equipment and Medicare Secondary Payors. The bulk of the Medicare budget documents include descriptions of the provisions included in the Medicare reform law: providing a discount prescription drug card and voluntary prescription drug benefit; expanding private plan choices for Medicare beneficiaries; improving Medicare fee for service benefits; combating waste, fraud and abuse; reforming regulatory procedures; and increasing payments to hospitals, physicians and other providers. The budget also incorporates a higher cost estimate of the Medicare reform law than the 10-year $395 billion estimate provided by the Congressional Budget Office (CBO). The document states that recent estimates by Medicare actuaries have put the cost of the bill at $534 billion over 10 years. "The largest portion of the difference in these cost estimates is attributable to assumptions regarding beneficiary participation, market behavior, and cost growth rates," states the HHS budget document. Medicare spending on benefits is estimated to total $324.6 in FY 2005. In addition, the budget proposes $205 million in provider user fees for FY 2005 that would allow the Secretary of HHS to assess fees associated with the submission of duplicate or unprocessable claims. Fees could also be assessed to providers who file a Medicare claims appeal. The budget also includes two legislative proposals that would affect policies for durable medical equipment (DME) and Medicare Secondary Payors. The proposals are estimated to save the Medicare program $130 million in FY 2005. The provider user fee proposal, the DME and Medicare Secondary Payor proposals would have to be acted upon by Congress before CMS implementation. Information: Lynne Davis Boyle, Assistant Vice President AAMC Office of Governmental Relations ldavisboyle@aamc.org (202) 828-0526 Brian Potts Managing Editor, CAL/AAEM News Service MS-IV, UC-Irvine --------------------------------- Do you Yahoo!? Yahoo! Finance: Get your refund fast by filing online --0-1524085731-1077035407=:88573 Content-Type: text/html; charset=us-ascii

 

-----Original Message-----

From: Jonathan Fishburn [mailto:jfishburn@aamc.org]

Sent: Friday, February 06, 2004 1:17 PM

AAMC WASHINGTON HEADLINES

Legislative and Regulatory News

from the Association of American Medical Colleges

February 6, 2004

***********************************************

President's Budget Devotes Attention to Implementing Prescription Drug Legislation; No Additional Medicare Cuts to Teaching Hospitals and Academic Physicians

February 6, 2004 - The President's FY 2005 budget proposal identifies the implementation of the "Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA)" as a top priority of the Department of Health and Human Services (HHS) and Centers of Medicare and Medicaid Services (CMS). Because the Medicare budget assumes that providers will be reimbursed at levels set forth by the MMA, there are no additional proposals to cut reimbursements to teaching hospitals and academic physicians. However, the budget does include proposals to assess $205 million in provider user fees and change policies affecting durable medical equipment and Medicare Secondary Payors.

The bulk of the Medicare budget documents include descriptions of the provisions included in the Medicare reform law: providing a discount prescription drug card and voluntary prescription drug benefit; expanding private plan choices for Medicare beneficiaries; improving Medicare fee for service benefits; combating waste, fraud and abuse; reforming regulatory procedures; and increasing payments to hospitals, physicians and other providers.

The budget also incorporates a higher cost estimate of the Medicare reform law than the 10-year $395 billion estimate provided by the Congressional Budget Office (CBO). The document states that recent estimates by Medicare actuaries have put the cost of the bill at $534 billion over 10 years. "The largest portion of the difference in these cost estimates is attributable to assumptions regarding beneficiary participation, market behavior, and cost growth rates," states the HHS budget document. Medicare spending on benefits is estimated to total $324.6 in FY 2005.

In addition, the budget proposes $205 million in provider user fees for FY 2005 that would allow the Secretary of HHS to assess fees associated with the submission of duplicate or unprocessable claims. Fees could also be assessed to providers who file a Medicare claims appeal.

The budget also includes two legislative proposals that would affect policies for durable medical equipment (DME) and Medicare Secondary Payors. The proposals are estimated to save the Medicare program $130 million in FY 2005.

The provider user fee proposal, the DME and Medicare Secondary Payor proposals would have to be acted upon by Congress before CMS implementation.

Information:

Lynne Davis Boyle, Assistant Vice President

AAMC Office of Governmental Relations

ldavisboyle@aamc.org

(202) 828-0526



Brian Potts
Managing Editor, CAL/AAEM News Service
MS-IV, UC-Irvine

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Yahoo! Finance: Get your refund fast by filing online --0-1524085731-1077035407=:88573-- From pottsbri@yahoo.com Wed Feb 18 23:09:10 2004 From: pottsbri@yahoo.com (CAL/AAEM News Service) Date: Wed, 18 Feb 2004 15:09:10 -0800 (PST) Subject: Institute of Medicine meets on Emergency Medicine Message-ID: <20040218230910.76955.qmail@web41313.mail.yahoo.com> --0-722762166-1077145750=:75593 Content-Type: text/plain; charset=us-ascii -----Original Message----- From: AAEM [mailto:info@aaem.org] Sent: Thursday, February 12, 2004 9:42 AM Subject: Institute of Medicine on Emergency Medicine IOM Committee Meets on EM AAEM Vice President Antoine Kazzi and Past President Robert McNamara attended the opening workshop of the Institute of Medicine's (IOM) Committee on the Future of Emergency Care in the U.S. Health System on February 2-3 in Washington, D.C. as observers on behalf of AAEM. The IOM is a component of the National Academy of Sciences with a mission to serve as adviser to the nation to improve health. This Committee is examining the future of the emergency medical healthcare system in the US and will be making recommendations for improving emergency care. Members of the committee include emergency physicians, other physicians, economists health-system experts and others. The committee's work is supported by the Josiah Macy, Jr. foundation and the Agency for Healthcare Research and Quality (AHRQ) of the Department of Health and Human Services. The listed issues to be addressed include: 1. The Role of Emergency Care 2. Professional Workforce Issues 3. Information Technology and System Issues 4. Research Agenda Additionally, it was announced that the committee will likely expand its agenda to look at pediatric issues. AAEM obviously has a stake in these issues, particularly those concerning the physician workforce. Although invited as observers, Drs. Kazzi and McNamara were able to discuss during breaks and a reception the issues of the EM practice environment and their impact on the physician workforce with committee members emphasizing our concerns about corporate practice, the lack of due process and the effects of restrictive covenants. As can be seen from the presentations available on the project web site at www.iom.edu/emergencycare, there was extensive discussion about ED overcrowding, education, rural EM, research and emergency preparedness. AAEM hopes that the committee also examines EM practice issues in non-rural community hospitals. AAEM will monitor the progress of this project and plans to provide input on the issues important to the physician at the bedside. American Academy of Emergency Medicine 611 E. Wells Street Milwaukee, WI 53202 800-884-2236 Fax: 414-276-3349 E-mail: info@aaem.org Website: www.aaem.org Brian Potts Managing Editor, CAL/AAEM News Service MS-IV, UC-Irvine --------------------------------- Do you Yahoo!? Yahoo! Mail SpamGuard - Read only the mail you want. --0-722762166-1077145750=:75593 Content-Type: text/html; charset=us-ascii

