When Elderly Drivers Must Stop Driving - NYTimes.com

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By JANE GROSS

In my many years of reporting about the elderly, I found little that caused doctors more angst than confronting a patient and family about driving. When is it time for someone with physical or cognitive problems to give up the car keys? Who makes that decision? And how can it safely and compassionately be enforced?

Late into the fray, but with a comprehensive and thoughtful handbook, is the American Medical Association, in collaboration with the National Highway Traffic Safety Administration. Recently updated, the “A.M.A. Physician’s Guide to Assessing and Counseling Older Drivers” is an invaluable addition to the literature on the subject, directed to its own members but accessible and informative to the layperson as well.

The guidebook has plenty of information about assessing a patient’s driving ability; medications and medical conditions that impair mobility, vision, hearing, reflexes and judgment; tips on having the conversation with patients and caregivers; advice on how to avoid isolation and dependence when driving is no longer sensible or safe; discussion of a doctor’s ethical responsibilities; and state-by-state guidelines for reporting drivers to the state department of motor vehicles, which has the ultimate say in who remains on the road.

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AMA Unhappy With Senate Plan For Medicare 'Doc Fix'

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from Medical News Today

The American Medical Association is criticizing "a Senate plan for avoiding a proposed 21 percent cut in government payments to physicians who treat the elderly, calling the proposal a 'Band-Aid' measure," Bloomberg/BusinessWeek reports.

"The plan, part of an $80 billion job-creation proposal announced yesterday by Senate Majority Leader Harry Reid, would block the Medicare payment cuts from taking place as scheduled March 1." But the AMA "urged a permanent repeal of Medicare's payment formula, which has led the government to propose annual fee cuts. While Congress has overridden the payment reductions each year so doctors would continue to treat elderly patients, the Chicago-based group backed a permanent fix in companion legislation to a proposed revamp of the U.S. health-care system, which now is stalled" (Thomas, 2/10).
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AARP, AMA Launch Health Care Ad Focused on Medicare « The Future of Aging Blog

AARP and the American Medical Association (AMA) recently launched a new ad campaign focused on promulgating how health care reform will improve Medicare.

Featured in the ad are a physician and a “spin doctor,” both offering different perspectives about health reform.

According to The Hill, “The ad takes aim at the arguments of Senate Republicans and health insurance interest groups who claim that Democratic health care reform cuts millions of dollars from the Medicare health care program for senior citizens.”

“Together, AMA and AARP are working to put the scare tactics to bed once and for all and inform patients about the benefits of health reform,” AMA president, Dr. J. James Rohack said in a release.

The ad is just one effort of a major education campaign that AARP has undertaken to inform its members about what is fact and what is fiction when it comes to the health care reform bills.

AMNews: Editorial - Sept. 7, 2009. Health plans still need to work on basic skills ... American Medical News

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In just one year since their problems were spotlighted in the American Medical Association's first National Health Insurer Report Card, health plans have made notable progress in the efficiency and transparency of their claims processes. But there is still a lot of room for improvement.

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Lack of interest derails Medicare B drug program

By Jane Cys, AMNews correspondent. Nov. 10, 2008 in American Medical News The alternative purchasing system for drugs given in the office had only about 4,200 physicians and one drug vendor sign on in three years. Randolph Johnston, MD, a Cheyenne, Wyo., ophthalmologist, jumped at the chance to sign up for Medicare's competitive acquisition program in 2006. As a CAP participant, he no longer would have to buy the Part B drugs his practice used and then bill patients for them; instead, a drug vendor chosen by the government would take on those roles. It seemed to make financial sense. Because some of Dr. Johnston's patients had trouble paying for their office-administered drugs, the practice would get small monthly payments and carry over the balance -- often thousands of dollars. But administrative hassles, drug delivery problems and other troubles quickly dampened his enthusiasm. "After three months of the program, we wrote a letter and begged to be let out," said the vitreoretinal specialist, who will become the American Academy of Ophthalmology's president-elect in January 2009. Although CAP is voluntary, he was stuck with it for the rest of the year. Looking ahead CMS officials urged Medicare participants to use the CAP hiatus to suggest changes that could improve the program. The agency will hold an open door forum on the issue in December. The AMA remains unsure about the program's viability, given inadequate pay to doctors for many Part B drugs, wrote AMA Executive Vice President and CEO Michael D. Maves, MD, MBA, in an August letter to CMS. Because payments to vendors under CAP are discounted, even below the average rates that doctors receive under Medicare, many vendors likely will decide CAP isn't worth it, he said.

States rapped for lax regulation of individual insurance market

Analysis by a consumer group finds that more Americans are moving to policies that offer them less government protection. By Emily Berry, AMNews staff. July 14, 2008. A report from the consumer group Families USA concluded that state regulation of individual health insurance is inadequate -- which is a problem, because more Americans are relying on individual coverage.

