Washington Highlights: June 17,
2005
Contents
Prior Issues
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House Panel Approves HHS Funding Bill
The House Appropriations Committee June 16 approved the FY 2006
Labor-HHS-Education funding bill by voice vote. The committee adopted
the funding recommendations proposed by the Labor-HHS-Education
subcommittee June 9, including $28.507 billion for NIH, an increase
of $142.3 million (0.5 percent), and elimination of nearly all Title
VII health professions funding.
The subcommittee had proposed elimination of all Title VII funding
except for the Scholarships for Disadvantaged Students program,
which it funded at the FY 2005 level of $47.1 million [see Washington
Highlights, June 10]. The full committee approved by voice
vote a managers' amendment to the subcommittee-passed bill that
includes a transfer of $12 million from the SDS program, reducing
it to $35.128 million, and shifting it to the Centers of Excellence
program, which received no funding in the subcommittee bill. The
committee also approved a provision to rescind $15.9 million in
unobligated balances from the Health Professions Student Loan program,
which provides long-term, low interest rate loans to financially
needy health professions students
The committee report provides no funds for NIH extramural research
facilities construction, the same as proposed by the Administration,
and $29 million less than was appropriated in FY 2005. The bill
maintains the cap on the amount of salary that can be charged to
an NIH grant at Executive Level I ($180,100 in 2005).
Overall, the bill provides $142.5 billion in discretionary funding
for FY 2006, which is $164 million less than the FY 2005 level.
In addition, the committee had to come up with nearly $1 billion
to help fund implementation of the new Medicare prescription drug
program.
The committee rejected, 36-29, an amendment by Rep. Dave Weldon
(R-Fla.) to prohibit NIH funding to any entity that performs or
funds human cloning or research using "all or part of any cloned
human embryo or human clone at a later stage of development."
Both supporters of stem cell research and committee leaders concerned
this controversial issue would jeopardize passage of the bill opposed
the amendment.
Information:
Dave Moore, Senior Director
AAMC Government Relations
dbmoore@aamc.org
(202) 828-0525
NGA Outlines Medicaid Reform Recommendations at
House, Senate Hearings
The National Governors Association (NGA) released a "preliminary
policy paper" outlining recommendations for Medicaid program
reform at a June 15 hearing
in the Senate Finance Committee. Testifying on behalf of the NGA
were Chairman Mark Warner (D-Va.) and Vice Chairman Mike Huckabee
(R-Ark.). The House Energy and Commerce Committee held a similar
hearing later in the day.
The NGA's preliminary recommendations, which will continue to be
refined and finalized over the next few months, include constraints
on prescription drug expenditures, changes in asset transfer policies,
increased cost-sharing by beneficiaries, increased state flexibility
in determining benefit packages, reforming the state waiver process,
and limiting federal judicial actions that impede state management
of Medicaid programs. The NGA recommendations also call for broad
national health reforms that would reduce the burden on Medicaid
by strengthening employer-based and other types of private healthcare
coverage.
The NGA document does not estimate the savings associated with
their proposals. During the Finance Committee hearing, Sen. Gordon
Smith (R-Ore.) asked Govs. Warner and Huckabee for suggestions on
how the recommendations might be used to achieve the $10 billion
in program savings required under the FY 2006 congressional budget
agreement. The governors replied that their objective was not to
cut costs, but to improve program efficiencies and slow the program
growth over the long-term. Sen. Craig Thomas (R-Wyo.) asked whether
the NGA had considered ways to address the "insufficient"
provider rates that discourage participation in the Medicaid program.
Gov. Warner suggested that, by increasing program flexibility, states
could achieve greater program efficiencies. These improved efficiencies
would potentially allow states to direct additional funds to providers.
At the conclusion of the Finance Committee hearing, Chairman Charles
Grassley (R-Iowa) announced that he had scheduled a two-day hearing
(June 28 and 29) to review fraud and abuse in the Medicaid program;
however, he did not elaborate on what issues might be raised at
the hearing.
Information:
Christiane Mitchell, Senior Legislative Analyst
AAMC Government Relations
cmitchell@aamc.org
(202) 828-0526
Dodd Introduces Legislation Extending Economic
Hardship Deferment
Senator Chris Dodd (D-Conn.) June 14 introduced legislation (S.
1246) that would extend the length of the Economic Hardship
Deferment for medical and dental residents to the length of their
internship, residency or fellowship. Under current law, the deferment
is only available for three years. In a June 15 letter
to Senator Dodd endorsing the legislation, AAMC President Jordan
J. Cohen, M.D., stated, "Medical education is a unique and
complex endeavor. Your legislation recognizes this and helps ensure
that aspiring physicians in all specialties are provided better
repayment options on their federal education loans throughout their
education."
Specifically, the "Medical Education Affordability Act"
would provide that medical and dental residents that qualify for
the Economic Hardship Deferment would be "available for the
length of the internship, residency, or fellowship program if the
program (A) must be successfully completed by the borrower before
the borrower may begin professional practice or service; or (B)
leads to a degree or certificate awarded by a health professional
school, hospital or health care facility that offers postgraduate
training." Additionally, S. 1246 provides that borrowers would
not be required to re-apply for the deferment annually.
Senators Jim Jeffords (I-Vt.), John Kerry (D-Mass.) and Russ Feingold
(D-Wis.) joined Senator Dodd as original co-sponsors of the legislation.
Similar legislation that extends the Economic Hardship Deferment
to five years was introduced by Rep. Rob Andrews (D-N.J.) in the
House of Representatives on May 23 [see Washington
Highlights, June 3].
Information:
Jonathan Fishburn, Director, Research, Education and Veterans' Legislative Affairs
AAMC Government Relations
jfishburn@aamc.org
(202) 828-0525
MedPAC Releases Report on Medicare Payment Policy
The Medicare Payment Advisory Commission (MedPAC) June 15 released
its second of two annual reports
entitled Report to the Congress: Issues in a Modernized Medicare
program. The Report examines issues related to implementation
of the Medicare Part D prescription drug benefit. It also provides
an overview of the Medicare Advantage program and makes recommendations
on Medicare Advantage payment policy.
As part of the Medicare Advantage payment recommendations, the
Commission recommends that Congress should remove indirect medical
education (IME) payments from the plan payment benchmarks. This
would end a perceived "double" IME payment by Medicare,
since teaching hospitals currently receive IME (and direct graduate
medical education) payments associated with Medicare managed care
enrollees directly from the Medicare program.
The June Report also addresses several other areas:
- Review of CMS' preliminary estimate of the physician update
for 2006;
- Using clinical and cost effectiveness in Medicare;
- Critical access hospitals;
- Payment for pharmacy handling costs in hospital outpatient
departments; and
- Payments for post-acute care and dialysis.
Information:
Karen Fisher, Sr. Director, Health Care Affairs
AAMC Health Care Affairs
kfisher@aamc.org
(202) 862-6140
Denise Dodero, Sr. Director, Health Care Affairs
AAMC Health Care Affairs
ddodero@aamc.org
(202) 828-0493
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