-----Original Message-----

From: AAEM [mailto:info@aaem.org]

Sent: Thursday, February 12, 2004 9:42 AM

Subject: Institute of Medicine on Emergency Medicine

IOM Committee Meets on EM

AAEM Vice President Antoine Kazzi and Past President Robert McNamara attended the opening workshop of the Institute of Medicine's (IOM) Committee on the Future of Emergency Care in the U.S. Health System on February 2-3 in Washington, D.C. as observers on behalf of AAEM.

The IOM is a component of the National Academy of Sciences with a mission to serve as adviser to the nation to improve health. This Committee is examining the future of the emergency medical healthcare system in the US and will be making recommendations for improving emergency care. Members of the committee include emergency physicians, other physicians, economists health-system experts and others. The committee's work is supported by the Josiah Macy, Jr. foundation and the Agency for Healthcare Research and Quality (AHRQ) of the Department of Health and Human Services.

The listed issues to be addressed include:

1. The Role of Emergency Care

2. Professional Workforce Issues

3. Information Technology and System Issues

4. Research Agenda

Additionally, it was announced that the committee will likely expand its agenda to look at pediatric issues.

AAEM obviously has a stake in these issues, particularly those concerning the physician workforce. Although invited as observers, Drs. Kazzi and McNamara were able to discuss during breaks and a reception the issues of the EM practice environment and their impact on the physician workforce with committee members emphasizing our concerns about corporate practice, the lack of due process and the effects of restrictive covenants. As can be seen from the presentations available on the project web site at www.iom.edu/emergencycare, there was extensive discussion about ED overcrowding, education, rural EM, research and emergency preparedness. AAEM hopes that the committee also examines EM practice issues in non-rural community hospitals. AAEM will monitor the progress of this project and plans to provide input on the issues important to the physi! cian at the bedside.

American Academy of Emergency Medicine

611 E. Wells Street

Milwaukee, WI 53202

800-884-2236

Fax: 414-276-3349

E-mail: info@aaem.org

Website: www.aaem.org



Brian Potts
Managing Editor, CAL/AAEM News Service
MS-IV, UC-Irvine

Do you Yahoo!?
Yahoo! Mail SpamGuard - Read only the mail you want. --0-722762166-1077145750=:75593-- From pottsbri@yahoo.com Mon Feb 23 07:51:25 2004 From: pottsbri@yahoo.com (CAL/AAEM News Service) Date: Sun, 22 Feb 2004 23:51:25 -0800 (PST) Subject: Update: Adverse Events Following Civilian Smallpox Vaccination --- United States, 2003 Message-ID: <20040223075125.99989.qmail@web41301.mail.yahoo.com> --0-1627041698-1077522685=:98801 Content-Type: text/plain; charset=us-ascii =================================== AHA NEWS NOW The Daily Report for Health Care Executives www.ahanews.com =================================== Thursday, Feb. 12, 2004 Today's headlines: Update: Adverse Events Following Civilian Smallpox Vaccination --- United States, 2003 During January 24--December 31, 2003, smallpox vaccine was administered to 39,213 civilian health-care and public health workers in 55 jurisdictions to prepare the United States for a possible terrorist attack using smallpox virus. This report updates information on vaccine-associated adverse events among civilians vaccinated since the beginning of the program and among contacts of vaccinees, received by CDC from the Vaccine Adverse Event Reporting System (VAERS) during August 9--December 31. In this vaccination program, CDC, the Food and Drug Administration, and state health departments are conducting surveillance for vaccine-associated adverse events among civilian vaccinees (1,2). As part of the vaccination program, civilian vaccinees receive routine follow-up, and reported adverse events after vaccination receive follow-up as needed. The U.S. Department of Defense is conducting surveillance for vaccine-associated adverse events among military vaccinees and providing follow-up care to those persons with reported adverse events (3). Adverse events associated with smallpox vaccination are classified on the basis of evidence supporting the reported diagnoses. Cases verified by virologic testing or, in some instances, by other diagnostic testing, are classified as confirmed (Table 1). Cases are classified as probable if possible alternative etiologies are investigated and excluded and supportive information for the diagnosis is found. Cases are classified as suspected if they have clinical features compatible with the diagnosis, but either further investigation is required or investigation of the case did not provide supporting evidence for the diagnosis. All reports of events that follow vaccination (i.e., events associated temporally) are accepted; however, reported adverse events are not necessarily associated causally with vaccination, and some or all of these events might be coincidental. This report includes cases reported as of December 31 that are either under investigation or have a reported final diagnosis. During August 9--December 31, no new cases of selected adverse events were reported (Table 1). During the vaccination program, no cases of eczema vaccinatum, erythema multiforme major, fetal vaccinia, or progressive vaccinia have been reported. During August 9--December 31, a total of 20 other serious adverse events were reported (Table 2). Also during this period, 59 other nonserious events were reported. Among the 712 vaccinees with reported other nonserious adverse events during January 24--December 31 (Table 2), the most common signs and symptoms were rash (n = 142), fever (n = 135), pain (n = 122), headache (n = 111), and fatigue (n = 97). All of these commonly reported events are consistent with mild expected reactions following receipt of smallpox vaccine. Some vaccinees reported multiple signs and symptoms. During this reporting period, no vaccinia immune globulin was released for civilian vaccinees. No cases of vaccine transmission from civilian vaccinees to their contacts have been reported during the vaccination program (Table 3). Surveillance for adverse events during the civilian and military smallpox vaccination programs is ongoing. Reported by: Smallpox vaccine adverse events coordinators; National Immunization Program, CDC. References CDC. Smallpox vaccine adverse events monitoring and response system for the first stage of the smallpox vaccination program. MMWR 2003;52:88--9, 99. CDC. Update: adverse events following civilian smallpox vaccination---United States, 2003. MMWR 2003;52:819--20. CDC. Secondary and tertiary transfer of vaccinia virus among U.S. military personnel---United States and worldwide, 2002--2004. MMWR 2004;53:103--5. Use of trade names and commercial sources is for identification only and does not imply endorsement by the U.S. Department of Health and Human Services. References to non-CDC sites on the Internet are provided as a service to MMWR readers and do not constitute or imply endorsement of these organizations or their programs by CDC or the U.S. Department of Health and Human Services. CDC is not responsible for the content of pages found at these sites. URL addresses listed in MMWR were current as of the date of publication. Disclaimer All MMWR HTML versions of articles are electronic conversions from ASCII text into HTML. This conversion may have resulted in character translation or format errors in the HTML version. Users should not rely on this HTML document, but are referred to the electronic PDF version and/or the original MMWR paper copy for the official text, figures, and tables. An original paper copy of this issue can be obtained from the Superintendent of Documents, U.S. Government Printing Office (GPO), Washington, DC 20402-9371; telephone: (202) 512-1800. Contact GPO for current prices. **Questions or messages regarding errors in formatting should be addressed to mmwrq@cdc.gov. Page converted: 2/12/2004 ================================== Copyright 2004 by the American Hospital Association. All rights reserved. For republication rights, contact Craig Webb. AHA News is a registered trademark of the American Hospital Association. The opinions expressed in AHA News Now are not necessarily those of the American Hospital Association. Brian Potts Managing Editor, CAL/AAEM News Service MS-IV, UC-Irvine --------------------------------- Do you Yahoo!? Yahoo! Mail SpamGuard - Read only the mail you want. --0-1627041698-1077522685=:98801 Content-Type: text/html; charset=us-ascii

