Denise Fulton

WASHINGTON – Programs to screen pregnant women for hepatitis C infection could go far to reduce a host of adverse outcomes, according to an analysis of a large national sample.

"Targeted HCV screening may overlook many pregnant women with chronic HCV infections, and that may contribute to the underdiagnosis of pediatric hepatitis C in the United States," study investigator Dr. Po-Hung Chen said at the annual meeting of the American Association for the Study of Liver Diseases.

Denise Fulton/IMNG Medical Media

"Chronic hepatitis C is associated with adverse maternal/fetal consequences. In light of these findings, there seems to be a need to further evaluate universal hepatitis C screening as a part of antepartum care," he added.

Dr. Chen of the division of gastroenterology at Johns Hopkins University, Baltimore, and colleagues collected data on all births and spontaneous abortions recorded in the National Inpatient Sample between 2003 and 2010.

More than 28,000 of the 32 million deliveries or miscarriages recorded in the National Inpatient Sample were to mothers infected with HCV, he reported.

Of HCV-positive mothers, 72% had no traditional risk factors for the disease.

HCV-positive mothers were significantly more likely to experience obstetric pulmonary embolism (adjusted OR, 3.05) and thyroid dysfunction (aOR, 1.37), and more likely to experience maternal death, but not significantly so (aOR, 2.49). They also were significantly more likely to be white, less affluent, on Medicaid, substance abusers, and have more comorbidities.

Women who were HCV positive were significantly more likely to have labor before 37 weeks’ gestation (aOR, 1.36), antepartum hemorrhage (aOR, 1.44), and poor fetal growth (aOR, 1.61).

Cost of care and length of stay were significantly greater for mothers who were HCV positive, Dr. Chen said.

Previous analysis using data from the National Health and Nutrition Examination Survey (NHANES) showed that the prevalence of hepatitis C virus infection in women aged 20-39 years was 1%-1.6% in the period between 1999 and 2002. Dr. Chen noted that this could be an underestimation because NHANES is based on home health surveys and therefore does not include prison populations and homeless women, who are at high risk for HCV infection.

Currently, no definitive guidelines exist on how to manage chronic HCV in pregnant women, likely because of a dearth of suitable proven management options, Dr. Chen said, adding that ribavirin is contraindicated in pregnancy, interferon is generally not recommended, and the currently approved protease inhibitors are not options for single-drug management.

The American College of Obstetricians and Gynecologists does not recommend routine prenatal screening for HCV; instead, the college recommends screening only in women who are at high risk based on Centers for Disease Control and Prevention criteria.

Dr. Chen did not report financial conflicts of interest.

[email protected]

WASHINGTON – Programs to screen pregnant women for hepatitis C infection could go far to reduce a host of adverse outcomes, according to an analysis of a large national sample.

"Targeted HCV screening may overlook many pregnant women with chronic HCV infections, and that may contribute to the underdiagnosis of pediatric hepatitis C in the United States," study investigator Dr. Po-Hung Chen said at the annual meeting of the American Association for the Study of Liver Diseases.

Denise Fulton/IMNG Medical Media

"Chronic hepatitis C is associated with adverse maternal/fetal consequences. In light of these findings, there seems to be a need to further evaluate universal hepatitis C screening as a part of antepartum care," he added.

Dr. Chen of the division of gastroenterology at Johns Hopkins University, Baltimore, and colleagues collected data on all births and spontaneous abortions recorded in the National Inpatient Sample between 2003 and 2010.

More than 28,000 of the 32 million deliveries or miscarriages recorded in the National Inpatient Sample were to mothers infected with HCV, he reported.

Of HCV-positive mothers, 72% had no traditional risk factors for the disease.

HCV-positive mothers were significantly more likely to experience obstetric pulmonary embolism (adjusted OR, 3.05) and thyroid dysfunction (aOR, 1.37), and more likely to experience maternal death, but not significantly so (aOR, 2.49). They also were significantly more likely to be white, less affluent, on Medicaid, substance abusers, and have more comorbidities.

Women who were HCV positive were significantly more likely to have labor before 37 weeks’ gestation (aOR, 1.36), antepartum hemorrhage (aOR, 1.44), and poor fetal growth (aOR, 1.61).

Cost of care and length of stay were significantly greater for mothers who were HCV positive, Dr. Chen said.

