Washington Highlights: March
16, 2007
AAMC Issues Letter of Support for "Resident
Physician Shortage Reduction Act"
Contents
Prior Issues
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AAMC President Darrell Kirch, M.D., March 14 sent a letter to Senator Bill Nelson (D-Fla.) and Senate Majority Leader Harry
Reid (D-Nev.) in support of the "Resident Physician Shortage
Reduction Act of 2007" (S.588).
The bill 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 [see Washington
Highlights, Feb. 23].
The AAMC believes the bill is a "positive beginning that will
help meet the nation's need for future physician services."
The letter states, "We express our support for this important
first step in what we hope will be an ongoing movement towards eliminating
the Medicare resident cap." The letter also asserts the AAMC
would not support the legislation if the bill would be financed
"from other cuts in Medicare payments in which we have an interest.
We are hopeful that Congress will work to maintain current levels
of support related to GME in Medicare and Medicaid so there is no
further deterioration of the academic medical community's ability
to educate the nation's future physician workforce." The letter
expresses concern about the bill's residency position allocation
process, which gives "too much discretion" to the Secretary
of Health and Human Services.
A similar letter was sent to Reps. Kendrick Meek (D-Fla.), Jon
Porter (R-Nev.) , and Kathy Castor (D-Fla.) regarding the House
companion bill, H.R.
1093, introduced Feb. 15.
Information:
AAMC Government Relations
AAMC Comments on Proposed Student Loan Regulations
The AAMC March 8 sent a comment letter to the Department
of Education's Negotiating Committee for Student Loan regarding
proposed draft regulations that were released Jan. 27. The draft regulations would require that preferred lender lists used by financial aid
administrators to recommend student loan companies have at least
three non-affiliated lenders. Additionally, financial aid administrators
must provide explanation of how these lists are developed and comparative
information about the interest rates and benefits of the preferred
lenders.
The AAMC letter explains the benefits of institution-lender relationships
and cautions the committee that regulations "need to be carefully
crafted so they do not inadvertently encourage lenders to circumvent
well-established safeguards and market directly to student without
the guidance of trained professional." The letter urges the
negotiating committee to minimize any resulting reporting requirements
by incorporating them into the Fiscal Operations Report and Application
to Participate (FISAP).
Information:
Matthew Shick, Senior Legislative Analyst
AAMC Government Relations
mshick@aamc.org
(202) 862-6116
House Committee Approves FY 2007 Supplemental
The House Appropriations Committee March 15 approved a $124 billion
FY 2007 supplemental war spending bill, which is over $20 billion
more than the President's request. The bill passed 36-28 along party
lines with the exception of Rep. Barbara Lee (D-Calif.).
The supplemental proposed nearly $1 billion in funds for pandemic
flu preparedness. Of this, $870 million are designated for the development
and purchase of vaccine, antivirals, necessary medical supplies,
diagnostics, and other surveillance tools. The measure also provides
$34.7 million to the Centers for Disease Control and Prevention
for laboratory diagnostics and analytical capabilities, $65 million
for global pandemic preparedness and training through the office
of the Department of Health and Human Services Assistant Secretary
for Preparedness Response, and $50 million for the compensation
fund established by the Public Readiness and Emergency Preparedness
Act (Division C of P.L.
109-148). The measure also transfers $49.5 million from the
National Institute for Allergy and Infectious Diseases to the Public
Health and Social Services Emergency Fund for advanced research
and development of biodefense countermeasures, as directed in the
Pandemic and All Hazards Preparedness Act (P.L.
109-417).
The bill provides an additional $35 million for the VA Medical
and Prothetic Research program. It is expected that these funds
will be designated for research on conditions that are prevelant
among veterans returning from Operations Iraq and Enduring Freedom.
During the markup, the committee approved by a voice vote an amendment
proposed by Appropriations Defense Subcommittee Chair John Murtha
(D-Pa.), providing $750 million for the State Children's Health
Insurance Program (SCHIP). The Senate Appropriations Committee plans
to markup the supplemental measure on March 22.
Information:
Tannaz Rasouli, Senior Legislative Analyst
AAMC Government Relations
trasouli@aamc.org
(202) 828-0525
Christiane Mitchell, Director, Federal Affairs
AAMC Government Relations
cmitchell@aamc.org
(202) 828-0526
Senate Budget Committee Approves FY 2008 Resolution
The Senate Budget Committee March 15 approved, 12-11, an FY 2008
budget resolution. Committee Chair Kent Conrad (D-N.D.) proposed
a "Chairman's
Mark" that would result in a budget surplus of $132 billion
by FY 2012. Chairman Conrad's plan would provide additional funding
for certain priorities including children's health, Medicare physician
payments, education, and veterans. The vote is expected to be close
when the budget resolution is considered on the Senate floor the
week of March 19.
The resolution includes $15 billion in Medicare savings over five
years by reducing certain overpayments to health care providers.
