plans form coalition, but will they support meaningful patient
urged to reconsider vote on Nickles amendment
calls $145 billion tobacco verdict a public health victory
internists earn significantly less than their male
wins impressive managed care reform victory
uses research, advocacy to work for Medicare payment increase
undertakes effort to help physicians help pharmacists
coalition tackles regional insurance hassles
tells lawmakers patients and physicians deserve better
hits the road for physicians' summer school
announces Tar Wars winners
theme issue to focus on tobacco
launches Internet site en espanol
Alliance launches new Web site
1. Health plans form coalition, but will they
support meaningful patient protections?
The AMA yesterday called on the executives of 22 health
plans and two trade groups to prove their commitment to
patients by supporting a strong patients' rights bill. The
executives announced they have formed the Coalition for
Affordable Quality Health Care.
"Health insurers seem to realize they have a credibility
problem with the public," said AMA President Randolph D. Smoak
''Most of the elements they say they want to improve are in
the patients' bill of rights,'' Dr. Smoak told USA Today.
''They ought to show their actions are genuine and join us
in seeing that it gets passed.''
The AMA said it will judge the sincerity of insurers by
results -- not by rhetoric.
here to read Dr. Smoak's full statement.
2. Senators urged to reconsider vote on
Calling legislation recently passed by the Senate more of
an HMO wish list than real managed care reform, the AMA called
on senators to take a closer look at Sen. Don Nickles' (R,
Okla.) language in an amendment to an HHS appropriations bill.
As is, the Nickles amendment would leave patients worse off
than under current statutory and case law.
"The liability provisions are a sham," said AMA Executive
Vice President E. Ratcliffe Anderson Jr., MD.
"Physicians across the country need to send a strong
message to Senator Nickles . . . that we are tired of the foot
dragging, smokescreens and posturing," AMA Board Chair D. Ted
Lewers, MD, said Tuesday on National Public Radio (NPR).
The Nickles amendment would:
Dr. Anderson's letter.
- Preempt state laws and recent court opinions that have
held HMOs liable for medical decisions that injure or kill
- Allow an HMO to escape responsibility for patient
injuries by alleging the patient or treating physician
failed to provide "sufficient information";
- Limit patient protections only to patients enrolled in
- Allow health plans to impose narrow definitions of
- Undermine access to medical specialists; and
- Subject patients to high levels of uncertainty about
potential out-of-pocket costs for clinical cancer trials.
the Tuesday, July 18 NPR Morning Edition program list to hear
the full story.
3. AMA calls $145 billion tobacco verdict a
public health victory
Big tobacco took a big hit last week when a Florida jury
handed down the largest punitive damage award in U.S. history.
The tobacco industry's largest producers will have to pay $145
billion to hundreds of thousands of Floridians suffering
"The jurors' message is loud and clear: The tobacco
industry must pay for addicting and poisoning people for
profit," said AMA President Randolph D. Smoak Jr., MD. "This
verdict against Big Tobacco is a victory for public health."
After jurors delivered the verdict, tobacco industry
lawyers and spokespeople complained the decision was unfair.
However, as Dr. Smoak pointed out, "this unprecedented verdict
sends a strong message to the tobacco industry that toying
with the health and lives of Americans can be a prohibitively
What the tobacco industry will have to pay:
here to read Dr. Smoak's full statement.
- Philip Morris: $73.96 billion
- R.J. Reynolds: $36.28 billion
- Brown & Williamson: $17.59 billion
- Lorillard Tobacco: $16.25 billion
- Liggett Group: $790 million
4. Women internists earn significantly less
than male counterparts
A study of internists in Pennsylvania found that male
internists earned 14 percent more per hour than women
internists. The data takes into account specialty, training,
number of hours worked and practice setting.
Other findings from the study:
The authors note that while their findings
reflect a gender gap among internists in Pennsylvania, they
may not relate to all U.S. physicians. However, they believe
that is unlikely -- due to both a lack of state-specific
physicians earnings data that suggests gender equity and the
fact that Pennsylvania has long been a center for the training
of female physicians.
- Women were more likely to be salaried employees and less
likely to be partners; and
- Women were half as likely as men to be in high-earning
specialties and twice as likely to be in low-earning
The study appears in the latest issue of the Annals of
Internal Medicine , published by the American College of
Physicians-American Society of Internal Medicine.
a summary of the findings.