Previous analysis using data from the National Health and Nutrition Examination Survey (NHANES) showed that the prevalence of hepatitis C virus infection in women aged 20-39 years was 1%-1.6% in the period between 1999 and 2002. Dr. Chen noted that this could be an underestimation because NHANES is based on home health surveys and therefore does not include prison populations and homeless women, who are at high risk for HCV infection.

Currently, no definitive guidelines exist on how to manage chronic HCV in pregnant women, likely because of a dearth of suitable proven management options, Dr. Chen said, adding that ribavirin is contraindicated in pregnancy, interferon is generally not recommended, and the currently approved protease inhibitors are not options for single-drug management.

The American College of Obstetricians and Gynecologists does not recommend routine prenatal screening for HCV; instead, the college recommends screening only in women who are at high risk based on Centers for Disease Control and Prevention criteria.

Dr. Chen did not report financial conflicts of interest.

[email protected]

WASHINGTON – Programs to screen pregnant women for hepatitis C infection could go far to reduce a host of adverse outcomes, according to an analysis of a large national sample.

"Targeted HCV screening may overlook many pregnant women with chronic HCV infections, and that may contribute to the underdiagnosis of pediatric hepatitis C in the United States," study investigator Dr. Po-Hung Chen said at the annual meeting of the American Association for the Study of Liver Diseases.

Denise Fulton/IMNG Medical Media

"Chronic hepatitis C is associated with adverse maternal/fetal consequences. In light of these findings, there seems to be a need to further evaluate universal hepatitis C screening as a part of antepartum care," he added.

Dr. Chen of the division of gastroenterology at Johns Hopkins University, Baltimore, and colleagues collected data on all births and spontaneous abortions recorded in the National Inpatient Sample between 2003 and 2010.

More than 28,000 of the 32 million deliveries or miscarriages recorded in the National Inpatient Sample were to mothers infected with HCV, he reported.

Of HCV-positive mothers, 72% had no traditional risk factors for the disease.

HCV-positive mothers were significantly more likely to experience obstetric pulmonary embolism (adjusted OR, 3.05) and thyroid dysfunction (aOR, 1.37), and more likely to experience maternal death, but not significantly so (aOR, 2.49). They also were significantly more likely to be white, less affluent, on Medicaid, substance abusers, and have more comorbidities.

Women who were HCV positive were significantly more likely to have labor before 37 weeks’ gestation (aOR, 1.36), antepartum hemorrhage (aOR, 1.44), and poor fetal growth (aOR, 1.61).

Cost of care and length of stay were significantly greater for mothers who were HCV positive, Dr. Chen said.

Previous analysis using data from the National Health and Nutrition Examination Survey (NHANES) showed that the prevalence of hepatitis C virus infection in women aged 20-39 years was 1%-1.6% in the period between 1999 and 2002. Dr. Chen noted that this could be an underestimation because NHANES is based on home health surveys and therefore does not include prison populations and homeless women, who are at high risk for HCV infection.

Currently, no definitive guidelines exist on how to manage chronic HCV in pregnant women, likely because of a dearth of suitable proven management options, Dr. Chen said, adding that ribavirin is contraindicated in pregnancy, interferon is generally not recommended, and the currently approved protease inhibitors are not options for single-drug management.

The American College of Obstetricians and Gynecologists does not recommend routine prenatal screening for HCV; instead, the college recommends screening only in women who are at high risk based on Centers for Disease Control and Prevention criteria.

Dr. Chen did not report financial conflicts of interest.

[email protected]

WASHINGTON – Implementation of recommended one-time screening of Baby Boomers would identify an additional 51,000 veterans infected with the hepatitis C virus, according to researchers with the Department of Veterans Affairs.

Investigators looked at records for all veterans in the VA health care system from 1999 to 2012 who had a VA outpatient visit in 2012.

Denise Fulton/IMNG Medical Media

Broken down by birth cohort, of the 5.5 million vets who were seen, hepatitis C virus (HCV) screening was performed for 42% of those born before 1945, 64% of those born in 1945-1965 (Baby Boomers), and 58% of those born after 1965, Dr. Lisa I. Backus of the VA Palo Alto (Calif.) Health Care System reported at the annual meeting of the annual meeting of the American Association for the Study of Liver Diseases.

In the Baby Boomer cohort, 13% of veterans screened had HCV antibodies and 10% were infected with HCV, compared with 3% and 1.7%, respectively, for veterans born before 1945 and 2% and 1% of those born after 1965. Dr. Backus noted that in excess of 95% of veterans who screen positive for HCV antibodies are subsequently tested for HCV viral load and/or genotyping.