The savings is “a down payment to reign in excessive growth
in health care costs” and will improve efficiency, quality,
and value in the Medicare program, without harming seniors’
access to care. The Chairman’s Mark also rejects the President’s
proposal for additional arbitrary across-the-board provider payment
cuts if general revenue financing exceeds 45 percent of Medicare
costs in the future. It also includes deficit-neutral reserve funds
to increase Medicare physician payments and establish a new "comparative
effectiveness" initiative. The Mark identifies $383 million for
efforts to reduce Medicare waste, fraud, and abuse.
The budget calls for a deficit-neutral reserve fund of up to $50
billion for the reauthorization of the State Children's Health Insurance
Program (SCHIP). These additional SCHIP funds will expand coverage
to the estimated six million children eligible, but not enrolled
in either SCHIP or Medicaid, and maintain coverage for all currently
enrolled children.
The budget provides an increase for discretionary funding for the
Department of Education of $6.1 billion (including $2 billion in
additional 2009 advance appropriations) above the President's request.
And it calls for $43.1 billion for veterans in FY 2008, an increase
of $3.5 billion above the President's budget. Overall, the Chairman's
budget proposes to increase the cap on overall discretionary spending
by $18 billion above the President's request of $929.8 billion.
Information:
Dave Moore, Senior Director
AAMC Government Relations
dbmoore@aamc.org
(202) 828-0525
Representatives Express Opposition to Medicare
and Medicaid Hospital Cuts
Reps. Richard Neal (D-Mass.) and Phil English (R-Pa.) March 9 sent
a letter with 221
other Members of Congress to House Budget Committee leaders urging
them to reject cuts to Medicare and Medicaid hospital funding in
the FY 2008 budget resolution.
The letter detailed hospitals' growing cost pressures and negative
Medicare margins, stating, "We hope you will agree with MedPAC
and both include an inflation update for hospitals, and refrain
from recommending any cuts in hospital spending in Medicare or Medicaid,
which has even lower operating margins."
The letter was sent in anticipation of the committee marking up
its FY 2008 budget resolution the week of March 19. A similar letter
was sent March 1 to the Senate Budget Committee [see Washington
Highlights, March 9].
Information:
AAMC Government Relations
House Panel Passes Slate of Health Bills
The House Energy and Commerce Subcommittee on Health March 13 approved
a number of health-related bills: the "Stroke Treatment and
Ongoing Prevention Act" (H.R.
477), the "Trauma Care Systems Planning and Development
Act" (H.R.
727), and the "Genetic Information Nondiscrimination Act"
(H.R.
493). The full Energy and Commerce Committee March 15 approved
H.R. 477 and H.R. 727, clearing them for House floor consideration.
H.R. 477, introduced Jan. 16 by Reps. Lois Capps (D-Calif) and
Chip Pickering (R-Miss.), authorizes funding to conduct stroke education
campaigns; provides critical resources to implement stroke care
systems; establishes a clearinghouse to support community efforts
to improve stroke care; and offers medical professional development
programs in new stroke therapies. The AAMC signed a March 5 letter supporting passage of the legislation.
H.R. 727 was introduced Jan. 30 by Reps. Gene Green (R-Texas) and
Michael Burgess (R-Texas) and reauthorizes the trauma care systems
program, which received no funds in FY 2007. The program supports
trauma networks, which coordinate emergency care between hospitals,
directing the most seriously injured patients to hospitals best
equipped to handle them. The reauthorization bill changes the program
to make more than half the grants awarded on a competitive basis
to states for improving their trauma care systems to meet national
standards. The Senate Health, Education, Labor and Pensions committee
March 14 approved the companion bill (S.
657), which is sponsored by Senators Jack Reed (D-R.I.) and
Pat Roberts (R-Kan.).
The subcommittee's passage of H.R. 493 followed its approval Feb.
14 by the House Education and Labor Committee [see Washington
Highlights, Feb. 16].
During the markup, Republicans expressed concern that the bill was
being moved through too quickly, not allowing full examination of
its impact on business and insurance. Subcommittee Chair Frank Pallone
(D-N.J.) said he expected the bill to be considered by the full
committee the week of March 19.
Information:
Erica Froyd, Director, Public Health and Research Legislative Affairs
AAMC Government Relations
efroyd@aamc.org
(202) 828-0525
Rep. English Reintroduces Student Loan Tax Legislation
Rep. Phil English (R-Pa.) March 8 introduced the "Higher Education
Affordability and Equity Act of 2007" (H.R.
1407) to amend the Internal Revenue Code to expand certain tax
incentives for education. Among other provisions, the bill:
- repeals the current $2,500 limitation on deductions of interest
paid on qualified educational loans;
- increases the income levels that trigger an eligibility phase
out to between $100,000-$115,000 ($200,000-$230,000 for joint
returns); and
- excludes amounts received as part of a scholarship, fellowship
or grant from taxable income if used for qualified higher education
expenses for undergraduate and graduate students.
The AAMC Jan. 14, 2005, joined 49 health and education organizations
in endorsing this legislation
when it was originally introduced as the "Higher Education
Affordability and Equity Act of 2003" (H.R.
3412) in the 108th Congress. The AAMC has reaffirmed its support of the bill in the 109th (H.R.1380)
and 110th Congresses.
Information:
Matthew Shick, Senior Legislative Analyst
AAMC Government Relations
mshick@aamc.org
(202) 862-6116
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