===================================

AHA NEWS NOW

The Daily Report for Health Care Executives

www.ahanews.com

===================================

Thursday, Feb. 12, 2004

Today's headlines:

Update: Adverse Events Following Civilian Smallpox Vaccination --- United States, 2003

During January 24--December 31, 2003, smallpox vaccine was administered to 39,213 civilian health-care and public health workers in 55 jurisdictions to prepare the United States for a possible terrorist attack using smallpox virus. This report updates information on vaccine-associated adverse events among civilians vaccinated since the beginning of the program and among contacts of vaccinees, received by CDC from the Vaccine Adverse Event Reporting System (VAERS) during August 9--December 31.

In this vaccination program, CDC, the Food and Drug Administration, and state health departments are conducting surveillance for vaccine-associated adverse events among civilian vaccinees (1,2). As part of the vaccination program, civilian vaccinees receive routine follow-up, and reported adverse events after vaccination receive follow-up as needed. The U.S. Department of Defense is conducting surveillance for vaccine-associated adverse events among military vaccinees and providing follow-up care to those persons with reported adverse events (3).

Adverse events associated with smallpox vaccination are classified on the basis of evidence supporting the reported diagnoses. Cases verified by virologic testing or, in some instances, by other diagnostic testing, are classified as confirmed (Table 1). Cases are classified as probable if possible alternative etiologies are investigated and excluded and supportive information for the diagnosis is found. Cases are classified as suspected if they have clinical features compatible with the diagnosis, but either further investigation is required or investigation of the case did not provide supporting evidence for the diagnosis. All reports of events that follow vaccination (i.e., events associated temporally) are accepted; however, reported adverse events are not necessarily associated causally with vaccination, and some or all of these events might be coincidental. This report includes cases reported as of December 31 that are either under investigation or have a reported fi! nal diagnosis.

During August 9--December 31, no new cases of selected adverse events were reported (Table 1). During the vaccination program, no cases of eczema vaccinatum, erythema multiforme major, fetal vaccinia, or progressive vaccinia have been reported.

During August 9--December 31, a total of 20 other serious adverse events were reported (Table 2). Also during this period, 59 other nonserious events were reported. Among the 712 vaccinees with reported other nonserious adverse events during January 24--December 31 (Table 2), the most common signs and symptoms were rash (n = 142), fever (n = 135), pain (n = 122), headache (n = 111), and fatigue (n = 97). All of these commonly reported events are consistent with mild expected reactions following receipt of smallpox vaccine. Some vaccinees reported multiple signs and symptoms.

During this reporting period, no vaccinia immune globulin was released for civilian vaccinees. No cases of vaccine transmission from civilian vaccinees to their contacts have been reported during the vaccination program (Table 3). Surveillance for adverse events during the civilian and military smallpox vaccination programs is ongoing.

Reported by: Smallpox vaccine adverse events coordinators; National Immunization Program, CDC.

References

CDC. Smallpox vaccine adverse events monitoring and response system for the first stage of the smallpox vaccination program. MMWR 2003;52:88--9, 99.

CDC. Update: adverse events following civilian smallpox vaccination---United States, 2003. MMWR 2003;52:819--20.

CDC. Secondary and tertiary transfer of vaccinia virus among U.S. military personnel---United States and worldwide, 2002--2004. MMWR 2004;53:103--5.

 

Use of trade names and commercial sources is for identification only and does not imply endorsement by the U.S. Department of Health and Human Services.

References to non-CDC sites on the Internet are provided as a service to MMWR readers and do not constitute or imply endorsement of these organizations or their programs by CDC or the U.S. Department of Health and Human Services. CDC is not responsible for the content of pages found at these sites. URL addresses listed in MMWR were current as of the date of publication.

Disclaimer All MMWR HTML versions of articles are electronic conversions from ASCII text into HTML. This conversion may have resulted in character translation or format errors in the HTML version. Users should not rely on this HTML document, but are referred to the electronic PDF version and/or the original MMWR paper copy for the official text, figures, and tables. An original paper copy of this issue can be obtained from the Superintendent of Documents, U.S. Government Printing Office (GPO), Washington, DC 20402-9371; telephone: (202) 512-1800. Contact GPO for current prices.