Dr. Backus noted that the VA population in general has a higher HCV infection rate than the general public – 6.1% for veterans vs. 2.5% for all Americans.

When HCV infection prevalence rates were extrapolated to veterans in the Baby Boom cohort who were not yet screened – approximately 900,000 – the data suggest that as many as 51,000 additional veterans would be identified with HCV infection with full birth cohort screening, Dr. Backus reported.

This study underlines the need for one-time screening for individuals born during the Baby Boom years, she said.

The Centers for Disease Control and Prevention and the U.S. Preventive Services Task Force both recommend one-time screening for this birth cohort.

"Without care and treatment, 1.7 million Americans with HCV will develop cirrhosis, 400,000 will develop hepatocellular carcinoma, and more than 1 million will go on to die of HCV-related disease. And obviously, they can’t get into care if they don’t know they have hepatitis C," Dr. Backus said, citing CDC data.

"Our work should also serve as an example to other health care organizations to prompt them to assess their own HCV screening rates and HCV prevalence rates and to make such rates public," she said.

The study was funded by the Department of Veterans Affairs. Dr. Backus had no relevant conflicts of interest.

[email protected]

WASHINGTON – Implementation of recommended one-time screening of Baby Boomers would identify an additional 51,000 veterans infected with the hepatitis C virus, according to researchers with the Department of Veterans Affairs.

Investigators looked at records for all veterans in the VA health care system from 1999 to 2012 who had a VA outpatient visit in 2012.

Denise Fulton/IMNG Medical Media

Broken down by birth cohort, of the 5.5 million vets who were seen, hepatitis C virus (HCV) screening was performed for 42% of those born before 1945, 64% of those born in 1945-1965 (Baby Boomers), and 58% of those born after 1965, Dr. Lisa I. Backus of the VA Palo Alto (Calif.) Health Care System reported at the annual meeting of the annual meeting of the American Association for the Study of Liver Diseases.

In the Baby Boomer cohort, 13% of veterans screened had HCV antibodies and 10% were infected with HCV, compared with 3% and 1.7%, respectively, for veterans born before 1945 and 2% and 1% of those born after 1965. Dr. Backus noted that in excess of 95% of veterans who screen positive for HCV antibodies are subsequently tested for HCV viral load and/or genotyping.

Dr. Backus noted that the VA population in general has a higher HCV infection rate than the general public – 6.1% for veterans vs. 2.5% for all Americans.

When HCV infection prevalence rates were extrapolated to veterans in the Baby Boom cohort who were not yet screened – approximately 900,000 – the data suggest that as many as 51,000 additional veterans would be identified with HCV infection with full birth cohort screening, Dr. Backus reported.

This study underlines the need for one-time screening for individuals born during the Baby Boom years, she said.

The Centers for Disease Control and Prevention and the U.S. Preventive Services Task Force both recommend one-time screening for this birth cohort.

"Without care and treatment, 1.7 million Americans with HCV will develop cirrhosis, 400,000 will develop hepatocellular carcinoma, and more than 1 million will go on to die of HCV-related disease. And obviously, they can’t get into care if they don’t know they have hepatitis C," Dr. Backus said, citing CDC data.

"Our work should also serve as an example to other health care organizations to prompt them to assess their own HCV screening rates and HCV prevalence rates and to make such rates public," she said.

The study was funded by the Department of Veterans Affairs. Dr. Backus had no relevant conflicts of interest.

[email protected]

WASHINGTON – Implementation of recommended one-time screening of Baby Boomers would identify an additional 51,000 veterans infected with the hepatitis C virus, according to researchers with the Department of Veterans Affairs.

Investigators looked at records for all veterans in the VA health care system from 1999 to 2012 who had a VA outpatient visit in 2012.

Denise Fulton/IMNG Medical Media

Broken down by birth cohort, of the 5.5 million vets who were seen, hepatitis C virus (HCV) screening was performed for 42% of those born before 1945, 64% of those born in 1945-1965 (Baby Boomers), and 58% of those born after 1965, Dr. Lisa I. Backus of the VA Palo Alto (Calif.) Health Care System reported at the annual meeting of the annual meeting of the American Association for the Study of Liver Diseases.