5. MMS wins impressive managed care reform
Perseverance paid off for the Massachusetts Medical Society
(MMS) when the state legislature last week passed managed care
reform legislation that provides patients with comprehensive,
tangible and immediate protections. MMS has championed patient
protection legislation as its top advocacy priority since 1997
and called the action "a strong framework of high quality care
for all the people of Massachusetts."
"We thank and congratulate the leaders and members of the
House and Senate for remaining focused on this legislation,"
said Virginia T. Latham, MD, MMS president. "We commend the
contributions of physicians, the rest of the health care
community, consumer groups and other advocates who worked with
us toward this shared goal. It is clear to me that everyone
played an important role in making this a reality."
Highlights of the legislation:
The legislation also calls for MMS
participation in the establishment of a special commission to
study physician compensation and an advisory committee to
arrange for and evaluate a study of universal access to
affordable health care.
- Establishes a nine-member Managed Care Oversight Board
(MCOB) representing state agencies;
- Creates a 14-member Advisory Committee, including MMS,
with authority to advise MCOB on managed care issues and
review proposed rules, regulations and guidelines issued by
state agencies at least 60 days before they become final,
except in emergencies;
- Applies the "prudent layperson" standard for emergency
- Requires development of an annual Health Plan Report
Card, allowing consumers to evaluate and compare managed
- Requires health plans to make "timely payment" of all
claims or face interest that will accrue at the rate of
1-1/2 percent per month (18 percent per year) from the
receipt of notice of claim;
- Strengthens "anti-gag" provisions, allowing providers to
discuss with their patients the provisions, terms or
requirements of plans as they relate to those patients'
needs, or the general method by which the provider is
- Forbids financial incentives that specifically induce
the non-provision of covered medically necessary services,
but allows capitation and shared risk arrangements with
physicians and physician groups;
- Establishes an independent external review procedure to
appeal rejected internal grievances process; and
- Creates medical necessity guidelines to be developed
using national standards and with input from practicing
MMS said it expects Gov. A. Paul Cellucci to sign the
For more information, e-mail MMS's Frank Fortin or phone (781)
6. NMMS uses research, advocacy to work for
Medicare payment increase
The New Mexico Medical Society (NMMS) wants the government
to take a hard look at how New Mexico's socioeconomic picture
is hurting its patients and physicians. NMMS recently released
findings that demonstrate poverty, a shortage of physicians
and insufficient health care financing are creating a health
NMMS presented its findings to New Mexico's congressional
delegation and will continue to emphasize how:
"It's unacceptable to say that 'some states
are fortunate and some are not,'" said G. Randy Marshall, NMMS
executive director. "We want our elected officials to know
that they need to work a little harder to protect the health
of all of New Mexico's citizens."
- More than 20 percent of New Mexicans are uninsured;
- 35 percent of New Mexico's children under age 5 live in
- 31 of New Mexico's 33 counties do not have enough health
- New Mexico's extremely low Medicare reimbursement rates
have led to fewer provider choices, greater expenses and
higher mortality rates; and
- A $25 million Medicare increase is required simply to
raise New Mexico to the national average.
For more information, e-mail NMMS's Bonnie Smith or phone
7. ISMA undertakes effort to help physicians
In response to increasing demands on pharmacists' time to
help patients, the Indiana State Medical Association (ISMA)
recently highlighted to its members how they could best help
pharmacists ensure accuracy when filling prescriptions.
"Pharmacists are part of the overall team to deliver
quality health care to patients," said Richard King, ISMA
ISMA recommends a series of steps for physicians to follow
to help pharmacists and reduce potential errors:
There is not currently a shortage of
pharmacists in Indiana, but ISMA reports that more pharmacists
are seeking jobs outside the community pharmacy setting. A
good portion of a pharmacist's time also is spent on the phone
with insurers trying to negotiate various drug formularies as
well as overseeing their technicians. The Indiana State Board
of Pharmacy currently allows pharmacists to supervise four
technicians at a time.
- Write legibly;
- Print out the name of the prescription;
- Write the number and then spell out the number in
- Avoid abbreviations;
- Include the indication(s) for the medication on the
- Have a nurse include the indication(s) for the
medication if the prescription is phoned in; and
- Remember to advise patients to review medication refills
before leaving the pharmacy.