**Questions or messages regarding errors in formatting should be addressed to mmwrq@cdc.gov.

Page converted: 2/12/2004

==================================

Copyright 2004 by the American Hospital Association. All rights reserved. For republication rights, contact Craig Webb.

AHA News is a registered trademark of the American Hospital Association. The opinions expressed in AHA News Now are not necessarily those of the American Hospital Association.



Brian Potts
Managing Editor, CAL/AAEM News Service
MS-IV, UC-Irvine

Do you Yahoo!?
Yahoo! Mail SpamGuard - Read only the mail you want. --0-1627041698-1077522685=:98801-- From pottsbri@yahoo.com Wed Feb 25 03:49:24 2004 From: pottsbri@yahoo.com (CAL/AAEM News Service) Date: Tue, 24 Feb 2004 19:49:24 -0800 (PST) Subject: AHA calls Senate liability bill 'good first step'; vote set for tomorrow Message-ID: <20040225034924.22879.qmail@web41310.mail.yahoo.com> --0-611044931-1077680964=:20983 Content-Type: text/plain; charset=us-ascii =================================== AHA NEWS NOW The Daily Report for Health Care Executives www.ahanews.com =================================== Monday, Feb. 23, 2004 1) AHA calls Senate liability bill 'good first step'; vote set for tomorrow AHA today called a Senate bill that would limit certain damages in medical liability lawsuits involving obstetrical and gynecological services "a good first step in medical liability reform." The Healthy Mothers and Healthy Babies Access to Care Act, S. 2061, would cap non-economic damages at $250,000 and limit punitive damages to $250,000 or twice the economic damage award, whichever is larger. "Access to care is being threatened by dramatic increases in the cost of medical liability insurance," AHA Executive Vice President Rick Pollack said. "Especially hard hit are women's health services, where OB/GYNs face some of the nation's highest liability costs." Pollack said the bill "will protect a woman's access to important health care services by maintaining unlimited awards of economic damages while placing reasonable caps on non-economic damages. Every American should have access to care and we look forward to working with Congress toward a more comprehensive medical liabil! ity reform law that protects this essential principle." Senate leadership will seek to invoke cloture on S. 2061 tomorrow. The procedure, which requires 60 votes to pass, would limit congressional debate on the bill to 30 more hours. The AHA statement can be found at http://www.aha.org under "What's New." +++ ================================== Copyright 2004 by the American Hospital Association. All rights reserved. For republication rights, contact Craig Webb. AHA News is a registered trademark of the American Hospital Association. The opinions expressed in AHA News Now are not necessarily those of the American Hospital Association. Brian Potts Managing Editor, CAL/AAEM News Service MS-IV, UC-Irvine --------------------------------- Do you Yahoo!? Yahoo! Mail SpamGuard - Read only the mail you want. --0-611044931-1077680964=:20983 Content-Type: text/html; charset=us-ascii

===================================

AHA NEWS NOW

The Daily Report for Health Care Executives

www.ahanews.com

===================================

Monday, Feb. 23, 2004

 

1) AHA calls Senate liability bill 'good first step'; vote set for tomorrow

AHA today called a Senate bill that would limit certain damages in medical liability lawsuits involving obstetrical and gynecological services "a good first step in medical liability reform." The Healthy Mothers and Healthy Babies Access to Care Act, S. 2061, would cap non-economic damages at $250,000 and limit punitive damages to $250,000 or twice the economic damage award, whichever is larger. "Access to care is being threatened by dramatic increases in the cost of medical liability insurance," AHA Executive Vice President Rick Pollack said. "Especially hard hit are women's health services, where OB/GYNs face some of the nation's highest liability costs." Pollack said the bill "will protect a woman's access to important health care services by maintaining unlimited awards of economic damages while placing reasonable caps on non-economic damages. Every American should have access to care and we look forward to working with Congress toward a more comprehensive medical lia! bility reform law that protects this essential principle." Senate leadership will seek to invoke cloture on S. 2061 tomorrow. The procedure, which requires 60 votes to pass, would limit congressional debate on the bill to 30 more hours. The AHA statement can be found at http://www.aha.org under "What's New."

+++

==================================

Copyright 2004 by the American Hospital Association. All rights reserved. For republication rights, contact Craig Webb.

AHA News is a registered trademark of the American Hospital Association. The opinions expressed in AHA News Now are not necessarily those of the American Hospital Association.



Brian Potts
Managing Editor, CAL/AAEM News Service
MS-IV, UC-Irvine

Do you Yahoo!?
Yahoo! Mail SpamGuard - Read only the mail you want. --0-611044931-1077680964=:20983-- From pottsbri@yahoo.com Wed Feb 25 23:59:59 2004 From: pottsbri@yahoo.com (CAL/AAEM News Service) Date: Wed, 25 Feb 2004 15:59:59 -0800 (PST) Subject: Cloture Vote on Medical Malpractice Bill for OB/GYNs Fails in Senate Message-ID: <20040225235959.41997.qmail@web41313.mail.yahoo.com> --0-74133912-1077753599=:41463 Content-Type: text/plain; charset=us-ascii -----Original Message----- From: California Healthline [mailto:CALIFORNIAHEALTHLINE@ADVISORY.COM] Sent: Wednesday, February 25, 2004 10:13 AM Cloture Vote on Medical Malpractice Bill for OB/GYNs Fails in Senate 02/25/2004 As expected, a Senate bill (S 2061 ) that would cap noneconomic damages at $250,000 in medical malpractice lawsuits against OB/GYNs was blocked by Democrats on Tuesday as a cloture vote to limit debate fell short of the necessary 60 votes, the New York Times reports (Stolberg, New York Times, 2/25). The malpractice legislation, sponsored by Sens. Judd Gregg (R-N.H.) and John Ensign (R-Nev.), also would have capped punitive damages in malpractice lawsuits against OB/GYNs at $250,000 or twice the amount of economic damages, whichever is higher ( http://www.californiahealthline.org/members/basecontent.asp?contentid=51008&collectionid=3&program=1&contentarea=42005 California Healthline, 2/23). In addition, the bill would have capped liability for manufacturers of drugs and medical devices for obstetrical/gynecological services and limited fees for lawyers who take such c! ases on a contingency basis (Dewar, Washington Post, 2/25). The OB/GYN bill was introduced after the Senate defeated a broader bill (S 11) last year when Senate Democrats blocked a vote on the bill, which included the same caps on noneconomic and punitive damages as the new legislation but would have applied to malpractice lawsuits against all physicians, HMOs, pharmaceutical companies and medical device companies. Republicans pared down last year's bill in an effort to gain support for malpractice caps on individual specialties, starting with obstetrics and gynecology (California Healthline, 2/23). The OB/GYN bill, which is supported by insurers and the American Medical Association , fell 12 votes short of the 60 needed for cloture in a vote that went largely along party lines (Holland, AP/Akron Beacon Journal, 2/25). Reaction Following the vote, Senate Judiciary Committee Chair Orrin Hatch (R-Utah) said it was "shameful" that Democrats "placed personal-injury lawyers above pregnant women" (Fagan, Washington Times, 2/25). "We're going to keep going until we succeed," Sen. Elizabeth Dole (R-N.C.) said (New York Times, 2/25). Republicans said they will highlight the issue in this fall's campaigns and intend to broaden the debate by introducing additional tort reform legislation (Washington Post, 2/25). Senate Majority Leader Bill Frist (R-Tenn.) and Gregg said the next bills will focus on protections for trauma and emergency department personnel and doctors who work in rural and underserved areas. Gregg said, "We're trying to make a very important point. The only way we're going to change the intransigence of the Democrats is through public opinion" (Schuler, CQ Today, 2/24). C-SPAN's "Washington Journal " on Tuesday included an interview with AMA President Donald Palmisano on the bill ("Washington Journal," C-SPAN, 2/24). The complete segment is available online in RealPlayer. Brian Potts Managing Editor, CAL/AAEM News Service MS-IV, UC-Irvine --------------------------------- Do you Yahoo!? Yahoo! Mail SpamGuard - Read only the mail you want. --0-74133912-1077753599=:41463 Content-Type: text/html; charset=us-ascii

