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public's views, and the professional expertise of HEW. The public normally will have 45 days to comment following publication of both HEW's intent to regulate and its proposed regulations. Each of these documents will include the name of a person in HEW who can be contacted for clarification or further information. HEW also said it plans training sessions for department regulation writers so that regulations are written in clear, concise Enghsh. The AM A has urged the House Commerce Committee to make major changes in legislation to bring the nation's clinical laboratories under tighter federal control. One of the most controversial provisions of the Clinical Laboratory Improvement Act (CLIA) as approved by the Commerce Health Subcommittee prohibits Medicare reimbursement for labs under any rental or lease which involves a percentage arrangement. "We particularly object to this section because it was never discussed or considered during public hearings," the AMA said in a legislative alert to constituent bodies. "This section has far reaching contractual considerations involving physicians and hospitals." the AMA said. "In the name of openness and fairness the matters covered in this section should be dealt with separately and we ask that this section be deleted." This disputed provision, which also covers Medicaid and Maternal and Child Health reimbursement, is similar to a key section of the Talmadge bill in the Senate. The AMA singled out two other provisions for special concern in the CLIA bill. One allows an exemption for a laboratory in a physician's office but only where physicians actually perform all tests and procedures in connection with the treatment of their patients. "With such a restriction, laboratories operated in physicians' offices would be forced to close down," said the AMA. "Existing law exempts laboratories operated by physicians where tests are done personally or through employees solely as an adjunct to the treatment of their own patients. This exemption should continue." The other provision deals with revocation of a license for a number of activities, one of which is finding that the owner or operator of a laboratory has engaged in a billing practice which creates a discriminatory effect between patients reimbursed, in whole or in part, under programs receiving federal funds and patients who are not so reimbursed. "This provision apparently seeks a uniformity of fees for services by the laboratory," said the AMA. "This provision could in fact require a raising of fees under federal programs and thus would increase federal program costs. Furthermore, any provision that would state that the prohibition would be against a charge higher for a federal program than for a non- federal program would still be objectionable. "A dangerous precedent is established where the licensing authority (the HEW secretary) can revoke a license based on fees charged to programs administered by him." House and Senate conferees have still not met to reach agreement on the crucial Health Manpower Bill. The major issue to be resolved is federal controls over residencies. The House Manpower Bill approved last fall was stripped of a residency control feature on the floor of the House. A rigid and sweeping Senate control plan over allocation of residencies was watered down substantially on the floor of the Senate but the final Senate bill requires medical schools to set aside minimum percentages of residency programs for "primary care" slots. Also important are the "payback" provisions for medical students. In this respect, the House bill is more stringent than the Senate bill. The House would require, starting in 1985, that medical students pay back, either in money or service in shortage areas, that portion of the individual student's yearly medical education subsidized by the federal government in the form of capitation subsidies to the medical schools. At present, this runs about $2,000 a year. The comparable Senate provision requires medical schools starting in 1978 to assure that 35 percent of their first-year places are available for students who. prior to admission, have submitted applications for National Health Service Corps scholarships and have agreed to accept such scholarships. Both bills contain provisions designed to reduce the inflow of foreign medical graduates. The major new thrust in the two bills, in addition to the extension of capitation aid to medical schools, is to produce more physicians in the "primary care" category and to get more physicians into shortage areas. The administration has had strong reservations about provisions in both bills, but as they stand now it appeared unlikely the legislation would encounter a presidential veto. Food and Drug Commissioner Alexander Schmidt. M.D.. believes Congress must shoulder much of the blame for the controversy swirling around his embattled agency. Dr. Schmidt, who is leaving the FDA in December to become Vice Chancellor for Health Services at the University of Illinois, made clear in an interview with AM NEWS that he believes the persistent critics of FDA on Capital Hill, in the press and television, and among consumer groups are unfair and damage the agency's morale and efficiency. He told AM MEWS the FDA has been driven into a "conservative" position in approving new drugs because of the pressures from Congressmen who believe the agency isn't tough enough with drug companies. Congress never calls a hearing when a drug is rejected. September 1976. NC MJ 504
Object Description
Rating | |