In the Baby Boomer cohort, 13% of veterans screened had HCV antibodies and 10% were infected with HCV, compared with 3% and 1.7%, respectively, for veterans born before 1945 and 2% and 1% of those born after 1965. Dr. Backus noted that in excess of 95% of veterans who screen positive for HCV antibodies are subsequently tested for HCV viral load and/or genotyping.

Dr. Backus noted that the VA population in general has a higher HCV infection rate than the general public – 6.1% for veterans vs. 2.5% for all Americans.

When HCV infection prevalence rates were extrapolated to veterans in the Baby Boom cohort who were not yet screened – approximately 900,000 – the data suggest that as many as 51,000 additional veterans would be identified with HCV infection with full birth cohort screening, Dr. Backus reported.

This study underlines the need for one-time screening for individuals born during the Baby Boom years, she said.

The Centers for Disease Control and Prevention and the U.S. Preventive Services Task Force both recommend one-time screening for this birth cohort.

"Without care and treatment, 1.7 million Americans with HCV will develop cirrhosis, 400,000 will develop hepatocellular carcinoma, and more than 1 million will go on to die of HCV-related disease. And obviously, they can’t get into care if they don’t know they have hepatitis C," Dr. Backus said, citing CDC data.

"Our work should also serve as an example to other health care organizations to prompt them to assess their own HCV screening rates and HCV prevalence rates and to make such rates public," she said.

The study was funded by the Department of Veterans Affairs. Dr. Backus had no relevant conflicts of interest.

[email protected]

Hydrocodone bitartrate extended-release capsules were approved by the Food and Drug Administration Oct. 25 for severe pain requiring daily long-term treatment and for which other treatment options are inadequate.

The drug, to be marketed as Zohydro ER, is the first FDA-approved extended-release formulation of hydrocodone that is not combined with another analgesic. It is classified as Schedule II under the Controlled Substances Act.

In December, an FDA advisory committee recommended against approval of Zohydro, citing the need for a tamper-proof formulation and a stronger risk mitigation strategy to address the high potential for abuse and misuse of the product.

Experts on the Anesthetic and Analgesic Drug Products Advisory Committee voted 11-2, with 1 abstention, against approval, although they agreed that the manufacturer met the standards for approval for the proposed indication.

However, concerns about the potential public health impact of the availability of an extended-release formulation of hydrocodone that does not contain acetaminophen – which would make it more attractive as a drug of abuse, particularly for intravenous drug abusers – or a tamper-resistant design, swayed their votes.

In approving the drug, the FDA noted that it carries new labeling and stronger warnings regarding the risks and safety of extended-release and long-acting opioid analgesics. The new labeling requirements were instituted by the agency in September. The drug also will be included in the Risk Evaluation and Mitigation Strategy (REMS) associated with the new labeling requirements.

"These warnings are expected to improve the safety of all such medicines by encouraging more appropriate prescribing, patient monitoring, and patient counseling practices," the FDA said in a statement. "Zohydro ER is the first opioid to be labeled in this manner."

Approval was based on safety studies of more than 1,100 chronic pain patients as well as efficacy studies of more than 500 chronic low-back-pain patients. Patients taking Zohydro ER in the efficacy study showed significant improvement in chronic pain, compared with those who took placebo.

FDA will require postmarketing studies of Zohydro ER to study potential abuse/overdose and hyperalgesia when used longer than 12 weeks.

Zohydro ER is manufactured by San Diego–based Zogenix.

Elizabeth Mechcatie contributed to this report.

[email protected]

Hydrocodone bitartrate extended-release capsules were approved by the Food and Drug Administration Oct. 25 for severe pain requiring daily long-term treatment and for which other treatment options are inadequate.

The drug, to be marketed as Zohydro ER, is the first FDA-approved extended-release formulation of hydrocodone that is not combined with another analgesic. It is classified as Schedule II under the Controlled Substances Act.

In December, an FDA advisory committee recommended against approval of Zohydro, citing the need for a tamper-proof formulation and a stronger risk mitigation strategy to address the high potential for abuse and misuse of the product.

Experts on the Anesthetic and Analgesic Drug Products Advisory Committee voted 11-2, with 1 abstention, against approval, although they agreed that the manufacturer met the standards for approval for the proposed indication.

However, concerns about the potential public health impact of the availability of an extended-release formulation of hydrocodone that does not contain acetaminophen – which would make it more attractive as a drug of abuse, particularly for intravenous drug abusers – or a tamper-resistant design, swayed their votes.

