Washington Highlights: February
23, 2007
Contents
Prior Issues
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Senators Introduce Legislation to Increase Medicare
Resident Caps
Senate Majority Leader Harry Reid (D-Nev.) and Senators Bill Nelson
(D-Fla.) and Joe Biden (D-Del.) Feb. 14 introduced legislation (S.
588) that would increase the number of residency positions for
which Medicare payments will be made to teaching hospitals in states
with a shortage of resident physicians.
Entitled the "Resident Physician Shortage Reduction Act,"
S. 588 would allow teaching hospitals in states that have resident
physician to 100,000 population ratios below the national median
to be eligible to increase their resident caps, pending an allocation
method determined by the Secretary of Health and Human Services.
According to the bill's formula, teaching hospitals in 24 states
would be eligible to receive additional resident cap slots.
The Secretary is required to take into account whether the hospital
will be able to fill the positions over a 3-year period, as well
as whether the filled positions will be in primary care, preventive
medicine, or geriatrics. The total number of additional cap slots
granted to teaching hospitals in each eligible state could not exceed
25 percent of the number of residents needed to increase that state
up to the national median. Overall, approximately 1,200 additional
cap slots would be added to the national resident limit. Increases
in the number of positions eligible for federal funding would be
phased in over a 5-year period.
In his introductory statement, Senator Nelson stated, "We
believe this legislation is a critical first step towards ensuring
an adequate supply of physicians in our health care system."
A companion bill is expected to be introduced in the House shortly.
Information:
Lynne Davis Boyle, Assistant Vice President
AAMC Government Relations
ldavisboyle@aamc.org
(202) 828-0526
Bipartisan Senate Letter Urges Halt to Proposed
Rule
A bipartisan group of 43 senators signed a Feb. 15 letter
to Senate Finance Committee Chairman Max Baucus (D-Mont.) and Ranking
Member Charles Grassley (R-Iowa) expressing "serious concern"
about a Jan.18 proposed rule that would "clarify" the
Medicaid statute regarding intergovernmental transfers (IGTs), certified
public expenditures (CPEs), and reimbursement for governmentally
operated providers [see Washington
Highlights, Jan. 19].
The proposed rule would cut an estimated $3.87 billion from the
Medicaid program over 5 years.
Circulated by Senators Richard Durbin (D-Ill.) and Elizabeth Dole
(R-N.C.), the letter urges Senators Baucus and Grassley to "work
with us to...prevent CMS from moving forward with the implementation
of this rule" via "an appropriate legislative vehicle."
The letter also criticizes the Administration for making "major
policy changes" to the Medicaid program "while disregarding
congressional input." Among the 43 signatures on the letter
are 7 Finance Committee Democrats, as well as 13 Republicans. A
similar letter was circulated in the House of Representatives and
is expected to be finalized soon.
Information:
Christiane Mitchell, Senior Legislative Analyst
AAMC Government Relations
cmitchell@aamc.org
(202) 828-0526
House, Senate Letters Request Title VII Program
Extension
Letters sent Feb. 16 from Members of Congress to Secretary of Health
and Human Services (HHS) Mike Leavitt and Health Resources and Services
Administration chief Betty Duke requested that HHS extend by 1 year
the no-cost extensions granted to the Title VII-supported Centers
of Excellence (COE) and Health Careers Opportunity Program (HCOP).
The programs' funding was eliminated in the FY 2006 budget and was
not restored in FY 2007. The House letter
has 52 signers, while the Senate letter
has 19.
The letters, organized by Rep. Joseph Crowley (R-N.Y.) and Senator
Richard Durbin (D-Ill.), state that one benefit of extending the
no-cost extension for COEs and HCOPs is eliminating "the need
to resubmit applications should funding become available for the
programs in the future." Additionally, retaining grantee status
allows the programs "to leverage additional sources of federal,
state and institutional funding," specifically, COEs are able
to apply for the endowment program administered by the National
Institutes of Health's National Center on Minority Health and Health
Disparities.
Information:
Erica Froyd, Director, Public Health and Research Legislative Affairs
AAMC Government Relations
efroyd@aamc.org
(202) 828-0525
Senators Introduce Bill to Freeze Rehab Rule
Senators Ben Nelson (D-Neb.), Jim Bunning (R-Ky.), Debbie Stabenow
(D-Mich.), Olympia Snowe (R-Maine), John Kerry (D-Mass.), Susan
Collins (R-Maine), Jack Reed (D-R.I.), Hillary Clinton (D-N.Y.),
and Robert Menendez (D-N.J.), Feb. 12 introduced the "Preserving
Patient Access to Inpatient Rehabilitation Hospitals Act of 2007"
(S.
543).
According to Senator Nelson's introductory statement, the bill
would "make changes to a rule issued by the Centers for Medicare
and Medicaid Services that has restricted the ability of rehabilitation
hospitals to provide critical care." S. 543 would permanently
"lock in" the current 60 percent compliance threshold
required of inpatient rehabilitation facilities' (IRF) patient populations.
The regulation, commonly known as the "75 percent rule,"
will require at least 75 percent of an IRF's patient population
to have 1 of 13 designated medical conditions for which intensive
inpatient rehabilitation services are medically necessary. The current
60 percent threshold is scheduled to increase to 65 percent on July
1, 2007, and to 75 percent on July 1, 2008.
A companion bill sponsored by Reps. John Tanner (D-Tenn.), Nita
Lowey (D-N.Y.), Kenny Hulshof (R-Mo.), and Frank LoBiondo (R-N.J.)
will be introduced in the House shortly.
Information:
Lynne Davis Boyle, Assistant Vice President
AAMC Government Relations
ldavisboyle@aamc.org
(202) 828-0526
AAMC Supports FAFSA Drug Question Elimination
The AAMC Feb. 21 signed a letter
with 170 organizations under the Coalition for Higher Education
Act Reform, urging Members of Congress to co-sponsor and pass the
soon-to-be-introduced Removing Impediments to Students' Education
(RISE) Act, sponsored by Rep. Barney Frank (D-Mass.). The bill would
reinstate aid to aspiring students by removing the confusing drug
conviction question from the Free Application for Federal Student
Aid (FAFSA).
The letter cites a Advisory Committee on Student Financial Assistance
report
that called the question "irrelevant" to determining eligibility
and stated the "questions add complexity to the form and can
deter some students from applying for financial aid."
Information:
Matthew Shick, Senior Legislative Analyst
AAMC Government Relations
mshick@aamc.org
(202) 862-6116
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