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From the January 2000 ACP-ASIM Observer, copyright 1999 by the American College of Physicians-American Society of Internal Medicine.

AHCPR: new name, expanded duties

On December 6 the Agency for Health Care Policy and Research (AHCPR) officially received a new name and an expanded set of duties when President Clinton signed into law legislation transforming the AHCPR into the Agency for Healthcare Research and Quality (AHRQ).

The new name reflects the agency's expanded responsibilities, which include working with the private sector to find the most efficient and cost-effective ways of providing health care. The agency's revamped mission will also allow it to support increased research on how the health care system works and how it could operate more effectively.

"This reauthorization has not changed our fundamental mission to support, conduct and disseminate research that improves access to care and the outcomes, quality, cost and use of health care services," John M. Eisenberg, MACP, the agency's administrator, said in a statement.

Officials emphasized that the agency will continue to support current activities like the Medical Expenditure Panel Survey, the National Guideline Clearinghouse, the Healthcare Cost and Utilization Project (HCUP), the U.S. Preventive Services Task Force, evidence-based practice centers and the Consumer Assessment of Health Plans.

College has concerns about new data bank to track doctors

The College says that a new data bank tracking health care fraud and abuse will track physicians who have admitted no wrongdoing.

The Healthcare Integrity and Protection Data Bank was originally created by the HHS Office of Inspector General (OIG) to track health care providers and suppliers convicted of fraud and abuse. The latest data bank, established last October, is required not to duplicate information already found in the 10-year-old National Practitioner Data Bank, which has data on medical malpractice payments, adverse licensing actions, adverse clinical privileges actions and adverse professional society actions.

The problem is that the HHS final rule, which was published in October, fails to guarantee that physicians who reach settlements without admitting liability won't be reported, according to the College. Though the final rule says that settlements with no admission of liability are not reportable to the data bank, it also states that final adverse actions related to the settlement—such as revocations or suspensions of licenses or certification—can be reported even if there is no finding of liability.

The College worries that this language greatly undermines the incentive and value of reaching a settlement, because physicians who do not admit liability can still be reported to the data bank. The language may also lead to unwarranted punishments and sanctions for physicians who have admitted no liability.

(Follow this link for more information on the data bank)

OIG releases new"safe harbors"

In November, the HHSOIG published eight long-awaited "safe harbor" rules to help alert physicians and other health care entities on how they can avoid violating the federal anti-kickback statute. The statute, originally enacted in 1972, prohibits certain payment exchanges or business practices that could influence referrals to federal programs, including Medicare and Medicaid.

Several of the safe harbors, which took effect last November, are expected to give managed care organizations and their provider networks more latitude to enter into direct-contracting relationships without violating federal anti-kickback provisions.

The new safe harbors address the following payment or business practices:

For details on the safe harbors, see the Nov. 19 Federal Register (pp. 63503-63557). For more information, see the OIG Web site.

Compiled by Janice Simmons, a Washington, D.C., writer specializing in health care.

 

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