In approving the drug, the FDA noted that it carries new labeling and stronger warnings regarding the risks and safety of extended-release and long-acting opioid analgesics. The new labeling requirements were instituted by the agency in September. The drug also will be included in the Risk Evaluation and Mitigation Strategy (REMS) associated with the new labeling requirements.

"These warnings are expected to improve the safety of all such medicines by encouraging more appropriate prescribing, patient monitoring, and patient counseling practices," the FDA said in a statement. "Zohydro ER is the first opioid to be labeled in this manner."

Approval was based on safety studies of more than 1,100 chronic pain patients as well as efficacy studies of more than 500 chronic low-back-pain patients. Patients taking Zohydro ER in the efficacy study showed significant improvement in chronic pain, compared with those who took placebo.

FDA will require postmarketing studies of Zohydro ER to study potential abuse/overdose and hyperalgesia when used longer than 12 weeks.

Zohydro ER is manufactured by San Diego–based Zogenix.

Elizabeth Mechcatie contributed to this report.

[email protected]

Hydrocodone bitartrate extended-release capsules were approved by the Food and Drug Administration Oct. 25 for severe pain requiring daily long-term treatment and for which other treatment options are inadequate.

The drug, to be marketed as Zohydro ER, is the first FDA-approved extended-release formulation of hydrocodone that is not combined with another analgesic. It is classified as Schedule II under the Controlled Substances Act.

In December, an FDA advisory committee recommended against approval of Zohydro, citing the need for a tamper-proof formulation and a stronger risk mitigation strategy to address the high potential for abuse and misuse of the product.

Experts on the Anesthetic and Analgesic Drug Products Advisory Committee voted 11-2, with 1 abstention, against approval, although they agreed that the manufacturer met the standards for approval for the proposed indication.

However, concerns about the potential public health impact of the availability of an extended-release formulation of hydrocodone that does not contain acetaminophen – which would make it more attractive as a drug of abuse, particularly for intravenous drug abusers – or a tamper-resistant design, swayed their votes.

In approving the drug, the FDA noted that it carries new labeling and stronger warnings regarding the risks and safety of extended-release and long-acting opioid analgesics. The new labeling requirements were instituted by the agency in September. The drug also will be included in the Risk Evaluation and Mitigation Strategy (REMS) associated with the new labeling requirements.

"These warnings are expected to improve the safety of all such medicines by encouraging more appropriate prescribing, patient monitoring, and patient counseling practices," the FDA said in a statement. "Zohydro ER is the first opioid to be labeled in this manner."

Approval was based on safety studies of more than 1,100 chronic pain patients as well as efficacy studies of more than 500 chronic low-back-pain patients. Patients taking Zohydro ER in the efficacy study showed significant improvement in chronic pain, compared with those who took placebo.

FDA will require postmarketing studies of Zohydro ER to study potential abuse/overdose and hyperalgesia when used longer than 12 weeks.

Zohydro ER is manufactured by San Diego–based Zogenix.

Elizabeth Mechcatie contributed to this report.

[email protected]

In the lead-up to the November general election, five major physicians’ and surgeons’ groups put lawmakers on notice, politely saying "get your noses out of our clinical business."

Leaders from the American College of Physicians, the American Academy of Family Physicians, the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, and the American College of Surgeons penned a joint editorial published Oct. 18 in the New England Journal of Medicine (2012; 367:1557-9 [doi:10.1056/NEJMsb1209858]).

Courtesy Wikimedia Commons/Jim Kuhn/Creative Commons Licence

They objected specifically to four kinds of what they termed "inappropriate legislative interference." Specifically, they called out federal and state legislators for:

• Attempting to prohibit discussions of risk factors that might affect the health of patients and families (gun ownership counseling).

• Requiring discussion of information and practices that might not be necessary at the time, based on the doctor’s clinical judgment (end-of-life counseling).

• Requiring physicians to provide tests or interventions that are not supported by evidence (preabortion ultrasound)

• Limiting information doctors can provide to their patients (chemicals used in "fracking").

Details on the measures that so irked physicians can be read on the journal’s website.

While it’s not uncommon for these groups to band together for advocacy purposes, their NEJM editorial was particularly pointed in its message to lawmakers and seemed designed to put elected leaders on notice that doctors are displeased with the meddling.

The question remains whether lawmakers will register the displeasure.