-----Original Message-----

From: California Healthline [mailto:CALIFORNIAHEALTHLINE@ADVISORY.COM]

Sent: Wednesday, February 25, 2004 10:13 AM

Cloture Vote on Medical Malpractice Bill for OB/GYNs Fails in Senate

02/25/2004

As expected, a Senate bill (S 2061 <http://thomas.loc.gov/cgi-bin/query/z?c108:s.2061:> ) that would cap noneconomic damages at $250,000 in medical malpractice lawsuits against OB/GYNs was blocked by Democrats on Tuesday as a cloture vote to limit debate fell short of the necessary 60 votes, the <http://www.nytimes.com/2004/02/25/politics/25MEDI.html> New York Times reports (Stolberg, New York Times, 2/25). The malpractice legislation, sponsored by Sens. Judd Gregg (R-N.H.) and John Ensign (R-Nev.), also would have capped punitive damages in malpractice lawsuits against OB/GYNs at $250,000 or twice the amount of economic damages, whichever is higher ( http://www.californiahealthline.org/members/basecontent.asp?contentid=51008&collectionid=3&program=1&contentarea=42005 California Healthline, 2/23). In addition, the bill would have capped liability for manufacturers of drugs and medical devices for obstetrical/gynecological services and limited fees for lawyers who take such cases on a contingency basis (Dewar, <http://www.washingtonpost.com/wp-dyn/articles/A3498-2004Feb24.html> Washington Post, 2/25). The OB/GYN bill was introduced after the Senate defeated a broader bill (S 11) last year! when Senate Democrats blocked a vote on the bill, which included the same caps on noneconomic and punitive damages as the new legislation but would have applied to malpractice lawsuits against all physicians, HMOs, pharmaceutical companies and medical device companies. Republicans pared down last year's bill in an effort to gain support for malpractice caps on individual specialties, starting with obstetrics and gynecology (California Healthline, 2/23). The OB/GYN bill, which is supported by insurers and the American Medical Association <http://www.ama-assn.org/> , fell 12 votes short of the 60 needed for cloture in a vote that went largely along party lines (Holland, <http://www.ohio.com/mld/beaconjournal/news/nation/8035051.htm> AP/! Akron Beacon Journal, 2/25).

Reaction

Following the vote, Senate Judiciary <http://judiciary.senate.gov/> Committee Chair Orrin Hatch (R-Utah) said it was "shameful" that Democrats "placed personal-injury lawyers above pregnant women" (Fagan, <http://www.washtimes.com/national/20040224-102204-7517r.htm> Washington Times, 2/25). "We're going to keep going until we succeed," Sen. Elizabeth Dole (R-N.C.) said (New York Times, 2/25). Republicans said they will highlight the issue in this fall's campaigns and intend to broaden the debate by introducing additional tort reform legislation (Washington Post, 2/25). Senate Majority Leader Bill Frist (R-Tenn.) and Gregg said the next bills will focus on protections for trauma and emergency department personnel and doctors w! ho work in rural and underserved areas. Gregg said, "We're trying to make a very important point. The only way we're going to change the intransigence of the Democrats is through public opinion" (Schuler, CQ Today, 2/24). C-SPAN's "Washington Journal <http://www.c-span.org/homepage.asp?Cat=Series&Code=WJE&ShowVidNum=6&Rot_Cat_CD=WJ&Rot_HT=204&Rot_WD=&ShowVidDays=15&ShowVidDesc=> " on Tuesday included an interview with AMA President Donald Palmisano on the bill ("Washington Journal," C-SPAN, 2/24). The complete segment is available online <rtsp://video.c-span.org/15days/wj022404_donald.rm> in RealPlayer.