For more information, e-mail ISMA's Adele Lash or phone
8. Beltway coalition tackles regional
Fairfax County Medical Society Executive Director Roberta
Sorensen knew medical societies surrounding the D.C. beltway
experienced similar managed care hassles, and she thought it
would be helpful to physicians if the medical societies
Sorensen took the lead and recently brought together a
coalition of representatives from the Medical Society of the
District of Columbia and county medical societies in Northern
Virginia and the Maryland suburbs to address what they
consider the objectionable practices of area insurance
The coalition will collect data concerning how insurers
affect physicians and patient care throughout the region. The
data will be used in discussions with health plans and will be
shared with the insurance departments in D.C., Maryland and
"Managed care has a strong foothold in the beltway area,"
said Sorensen. "It seemed natural for us to share information
about how each jurisdiction interacts with health plans and
develop ways in which to effectively advocate for the shared
concerns of our physicians."
The coalition also includes representatives from the
Arlington County and Alexandria Medical Societies in Virginia,
and the Montgomery County Medical Society in Maryland.
For more information, e-mail Soresnen or phone
9. PaMS tells lawmakers patients and
physicians deserve better
The Pennsylvania Medical Society (PaMS) yesterday told
state legislators that dominant health insurance companies are
limiting physicians' abilities to provide appropriate patient
care and that it is time to level the playing field so that
patients and their doctors have a greater say in the delivery
of health care. Economist Stephen E. Foreman, PhD, explained
to lawmakers that one or two dominant insurers control each of
Donald H. Smith, MD, PaMS president, told lawmakers that
insurers with unusually large shares of the market are
"beating down the delivery of health care by deciding what
kind of care to deliver, who will deliver that care, when to
deliver the care, and where that care will be delivered."
For more information, e-mail PaMS's Chuck Moran or phone
10. TMA hits the road for physicians' summer
The Texas Medical Association (TMA) recently announced its
summer schedule of seminars. TMA staff will travel to 12
cities to teach courses including:
For more information, visit the TMA Web site.
- Beginner ICD/CPT Coding;
- Clean Claims;
- Employing a Non-Physician Practitioner;
- Alcohol and Other Drug Abuse Among Physicians;
- Nicotine Dependence and its Treatment; and
- Basics of MEDLINE Searching.
11. AAFP announces Tar Wars winners
Fifth grader Jenny Beck wants everyone to have healthier
lungs and live a longer, happier life -- by choosing NOT to
smoke. Beck's message was part of her first-place
poster in the national Tar Wars poster contest, sponsored
by the American Academy of Family Physicians (AAFP).
For winning first place, Jenny and her family are going to
Developed in 1988, the Tar Wars poster contest aims to
increase students' awareness of attitudes about tobacco use
and the effects of tobacco on the body. Creating the posters
also allows students and educators to discuss and examine the
different messages in tobacco advertising and how these ads
For more information, e-mail AAFP's Kelly Cannon or phone (800)
12. JAMA theme issue to focus on
During the 11th World Conference on Tobacco OR Health
(WCTOH), JAMA will hold a media briefing to release new
research on tobacco. The briefing will be held on Tuesday,
Aug. 8 at the Chicago Hilton and Towers, 12:15 - 2:45 p.m.
For more information, visit the WCTOH Web site.
13. CDC launches Internet site en espanol
The Centers for Disease Control and Prevention (CDC)
recently launched a Spanish language Web site -- CDC En Espanol. This is
not a translation of the English language CDC Web site.
Rather, it is tailored for the specific needs of the
Hispanic/Latino population. Health information is supplemented
by information focusing on adolescents, students, teachers,
patients, health care providers, women and men.
14. AMA Alliance launches new Web site
The AMA Alliance last week launched its redesigned Web site
to better serve its members and the public. The new site
features the well-known Alliance Stop America's Violence
Everywhere (SAVE) program, links to its many educational
publications, links to state and county Alliances, and
information about the Alliance Health Awareness Promotion
Visit the AMA
Alliance Web site.
External links to Web sites and e-mail
addresses are offered to provide readers with additional
sources of news and information. The AMA is not responsible
for the content contained in these external sources.
If you have any questions regarding this newsletter, or if
you have difficulty opening the attached files, please e-mail
Blaney-Koen or call (312) 464-4415.