Washington Highlights: June 10,
2005
House Labor-HHS
Subcommittee Eliminates All Title VII Funding Except SDS
Contents
Prior Issues
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In the FY 2006 spending bill it approved June 9, the House Labor-HHS-Education
Appropriations Subcommittee eliminated funding for all Title VII
health professions education programs except scholarships for disadvantaged
students (SDS) and provided less than the President's request for
the National Institutes of Health. The subcommittee, provided $28.507
billion for NIH, an increase of $142.3 million (0.5 percent) but
$3 million less than the President's FY 2006 budget request.
The subcommittee failed to restore funding for the Title VII programs
except for the SDS program, which was funded at the FY 2005 level
of $47.1 million. For the Title VIII nursing education programs,
the subcommittee adopted the President's request of $150 million,
which is $670,000 less than FY 2005. The subcommittee included $126.8
million for the National Health Service Corps, the same as the President's
budget and $4.7 million less than FY 2005. The subcommittee provided
$300 million for children's hospitals graduate medical education,
which is $730,000 less than FY 2005 but $100 million more than the
President's request.
The Agency for Healthcare Research and Quality (AHRQ) received
$319 million, the same as in FY 2005. However, the subcommittee
funded AHRQ with appropriated funds rather than money transferred
from other Public Health Service programs as in previous years.
The subcommittee directs $50 million of the AHRQ budget for health
information technology. The subcommittee also provided $75 million
for the Office of the National Coordinator for Health Information
Technology within the Office of the Secretary of Health and Human
Services.
The subcommittee provided $5.946 billion for the Centers for Disease
Control and Prevention (CDC), which appears to be an increase of
$1.435 billion (32 percent) over FY 2005. However, $1.616 billion
of this total is for terrorism preparedness that had been previously
provided through the Public Health and Social Service Emergency
Fund. When these funds are factored out of the FY 2006 appropriation,
the remaining CDC budget received $4.329 billion, which is $181
million (4 percent) below the FY 2005 level. The subcommittee also
cut funding for the Substance Abuse and Mental Health Services Administration
(SAMHSA), which received $3.231 billion, a decrease of $38 million
(1.1 percent).
The full House Appropriations Committee is expected to consider
the bill the week of June 13.
Information:
Dave Moore, Senior Director
AAMC Government Relations
dbmoore@aamc.org
(202) 828-0525
Moratorium on Physician-Owned Hospitals Expires
The Medicare Modernization Act's (MMA) 18-month moratorium or limitation
on physician ownership and investment interests in a "specialty"
hospital expired June 8, a date marked with a series of statements
by policymakers and organizations supporting as well as opposing
the continuation of a moratorium. New physician-owned hospitals
can now be developed and specialty hospitals grandfathered by the
moratorium can now increase the number of physician investors, change
or expand the field of specialization they treat, and expand their
location and numbers of beds. However, temporary actions
taken by the Centers for Medicare and Medicaid Services (CMS) will
delay approval of any specialty hospitals until January 2006.
According to a statement issued by the American Hospital Association
and the Federation of American Hospitals, "Actions taken by
the Centers for Medicare and Medicaid Services (CMS) to freeze approval
of new physician-owned specialty hospitals until January 2006 -
as well as the leadership of the Senate Finance Committee - basically
continue the moratorium prohibiting physicians from self-referring
patients to specialty hospitals that they own."
Sens. Charles Grassley (R-Iowa) and Max Baucus (D-Mont.) sent
a June 8 "Dear Colleague" letter to all Senators urging
them to cosponsor the "Hospital Fair Competition Act of 2005,"
which would permanently extend the moratorium. Sens. Grassley and
Baucus also announced that the General Accountability Office was
expected to release a report June 9 finding that 37 physician-owned
specialty hospitals could open within a year or two if the government
takes no action. As of press time the report had yet to be released.
In a press release, the American Surgical Hospital Association
(ASHA) welcomed "the expiration of the specialty hospital moratorium.
Despite the limits imposed by the moratorium, specialty hospitals
continued to provide efficient, high quality healthcare to patients."
In a separate statement, American Medical Association Trustee William
Plested, M.D., said, "Patients can now continue to benefit
from the increased choice and competition that results from specialty
hospitals."
Also, the Business Roundtable June 2 sent a letter to Congress
urging them to "act on legislation that would establish a ban,
or at a minimum, extend the moratorium on the creation of new-physician-owned
specialty hospitals." The Business Roundtable is an association
of chief executive officers of leading corporations with a combined
workforce of more than 10 million employees in the United States
and $4 trillion in annual revenues.
Informaton:
Lynne Davis Boyle, Assistant Vice President
AAMC Government Relations
ldavisboyle@aamc.org
(202) 828-0526
61 Senators Urge CMS to Extend Non-Hospital Site
Moratorium
Senators Susan Collins (R-Maine), Richard Durbin (D-Ill.) and 59
Senators sent a May 31 letter
to Centers for Medicare and Medicaid (CMS) Administrator Mark McClellan,
M.D., Ph.D., regarding Medicare regulations for resident training
in non-hospital sites and the importance of volunteer supervising
physicians. The letter specifically requests that CMS extend the
moratorium established by Section 713 of the MMA as well as work
with Congress to resolve the many issues surrounding these regulations.
The moratorium expired on December 31, 2004.
