Washington Highlights: December
9, 2005
Contents
Prior Issues
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AAMC Signs Letter Opposing Student Loan Rescissions
The AAMC, along with 40 health organizations, sent a letter
Dec. 5 to House and Senate Appropriators, urging them to reject
the Administration's proposed rescissions to the Title VII and VIII
health professions student loan programs. The Administration submitted
to Congress Oct. 28 a package
of rescission requests to offset hurricane relief efforts [see Washington
Highlights, Nov. 4]. Included
is a proposal to rescind funds from Health Profession Student Loan
(HPSL), Primary Care Loan (PCL), Loans for Disadvantaged Students
(LDS), and Nursing Student Loan (NSL) programs, which are administered
by the Health Resources and Services Administration (HRSA).
The letter states, "Reclaiming the original federal contribution
to these programs reneges on a national commitment to support a
well-educated, well-distributed supply of health professionals who
deliver care in our most needy communities. Eliminating these programs
will not only neglect financially disadvantaged and minority students,
but also threaten the stability of our nation's healthcare infrastructure."
Congress reportedly intends to include the proposals in the next
hurricane relief package, which is expected to be attached to the
FY 2006 Defense Appropriations bill.
Information:
Matthew Shick, Senior Legislative Analyst
AAMC Government Relations
mshick@aamc.org
(202) 862-6116
Erica Froyd, Director, Public Health and Research Legislative Affairs
AAMC Government Relations
efroyd@aamc.org
(202) 828-0525
House Agrees to Return HHS Funding Bill to Conference
The House of Representatives Dec. 7 agreed to send the FY 2006
Labor-HHS-Education appropriations bill (H.R.
3010) back to a conference with the Senate. The House rejected
the initial conference report on the bill (H.
Rept. 109-300) Nov. 17 by a 209-224 vote. Twenty-two Republicans
voted against the conference report, with some objecting to reductions
in rural health programs and others concerned about insufficient
increases in education spending.
H.R. 3010 includes $142.5 billion in discretionary funding. The
House leadership has rejected the idea of adding additional discretionary
funds to the bill, and hopes to persuade moderate Republicans to
support a revised conference agreement by shifting small amounts
of funds to rural health programs
The Senate voted Nov. 18 to instruct its conferees to designate
the $2.2 billion in the bill for the Low Income Home Energy Assistance
Program (LIHEAP) as emergency spending, thus freeing funds under
the bill's spending cap for other purposes, and to restore the 3.7
percent increase recommended for NIH in the Senate version of the
bill. The House rejected two motions by Rep. David Obey (D-Wis.)
to instruct its conferees to increase funding for LIHEAP.
The House appointed the following Members as conferees: Regula
(R-Ohio), Istook (R-Okla.), Wicker (R-Miss.), Northup (R-Ky.), Granger
(R-Texas), Peterson (R-Pa.), Sherwood (R-Pa.), Weldon (R-Fla.),
Walsh (R-N.Y.), Lewis (R-Calif.), Obey, Hoyer (D-Md.), Lowey (D-N.Y.),
DeLauro (D-Conn.), Jackson (D-Ill.), Kennedy (D-R.I.), and Roybal-Allard
(D-Calif.).
House and Senate conferees are expected to meet early the week
of Dec. 12 to revise the conference report.
Information:
Dave Moore, Senior Director
AAMC Government Relations
dbmoore@aamc.org
(202) 828-0525
GOP Leaders Outline New Budget Reconciliation
Target
Republican leaders have reportedly agreed to a House-Senate conference
budget reconciliation target of $45 billion in cuts over five years.
While conferees have yet to be named, House and Senate staff from
the committees with jurisdiction over the various titles of the
House-Senate budget reconciliation bills are reportedly "pre-conferencing"
before the Senate returns from recess the week of Dec.12.
House and Senate leadership are reported to have directed health
committee chairs to find $7 billion in savings from the Medicare
program and $6 billion from the Medicaid program. The Senate-passed
budget reconciliation bill contains a net savings of $5.7 billion
over 5 years to Medicare and a net savings of $4.3 billion over
5 years in Medicaid. The House-passed budget reconciliation bill
contains $11.9 billion in net Medicaid savings over 5 years and
no cuts to the Medicare program.
Despite the many differences between the two bills beyond Medicare
and Medicaid, the House and Senate Republican leadership have resolved
to complete the conference before Christmas. Senate Majority Leader
Bill Frist (R-Tenn.) and House Speaker Dennis Hastert (R-Ill.) Dec.
