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that gave physicians a 0.5 percent payment increase from Jan. 1 through June 30, 2008, temporarily cancelling a 10.1 percent cut that was scheduled to take effect Jan. 1. Congress financed this temporary reimbursement increase in such a way that, in the absence of congressional action, the payment cut in July will be about 10.6 percent. The Congressional Budget Office now estimates that the cut in 2009 will be approximately 5 percent. In light of the passage of the Medicare, Medicaid and SCHIP Extension Act of 2007, the Centers for Medicare and Medicaid Services reopened the Medicare participation decision period for an additional 45 days to Feb. 15, with all participating status changes effective Jan. 1. The document Medicare Participation Options for Physicians, developed by the AANS and the Congress of Neurological Surgeons outlines the various Medicare participation options available to physicians. www.aans.org/legislative/aans/medical.asp
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Medical Liability Rates Improve Nationwide
Medical liability insurance rates are easing nationwide for the second straight
year, reported American Medical News. Citing a survey in Medical Liability
Monitor, a publication which tracks medical liability rates, it reported that
nearly 84 percent of company-reported rates held steady or decreased in 2007.
More than half of premiums did not change, nearly one third declined, and increases
were slowing, but premiums were still considered high. Further, while the frequency
of lawsuit filings decreased, the number of large claims increased as did litigation
expenses. www.ama-assn.org/amednews/2007/12/17/prl11217.htm
Most Medical School Chairs Have Industry Ties
A national survey of medical school department chairs revealed that almost
two-thirds had some form of personal relationship with industry, including
serving as a consultant (27 percent), a member of a scientific advisory board
(27 percent), a paid speaker (14 percent), an officer (7 percent), a founder
(9 percent), or a member of the board of directors (11 percent). Campbell and
colleagues found that two-thirds of departments as administrative units had
relationships with industry. Clinical departments were more likely than nonclinical
departments to receive research equipment, unrestricted funds, residency or
fellowship training support, and continuing medial education support, but nonclinical
departments were more likely to receive funding from intellectual property
licensing. More than two-thirds of chairs perceived that having a relationship
with industry had no effect on their professional activities. JAMA 298(15):
1779-86, 2007
Device Fragments Can Trigger Serious Adverse Events
The FDA warned of serious adverse events, nearly 1,000 annually, associated
with unretrieved device fragments. The January 2008 notification reported adverse
events including local tissue reaction, infection, perforation and obstruction
of blood vessels, and death. The FDA cited biocompatibility of the device materials,
location of the fragment, potential migration of the fragment, and patient
anatomy, among the contributing factors. It further noted that during MRI procedures
magnetic fields may cause metallic fragments to migrate and radiofrequency
fields may cause them to heat, causing internal tissue damage and/or burns.
The FDA cautioned usage of medical devices in accordance with their labeled
indications and the manufacturer’s instructions for use, particularly during
insertion and removal. Recommendations included: inspection of devices prior
to use for damage during shipment or storage or any out-of-box defects that
might increase the likelihood of fragmentation during a procedure; inspection
of devices immediately upon removal from the patient for any signs of breakage
or fragmentation; retention of damaged devices to assist with the manufacturer’s
analysis of the event; and disclosure to and discussion with the patient of
the risks and benefits of
retrieving or leaving the fragment in the patient.
www.fda.gov/cdrh/safety/011508-udf.html
New Web Site Promotes Healthcare as a Marketplace
A Web site launched in January 2008 offers consumers the ability to compare
healthcare services like they might shop for cars or travel at sites such as
Cars.com and Travelocity.com. Carol.com, named to evoke the persona of a trusted
neighbor, compares doctors, prices, location, credentials and availability.
For example, a search on the keyword “brain” presents listings that include
“care packages” for brain CT, brain MRI, and brain cancer evaluation. Results
for a search on “spine” include similar diagnostic tests as well as packages
that address types of pain experienced (chronic neck pain with or without arm
pain; chronic back pain with or without leg pain). Site users can review the
packages as well as providers that are offering the services, book appointments,
and share their healthcare experiences in the “community” area of the site.
The site currently focuses on Minneapolis and St. Paul, Minn., with plans to
expand to other markets in 2008. www.carol.com
FDA Authority Over Medical Devices Expanded
The Food and Drug Administration Amendments Act of 2007, H.R. 3580, passed
by Congress in late September 2007, expanded the FDA’s role in reviewing, approving
and monitoring medical devices. The FDAAA also reauthorized aspects of the
Medical Device User Fee and Modernization Act of 2002 through 2012, including
the medical device user fee program. In addition, the FDAAA provides several
incentives for manufacturers, including those for development of pediatric
devices. https://thomas.loc.gov