Fixed Title * | NCHH-17: North Carolina Medical Journal [1940-Present] |
Document Title | North Carolina Medical Journal [1940-Present] |
Subject Topical Other | Public Health -- Periodicals.; Physicians -- North Carolina -- Directory.; Societies, Medical -- North Carolina -- Periodicals. |
Description | Includes Transactions of the Society, -1960; 1961- , Transactions issued separately, bound in.; Includes Transactions of the auxiliary to the Medical Society of the State of North Carolina and Proceedings of the North Carolina Public Health Association. Official organ of the Medical Society of the State of North Carolina, 1940-May 1972; of the North Carolina Medical Society, June 1972-. Vols. for 1940-May 1972 published by the Medical Society of the State of North Carolina; June 1972- by the North Carolina Medical Society. |
Contributor | Medical Society of the State of North Carolina. Transactions.; Medical Society of the State of North Carolina.; North Carolina Medical Society.; North Carolina Medical Society. Transactions.; North Carolina Public Health Association. Proceedings. |
Publisher | [Winston-Salem] : North Carolina Medical Society [etc.], 1940- |
Repository | University of North Carolina at Chapel Hill. Health Sciences Library. |
Host | University of North Carolina at Chapel Hill |
Date | 1976 |
Identifier | NCHH-17-037 |
Form General | Periodicals |
Language | English |
Rights | This item is part of the North Carolina History of Health Digital Collection. Some materials in the Collection are protected by U.S. copyright law. This item is presented by the Health Sciences Library of the University of North Carolina at Chapel Hill for research and educational purposes. It may not be republished or distributed without permission of the Health Sciences Library. |
Digital Collection | North Carolina History of Health Digital Collection |
Sponsor | The North Carolina History of Health Digital Collection is an open access publishing initiative of the Health Sciences Library of the University of North Carolina at Chapel Hill. Financial support for the initiative was provided in part by a multi-year NC ECHO (Exploring Cultural Heritage Online) digitization grant, awarded by the State Library of North Carolina, and funded through the Library Services and Technology Act (LSTA). |
Volume Number | 37 |
Health Discipline | Medicine |
Digital Format | JPEG 2000 |
Print / Download PDF Version | http://archives.hsl.unc.edu/nchh/nchh-17/nchh-17-037.pdf |
Document Sort | all; nchh-17 |
Volume Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/identi/searchterm/NCHH-17-037 |
Title Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/documa/searchterm/NCHH-17 |
Catalog Record link | http://search.lib.unc.edu/search?R=UNCb1306322 |
Revision History | done |
Description
Fixed Title * | Page 513 |
Document Title | North Carolina Medical Journal [1940-Present] |
Subject Topical Other | Public Health -- Periodicals.; Physicians -- North Carolina -- Directory.; Societies, Medical -- North Carolina -- Periodicals. |
Description | Includes Transactions of the Society, -1960; 1961- , Transactions issued separately, bound in.; Includes Transactions of the auxiliary to the Medical Society of the State of North Carolina and Proceedings of the North Carolina Public Health Association. Official organ of the Medical Society of the State of North Carolina, 1940-May 1972; of the North Carolina Medical Society, June 1972-. Vols. for 1940-May 1972 published by the Medical Society of the State of North Carolina; June 1972- by the North Carolina Medical Society. |
Contributor | Medical Society of the State of North Carolina. Transactions.; Medical Society of the State of North Carolina.; North Carolina Medical Society.; North Carolina Medical Society. Transactions.; North Carolina Public Health Association. Proceedings. |
Publisher | [Winston-Salem] : North Carolina Medical Society [etc.], 1940- |
Repository | University of North Carolina at Chapel Hill. Health Sciences Library. |
Host | University of North Carolina at Chapel Hill |
Date | 1976 |
Identifier | NCHH-17-037-0553 |
Form General | Periodicals |
Page Type | all; organizational news |
Language | English |
Rights | This item is part of the North Carolina History of Health Digital Collection. Some materials in the Collection are protected by U.S. copyright law. This item is presented by the Health Sciences Library of the University of North Carolina at Chapel Hill for research and educational purposes. It may not be republished or distributed without permission of the Health Sciences Library. |
Filename | ncarolinamed371976medi_0553.jp2 |
Digital Collection | North Carolina History of Health Digital Collection |
Sponsor | The North Carolina History of Health Digital Collection is an open access publishing initiative of the Health Sciences Library of the University of North Carolina at Chapel Hill. Financial support for the initiative was provided in part by a multi-year NC ECHO (Exploring Cultural Heritage Online) digitization grant, awarded by the State Library of North Carolina, and funded through the Library Services and Technology Act (LSTA). |
Volume Number | 37 |
Issue Number | 9 |
Page Number | 513 |
Health Discipline | Medicine |