2 released a joint statement commenting on the budget reconciliation
process: "The Republican leadership for both the U.S. House
and Senate are deeply committed to restraining spending, reforming
government so that it is more effective and efficient, and accomplishing
this task by the end of this year."
Information:
Lynne Davis Boyle, Assistant Vice President
AAMC Government Relations
ldavisboyle@aamc.org
(202) 828-0526
Bipartisan Bills Support Rural and Community
Residency Training
A bipartisan group of Senators and Representatives Nov. 18 introduced
legislation supporting residency training in community and rural
settings. Introduced by Sens. Olympia Snowe (R-Maine), Jeff Bingaman
(D-N.M.), Susan Collins (R-Maine), Byron Dorgan (D-N.D.), John Rockefeller
(D-W.Va..), and Reps. Kenny Hulshof (R-Mo.) and John Tanner (D-Tenn.),
the "Community and Rural Medical Residency Preservation Act
of 2005" (S.
2071/ H.R.
4473) will ensure that CMS regulations and guidance no longer
impede the ability of teaching programs to train resident physicians
in ambulatory and rural settings.
Specifically, the legislation clarifies that supervising physicians
would be allowed to volunteer their teaching time. It also ensures
that any teaching costs associated with supervising physicians who
are not volunteers would be based on negotiations between the hospital
and the non-hospital setting, rather than a complicated formula
requiring unreasonable administrative burdens on both the teaching
programs and non-hospital training settings.
The bills are based on an amendment (S.A. 2402) filed by Sen. Snowe
during the Senate floor debate on budget reconciliation. She was
unable to offer the amendment before final passage.
The AAMC endorsed the legislation and is seeking cosponsors for
the bills.
Information:
Lynne Davis Boyle, Assistant Vice President
AAMC Government Relations
ldavisboyle@aamc.org
(202) 828-0526
CMS Seeks PPAC Input On Quality Reporting
The Centers for Medicare and Medicaid Services (CMS) presented
Dec. 5 an overview of its new national quality demonstration, the
Physician Voluntary Reporting Program (PVRP), to the Practicing
Physician's Advisory Council (PPAC) at PPAC's quarterly meeting.
PVRP collects clinical information on 36 quality measures through
special codes on claims data and reports back to physicians and
physician group practices. CMS specifically requested input on:
physician reaction to using claims data; how to maximize physician
participation; other data sources or methods that could be used
to capture data; and whether hospital quality data could be used
to measure physician quality.
PPAC responded that claims data seemed the least burdensome data
collection method in the short run, since most physicians still
do not have Electronic Health Records (EHRs). It noted that there
will still be significant costs associated with collecting data
through claims, including educating coders, redesigning office flow,
and adjusting current claims processing software. To maximize participation,
CMS should implement pay-for-reporting, similar to the hospital
pay-for-reporting system, and assure the physician community that
the results will be confidential. Capturing data from electronic
records could be assisted if CMS identified standard data to be
collected and incorporated these into certification processes of
EHRs. Finally, PPAC did not consider hospital data sufficient to
measure physicians, in part because many physician services are
performed in an office or outpatient environment.
Other items covered at the meeting include: update on the previous
recommendations; update on Physician Regulatory Issues Team (PRIT);
overview of final physician fee and outpatient fee schedule; overview
of oncology demonstration project; and updates on competitive acquisition
program (CAP) and recovery audit contractors (RAC).
Information:
Mary Patton, Senior Specialist
AAMC Health Care Affairs
mpatton@aamc.org
(202) 862-6297
CBO Assesses Potential Influenza Pandemic Impact
In response to a request from Senate Majority Leader Bill Frist
(R-Tenn.), the Congressional Budget Office (CBO) Dec. 8 released
a paper
assessing the economic effects of a potential avian flu pandemic
and discussing preparedness policy options. The paper examines the
effects of both a severe pandemic, in which an estimated 2 million
people would die in the United States and the gross domestic product
(GDP) would decrease by about 5 percent, and a mild pandemic scenario,
in which about 100,000 die and GDP drops by 1.5 percent.
CBO notes that preparedness for an influenza pandemic is dependent
upon the nation's capacity to address public health emergencies,
which has been under increased scrutiny following the 2001 terrorist
attacks. The paper also asserts that the effectiveness of the nation's
response to an outbreak will depend not only on the federal government
but also on the state and local health authorities and the private
sector. In the longer term, the nation needs to significantly expand
its existing tools and resources to be adequately prepared for a
serious influenza pandemic.
Information:
Erica Froyd, Director, Public Health and Research Legislative Affairs
AAMC Government Relations
efroyd@aamc.org
(202) 828-0525
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