Washington Highlights: July 15,
2005
Contents
Prior Issues
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Senate Panel Restores Title VII, Boosts NIH Funding
The Senate Appropriations Committee July
14 voted to restore funding for the majority of Title VII health
professions programs and to give the National Institutes of Health
(NIH) a $1 billion increase over the current year's level. The committee
voted to report its version of the FY 2006 Labor-HHS-Education Appropriations
bill (H.
R. 3010, S.
Rept. 109-103). The Labor-HHS-Education Appropriations Subcommittee
marked up the bill July 12. The House passed its version of the
bill on June 24 [see Washington
Highlights, June 24]
The Senate bill provides $298.7 million for Title VII health professions,
an $820,000 (0.3 percent) increase over FY 2005. Most Title VII
programs were restored to their FY 2005 funding levels. Primary
care medicine and dentistry received a $1.2 million (1.3 percent)
increase to $90 million, and geriatric programs were cut by $2 million
(6.3 percent) to $29.5 million. The House-passed bill provides just
$12 million for Centers of Excellence and $35 million for Scholarships
for Disadvantaged Students, an 84 percent cut below the current
funding level for Title VII. The Senate bill provides $155.7 million
for Title VIII nursing education programs, a $5 million (3.3 percent)
increase over FY 2005 and $5.7 million more than the House bill.
The Senate bill includes $29.415 billion for NIH, an increase of
$1.050 billion (3.7 percent) over the FY 2005 appropriation and
$905 million over the President's FY 2006 budget request. The House-passed
bill includes $28.507 billion for NIH, an increase of $142.3 million
(0.5 percent) but $3 million less than the President's request.
The Senate bill retains the salary cap on extramural grants at
Executive Level I, and provides $30 million through the National
Center for Research Resources for extramural facility renovation
and construction, equal to the FY 2005 funding level. The House
bill eliminates funding for this program. The Senate bill also includes
legislative language permitting the National Institute for Allergy
and Infectious Diseases for extramural construction grants for biodefense
research.
For the Agency for Healthcare Research and Quality (AHRQ), the
Senate bill provides $323.7 million, an increase of $5 million over
the FY 2005 and House-passed levels. However, all the AHRQ funding
in the Senate is transferred from other programs; the House bill
directly appropriated funds to AHRQ. The Senate committee report
directs AHRQ to devote $84 million of its budget to determining
ways to reduce medical errors. Of this amount, $50 million is to
be used to support the department's initiative to promote the development,
adoption, and diffusion of information technology in health care.
In addition, the Senate bill provides $25.15 million to the Office
of the National Coordinator for Health Information Technology, which
is $21.1 million above FY 2005 but $29.9 million less than the House
bill.
The Senate bill additionally provides $126.8 million for the National
Health Service Corps, a decrease of $4.7 million (3.5 percent) from
FY 2005 and the same level provided in the House bill. This decrease
is the result of proposed administrative cost savings, and the number
of awards is anticipated to remain the same. The bill also includes
$300 million for the Children's Hospitals Graduate Medical Education
program, a decrease of $730,000 (0.2 percent) from FY 2005, and
the same level as the House bill.
Information:
Dave Moore, Senior Director
AAMC Government Relations
dbmoore@aamc.org
(202) 828-0525
House Subcommittee Approves HEA Reauthorization
Bill
The House Education and the Workforce 21st Century Competitiveness
Subcommittee July 14 approved, as amended, H.R.
609, the "College Access and Opportunity Act of 2005,"
which would reauthorize the Higher Education Act (HEA), by a party
line vote of 18-15. The full Education and the Workforce Committee
is expected to mark-up the bill during the week of July 18.
Specifically, H.R. 609 contains several provisions of particular
interest to medical schools and teaching hospitals. The bill seeks
to increase loan limits, but limits increases in subsidized loan
limits to freshmen and sophomores, and to a small increase from
$10,000 to $12,000 in unsubsidized loans for graduate and professional
students. H.R. 609 also includes provisions shifting all Stafford
loans, including consolidation loans, to a variable interest rate.