Full Text | public's views, and the professional expertise of HEW. The public normally will have 45 days to comment following publication of both HEW's intent to regulate and its proposed regulations. Each of these documents will include the name of a person in HEW who can be contacted for clarification or further information. HEW also said it plans training sessions for department regulation writers so that regulations are written in clear, concise Enghsh. The AM A has urged the House Commerce Committee to make major changes in legislation to bring the nation's clinical laboratories under tighter federal control. One of the most controversial provisions of the Clinical Laboratory Improvement Act (CLIA) as approved by the Commerce Health Subcommittee prohibits Medicare reimbursement for labs under any rental or lease which involves a percentage arrangement. "We particularly object to this section because it was never discussed or considered during public hearings" the AMA said in a legislative alert to constituent bodies. "This section has far reaching contractual considerations involving physicians and hospitals." the AMA said. "In the name of openness and fairness the matters covered in this section should be dealt with separately and we ask that this section be deleted." This disputed provision, which also covers Medicaid and Maternal and Child Health reimbursement, is similar to a key section of the Talmadge bill in the Senate. The AMA singled out two other provisions for special concern in the CLIA bill. One allows an exemption for a laboratory in a physician's office but only where physicians actually perform all tests and procedures in connection with the treatment of their patients. "With such a restriction, laboratories operated in physicians' offices would be forced to close down" said the AMA. "Existing law exempts laboratories operated by physicians where tests are done personally or through employees solely as an adjunct to the treatment of their own patients. This exemption should continue." The other provision deals with revocation of a license for a number of activities, one of which is finding that the owner or operator of a laboratory has engaged in a billing practice which creates a discriminatory effect between patients reimbursed, in whole or in part, under programs receiving federal funds and patients who are not so reimbursed. "This provision apparently seeks a uniformity of fees for services by the laboratory" said the AMA. "This provision could in fact require a raising of fees under federal programs and thus would increase federal program costs. Furthermore, any provision that would state that the prohibition would be against a charge higher for a federal program than for a non- federal program would still be objectionable. "A dangerous precedent is established where the licensing authority (the HEW secretary) can revoke a license based on fees charged to programs administered by him." House and Senate conferees have still not met to reach agreement on the crucial Health Manpower Bill. The major issue to be resolved is federal controls over residencies. The House Manpower Bill approved last fall was stripped of a residency control feature on the floor of the House. A rigid and sweeping Senate control plan over allocation of residencies was watered down substantially on the floor of the Senate but the final Senate bill requires medical schools to set aside minimum percentages of residency programs for "primary care" slots. Also important are the "payback" provisions for medical students. In this respect, the House bill is more stringent than the Senate bill. The House would require, starting in 1985, that medical students pay back, either in money or service in shortage areas, that portion of the individual student's yearly medical education subsidized by the federal government in the form of capitation subsidies to the medical schools. At present, this runs about $2,000 a year. The comparable Senate provision requires medical schools starting in 1978 to assure that 35 percent of their first-year places are available for students who. prior to admission, have submitted applications for National Health Service Corps scholarships and have agreed to accept such scholarships. Both bills contain provisions designed to reduce the inflow of foreign medical graduates. The major new thrust in the two bills, in addition to the extension of capitation aid to medical schools, is to produce more physicians in the "primary care" category and to get more physicians into shortage areas. The administration has had strong reservations about provisions in both bills, but as they stand now it appeared unlikely the legislation would encounter a presidential veto. Food and Drug Commissioner Alexander Schmidt. M.D.. believes Congress must shoulder much of the blame for the controversy swirling around his embattled agency. Dr. Schmidt, who is leaving the FDA in December to become Vice Chancellor for Health Services at the University of Illinois, made clear in an interview with AM NEWS that he believes the persistent critics of FDA on Capital Hill, in the press and television, and among consumer groups are unfair and damage the agency's morale and efficiency. He told AM MEWS the FDA has been driven into a "conservative" position in approving new drugs because of the pressures from Congressmen who believe the agency isn't tough enough with drug companies. Congress never calls a hearing when a drug is rejected. September 1976. NC MJ 504 |
Digital Format | JPEG 2000 |
Print / Download PDF Version | http://archives.hsl.unc.edu/nchh/nchh-17/nchh-17-037.pdf |
Document Sort | all; nchh-17 |
Volume Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/identi/searchterm/NCHH-17-037 |
Title Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/documa/searchterm/NCHH-17 |
Catalog Record link | http://search.lib.unc.edu/search?R=UNCb1306322 |
Revision History | done |
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