Concerned with CMS' actions that have resulted in the denial of
payments for the time residents spent in non-hospital settings where
teaching physicians were freely volunteering their supervisory time,
the Senators urged "CMS to act immediately, through its inherent
regulatory authority, to extend and expand the moratorium"
established by Section 713 of the MMA. "Such action would allow
Congress and CMS to further study and work collaboratively toward
a clear and appropriate policy." The Senators are concerned
that Medicare regulations are discouraging "community physicians
in non-hospital settings from agreeing to supervise residents."
In addition to Sens. Collins and Durbin, the letter was signed
by Evan Bayh (D-Ind.), Robert Bennett (R-Utah), Joseph Biden (D-Del.),
Jeff Bingaman (D-N.M.), Christopher Bond (R-Mo.), Barbara Boxer
(D-Calif.), Conrad Burns (R-Mont.), Maria Cantwell (D-Wash.), Thomas
Carper (D-Del.), Lincoln Chafee (R-R.I.), Hillary Clinton (D-N.Y.),
Tom Coburn (R-Okla.), Thad Cochran (R-Miss.), Norm Coleman (R-Minn.),
Kent Conrad (D-N.D.), Jon Corzine (D-N.J.), Mark Dayton (D-Minn.),
Mike DeWine (R-Ohio), Christopher Dodd (D-Conn.), Pete Domenici
(R-N.M.), Byron Dorgan (D-N.D.), John Ensign (R-Nev.), Russell Feingold
(D-Wis.), Dianne Feinstein (D-Calif.), Lindsey Graham (R-S.C.),
Tom Harkin (D-Iowa), Orrin Hatch (R-Utah), Kay Bailey Hutchison
(R-Texas), James Jeffords (I-Vt.), Tim Johnson (D-S.D.), Edward
Kennedy (D-Mass.), John Kerry (D-Mass.), Herb Kohl (D-Wisc.), Jon
Kyl (R-Ariz.), Mary Landrieu (D-La.), Frank Lautenberg (D-N.J.),
Pat Leahy (D-Vt.), Carl Levin (D-Mich.), Blanche Lincoln (D-Ark.),
Barbara Mikulski (D-Md.), Lisa Murkowski (R-Alaska), Patty Murray
(D-Wash.), Ben Nelson (D-Neb.), Barack Obama (D-Ill.), Mark Pryor
(D-Ark.), Jack Reed (D-R.I.), Pat Roberts (R-Kan.), Jay Rockefeller
(D-W.Va.), Ken Salazar (D-Colo.), Rick Santorum (R-Pa.), Charles
Schumer (D-N.Y.), Gordon Smith (R-Ore.), Olympia Snowe (R-Maine),
Arlen Specter (R-Pa.), Debbie Stabenow (D-Mich.), Jim Talent (R-Mo.),
John Thune (R-S.D.), George Voinovich (R-Ohio), and Ron Wyden (D-Ore.).
Information:
Lynne Davis Boyle, Assistant Vice President
AAMC Government Relations
ldavisboyle@aamc.org
(202) 828-0526
AAMC Signs Letter Urging Passage of Patient Safety
Legislation
The AAMC joined the American Medical Association, American Hospital
Association, and over 125 other healthcare organizations in signing
a June 7 letter,
urging Congress to "pass a patient safety bill that …
will improve and protect the safety of America's patients."
The letter expresses concern that the "full potential"
of patient safety initiatives "will remain unrealized"
unless Congress passes legislation "that establishes an environment
in which health care professionals and organizations can report
and analyze healthcare errors and share their experiences with others
in order to prevent similar occurrences."
Information:
Christiane Mitchell, Senior Legislative Analyst
AAMC Government Relations
cmitchell@aamc.org
(202) 828-0526
HHS Creates New Commission to Accelerate Implementation
of Electronic Health Records
Health and Human Services (HHS) Secretary Mike Leavitt June 6 announced
the formation of a 17-member advisory commission to "recommend
specific actions that will accelerate the widespread application"
of health information technology (IT). Called the "American
Health Information Community" (AHIC), the commission will focus
on the creation of standards, a certification process, and a secure
"national architecture" for sharing electronic health
information. The commission will be chaired by Secretary Leavitt,
and will include consumers, payers, providers, purchasers, vendors,
and other stakeholders among its membership.
According to background
materials released by HHS, the AHIC was created because a "multitude
of competitive interests" have "prevented a unified effort
to achieve common standards and interoperability." This necessitated
the creation of a new "national strategy" that "calls
for Federal agencies … to collaborate with private payers in
developing and adopting an architecture, standards, certification
process, and a method of governance for ongoing implementation of
health IT."
Information:
Christiane Mitchell, Senior Legislative Analyst
AAMC Government Relations
cmitchell@aamc.org
(202) 828-0526
Patent Reform Bill Introduced in the House
Representative Lamar Smith (R-Texas) and 9 co-sponsors June 8 introduced
H.R. 2795, the "Patent Act of 2005," which proposes reforms
to the U.S. Patent System intended to improve its efficiency and
reliability, and bring some elements into harmony with international
norms. Among its provisions, H.R. 2795 would establish a "first
inventor to file" standard for award of a patent, designed
to reduce the number of "interferences" from parties disputing
who invented first. The bill would also provide for post-grant review
of patents and extend a grace period for publication of information
relating to a patented application. The House Judiciary Subcommittee
on the Courts, Internet, and Intellectual Property held a hearing
on the bill on June 9.
Information:
Stephen Heinig, Lead Science Policy Analyst
AAMC Biomedical Health Sciences Research
sheinig@aamc.org
(202) 828-0488
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