In the lead-up to the November general election, five major physicians’ and surgeons’ groups put lawmakers on notice, politely saying "get your noses out of our clinical business."

Leaders from the American College of Physicians, the American Academy of Family Physicians, the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, and the American College of Surgeons penned a joint editorial published Oct. 18 in the New England Journal of Medicine (2012; 367:1557-9 [doi:10.1056/NEJMsb1209858]).

Courtesy Wikimedia Commons/Jim Kuhn/Creative Commons Licence

They objected specifically to four kinds of what they termed "inappropriate legislative interference." Specifically, they called out federal and state legislators for:

• Attempting to prohibit discussions of risk factors that might affect the health of patients and families (gun ownership counseling).

• Requiring discussion of information and practices that might not be necessary at the time, based on the doctor’s clinical judgment (end-of-life counseling).

• Requiring physicians to provide tests or interventions that are not supported by evidence (preabortion ultrasound)

• Limiting information doctors can provide to their patients (chemicals used in "fracking").

Details on the measures that so irked physicians can be read on the journal’s website.

While it’s not uncommon for these groups to band together for advocacy purposes, their NEJM editorial was particularly pointed in its message to lawmakers and seemed designed to put elected leaders on notice that doctors are displeased with the meddling.

The question remains whether lawmakers will register the displeasure.

In the lead-up to the November general election, five major physicians’ and surgeons’ groups put lawmakers on notice, politely saying "get your noses out of our clinical business."

Leaders from the American College of Physicians, the American Academy of Family Physicians, the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, and the American College of Surgeons penned a joint editorial published Oct. 18 in the New England Journal of Medicine (2012; 367:1557-9 [doi:10.1056/NEJMsb1209858]).

Courtesy Wikimedia Commons/Jim Kuhn/Creative Commons Licence

They objected specifically to four kinds of what they termed "inappropriate legislative interference." Specifically, they called out federal and state legislators for:

• Attempting to prohibit discussions of risk factors that might affect the health of patients and families (gun ownership counseling).

• Requiring discussion of information and practices that might not be necessary at the time, based on the doctor’s clinical judgment (end-of-life counseling).

• Requiring physicians to provide tests or interventions that are not supported by evidence (preabortion ultrasound)

• Limiting information doctors can provide to their patients (chemicals used in "fracking").

Details on the measures that so irked physicians can be read on the journal’s website.

While it’s not uncommon for these groups to band together for advocacy purposes, their NEJM editorial was particularly pointed in its message to lawmakers and seemed designed to put elected leaders on notice that doctors are displeased with the meddling.

The question remains whether lawmakers will register the displeasure.

Medicare payments to doctors are locked in for the rest of the year, now that Congress has passed and the President has signed H.R. 3630.

That bill -- which delayed Medicare physician fee cuts called for by the Sustainable Growth Rate formula -- also extended the payroll tax holiday and benefits for the long-term unemployed.

Courtesy flickr/Caveman Chuck Coker/Creative Commons

Still, doctors' groups are dismayed that Congress once again "kicked the can" down the road instead of buckling down and solving this recurrent problem.

Has a golden opportunity been lost for good? 

To hear about that, and about federal fraud-busting efforts and new, tight deadlines to return Medicare overpayments, listen to the Policy & Practice Podcast: 

Medicare payments to doctors are locked in for the rest of the year, now that Congress has passed and the President has signed H.R. 3630.

That bill -- which delayed Medicare physician fee cuts called for by the Sustainable Growth Rate formula -- also extended the payroll tax holiday and benefits for the long-term unemployed.

Courtesy flickr/Caveman Chuck Coker/Creative Commons

Still, doctors' groups are dismayed that Congress once again "kicked the can" down the road instead of buckling down and solving this recurrent problem.

Has a golden opportunity been lost for good? 

To hear about that, and about federal fraud-busting efforts and new, tight deadlines to return Medicare overpayments, listen to the Policy & Practice Podcast: 

Medicare payments to doctors are locked in for the rest of the year, now that Congress has passed and the President has signed H.R. 3630.

That bill -- which delayed Medicare physician fee cuts called for by the Sustainable Growth Rate formula -- also extended the payroll tax holiday and benefits for the long-term unemployed.

Courtesy flickr/Caveman Chuck Coker/Creative Commons

Still, doctors' groups are dismayed that Congress once again "kicked the can" down the road instead of buckling down and solving this recurrent problem.

Has a golden opportunity been lost for good? 

