Washington Highlights: January
19, 2007
ContentsPrior Issues
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AAMC Urges Increased Health Professions Education
Funding
The AAMC signed two Jan. 12 letters urging Congressional leadership
to provide more funding for health and education programs in the
final appropriations for FY 2007. One letter,
organized by the Coalition for Health Funding, requests $7 billion
over the President's FY 2007 budget request for health and education
programs. Democrats and moderate Republicans in the 109th Congress
pushed for this amount in efforts led by Senators Arlen Specter
(R-Pa.) and Tom Harkin (D-Iowa) and Rep. Mike Castle (R-Del.). According
to the letter, the $7 billion would allow public health programs
under the Labor-HHS-Education Appropriations bill to be funded at
FY 2005 levels.
A second letter
organized by the Health Professions and Nursing Education Coalition
(HPNEC) urges House and Senate leadership to provide $155 million
over FY 2006 levels for Title VII health professions programs, to
return the programs to FY 2005 funding levels. The letter highlights
the 51.5 percent cut to the Title VII programs in FY 2006, including
the elimination or drastic reduction of funding for geriatric training,
rural training, primary care training, and the Health Careers Opportunity
Program and the Centers of Excellence diversity programs. Signers
emphasize that with the additional $155 million, "Congress
can revive the Title VII programs and avoid the far more costly
expense of losing these unique programs that help resolve systemic
workforce shortages and deliver care to our nation's most vulnerable
communities."
Information:
Erica Froyd, Director, Public Health and Research Legislative Affairs
AAMC Government Relations
efroyd@aamc.org
(202) 828-0525
Tannaz Rasouli, Senior Legislative Analyst
AAMC Government Relations
trasouli@aamc.org
(202) 828-0525
Proposed Rule Addresses Medicaid Financing
Policies
The Centers for Medicare and Medicaid Services (CMS) Jan. 18 published
a proposed rule (72 Federal Register 2236) to "clarify"
Medicaid statute regarding intergovernmental transfers (IGTs), certified
public expenditures (CPEs), and reimbursement for "governmentally
operated providers."
Under the proposed rule, state reimbursement to government-operated
providers could not exceed costs. The proposed rule (estimated to
cut Medicaid provider payments by $3.8 billion over five years)
would also narrow the types of entities that may be "involved
in the financing of the non-Federal share of Medicaid payments."
Additionally under the proposed rule, states would have to assure
the "appropriate documentation" of any CPEs used to fund
the non-federal share of Medicaid expenditures. A new regulation
in the proposed rule "explicitly" requires that Medicaid
providers "receive and retain the total computable amount of
their Medicaid payments."
President Bush had proposed similar "administrative proposals"
in his FY 2007 budget proposal [see Washington
Highlights, Feb. 10,
2006]. AAMC President Darrell Kirch, M.D., American Hospital
Association Executive Vice President Rick Pollack, and National
Association of Public Hospitals and Health Systems President Larry
Gage co-signed a Dec. 4 letter to current and incoming congressional
leaders expressing "concern with the administration's plan
to cut the Medicaid program through the regulatory process"
[see Washington Highlights,
Dec. 8, 2006].
Information:
Christiane Mitchell, Senior Legislative Analyst
AAMC Government Relations
cmitchell@aamc.org
(202) 828-0526
Genetics Nondiscrimination Bill Reintroduced
Reps. Louise Slaughter (D-N.Y.), Judy Biggert (R-Ill.), Anna Eshoo
(D-Calif.), and Greg Walden (R-Ore.) Jan. 16 introduced the Genetic
Information Non Discrimination Act (H.R.
