Washington Highlights: Date
House Committee
Approves FY 2005 VA-HUD Appropriations Bill
Contents
Prior Issues
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The House Appropriations Committee July 22 approved its version
of the FY 2005 Veterans Affairs, Housing and Urban Development and
Independent Agencies appropriations bill which includes funding
for various agencies including the Department of Veterans Affairs
(VA) and the National Science Foundation (NSF). Appropriators proposed
a significant increase for VA Medical Care; however, the VA medical
and prosthetics research program and the NSF were both subjected
to significant cuts. The VA-HUD Subcommittee approved the bill on
July 20.
The Committee provided a total of $30.3 billion to the Veterans
Health Administration. This represents a $1.2 billion increase over
the President's budget request and $1.9 billion more than FY 2004.
Included in the total is $385 million for VA medical and prosthetics
research, a decrease of $20.6 million (5.1 percent) from the current
year. For the NSF, the Committee recommended a total of $5.47 billion,
$111 million less than FY 2004 and $278 million less than the Administration
requested. This total includes $4.2 billion for NSF Research, a
decrease of approximately $50 million (1 percent) from FY 2004.
Information:
Jonathan Fishburn, Director, Research, Education and Veterans' Legislative Affairs
AAMC Government Relations
jfishburn@aamc.org
(202) 828-0525
Patient Safety Bill Passes Senate; Heads to Conference
Patient safety provisions that establish a system and legal protections
for reporting patient safety passed the Senate by unanimous consent
on July 22. The "Patient Safety and Quality Improvement Act
of 2003," S.
720, was passed as an amendment in the nature of a substitute
to House-passed patient safety legislation (H.R.
663).
The amended language was laid before the Senate after the Health,
Education, Labor, and Pensions Committee Chairman Sen. Judd Gregg
(R-N.H.) and Ranking Member Sen. Edward Kennedy (D-Mass.) agreed
to technical changes in the bill. The changes confirmed that existing
patient access to medical records would not be pre-empted by the
bill, which establishes legal protections for data that is reported
for patient safety improvement purposes.
The House and Senate versions of the legislation will need to be
reconciled by a conference committee consisting of Senate Majority
Leader Bill Frist (R-Tenn.) and Sens. Kennedy, Gregg, Michael Enzi
(R-Wyo.), Lamar Alexander (R-Tenn.), Christopher Dodd (D-Conn.),
and John Edwards (D-N.C.). Earlier in the week, Senate Republicans
faced opposition to a floor vote on S. 720 because of Democrats'
concerns regarding patient access to medical information.
Information:
Christiane Mitchell, Senior Legislative Analyst
AAMC Government Relations
cmitchell@aamc.org
(202) 828-0526
Senate Panel Approves VA Physician Pay Bill
The Senate Veterans Affairs Committee July 20 approved by voice
vote S.
2484 as amended, the "Department of Veterans Affairs Health
Care Personnel Enhancement Act of 2004," also known as the
VA physician pay bill. The substitute bill will create three new
pay elements, one for base/longevity pay, one for market pay, and
one for incentive pay.
Under the proposed base pay system, there are 15 tiers beginning
at $90K for Tier 1 and increasing to $133K at Tier 15, with about
a 2.5 percent increase between tiers. VA physicians would start
at Tier 1 and be bumped up to the next tier every 2 years. The base
salaries would increase with the overall federal pay increases that
occur approximately annually.
The market pay system would allow for the Secretary to set maximum
and minimum salaries for VA physicians nationwide, with maximum
and minimum parameters by specialty and subspecialty, and set
tiers within each specialty or subspecialty. An individual VA
physician's total salary would be within the set parameters but
specifically determined by the local facility on the recommendation
of the Professional Standards Boards (PSBs). The market pay portion
of the salary would then be the total salary, minus the base pay.
The rates of pay in the market pay system would be adjusted at
least every two years by the Secretary, who would be
required to consult 2 appropriate national pay surveys before making
his recommendation. The third element would be incentive pay,
and would include the ability for a one-time annual bonus of up
to $10,000. There would be no salary reductions.
Information:
Jonathan Fishburn, Director, Research, Education and Veterans' Legislative Affairs
AAMC Government Relations
jfishburn@aamc.org
(202) 828-0525
Bi-Cameral Legislation Gives CMS Greater Authority Over JCAHO's
Accreditation Process of Hospitals
At a July 20 press conference, Senate Finance Committee Chairman
Charles Grassley (R-Iowa) and Rep. Pete Stark (D-Calif.), Ranking
Minority Member of the House Ways and Means Subcommittee on Health,
released a study by the Goverment Accountability Office (GAO) on
the deficiencies of the Joint Commission on Accreditation of Healthcare
Organizations' (JCAHO) accreditation process of hospitals. The legislators
also announced the introduction of corrective legislation that would
provide the Centers for Medicare and Medicaid Services (CMS) with
greater oversight authority over JCAHO.
The study found that JCAHO failed to identify a number of serious
deficiencies that were later identified by routine government surveyors.
Sen. Grassley said such deficiencies shouldn't "be dismissed
as one-time incidents," and Rep. Stark questioned "the
ability of the hospital accreditation process to assure compliance
with Medicare's requirements."
Currently, hospitals accredited by JCAHO automatically are considered
to comply with Medicare patient safety and health requirements.
Taking into account the study's recommendations, Sen. Grassley and
Rep. Stark introduced legislation, S. 2698 and H.R.
4877, to give CMS greater authority over JCAHO. The bills will
require JCAHO to renew their status to accredit hospitals, giving
CMS the authority to restrict or remove JCAHO from its hospital
accreditation authority. Such legislation will provide CMS with
the same oversight authority over the accreditation of hospitals
that it has for all other health care providers.
