Washington Highlights: January 27,
2006
Contents
Prior Issues
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Research Resources Advisory Council Examines BIRN
The advisory council of the National Institutes of Health's (NIH)
National Center on Research Resources (NCRR) met Jan. 19 and focused
its public session on a review of the Biomedical Informatics Research
Network (BIRN) launched in 2001. The network and component research
programs include a coordinating center at the University of California-San
Diego (UCSD) and several "test bed" projects at collaborating
institutions focused on aspects of neurological disease, including
brain morphology, functional imaging of schizophrenia, and multi-scale
mouse models of disease.
Presenters were Bruce Rosen, M.D., Ph.D., Harvard Medical School;
Mark Ellisman, Ph.D., UCSD; Steven Potkin, M.D., UC-Irvine; and
Arthur Toga, Ph.D., UCLA (Drs. Ellisman and Toga are also council
members). They discussed how BIRN's participating researchers are
developing useful resources and tools, such as techniques for re-calibrating
data collected by magnetic resonance imaging (MRI) scanners so that
images created on different scanners can be reliably compared. Researchers
have also developed a tool that automatically de-identifies images
of human subjects recorded from MRI or other instruments.
Information:
Stephen Heinig, Lead Science Policy Analyst
AAMC Biomedical Health Sciences Research
sheinig@aamc.org
(202) 828-0488
CMS Publishes Psychiatric and Long-Term Care
PPS Proposed Rules
The Centers for Medicare and Medicaid Services (CMS) published
in the Jan.
23 Federal Register its annual Medicare proposed rule for the
inpatient psychiatric facility (IPF) prospective payment system
(PPS). CMS released Jan. 19 on its web site its annual Medicare
proposed rule for the long-term care hospital (LTCH) PPS; the proposed
rule is scheduled to be published in the Jan.
27 Federal Register. If finalized, changes in both proposed
rules would be effective for discharges occurring from July 1, 2006,
through June 30, 2007 (know as "rate year" (RY) 2007).
For inpatient psychiatric facilities, CMS is proposing that the
PPS payment rate be updated by 4.5 percent. This increase is based
on a new "market basket" definition reflecting the cost
structures of inpatient rehabilitation facilities, inpatient psychiatric
facilities, and long-term care facilities. In the past, updates
were based on a market basket calculated to reflect the costs of
those facilities as well as cancer and children's hospitals. Most
IPFs are in the second year of a transition from a cost-based payment
system to a prospective payment system; currently they receive a
blended payment consisting of 50 percent of the cost-based payment
and 50 percent of the IPF PPS payment. The 4.5 percent update applies
only to the IPF PPS payments; the cost-based portion will be updated
by 4.8 percent.
Due to a technical error, CMS believes that total payments for
the first year of the IPF PPS (which began January 1, 2005), were
underestimated by about 1.36 percent. CMS is proposing to correct
this error by reducing the federal per-diem base rate that will
be updated for 2007. The agency is proposing to retain the current
teaching adjustment of 5.15 percent to the federal per-diem base
rate.
CMS is proposing a zero percent update for the LTCH PPS. The agency
believes that a freeze is appropriate because current payments are
"more than adequate" to account for 2007 price increases
in the services furnished by LTCHs. CMS believes its decision is
supported by the Medicare Payment Advisory Commission's (MedPAC)
analyses showing a rapid growth in the number of LTCHs, an increase
in beneficiaries' access to care and an increase in Medicare margins.
According to MedPAC's recent findings, LTCHs received margins of
8.8 percent for FY 2003 (the first year of the LTCH PPS) and 11.7
percent for FY 2004.
Currently, there is no indirect medical education (IME) adjustment
in the LTCH PPS. Because the LTCH PPS has only been in existence
for slightly over three years, and there is a five-year transition
period going from a reasonable cost-base payment system to a 100
percent prospective payment system, CMS does not believe that it
has sufficient data to conduct analyses that would enable it to
determine whether it should include an IME adjustment.
However, at the end of the five-year transition period (that is,
after RY 2007), CMS believes it will have acquired sufficient data
to be able to study the need for an IME adjustment as well as adjustments
for geographic reclassification, rural location and disproportionate
share of low-income patients (DSH).
Comments for the IPF PPS proposed rule are due March 14, 2006,
and those for the LTCH PPS proposed rule are due 60 days after the
date of publication in the Federal Register.
Information:
Karen Fisher, Sr. Director, Health Care Affairs
AAMC Health Care Affairs
kfisher@aamc.org
(202) 862-6140
Diana Mayes, Specialist
AAMC Health Care Affairs
dmayes@aamc.org
(202) 828-0498
Senators Introduce National Science Competitiveness
Legislation
Sens. Pete Domenici (R-N.M.), Jeff Bingaman (D-N.M.), Lamar Alexander
(R-Tenn.), and Barbara Mikulski (D-Md.) Jan. 25 introduced the "Protecting
America's Competitive Edge (PACE) Act", a bipartisan package
focused on strengthening America's competitiveness as a global scientific
and technological powerhouse. Consisting of three bills (PACE-Energy
(S.
2197), PACE-Education (S.
2198) and PACE-Finance (S.
2199)), the package strives to increase investments in basic
research in the physical sciences, to improve science and math training
across all levels of education and to foster innovation through
tax incentives.
In May 2005, Alexander and Bingaman asked the National Academies
of Sciences and Engineering and the Institute of Medicine to examine
the issue of scientific competitiveness, resulting in the report
"Rising
Above the Gathering Storm" The PACE Act incorporates the
20 recommendations outlined in the report.
Rep. Bart Gordon (D-Tenn.) Dec. 16 introduced a bill based on the
National Academies' report (H.R.
4596). Similar legislation also was introduced Dec. 15 by Sens.
John Ensign (R-Nev.) and Joe Lieberman (D-Conn.) (S.
2109); however, it is based on a July report released by the
Council on Competitiveness.
Information:
Tannaz Rasouli, Legislative Assistant
AAMC Office of Governmental Relations
trasouli@aamc.org
(202) 828-0457
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