California bill would mandate discussions of end-of-life options

By Kevin B. O'Reilly, AMNews staff. July 14, 2008. The California State Assembly in late May passed a bill requiring physicians to have comprehensive discussions about legal end-of-life care options with terminally ill patients who request such information. The measure, up for consideration in the Senate at AMNews press time, would be the first of its kind to gain passage nationally. A similar bill in Vermont is stuck in House committee. The California proposal requires doctors to tell patients whose prognosis suggests less than a year to live about hospice and palliative care, and about alternatives such as palliative sedation and refusing food and water to speed the dying process.

Criminal HIPAA case targets employee, not clinic, for breach

By Amy Lynn Sorrel, AMNews staff. July 14, 2008. The latest HIPAA criminal case may signal more aggressive efforts by the government to root out privacy breaches, while highlighting some legal risks for doctors and other "covered entities" for violations made by their employees, experts said.

New Medicare hospice rules aim to boost physicians' role

The most significant changes are designed to give patients more rights. By David Glendinning, AMNews staff. July 14, 2008 Medicare, for the first time in 25 years, has updated the rules for hospice physicians. The Centers for Medicare & Medicaid Services in June released final conditions of participation for hospice professionals. The new guidelines, the only overhaul of the regulations since Medicare first offered the benefit in 1983, will take effect on Dec. 2.

Medicare double-delay: Senate fails to act, CMS holds physician claims

The government won't process doctors' Medicare claims until July 15 to give lawmakers more time to pass legislation stopping pay cuts. By David Glendinning, AMNews staff. July 14, 2008

Doctors Press Senate to Undo Medicare Cuts

By ROBERT PEAR Published: July 7, 2008 New York Times Ads by the American Medical Association blame Senate Republicans for a 10.6 percent cut in payments to doctors who care for older Americans.

AHIP, American Medical Association Television Ads Intended To Influence Lawmakers on Medicare Legislation

Kaiser Daily Health Policy Report The American Medical Association and America's Health Insurance Plans this week are launching "dueling advertising campaigns" over Senate votes on a House-passed bill (HR 6331) to avert a 10.6% reduction to Medicare physician fees that was scheduled to go into effect on Tuesday, CongressDaily reports (Edney, CongressDaily, 7/1).

Centers offer ways to bridge language, cultural differences

Community health centers find that hiring bilingual staff and installing telephone translation lines are key to providing the best care. By Susan J. Landers, AMNews staff. July 7, 2008

PHR vendors bypass patients, pitch to business

After several years of mostly striking out with consumers, personal health record vendors are adopting a business-to-business marketing model, courting employers and insurers in hopes of expanding PHR adoption. By Pamela Lewis Dolan, AMNews staff. July 7, 2008

AMA OKs palliative sedation for terminally ill

When all else fails to control patients' pain at the end of life, it is appropriate for physicians to sedate such patients to unconsciousness, according to new ethical policy adopted at the AMA Annual Meeting in June. The rarely employed practice of palliative or terminal sedation is sometimes perceived as speeding the dying process, leading critics to dub it a form of physician-assisted suicide. But evidence of such a hastening effect is lacking, according to a Council on Ethical and Judicial Affairs report adopted by the House of Delegates. By Kevin B. O'Reilly, AMNews staff. July 7, 2008

Physicians demand greater oversight of doctors of nursing

Citing patient safety concerns, members of the AMA House of Delegates protested the unregulated expansion of doctors of nursing practice and urged organized medicine to ensure transparency in and supervision of their role in medical care. By Amy Lynn Sorrel, AMNews staff. July 7, 2008.

Medicare audit overreach? Doctors think so, but audits aren't going away

Aggressive tactics, vague charges, interrupted patient care, drained staff resources and administrative headaches. These are some of the problems doctors say they encountered during their experiences with Medicare's newest breed of auditor. The Centers for Medicare & Medicaid Services this spring wrapped up a three-year pilot program in which "recovery audit contractors," or RACs, scoured physician and hospital claims in three states to find overpayments and to recoup those dollars for Medicare. Thrilled by the project's financial success, lawmakers ordered CMS to expand the program to all 50 states by 2010. The agency plans to choose four national contractors to administer the program this summer. A new round of audits could start right away. By David Glendinning, AMNews staff. July 7, 2008

AMA grades health plans on how they handle claims

The AMA has launched a campaign to fix a claims-payment system that doctors say requires them to spend precious time and their own money to get paid what they're owed by insurance companies. As a starting point for its Cure the Claims campaign, the AMA released a report card at its Annual Meeting in June comparing the administrative accuracy and efficiencies of Medicare and several commercial payers. The report showed that insurers' claims payments are often late and inaccurate, explanations for denials are inconsistent, and payment rules are sometimes impossible to decipher. By Emily Berry, AMNews staff. July 7, 2008.