Part B Insider (Multispecialty) Coding Alert

PHYSICIAN NOTES:

CDC Sees HIV as Fertile Ground for Prevention

Published on Fri May 23, 2003

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"Prevention efforts have stalled" on HIV, with 40,000 new infections now occurring annually in the U.S., CDC chief Julie Gerberding, MD, says. She announced a new federal initiative April 17 to "open the door" to HIV diagnostic testing. An estimated 200,000 out of 800,000 HIV-positive Americans are unaware of their status, Gerberding said.

Federal agencies will work with individual clinicians "in medical settings and make HIV testing a routine component of medical care," testing anyone who admits to having unsafe sex. CDC will end its requirement that patients participate in what Gerberding called "a fairly comprehensive behavioral counseling intervention" before being tested. Counseling is important, but "it's a barrier."

The program will also increase access to a new rapid HIV test in communities with high rates of infection; focus prevention programs more on HIV-infected people rather than on the uninfected people who were the main emphasis of such efforts in the past; and make HIV testing a routine part of perinatal care.

Physicians have breathing room on a controversial element of the Stark physician self-referral regulations because the Centers for Medicare & Medicaid Services again delayed the effective date of a clause on percentage compensation agreements. At issue is the definition of the phrase "set in advance."

Many of the exceptions to the Stark rule that apply to compensation arrangements can be invoked only if the amount of compensation is set in advance. CMS is grappling with whether its interpretation of "set in advance" automatically excludes percentage compensation deals from the Stark exceptions - a reading that could leave teaching hospitals, physician practices and medical foundations scrambling to rework thousands of contracts.

The rule now takes effect Jan. 7, 2004.

More physicians use the Internet to attend online "conferences," 42 percent in 2002 versus 31 percent in 2001, according to a new BCG/Harris Interactive poll. And 58 percent of physicians complete continuing medical education online, compared with just 45 percent in 2001. But the number of physicians reading medical journals online dropped slightly, from 78 percent to 74 percent.

The U.S. Food and Drug Administration on April 24 gave long-awaited approval to the first drug-eluting variety of stent, a device inserted in arteries to keep them unclogged after angioplasties. Compared to traditional stents, the drug-eluting variety substantially reduces the number of arteries that reclog and the number of patients who must undergo repeat angioplasties or bypass surgeries. But Johnson & Johnson will charge $3,195 for its new stents, three times the price of the older devices.