Washington Highlights: May 12, 2006
Contents
Prior Issues
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Leadership Still Negotiating House Budget Resolution
House Majority Leader John Boehner (R-Ohio) announced late in
the day on May 11 that he would not bring the FY 2007 budget resolution
(H.Con.Res.
376) to the floor for a vote, as anticipated. He hopes to bring
it to the floor next week.
The budget approved by the House Budget Committee March 29 includes
the $873 billion discretionary spending cap proposed by the President
[see Washington Highlights,
March 31]. In response to the efforts of Republican moderates,
led by Reps. Mike Castle (Del.) and Nancy Johnson (Conn.), and the
combined advocacy of the health, education, and labor communities,
the House leadership agreed to move funds from defense and foreign
aid to domestic programs. On May 9, the House Appropriations Committee
approved its subcommittee allocations (also known as 302(b) allocations).
The Labor-HHS-Education subcommittee received an allocation of $141.9
billion, which is $843 million (0.6 percent) over the FY 2006 enacted
level and $4.136 billion (3 percent) more than the President proposed.
The AAMC joined more than 800 health, education, and labor organizations
on a May 8 letter
to the House Committee leadership. The letter, organized by the
Coalition for Health Funding and the Committee on Education Funding,
calls on Congress to add $7 billion to the budget in discretionary
funding for health, education, and labor programs.
Information:
Dave Moore, Senior Director
AAMC Government Relations
dbmoore@aamc.org
(202) 828-0525
NIH Seeks Comments on NRSA Policy Changes
The National Institutes of Health (NIH) May 3 announced it is seeking
comments
on proposed policy
changes to the Ruth L. Kirschstein National Research Service
Award (NRSA) program. The NIH is proposing changes to its policies
for funding tuition, fees, and health insurance for these awards,
arguing that these costs are increasing at rates that are beyond
NIH's fiscal capacity to sustain. The new policy would institute
a cap on the reimbursement of tuition and fees of $16,000 per year
for pre-doctoral trainees, $4,500 per year for post-doctoral trainees,
and $21,000 per year for trainees in a combined dual-degree training
program. The NIH also proposes providing an additional fixed amount
of funding toward reimbursement of health insurance costs.
The NRSA program supports individual and institutional training
grants at the pre-doctoral and post-doctoral levels. Last November,
AAMC submitted a comment letter
to NIH and was among the presenters at a Town Hall meeting convened
to address several NRSA changes then under consideration [see Washington
Highlights, Dec. 2,
2005].
Information:
Jodi Lubetsky, Staff Associate
AAMC Biomedical Health Sciences Research
jlubetsky@aamc.org
(202) 828-0485
MedPAC Chair and Vice Chair Reappointed
The Comptroller General of the United States has reappointed
the chair and vice chair and appointed four new members to the
Medicare Payment Advisory Commission (MedPAC),
an independent federal body that advises Congress on issues affecting
the Medicare program.
The Commission comprises 17 members who bring diverse expertise
in the financing and delivery of health care services. Commissioners
are appointed to three-year terms (subject to renewal) by the Comptroller
General and serve part time. Appointments are staggered; the terms
of five or six commissioners expire each year.
Despite already serving two terms (6 years) - the traditional length
of service of MedPAC commissioners - chair Glenn M. Hackbarth, J.D.,
and vice chair Robert D. Reischauer, Ph.D., each were reappointed
to another 3-year term. Mr. Hackbarth, currently an independent
consultant, was chief executive officer and one of the founders
of Harvard Vanguard Medical Associates, a multispecialty group practice
in Boston that serves as a major teaching affiliate of Harvard Medical
School. He also has held positions at the Department of Health and
Human Services, including deputy administrator of the Health Care
Financing Administration (now Centers for Medicare and Medicaid
Services). Dr. Reischauer is the president of The Urban Institute
and was director of the Congressional Budget Office (CBO) from 1989
to 1995.
The newly appointed members, whose terms will expire in 2009, are:
- Mitra Behroozi, J.D., executive director of 1199SEIU Benefit
and Pension Funds, where she oversees eight major benefit and
pension funds for health care workers;
- Karen R. Borman, M.D., professor of surgery and vice chair
for surgical education at the University of Mississippi Medical
Center;
- Ronald D. Castellanos, M.D., an independent practicing physician
specializing in urology in Fort Myers, Florida; and
- Douglas Holtz-Eakin, Ph.D., director of the Maurice R. Greenberg
Center for Geoeconomic Studies at the Council on Foreign Relations.
He served as director of the CBO from 2003 to 2005 and chief economist
for the President's Council of Economic Advisors from 2001 to
2002.
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
House Appropriations Committee Freezes VA Research
Funding
The House Committee on Appropriations May 10 approved a $94.7 billion
FY 2007 spending bill for the Department of Veterans Affairs (VA).
The bill includes 25.4 billion for Medical Services, a $2.6 billion
increase over FY 2006, but $100 million below the President's request.
During the mark-up, this $100 million was shifted from Medical Services
to Medical Administration to "ensure that care is being administered
effectively and to help avoid potential shortfalls in funding."
The bill does not contain the Administration's proposed copays and
enrollment fees.
The FY 2007 VA Medical and Prosthetics Research program is frozen
at $412 million despite an amendment offered by Rep. David Price
(R-N.C.) that would have added an additional $23 million. The proposed
amendment failed on a party line vote. The minor construction budget
is increased by $12 million to start upgrading VA medical research
facilities nationwide.
