American College of Physicians: Internal Medicine — Doctors for Adults ®


Policy briefs

From the January ACP-ASIM Observer, copyright 2002 by the American College of Physicians-American Society of Internal Medicine.

ACP-ASIM announces efforts to prepare internists for bioterrorism

Throughout the fall, the College made plans to help internists prepare for the threat of bioterrorism.

At a press conference held in late November, ACP-ASIM President William J. Hall, FACP, said that primary care physicians are "the front line in the war on terrorism." As a result, he explained, the College is taking several steps to help primary care physicians respond to a biological or chemical attack.

Besides expanding ACP-ASIM's Bioterrorism Resource Center (, Dr. Hall said the College is making a series of recommendations to procure more resources for physicians from federal, state and local governments and public health departments. Those recommendations call for increased funding for health departments and hospitals to help develop crisis management strategies, stock adequate supplies and expand training for medical personnel.

A new ACP-ASIM position paper offers more information on the College's recommendations to help internists combat bioterrorism. The paper is available online at

To help internists distinguish diseases caused by biological agents from other conditions, the College last month added images to its Bioterrorism Resource Center. Photographs show cutaneous anthrax and smallpox, as well as inhalation anthrax on a chest X-ray.

ACP-ASIM officials have also advocated for more resources for bioterrorism preparedness. In Nov. 15 letters to key members of the House and Senate, the College expressed its support for the Bioterrorism Preparedness Act of 2001. The act would provide $3.2 billion to strengthen the public health infrastructure and protect the nation's food supply against biological or chemical attack.

In early December, ACP-ASIM came out in support of Senate legislation that would give the CDC nearly $3.4 billion to improve training for health care professionals at state and local levels.

The letters are available online at


Senate stimulus proposal would help improve access

While a Senate plan to stimulate the economy would help the uninsured, ACP-ASIM has asked legislators to do more.

In a Nov. 7 letter to members of the Senate Finance Committee, College President William J. Hall, FACP, applauded legislators for addressing the needs of uninsured Americans in the economic stimulus proposal.

The Economic Recovery and Assistance for American Workers Act of 2001 would give temporarily unemployed workers a 75% subsidy to purchase additional health coverage for up to 12 months. The bill would also expand the Medicaid program and give states the option to cover displaced workers and their families through Medicaid.

The College, however, urged the Finance Committee to enact additional legislation to provide 100% premium support for individuals at or below the poverty level and provide refundable tax credits so individuals with no tax liability can receive credits.

In addition, ACP-ASIM urged the committee to include an advance payment option that allows the credit to be paid when premiums are due rather than at the end of the year.

In a follow-up Nov. 14 letter, the College joined more than 60 medical, advocacy and religious groups in asking Senate Republicans to include temporary health insurance assistance in economic stimulus legislation. The letter called for premium assistance for displaced workers and increased federal contributions to Medicaid in order to prevent eligibility reductions.

Both letters are online at


College position paper outlines support for Medicare drug benefit

A new ACP-ASIM position paper lays out strategies to make a Medicare drug benefit a reality for needy seniors.

In the 20-page paper, the College said that Medicare should focus on providing drug benefits for low-income beneficiaries who do not have access to drug coverage under other plans. The paper stated, however, that any such benefit must have viable funding so the financial health of the overall Medicare program is not jeopardized.

The paper suggested several mechanisms to fund a drug benefit without bankrupting Medicare, such as a tax increase and a combination of income-based premiums, co-pays and deductibles.

The position paper also addressed reimporting drugs from other countries and the use of generic drugs, formularies and pharmacy benefit managers. The full text of "Providing Medicare Beneficiaries with a Prescription Drug Benefit: Whom Do We Target and How Do We Deliver?" is online at


ACP-ASIM to insurance commissioners: prohibit restricted drug formularies

ACP-ASIM has asked the National Association of Insurance Commissions to support state laws that prohibit restricted drug formularies.

In a Nov. 9 letter, C. Anderson Hedberg, FACP, Chair of the College's Medical Services Committee, said that restrictive formularies penalize patients by forcing them to pay full price for non-formulary medications.

The letter pointed out that restrictive formularies can harm patient care because individuals differ in how they respond to different drugs within a similar class. The letter also noted that establishing only one class of drug to treat a condition is harmful when that drug is either ineffective or contraindicated by a patient's history or other medications.

The letter is online at


Standards approved for national claims-processing accreditation program

The board of directors for the American Accreditation Healthcare Commission, also known as URAC, has approved standards for the nation's first national claims-processing accreditation program. The standards will address timeliness, protocols, appeals and communication in the claims process.

The voluntary standards could be made mandatory in states that choose to adopt them as part of their claims-processing requirements. Many claims-processing companies and health insurers are likely to adopt the standards and seek accreditation from the URAC.

The advisory committee that developed the standards had representatives from health care purchaser and provider organizations, including ACP-ASIM. College representatives who sit on URAC's board had initially asked the commission to develop an accreditation program for claims processing.


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