 



Brian Potts
Managing Editor, CAL/AAEM News Service
MS-IV, UC-Irvine

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Yahoo! Mail SpamGuard - Read only the mail you want. --0-74133912-1077753599=:41463-- From pottsbri@yahoo.com Thu Feb 26 17:23:03 2004 From: pottsbri@yahoo.com (CAL/AAEM News Service) Date: Thu, 26 Feb 2004 09:23:03 -0800 (PST) Subject: Ruling Issued in Resident Lawsuit Message-ID: <20040226172303.35841.qmail@web41304.mail.yahoo.com> --0-363306668-1077816183=:33873 Content-Type: text/plain; charset=us-ascii -----Original Message----- AAMC WASHINGTON HEADLINES Legislative and Regulatory News from the Association of American Medical Colleges February 13, 2004 *********************************************** Ruling Issued in Resident Lawsuit The United States District Court for the District of Columbia Feb. 11 issued a ruling dismissing the plaintiff's claims against several defendants in the resident anti-trust litigation (Jung et al. v. AAMC et al.). Information: Joe Keyes , AAMC General Counsel, 202-828-0554. The complete story is at: http://www.aamc.org/advocacy/library/washhigh/2004/021304/_1.htm *********************************************** House GOP Pledge to Limit Federal Spending House Republicans are uniting behind a renewed call to hold the line on federal spending at or below the levels proposed by President Bush in his FY 2005 budget. The push to control spending is coupled with a proposal to reform the budget process to create legally enforceable spending limits. However, the proposed reforms and the "belt-tightening" they hope to achieve face uphill battles at the hands of the House Budget and Appropriations committees as well as the Senate. Information: Dave Moore , AAMC Office of Governmental Relations, 202-828-0525. The complete story is at: http://www.aamc.org/advocacy/library/washhigh/2004/021304/_2.htm *********************************************** Medicaid/SCHIP Budget Highlights Program Reforms and Tighter Management President Bush's FY 2005 budget proposal continues proposals to reform Medicaid and the State Children Health Insurance Program (SCHIP) as well as bolster efforts to ensure Medicaid and SCHIP program integrity. The budget estimates that total spending in FY 2005 on Medicaid will be $322 billion, of which $182 billion is the federal share. Information: Lynne Davis Boyle or Christiane Mitchell , AAMC Office of Governmental Relations, 202-828-0526. The complete story is at: http://www.aamc.org/advocacy/library/washhigh/2004/021304/_3.htm *********************************************** Brian Potts Managing Editor, CAL/AAEM News Service MS-IV, UC-Irvine --------------------------------- Do you Yahoo!? Get better spam protection with Yahoo! Mail --0-363306668-1077816183=:33873 Content-Type: text/html; charset=us-ascii

-----Original Message-----

AAMC WASHINGTON HEADLINES

Legislative and Regulatory News

from the Association of American Medical Colleges

February 13, 2004

***********************************************

Ruling Issued in Resident Lawsuit

The United States District Court for the District of Columbia Feb. 11 issued a ruling dismissing the plaintiff's claims against several defendants in the resident anti-trust litigation (Jung et al. v. AAMC et al.).

Information: Joe Keyes <jakeyes@aamc.org>, AAMC General Counsel, 202-828-0554.

The complete story is at: http://www.aamc.org/advocacy/library/washhigh/2004/021304/_1.htm

***********************************************

House GOP Pledge to Limit Federal Spending

House Republicans are uniting behind a renewed call to hold the line on federal spending at or below the levels proposed by President Bush in his FY 2005 budget. The push to control spending is coupled with a proposal to reform the budget process to create legally enforceable spending limits. However, the proposed reforms and the "belt-tightening" they hope to achieve face uphill battles at the hands of the House Budget and Appropriations committees as well as the Senate.

Information: Dave Moore <dbmoore@aamc.org>, AAMC Office of Governmental Relations, 202-828-0525.

The complete story is at: http://www.aamc.org/advocacy/library/washhigh/2004/021304/_2.htm

***********************************************

Medicaid/SCHIP Budget Highlights Program Reforms and Tighter Management

President Bush's FY 2005 budget proposal continues proposals to reform Medicaid and the State Children Health Insurance Program (SCHIP) as well as bolster efforts to ensure Medicaid and SCHIP program integrity. The budget estimates that total spending in FY 2005 on Medicaid will be $322 billion, of which $182 billion is the federal share.

Information: Lynne Davis Boyle <ldavisboyle@aamc.org> or Christiane Mitchell <cmitchell@aamc.org>, AAMC Office of Governmental Relations, 202-828-0526.

The complete story is at: http://www.aamc.org/advocacy/library/washhigh/2004/021304/_3.htm

***********************************************



Brian Potts
Managing Editor, CAL/AAEM News Service
MS-IV, UC-Irvine

Do you Yahoo!?
Get better spam protection with Yahoo! Mail --0-363306668-1077816183=:33873-- From pottsbri@yahoo.com Sat Feb 28 20:11:55 2004 From: pottsbri@yahoo.com (CAL/AAEM News Service) Date: Sat, 28 Feb 2004 12:11:55 -0800 (PST) Subject: Officials From Los Angeles, Orange Counties To Request Help With State Mandates for Hospitals Message-ID: <20040228201155.31365.qmail@web41315.mail.yahoo.com> --0-2022680421-1077999115=:31221 Content-Type: text/plain; charset=us-ascii -----Original Message----- From: California Healthline [mailto:CALIFORNIAHEALTHLINE@ADVISORY.COM] Sent: Wednesday, February 25, 2004 10:13 AM Officials From Los Angeles, Orange Counties To Request Help With State Mandates for Hospitals 02/25/2004 Officials from Los Angeles and Orange counties plan to send a letter to Gov. Arnold Schwarzenegger (R) to request help in efforts to meet state seismic retrofit requirements and nurse-to-patient ratio rules for hospitals, the Los Angeles Times reports (Pfeifer, Los Angeles Times, 2/25). Under the seismic retrofit requirements, hospitals must guarantee by 2008 -- or by 2013 if they expect to continue to use their buildings for an additional 30 years -- that their buildings will not collapse in a major earthquake. By 2030, hospitals must guarantee that their buildings will not collapse in a major earthquake and will to continue to function immediately afterward ( http://www.californiahealthline.org/members/basecontent.asp?contentid=51030&collectionid=3&program=1 California Healthline, 2/24). Under the nurse-to-patient ratio rules, which took effect Jan. 1, nurses do not have to care for more than eight p! atients at a time. The rules also call for one nurse per five patients in medical-surgical units by 2005, as well as one nurse per four patients in specialty care and telemetry units and one nurse per three patients in step-down units by 2008. In addition, the regulations state that licensed vocational nurses can comprise no more than 50% of the licensed nurses assigned to patient care and that only registered nurses can care for critical trauma patients. The rules also require at least one registered nurse to serve as a triage nurse in emergency departments ( http://www.californiahealthline.org/members/basecontent.asp?contentid=50694&collectionid=3&contentarea=40177 California Healthline, 1/15). Letter Details In the letter, officials from Orange and Los Angeles counties will ask Schwarzenegger to establish a program to help hospitals cover the estimated $24 billion cost of seismic retrofits needed to meet the state requirements, the Times reports. In addition, they will ask the governor to order state health officials to waive penalties for hospitals found not in compliance with the nurse-to-patient ratio rules. The letter also will raise concerns that a disaster, such as a bioterrorist attack, could "inundate hospitals with patients and push them into a violation" of the nurse-to-patient ratio rules, the Times reports. According to officials from both counties, the financial effects of the two state mandates could prompt hospitals to close. Orange County Supervisor Chuck Smith said that the mandates have the potential of "demolishing health care in Orange County," adding, "Let's use a little reasonableness and common sense in Sacramento. That's all we're asking for." Orange Coun! ty Supervisor Bill Campbell said that the Legislature should not "tell hospitals how many nurses they need on duty," adding that the seismic retrofit requirements make "no sense" because they apply to "all hospitals, even though some are less susceptible to earthquakes than others," the Times reports (Los Angeles Times, 2/25). Brian Potts Managing Editor, CAL/AAEM News Service MS-IV, UC-Irvine --------------------------------- Do you Yahoo!? Get better spam protection with Yahoo! Mail --0-2022680421-1077999115=:31221 Content-Type: text/html; charset=us-ascii

