Washington Highlights: May 26, 2006
Contents
Prior Issues
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AAMC Opposes Student Loan Rescissions
AAMC President Jordan J. Cohen, M.D., in a May 24 letter
urged the House and Senate Appropriations Committees not to approve
any further rescissions to the Title VII health professions student
loan programs. In each of the past two years, Congress has rescinded
the "unobligated balance" from the Health Professions
Student Loan, Primary Care Loan, Loans for Disadvantaged Students,
and Nursing Student Loan programs. In addition, the Administration's
FY 2007 budget proposes to recall the "Federal portion of all
of the liquid assets of such fund," which it estimates to be
over $100 million.
In the letter, Dr. Cohen asks appropriators to consider that the
demand for these affordable loans will increase in the coming years
as interest rates rise and that these programs pose no burden on
the American taxpayer. The letter also states, "Rescinding
funds from these programs not only neglects financially disadvantaged
and minority students, but also threatens the stability of our nation's
healthcare infrastructure."
Information:
Matthew Shick, Senior Legislative Analyst
AAMC Government Relations
mshick@aamc.org
(202) 862-6116
House Passes FY 2007 VA Appropriations
The House May 19 passed the FY 2007 Military Quality of Life and
Veterans Affairs appropriations bill (H.R.
5385). The bill includes $412 million for the VA Medical and
Prosthetic Research program, the same as in FY 2006. The VA minor
construction budget for FY 2007 is increased by $12 million to begin
upgrading VA medical research facilities nationwide.
The House bill does not specify funding for Gulf War Veteran's
Illness (GWVI) research. In the FY 2006 appropriation, Congress
dedicated $15 million for GWVI research, indicating in accompanying
report language that the appropriation was part of a 5-year commitment
to GWVI research.
The House bill includes $25.412 billion for VA Medical Services,
a $2.9 billion (12.7 percent) increase over FY 2006, but $100 million
below the President's request. $2.8 billion of the Medical Services
appropriation is dedicated to specialty mental health care, compared
to the $2.2 billion dedicated for this purpose in FY 2006. VA Medical
Administration is funded at $3.277 billion, a $419 million (14.7
percent) increase over FY 2006, and VA Medical Facilities receives
$3.954 billion, a $296 million (9 percent) increase over FY 2006.
The House-passed bill does not contain the Administration's proposed
enrollment fees and copays. The Senate has not yet scheduled consideration
of the VA appropriations bill.
Information:
Matthew Shick, Senior Legislative Analyst
AAMC Government Relations
mshick@aamc.org
(202) 862-6116
House Republican Letter Addresses Medicaid Documentation
Requirements
Rep. Rick Renzi (R-Ariz.) is circulating a Medicaid sign-on letter
among his House Republican colleagues. The letter to HHS Secretary
Michael Leavitt expresses concern about the Medicaid documentation
requirements established by Section 6036 of the Deficit Reduction
Act [P.L.
109-171]. Section 6036, which is effective July 1, requires
beneficiaries to provide specified "documentary evidence"
of citizenship or nationality, such as a U.S. passport or Certificate
of Naturalization.
The letter advises that the policy "could create enrollment
barriers for millions of low-income citizens who otherwise meet
all Medicaid eligibility requirements." It adds that the policy
should "minimize any negative impact on Medicaid beneficiaries
and the ability of states and healthcare providers to enroll patients
in the program."
According to the letter, many Native Americans lack paper birth
records, as do older Americans who were born at home. Citizens in
emergency situations, Alzheimer's patients, and homeless individuals
also could lack the appropriate documentation.
The AAMC May 12 sent a similar letter to Secretary Leavitt [see
Washington Highlights,
May 19]. The letter was also signed by the American Hospital
Association, Catholic Health Association of the United States, Federation
of American Hospitals, National Association of Children's Hospitals,
National Association of Public Hospitals and Health Systems, Premier,
and VHA Inc.
Information:
Christiane Mitchell, Senior Legislative Analyst
AAMC Government Relations
cmitchell@aamc.org
(202) 828-0526
House Committee Approves Preparedness Changes
The House Energy and Commerce Committee May 24 approved legislation
(H.R.