Information:
Matthew Shick, Senior Legislative Analyst
AAMC Government Relations
mshick@aamc.org
(202) 862-6116
Senate Republicans Pull Medical Liability Bills
Senate leaders May 8 pulled two Republican-supported medical liability
reform bills [see Washington
Highlights, May 5] from
consideration on the Senate floor, following two unsuccessful votes
to invoke cloture and avert filibusters.
The 48-42 vote to limit debate over the "Medical Care and
Access Protection Act of 2006" (S.
22) fell short of the 60 votes needed to invoke cloture. The
cloture vote on the bill, which was introduced by Sen. John Ensign
(R-Nev.), was split primarily along party lines, with three Republicans
voting against cloture: Sens. Richard Shelby (Ala.), Lindsey Graham
(S.C.), and Mike Crapo (Idaho). Republican Sens. Sam Brownback (Kan.),
Conrad Burns (Mont.), Tom Coburn (Okla.) and John McCain (Ariz.)
did not vote.
A subsequent 49-44 vote to limit debate over the "Healthy
Mothers and Healthy Babies Access to Care Act" (S.
23) also fell short of the required 60 votes. Sens. Shelby,
Graham, and Crapo voted against cloture for S. 23, which had been
introduced by Sen. Rick Santorum (R-Pa.). Republican Sens. Brownback,
Burns, and McCain did not vote.
As a member of the Health Coalition on Liability and Access (HCLA),
the AAMC has endorsed S. 22 and S. 23.
Information:
Christiane Mitchell, Senior Legislative Analyst
AAMC Government Relations
cmitchell@aamc.org
(202) 828-0526
CMS Publishes Medicare Psychiatric Facility Final
Rule
The Centers for Medicare and Medicaid Services (CMS) May 9 published
its annual Medicare final
rule for the inpatient psychiatric facility (IPF) prospective
payment system (PPS) in the Federal Register. Changes will be effective
for discharges occurring July 1, 2006, through June 30, 2007 (known
as "rate year" (RY) 2007).
Under the final rule changes, CMS estimates that Medicare payments
to psychiatric facilities will increase by 4.0 percent in RY 2007.
Major teaching psychiatric facilities will see a 4.3 percent average
increase in payments compared to a 3.8 percent increase for non-teaching
psychiatric facilities.
For RY 2007, CMS retains the current teaching adjustment of 5.15
percent to the federal per diem base rate. The final rule also defines
a new graduate medical education (GME) program as a medical education
program that received initial accreditation by the appropriate accrediting
body or begins training residents on or after Nov. 15, 2004.
CMS increases the fixed-dollar loss threshold amount for outlier
payments from $5,700 to $6,200 to keep the overall estimated outlier
payments at two percent of total payments.
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
HRSA Announces Personnel Changes
Elizabeth Duke, Ph.D., Administrator of the Health Resources and
Services Administration (HRSA), announced May 9 that Bureau of Primary
Health Care Associate Administrator Michelle Snyder will be Associate
Administrator of the Bureau of Health Professions, effective May
28. Current head of health professions, Kerry Nesseler, will be
the first director of the new Office of Commissioned Corps Affairs,
effective May 15. The Bureau of Health Professions administers the
Title VII and VIII health professions and nursing education and
training programs.
Additionally, National Health Service Corps (NHSC) Acting Director
Jennifer Burks will serve as a senior policy analyst in the HRSA
Office of Planning and Evaluation. A new NHSC director is not named.
Dr. Duke states these changes are designed to realign HRSA leadership,
noting that "the (HHS) Secretary has already announced a major
transformation of the commissioned corps and other changes to our
operations are likely to result from the Department's response to
the White House recommendations on emergency preparedness."
Information:
Erica Froyd, Director, Public Health and Research Legislative Affairs
AAMC Government Relations
efroyd@aamc.org
(202) 828-0525
FDA, APHIS and NIH Sign MOU to Promote Laboratory
Animal Care
The Food and Drug Administration (FDA), Animal and Plant Health
Inspection Service (APHIS), and the National Institutes of Health
(NIH) have announced a Memorandum of Understanding (MOU) regarding
the framework for reciprocal cooperation that will assist each agency
in meeting its responsibilities in promoting laboratory animal care
and welfare. The MOU, which became effective Feb.14, was published
in the May 3 Federal
Register (71 FR 26095). The substance of the agreement provides
for the sharing of information
between the individual agencies regarding animal welfare matters.
Specifically, FDA, APHIS and NIH agree:
- To share information contained in their respective registries/inventories/listings
of organizations that fall under their purview.
- To provide one another with information concerning significant
adverse findings regarding animal care and use at organizations
investigated, inspected, or site-visited, and the actions taken
by the agency in response to the findings.
- To provide one another with information regarding evidence
of serious noncompliance with required standards or policies for
the care and use of laboratory animals at organizations that fall
under the authority of the participating agencies.
- To coordinate successive evaluations and to avoid redundant
evaluations of the same entities.
- To consult and coordinate with each other on regulatory or
policy proposals and significant policy interpretations involving
animal care and use under consideration by each agency, and
- To provide each other with resource persons for scientific
and educational seminars, speeches, and workshops related to laboratory
animal welfare.
Information:
Tony Mazzaschi, Senior Associate Vice President
AAMC Biomedical Health Sciences Research
tmazzaschi@aamc.org
(202) 828-0059
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