-----Original Message-----

From: California Healthline [mailto:CALIFORNIAHEALTHLINE@ADVISORY.COM]

Sent: Wednesday, February 25, 2004 10:13 AM

Officials From Los Angeles, Orange Counties To Request Help With State Mandates for Hospitals

02/25/2004

Officials from Los Angeles and Orange counties plan to send a letter to Gov. Arnold Schwarzenegger (R) to request help in efforts to meet state seismic retrofit requirements and nurse-to-patient ratio rules for hospitals, the <http://www.latimes.com/news/local/la-me-hospital25feb25,1,2596229.story> Los Angeles Times reports (Pfeifer, Los Angeles Times, 2/25). Under the seismic retrofit requirements, hospitals must guarantee by 2008 -- or by 2013 if they expect to continue to use their buildings for an additional 30 years -- that their buildings will not collapse in a major earthquake. By 2030, hospitals must guarantee that their buildings will not collapse in a major earthquake and will to continue to function immediately afterward ( ! http://www.californiahealthline.org/members/basecontent.asp?contentid=51030&collectionid=3&program=1 California Healthline, 2/24). Under the nurse-to-patient ratio rules, which took effect Jan. 1, nurses do not have to care for more than eight patients at a time. The rules also call for one nurse per five patients in medical-surgical units by 2005, as well as one nurse per four patients in specialty care and telemetry units and one nurse per three patients in step-down units by 2008. In addition, the regulations state that licensed vocational nurses can comprise no more than 50% of the licensed nurses assigned to patient care and that only registered nurses can care for critical trauma patients. The rules also require at least one registered nurse to serve as a triage nurse in emergency department! s ( http://www.californiahealthline.org/members/basecontent.asp?contentid=50694&collectionid=3&contentarea=40177 California Healthline, 1/15).

Letter Details

In the letter, officials from Orange and Los Angeles counties will ask Schwarzenegger to establish a program to help hospitals cover the estimated $24 billion cost of seismic retrofits needed to meet the state requirements, the Times reports. In addition, they will ask the governor to order state health officials to waive penalties for hospitals found not in compliance with the nurse-to-patient ratio rules. The letter also will raise concerns that a disaster, such as a bioterrorist attack, could "inundate hospitals with patients and push them into a violation" of the nurse-to-patient ratio rules, the Times reports. According to officials from both counties, the financial effects of the two state mandates could prompt hospitals to close. Orange County Supervisor Chuck Smith said that the mandates have the potential of "demolishing health care in Orange County," adding, "Let's use a little reasonableness and common sense in Sacramento. That's all we're asking for." Orange C! ounty Supervisor Bill Campbell said that the Legislature should not "tell hospitals how many nurses they need on duty," adding that the seismic retrofit requirements make "no sense" because they apply to "all hospitals, even though some are less susceptible to earthquakes than others," the Times reports (Los Angeles Times, 2/25).



