Imaging Self-Referral Ban Proposed
A proposed ban on self-referral for certain imaging procedures used in Medicare patients has drawn criticism from the American Society of Neuroimaging. “We are concerned with the overall tone of the proposed rule as it relates to imaging,” the society wrote in its comments to the Centers for Medicare and Medicaid Services. “There are broad assumptions that mimic the [Medicare Payment Advisory Commission] report [saying] that much of the growth in imaging services is due to inappropriate self-referral for financial gain. We would strongly disagree with this.” The proposed regulation, which was published in the Aug. 8 Federal Register, bars physician self-referral for PET scans and other nuclear medicine procedures performed at outside facilities in which the referring physician has a financial interest. The ban would not affect services performed at the physician's office. The ASN praised the agency for keeping that “in-office ancillary exception,” noting that the exception is “critically important … for patient access and high-quality imaging.”
Visually Induced Seizure Guidelines
The Epilepsy Foundation has released recommendations for reducing seizures triggered by flashing images and other patterns on television and in video games and computers. The guidelines, which appeared in the September issue of Epilepsia and on the foundation's Web site, address light intensity, flicker, contrast, duration, and pattern and define the technical parameters within these factors that are most likely to provoke seizures in people who are susceptible to them. Although no numbers are available on how many people experience seizures while watching television or surfing the Internet, some epileptologists say they have noticed an increase in the number of young people coming to them with this complaint. “Children and young adults 7–19 years of age are especially susceptible to visually induced seizures,” the journal said in a statement. Although flashing images and other patterns don't cause epilepsy, “some children will have a seizure when exposed to a specific video game and will not have another seizure unless again exposed to the same stimulus,” said Giuseppe Erba, M.D., of the neurology and pediatrics departments at the University of Rochester (N.Y.), who led the development of the recommendations. “This doesn't mean that the video game caused the epilepsy, but it reveals the vulnerability of individuals who carry the photosensitive trait when they are exposed to visual stimuli capable of triggering the abnormal response.”
NIH Eases Stock Rules
Officials at the Department of Health and Human Services have loosened restrictions on ownership of pharmaceutical and biotech company stocks for employees of the National Institutes of Health under a final rule on conflict of interest. However, the final regulation continues to bar NIH employees from engaging in outside consulting relationships with industry. The rule represents a shift in the policy spelled out in February 2005, under which about 6,000 top NIH employees would have been required to sell all of their stock holdings in companies impacted by NIH decisions. Under the final rule, which became effective in August, about 200 NIH employees with senior decision-making authority and their families will be required to divest of all stock holdings in excess of $15,000 per company for organizations substantially affected by NIH decisions. The deadline for divestiture is Jan. 30, 2006. The final rule does not impose restrictions on extramural scientists, but NIH Director Elias Zerhouni, M.D., said it's important to have a broad dialogue on conflict of interest with the entire scientific community. “This debate is way beyond that of NIH,” he said.
Walter Reed to Close
Walter Reed Army Medical Center in Washington, which has cared for hundreds of thousands of soldiers and dignitaries over the past 96 years, is slated to be shuttered. The Department of Defense's recommendation for Walter Reed's closure was recently approved by members of the Defense Base Realignment and Closure Commission. The commission sent its final report to President Bush on Sept. 8. If the president agrees with the recommendations, he will send the entire list to Congress for a vote. Congress must accept or reject the list in full, but cannot amend it. Not included in the closure plan is the National Museum of Health and Medicine, which is on the hospital grounds and houses a neuroanatomic collection with more than 35,000 specimens. If the closure is approved, most of the staff and services from the army hospital will be combined with services at the National Naval Medical Center in Bethesda, Md., and renamed the Walter Reed National Military Medical Center. Other services will be moved to Fort Belvoir, Va.