5438), which returns the National Disaster Medical System (NDMS)
to the Department of Health and Human Services (HHS) from the Department
of Homeland Security (DHS). NDMS was first moved from HHS when DHS
was created in 2002. The "Public Health and Medical Emergency
Coordination Act of 2006," sponsored by Committee Chairman
Joe Barton (R-Texas) and Ranking Member John Dingell (D-Mich.),
also designates HHS as responsible for coordinating the federal
government's response to medical emergencies, including bioterrorist
attacks.
The NDMS, currently housed within the Federal Emergency Management
Agency, was first created under the Public Health Security and Bioterrorism
Response Act of 2001 (P.L.
107-188). It is a collaborative effort among federal and state
agencies and private health entities, including hospitals, to provide
health services to victims of public health emergencies.
Information:
Erica Froyd, Director, Public Health and Research Legislative Affairs
AAMC Government Relations
efroyd@aamc.org
(202) 828-0525
Senate Panel Approves Ryan White Reauthorization
Bill
The Senate Health, Education, Labor and Pensions (HELP) Committee
May 17 approved legislation (S. 2823) to reauthorize the Ryan White
CARE Act (P.L.
101-381). Sponsored by HELP Committee Chairman Michael Enzi
(R-Wyo.) and co-sponsored by Ranking Member Edward Kennedy (D-Mass.),
the bill attempts to address changes in the AIDS epidemic since
the act's last reauthorization in 2000.
Specifically, the bill includes a provision to include the number
of HIV cases in addition to AIDS cases for funding formulas; requires
that 75 percent of funds be spent on "core medical services;"
and attempts to more evenly distribute funds between rural and urban
areas, a contentious issue among lawmakers. The committee voted
19-1 in favor of the measure, with Sen. Hillary Clinton (D-N.Y.)
voting against it on the grounds that New York will lose $20 million
under the new formula.
Information:
Tannaz Rasouli, Senior Legislative Analyst
AAMC Government Relations
trasouli@aamc.org
(202) 828-0525
CMS Updates PPAC on Pay-for-Performance
The Centers for Medicare and Medicaid Services (CMS) May 22 updated
the Practicing Physicians Advisory Council (PPAC) on its pay-for-performance
metrics. Specifically, the staff outlined the analytic work that
CMS is conducting to measure efficiency and resource use. In addition,
CMS provided an update on the physician voluntary reporting program
(PVRP), which encourages physicians to report
voluntarily on quality measures through administrative claims data.
CMS staff also reported that they expected an initial release of
the proposed rule for the 2007 physician fee schedule in May. The
proposed rule will list the projected changes to the work component
of the physician fee schedule as part of the 5-year review required
by law. In addition, CMS will outline the proposed methodology to
calculate the practice expense (PE) component of the fee schedule.
Overall, the work component accounts for approximately half of the
physician payment, PE accounts for about 45 percent, and professional
liability accounts for the final 5 percent.
Other topics discussed include updates on Physicians Regulatory
Issues Team (PRIT) activities, Medically Unbelievable Edits (MUEs),
and disease management demonstrations.
Information:
Denise Dodero, Sr. Director, Health Care Affairs
AAMC Health Care Affairs
ddodero@aamc.org
(202) 828-0493
Mary Patton, Senior Specialist
AAMC Health Care Affairs
mpatton@aamc.org
(202) 862-6297
HHS Seeks Information on Storage of Personal Information
in Emergencies
The Department of Health and Human Services (HHS) May 23 published
a request for information (RFI) about the availability or feasibility
of private sector services that store personal informal in the event
of an emergency, such as Hurricane Katrina. HHS is seeking a synthesis
of ideas and does not intend this request to be part of any procurement
process.
The RFI
poses a series of questions related to: approach, finance, sustainability,
and roles; function, capabilities, and performance; rights, rules,
responsibilities, and enforcement; security and standards; and potential
federal roles. Respondents are asked to differentiate between already
existing capabilities and those which are planned or desirable in
the future. Responses must be submitted by July 24.
Information:
Ivy Baer, Director & Regulatory Counsel
AAMC Health Care Affairs
ibaer@aamc.orc
(202) 828-0490
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