Brian Potts
Managing Editor, CAL/AAEM News Service
MS-IV, UC-Irvine

Do you Yahoo!?
Get better spam protection with Yahoo! Mail --0-2022680421-1077999115=:31221-- From pottsbri@yahoo.com Sun Feb 29 20:31:25 2004 From: pottsbri@yahoo.com (CAL/AAEM News Service) Date: Sun, 29 Feb 2004 12:31:25 -0800 (PST) Subject: FW: Team Health is retiring its debt early Message-ID: <20040229203125.83973.qmail@web41310.mail.yahoo.com> --0-1161629800-1078086685=:83669 Content-Type: text/plain; charset=us-ascii -----Original Message----- Team Health, Inc. Commences Tender Offer and Consent Solicitation KNOXVILLE, Tenn., Feb. 25 /PRNewswire/ -- Team Health, Inc. (the "Company") announced today that it has commenced a cash tender offer and consent solicitation (the "Offer") for any and all of its $100.0 million aggregate principal amount of 12% Senior Subordinated Notes due 2009 (CUSIP No. 87815VAC7) (the "Notes"). The Offer is scheduled to expire at 12:00 midnight, New York City time, on Monday, March 22, 2004, unless extended or earlier terminated (the "Expiration Date"). The consent solicitation will expire at 5:00 p.m., New York City time, on Monday, March 8, 2004 (the "Consent Date"). Holders tendering their Notes will be required to consent to certain proposed amendments to the indenture governing the Notes, which will eliminate substantially all of the restrictive covenants. Holders may not tender their Notes without delivering consents or deliver consents without tendering their Notes. Holders who validly tender their notes by the Consent Date will receive the total consideration of $1,082.50 per $1,000 principal amount of Notes (if such notes are accepted for purchase). Holders who validly tender their Notes after the Consent Date and prior to the Expiration Date will receive as payment for the Notes $1,062.50 per $1,000 principal amount of Notes (if such notes are accepted for purchase). In either case, Holders who validly tender their Notes also will be paid accrued and unpaid interest up to, but not including, the date of payment for the Notes (if such notes are accepted for purchase). In addition to the Offer, the Company intends to (i) consummate a private offering of a new series of senior subordinated notes, (ii) enter into new senior secured credit facilities, (iii) redeem its outstanding preferred stock and (iv) pay a dividend to holders of the Company's common stock (if approved by the Company's board of directors). We refer to these transactions, collectively, as the "Refinancing Transactions". The Offer is subject to the satisfaction of certain conditions, including the Company's receipt of tenders of Notes representing a majority of the principal amount of the Notes outstanding and the consummation of the Refinancing Transactions, and is expected to be financed by a combination of the new senior subordinated notes and borrowings under the new credit facilities. The Company currently plans to call for redemption, upon the closing of the new senior subordinated notes offering and the new credit facilities, in accordance with the terms of the indenture governing the Notes, all Notes that remain outstanding. The terms of the Offer are described in the Company's Offer to Purchase and Consent Solicitation Statement dated February 24, 2004, copies of which may be obtained from Georgeson Shareholder Communications. The Company has engaged J.P. Morgan Securities Inc. and Banc of America Securities LLC to act as dealer managers and solicitation agents in connection with the Offer. Questions regarding the Offer may be directed to J.P. Morgan Securities Inc., Chad Joplin, at (212) 270-1171 (collect) and Banc of America Securities LLC, High Yield Special Products, at (888)-292-0070 (toll-free) and (212)-847-5834 (collect). Requests for documentation may be directed to Georgeson Shareholder Communications, the information agent for the Offer, at (866) 399-8793 (toll-free) and (212) 440-9800. The announcement is not an offer to purchase, a solicitation of an offer to purchase or a solicitation of consent with respect to any securities. The Offer is being made solely by the Offer to Purchase and Consent Solicitation Statement dated February 24, 2004. The Company will be issuing the new senior subordinated notes in a transaction that will not be and has not been registered under the Securities Act of 1933, as amended, or any state securities laws and the new notes may not be offered or sold in the United States absent registration or an applicable exemption from the registration requirements of the Securities Act and applicable state securities laws. This press release does not constitute an offer to sell or the solicitation of an offer to buy any security. SOURCE Team Health, Inc. CO: Team Health, Inc. ST: Tennessee SU: TNM http://www.prnewswire.com 02/25/2004 08:50 EST Brian Potts Managing Editor, CAL/AAEM News Service MS-IV, UC-Irvine --------------------------------- Do you Yahoo!? Get better spam protection with Yahoo! Mail --0-1161629800-1078086685=:83669 Content-Type: text/html; charset=us-ascii

-----Original Message-----

Team Health, Inc. Commences Tender Offer and Consent Solicitation

 

KNOXVILLE, Tenn., Feb. 25 /PRNewswire/ -- Team Health, Inc. (the

"Company") announced today that it has commenced a cash tender offer and consent solicitation (the "Offer") for any and all of its $100.0 million aggregate principal amount of 12% Senior Subordinated Notes due 2009 (CUSIP No. 87815VAC7) (the "Notes").

The Offer is scheduled to expire at 12:00 midnight, New York City time, on Monday, March 22, 2004, unless extended or earlier terminated (the "Expiration Date"). The consent solicitation will expire at 5:00 p.m., New York City time, on Monday, March 8, 2004 (the "Consent Date"). Holders tendering their Notes will be required to consent to certain proposed amendments to the indenture governing the Notes, which will eliminate substantially all of the restrictive covenants. Holders may not tender their Notes without delivering consents or deliver consents without tendering their Notes.

Holders who validly tender their notes by the Consent Date will receive the total consideration of $1,082.50 per $1,000 principal amount of Notes (if such notes are accepted for purchase). Holders who validly tender their Notes after the Consent Date and prior to the Expiration Date will receive as payment for the Notes $1,062.50 per $1,000 principal amount of Notes (if such notes are accepted for purchase). In either case, Holders who validly tender their Notes also will be paid accrued and unpaid interest up to, but not including, the date of payment for the Notes (if such notes are accepted for purchase).

In addition to the Offer, the Company intends to (i) consummate a private offering of a new series of senior subordinated notes, (ii) enter into new senior secured credit facilities, (iii) redeem its outstanding preferred stock and (iv) pay a dividend to holders of the Company's common stock (if approved by the Company's board of directors). We refer to these transactions, collectively, as the "Refinancing Transactions".

The Offer is subject to the satisfaction of certain conditions, including the Company's receipt of tenders of Notes representing a majority of the principal amount of the Notes outstanding and the consummation of the Refinancing Transactions, and is expected to be financed by a combination of the new senior subordinated notes and borrowings under the new credit facilities. The Company currently plans to call for redemption, upon the closing of the new senior subordinated notes offering and the new credit facilities, in accordance with the terms of the indenture governing the Notes, all Notes that remain outstanding. The terms of the Offer are described in the Company's Offer to Purchase and Consent Solicitation Statement dated February 24, 2004, copies of which may be obtained from Georgeson Shareholder Communications.

The Company has engaged J.P. Morgan Securities Inc. and Banc of America Securities LLC to act as dealer managers and solicitation agents in connection with the Offer. Questions regarding the Offer may be directed to J.P. Morgan Securities Inc., Chad Joplin, at (212) 270-1171 (collect) and Banc of America Securities LLC, High Yield Special Products, at (888)-292-0070 (toll-free) and (212)-847-5834 (collect). Requests for documentation may be directed to Georgeson Shareholder Communications, the information agent for the Offer, at (866) 399-8793 (toll-free) and (212) 440-9800.

The announcement is not an offer to purchase, a solicitation of an offer to purchase or a solicitation of consent with respect to any securities. The Offer is being made solely by the Offer to Purchase and Consent Solicitation Statement dated February 24, 2004.

The Company will be issuing the new senior subordinated notes in a transaction that will not be and has not been registered under the Securities Act of 1933, as amended, or any state securities laws and the new notes may not be offered or sold in the United States absent registration or an applicable exemption from the registration requirements of the Securities Act and applicable state securities laws. This press release does not constitute an offer to sell or the solicitation of an offer to buy any security.

SOURCE Team Health, Inc.

CO: Team Health, Inc.

ST: Tennessee

SU: TNM

http://www.prnewswire.com

02/25/2004 08:50 EST



Brian Potts
Managing Editor, CAL/AAEM News Service
MS-IV, UC-Irvine

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