493). The legislation, which has 143 sponsors, is identical
to the bill passed unanimously by the Senate in February 2005 [see
Washington Highlights,
Feb. 18, 2005]. The same bill also was introduced in the House
in the 109th Congress, but was held up in committee. In his remarks
at a NIH Roundtable on Advances in Cancer Prevention, President
Bush Jan. 17 urged the passage of legislation that makes genetic
discrimination illegal. He stated, "if a person is willing
to share his or her genetic information, it is important that that
information not be exploited in improper ways -- and Congress can
pass good legislation to prevent that from happening. In other words,
we want medical research to go forward without an individual fearing
of personal discrimination."
H.R. 493 seeks to prohibit discrimination on the basis of genetic
information with respect to health insurance and employment. The
bill also prevents employers and insurers from requiring applicants
to submit to genetic tests, requires the strict use and disclosure
requirements of genetic test information, and imposes penalties
against employers and insurers who violate these provisions.
Senate Health, Education, Labor, and Pensions Committee Chair Edward
Kennedy (D-Mass.) announced Jan. 18 that his committee would vote
Jan. 24 on genetics discrimination legislation drafted by Senator
Olympia Snowe (R-Maine). The Senate has passed similar bills in
2003 and 2005 on unanimous votes.
Information:
Erica Froyd, Director, Public Health and Research Legislative Affairs
AAMC Government Relations
efroyd@aamc.org
(202) 828-0525
Bush Signs NIH Reauthorization
President Bush Jan. 15 signed the National Institutes of Health
Reform Act of 2006 (H.R. 6164, P.L. 109-687). Congress approved
the bill in the final hours of the 109th Congress [see Washington
Highlights, Dec.
15, 2006]. The bill authorizes appropriations for NIH through
FY 2009, authorizes the restructuring of NIH's Institutes and Centers
under certain conditions, creates a "Common Fund" to promote
trans-NIH research, and redistributes funds for the State Children's
Health Insurance Program (SCHIP) that were unspent in FY 2004 and
FY 2005 to alleviate anticipated SCHIP funding shortages.
Information:
Dave Moore, Senior Director
AAMC Government Relations
dbmoore@aamc.org
(202) 828-0525
NRC Recommends Withdrawing OMB Risk Assessment
The National Research Council (NRC) Jan. 11 strongly recommended
that a proposed bulletin governing federal agency risk assessments
be withdrawn. The draft
bulletin was released in January 2006 by the Office of Management
and Budget (OMB) [see Washington
Highlights, Jan.
20, 2006] and would have set standards and requirements for
Federal agencies performing such assessments, usually as a prelude
to regulation or other decision making. A press release and summary
of the NRC report described the technical standards in OMB's proposed
bulletin as "fundamentally flawed," stating that the agency
was attempting to promote standards "beyond what previous reports
have recommended and beyond the current state of the science."
The committee also noted that OMB's definition of risk assessment
is too broad and "in conflict with long-established concepts
and practices."
In its comments on the bulletin last March, the AAMC
cautioned that the standards, as proposed and without qualification,
could interfere with critical decision making in the Public Health
Service, such as a determination by a data safety monitoring board
to intercede in a clinical trial.
In place of the proposed bulletin, the NRC recommends that the
OMB outline goals and general principles to guide federal agencies
in developing their own risk assessment guidelines and procedures.
Agencies should be encouraged to collaborate in respective areas
where risk assessments may overlap. The risk assessment bulletin
and the request for the NRC review were issued by the OMB's Office
for Information and Regulatory Affairs (OIRA), which in recent years
has established sweeping guidance on the quality of information
disseminated by Federal Agencies or used in rulemaking and policy.
Potentially complicating a final decision about the bulletin, OIRA
remains without a confirmed director. President Bush's nominee for
that position, Susan Dudley, is awaiting confirmation by the Senate,
but her nomination has been vigorously opposed by environmental
activists. The President Jan. 10 appointed Dudley to be a Senior
Advisor in the office, permitting her to begin work at OMB pending
confirmation.
Information:
Stephen Heinig, Lead Science Policy Analyst
AAMC Biomedical Health Sciences Research
sheinig@aamc.org
(202) 828-0488
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