Full Committee Chairman John Boehner (R-Ohio) noted that he is working
on compromise legislation that would allow borrowers a choice of
consolidating student loans at a fixed or a variable rate, with
the rates for each based on different underlying financial instruments.
Chairman Boehner stated during the mark-up that he will continue
his discussions and may have a compromise to announce at the full
committee mark-up. The subcommittee rejected amendments offered
by Ranking Member Dale Kildee (D-Mich.) that would have retained
the fixed rate option for consolidation, and capped Stafford Loan
interest rates at 6.8 percent rather than the 8.25 percent included
in the bill.
Information:
Jonathan Fishburn, Director, Research, Education and Veterans' Legislative Affairs
AAMC Government Relations
jfishburn@aamc.org
(202) 828-0525
Matthew Shick, Senior Legislative Analyst
AAMC Government Relations
mshick@aamc.org
(202) 862-6116
Ways and Means Leadership Urges CMS to Address
Flaws in SGR Methodology
In a July 12 letter to Centers for Medicare and Medicaid Services
(CMS) Administrator Mark McClellan, M.D., Ph.D., House Ways and
Means Committee Chairman Bill Thomas (R-Calif.) and Health Subcommittee
Chairwoman Nancy Johnson (R-Conn.) urged "consideration of
administrative changes" to the Sustainable Growth Rate (SGR)
methodology used to calculate Medicare physician payments.
The letter asks Dr. McClellan to "undertake new action"
to remove prescription drugs and biologic expenditures from the
SGR calculation. It also urges CMS to review how it determines the
costs of national coverage decisions, which are reflected in the
SGR target. Reps. Thomas and Johnson are concerned that a legislative
SGR fix "would be prohibitively expensive, given current interpretations
of the formula." However, they suggest that an SGR fix that
combines both administrative and legislative actions "could
proceed."
Also in the letter, Reps. Thomas and Johnson applaud recent CMS
initiatives to develop and evaluate performance-based Medicare payments.
Such initiatives, they believe, "will provide us with the experience
we need to design appropriate rewards for delivering quality care."
Reps. Thomas and Johnson state that they look forward to working
with CMS "to develop incentives for physicians to provide high-quality
care to Medicare beneficiaries."
Information:
Christiane Mitchell, Senior Legislative Analyst
AAMC Government Relations
cmitchell@aamc.org
(202) 828-0526
DoD Publishes Proposed Rule on Unauthorized Disclosure
of Export Controlled Information and Technology
The Department of Defense (DoD) July 12 published in the Federal
Register [70
FR 39976] its proposed amendments to the Defense Federal Acquisition
Regulation Supplement (DFARS) to address requirements for preventing
unauthorized disclosure of export controlled information and technology
under DoD contracts. The proposed rule would add to DoD contracts
with universities and medical schools language requiring, among
other things, that the contractor maintain "unique badging
requirements for foreign nationals and foreign persons and segregated
work areas for export-controlled information and technology,"
with no reference to the fundamental research exemption. There is
also a requirement for periodic training on export compliance controls
for employees with access to controlled information and technology.
This proposed rules come on the heels of the Department of Commerce's
Advance Notice on Proposed Rulemaking on deemed exports [see Washington Highlights, April 1].
The DoD proposed rule is especially ominous in its absence of reference
to the fundamental research exemption and in its potential for further
inhibiting the participation of foreign students and scholars at
U.S. universities and medical schools. Comments on the rule are
due by Sept. 12.
Information:
Susan Ehringhaus, Sr. Director & Regulatory Counsel
AAMC Biomedical Health Sciences Research
sehringhaus@aamc.org
(202) 828-0543
Stephen Heinig, Lead Science Policy Analyst
AAMC Biomedical Health Sciences Research
sheinig@aamc.org
(202) 828-0488
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