According to a written statement by the Senate Finance Committee's
Ranking Minority Member Max Baucus (D-Mont.), who is also a cosponsor
of the Senate legislation, "While the GAO's findings are a
reason for concern, the report does not mean that American hospitals
are unsafe. But it does send a clear message - one that the Congress
and the Administration should heed - that there is room for improvement
in identifying problems at hospitals. Given my commitment to keep
hospitals as safe as possible, I view the GAO's recommendations
as a call to action."
Information:
Lynne Davis Boyle, Assistant Vice President
AAMC Government Relations
ldavisboyle@aamc.org
(202) 828-0526
New Legislation Would Increase State FMAP Levels
Senators John Rockefeller (D-W.V.) and Gordon Smith (R-Ore.) July
15 introduced the "State Fiscal Relief Act of 2004" (S.
2671), which would temporarily extend the state fiscal relief
provisions passed as part of the 2003 economic stimulus package
that expired July 1.
The provisions in S. 2671 are retroactive to July 1, and grant
states a temporary 1.26 percent increase in their Federal Medical
Assistance Percentage (FMAP, or "match"). The 15-month
increase would expire September 30, 2005, and cost $4.8 billion.
S. 2671 also includes up to $1.2 billion in "Transitional
Funds" to help states implement federal mandates outlined in
the Medicare Modernization Act (MMA) related to dual eligibles and
low-income individuals who qualify for Medicare cost-sharing. States
could apply the funds to MMA-related expenditures made from October
1, 2004, through April 1, 2006.
Acknowledging that the new bill is significantly less generous
than the previous round of state fiscal relief, Sens. Rockefeller
and Smith consider the legislation a "workable phase-down transition"
in federal assistance. While Sens. Rockefeller and Smith have not
publicly discussed a legislative strategy for S. 2671, the bill
could potentially be attached to an appropriations or omnibus bill.
Information:
Christiane Mitchell, Senior Legislative Analyst
AAMC Government Relations
cmitchell@aamc.org
(202) 828-0526
AAMC and FASEB Question New HHS Policy on WHO
Consultation
The AAMC and the Federation of American Societies for Experimental
Biology (FASEB) sent a July 20 letter
to the Department of Health and Human Services (HHS) seeking to
clarify and, if necessary, change the Department's new policy for
vetting federal scientists who participate in meetings of the World
Health Organization (WHO). At issue is an April 15 letter from Dr.
William Steiger, the Secretary's Special Assistant for International
Affairs, to Dr. Dennis Aitken, Assistant to the Director of the
World Health Organization. Mr. Steiger directs that WHO's requests
for HHS scientists to serve as technical consultants or advisors
be routed through the HHS Office of Global Affairs, from which the
Department will - in consultation with other HHS agencies - identify
and designate appropriate specialists. The letter goes on to state
that federal regulations require HHS experts "to serve as representatives
of the U.S. Government at all times and advocate U.S. Government
Policies."
AAMC and FASEB agree that federal scientists asked to represent
the U.S. government on matters of policy certainly are expected
to conform to those applicable policies. However, the organizations
asked for assurance that the department's stance is "not intended
to interfere with the ability of scientists employed by the federal
government to interact with their peers freely on scientific matters,
in an environment free of political constraint or distortion."
The presidents of AAMC and FASEB go on to note that in the history
of their interactions with federal advisory bodies, they have never
been informed that expressions of scientific opinion and judgment
were regulated by requirements to advocate for certain policies.
Information:
Stephen Heinig, Lead Science Policy Analyst
AAMC Biomedical Health Sciences Research
sheinig@aamc.org
(202) 828-0488
AAMC Submits Language to Republican Platform Committee
AAMC President Jordan J. Cohen, M.D., July 21 submitted language
to the Platform Committee for the 2004 Republican National Convention
emphasizing the role of medical schools and teaching hospitals.
The language, which is similar to that submitted to the Democratic
Platform Committee earlier this year, states, in part, "Our
teaching hospitals and medical schools make enormous contributions
by educating future physicians and biomedical scientists; leading
biomedical, behavioral, and health services research; championing
the application of new knowledge to alleviate suffering; rehabilitating
injury, and preventing disease and premature death; and fulfilling
this nation's obligation to provide care to its poorest and sickest
members." The AAMC also urged the inclusion of language supporting
"a continued investment in the continuum of public health activities
within the U.S. Public Health Service to achieve improved health
outcomes and protect Americans against the health consequences of
terrorist attacks."
Republican National Committee Chairman Ed Gillespie announced July
13 that Senate Majority Leader Bill Frist (Tenn.) will serve as
Chairman of the 2004 Platform Committee and that Rep. Melissa Hart
(Pa.) and Colorado Governor Bill Owens will serve as Co-Chairs.
The Republican platform will be approved at the Republican National
Convention in New York beginning Aug. 30.
Meanwhile, the Democratic
Platform Committee approved its report July 10. The platform
will be formally approved at the Democratic National Convention
in Boston beginning July 26.
Information:
Dave Moore, Senior Director
AAMC Government Relations
dbmoore@aamc.org
(202) 828-0525
Greenwood to Retire
Representative James Greenwood (R-Pa.) announced July 22 his intention
to retire from the House of Representatives at the end of the 108th
Congress and become President of the Biotechnology Industry Organization
(BIO), effective January 5, 2005. Mr. Greenwood has served in Congress
since November 1992, and currently sits on the Energy and Commerce
and the Education and the Workforce committees. On the Commerce
Committee, Rep. Greenwood sits on the Subcommittee on Health and
chairs the Subcommittee on Oversight and Investigations, where he
has been leading recent hearings on oversight of the National Institutes
of Health (NIH).
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