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John I. Gallin, M.D., Director, NIH Clinical Center
Dr. John I. Gallin, Director of the NIH Clinical Center, addressed Council about managed care issues facing NIH clinical research. Recommendations from the Inspector General (IG) have raised many issues, including a recommendation to segregate research from nonresearch costs and charge for nonresearch care.
Early this year, NIH benefited from the advice of an Options Team, which concluded with several recommendations and issues: Segregation of nonresearch care is problematic and conflicts with the principles of clinical research, 2) NIH should explore creative arrangements with large insurers and managed care organizations, 3) NIH should avoid complex fee-for-service arrangements, 4) NIH should maintain a policy of no out-of-pocket expenses to the patient, 5) payment agreements should not affect participation in research, and 6) NIH must protect patient confidentiality.
Dr. Gallin said that while NIH is committed to treating patients without cost to them, we are moving rapidly to a system in which we recruit patients from managed care organizations with whom we have financial arrangements. NIH is already pursuing discussions with managed care organizations, and these have been productive.
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