To hear about that, and about federal fraud-busting efforts and new, tight deadlines to return Medicare overpayments, listen to the Policy & Practice Podcast: 

*UPDATED 12/23/11

Congress sent President Obama an early Christmas present – a 2-month extension of the payroll tax holiday and along with it, a 2-month delay of the looming 27% cut to Medicare physicians’ fees.

Bowing to pressure from all sides, House Republicans agreed Dec. 22 to pass a Senate-authored bill to extend the two key provisions. The Senate passed an amended version of its extension bill by unanimous consent on Dec. 23 and the House quickly followed suit.

By using the unanimous consent vote, congressional leaders were able to move the bill forward even though many members had already traveled home for the holidays.

The president signed the bill in short order.

The developments represent a reprieve for physicians who faced a 27% cut in their Medicare payments beginning Jan. 1 based on the Sustainable Growth Rate (SGR) formula, which controls total spending on physicians’ services based on the gross domestic product.

Doctors’ groups expressed relief that the pay cut was averted, as well as dismay at Congress’ continued short-term fixes to the SGR problem.

"Eleventh-hour legislation that fails to meet the needs of constituents is no way to conduct the nation’s business. That is particularly true when millions of Americans’ health and welfare are at stake," Dr. Glen Stream, president of the American Academy of Family Physicians, said in a statement. "Americans are tired of short-term, insufficient answers to long-standing problems. Americans want a permanent solution. They want Congress to look beyond the next few months or the next year. They want health security. Instead, they got a bitter holiday gift – an extra 60 days before health insecurity again sets in."

*UPDATED 12/23/11

Congress sent President Obama an early Christmas present – a 2-month extension of the payroll tax holiday and along with it, a 2-month delay of the looming 27% cut to Medicare physicians’ fees.

Bowing to pressure from all sides, House Republicans agreed Dec. 22 to pass a Senate-authored bill to extend the two key provisions. The Senate passed an amended version of its extension bill by unanimous consent on Dec. 23 and the House quickly followed suit.

By using the unanimous consent vote, congressional leaders were able to move the bill forward even though many members had already traveled home for the holidays.

The president signed the bill in short order.

The developments represent a reprieve for physicians who faced a 27% cut in their Medicare payments beginning Jan. 1 based on the Sustainable Growth Rate (SGR) formula, which controls total spending on physicians’ services based on the gross domestic product.

Doctors’ groups expressed relief that the pay cut was averted, as well as dismay at Congress’ continued short-term fixes to the SGR problem.

"Eleventh-hour legislation that fails to meet the needs of constituents is no way to conduct the nation’s business. That is particularly true when millions of Americans’ health and welfare are at stake," Dr. Glen Stream, president of the American Academy of Family Physicians, said in a statement. "Americans are tired of short-term, insufficient answers to long-standing problems. Americans want a permanent solution. They want Congress to look beyond the next few months or the next year. They want health security. Instead, they got a bitter holiday gift – an extra 60 days before health insecurity again sets in."

*UPDATED 12/23/11

Congress sent President Obama an early Christmas present – a 2-month extension of the payroll tax holiday and along with it, a 2-month delay of the looming 27% cut to Medicare physicians’ fees.

Bowing to pressure from all sides, House Republicans agreed Dec. 22 to pass a Senate-authored bill to extend the two key provisions. The Senate passed an amended version of its extension bill by unanimous consent on Dec. 23 and the House quickly followed suit.

By using the unanimous consent vote, congressional leaders were able to move the bill forward even though many members had already traveled home for the holidays.

The president signed the bill in short order.

The developments represent a reprieve for physicians who faced a 27% cut in their Medicare payments beginning Jan. 1 based on the Sustainable Growth Rate (SGR) formula, which controls total spending on physicians’ services based on the gross domestic product.

Doctors’ groups expressed relief that the pay cut was averted, as well as dismay at Congress’ continued short-term fixes to the SGR problem.

"Eleventh-hour legislation that fails to meet the needs of constituents is no way to conduct the nation’s business. That is particularly true when millions of Americans’ health and welfare are at stake," Dr. Glen Stream, president of the American Academy of Family Physicians, said in a statement. "Americans are tired of short-term, insufficient answers to long-standing problems. Americans want a permanent solution. They want Congress to look beyond the next few months or the next year. They want health security. Instead, they got a bitter holiday gift – an extra 60 days before health insecurity again sets in."