Washington Highlights: March 30,
2007
House, Senate Approve Budget Resolutions
Contents
Prior Issues
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The House and Senate each approved their respective FY 2008 budget
resolutions. The House March 29 passed, 216-210, its plan (H.Con.Res.
99) [see Washington Highlights,
March 23], with 12 Democrats voting against the measure. The
measure sets a $1.1 trillion cap on discretionary spending and projects
a $153 billion surplus in 2012 by observing strict pay-as-you-go
budget rules. Alternatives proposed by Republicans, the Congressional
Black Caucus, and progressive Democrats were all defeated.
The Senate March 23 passed its version (S.Con.Res.21)
by a vote of 52 to 47 [see Washington
Highlights, March 16].
The Senate also cleared by voice vote an amendment sponsored by
Labor, Health and Human Services, and Education Appropriations Subcommittee
Chair Tom Harkin (D-Iowa) and ranking member Arlen Specter (R-Pa.)
to increase the amount provided for Function 550 discretionary health
programs by $2.2 billion. The amendment specifies restoring National
Institutes of Health funds to the FY 2005 inflation-adjusted level,
an increase of $3.5 billion; increasing funds for the Centers for
Disease Control and Prevention for facilities construction and revitalization;
and restoring funds for the Title VII health professions programs
to their FY 2005 levels. Unlike the House version, the Senate bill
also was amended to spend its projected FY 2012 surplus on tax cut
extensions and children's health care.
House Democrats hope to conference with the Senate by May 1.
Information:
Dave Moore, Senior Director
AAMC Government Relations
dbmoore@aamc.org
(202) 828-0525
House, Senate Pass FY 2007 Supplemental
The House March 23 (218-212) and Senate March 29 (51-47) passed
their respective versions of the "U.S. Troop Readiness, Veterans'
Health, and Iraq Accountability Act, 2007" (H.R.
1591). The Senate provides $123.2 billion for the emergency
war spending measure, $1.5 billion greater than the House.
Both the House [see Washington
Highlights, March 16]
and Senate [see Washington Highlights,
March 23] provide funding for domestic programs such as the
State Children's Health Insurance Program (SCHIP), the Department
of Veterans Affairs Medical and Prosthetic Research, and transfers
from the National Institutes of Health for biodefense research programs.
In the Senate, a manager's amendment that was adopted by voice
vote included language that would prevent the reorganization or
relocation of the Armed Forces Institute of Pathology (AFIP) until
the Secretary of Defense submits a plan and timetable for such action.
The language directs the Secretary to submit the plan by Dec. 31,
2007, and to take into account the recommendations of an upcoming
Government Accountability Office report that analyzes the impact
of dismantling AFIP's various functions. Another amendment provides
for a moratorium on certain Medicaid provisions (see
related story). The House did not allow amendments to the committee-approved
bill .
House Defense Appropriations Subcommittee Chair John P. Murtha
(D-Pa.) said he hopes to have a conferenced version approved by
both Chambers ready for the President by April 26. President Bush
has vowed to veto the House bill because of binding language that
would require withdrawal of troops from Iraq no later than the end
of August 2008.
Information:
Dave Moore, Senior Director
AAMC Government Relations
dbmoore@aamc.org
(202) 828-0525
Senate Passes Medicaid Moratorium
The Senate March 29 approved legislation containing a 2 year moratorium
of the Jan. 18 Medicaid Cost Limit/Unit of Government Proposed Rule.
The amendment also delays for 2 years any proposal to restrict Medicaid
funding for graduate medical education (GME). The provisions were
passed as an amendment to the Senate's version of the "US Troop
Readiness, Veterans' Health, and Iraq Accountability Act, 2007"
(H.R.
1591) (see related story).
Sen. Richard Durbin (D-Ill.), who offered the amendment during
the committee mark up of the bill on March 22 [see Washington
Highlights, March 23],
reiterated the need for its inclusion in the supplemental: "This
is money that helps hospitals provide basic services to the uninsured
and those with limited insurance."
Senate Finance Committee Ranking Minority Member Charles Grassley
(R-Iowa) was prepared to offer an amendment to alter the Medicaid
language, however Sen. Patty Murray (D-Wash.) objected. Referring
to a letter from CMS Acting Administrator Leslie Norwalk, Grassley
expressed concerns with the breadth of the amendment and that the
Durbin language could "seriously limit the agency's ability
to do the normal program oversight to ensure program integrity."
Grassley also took issue that the subject matter had bypassed the
Senate Finance Committee's consideration.
The bill must now be reconciled with the House version, which does
not include the Medicaid moratorium language.
Information:
AAMC Government Relations
AAMC Endorses "Medical Education Affordability
Act"
The AAMC March 29 endorsed
the "Medical
Education Affordability Act" (S.1066). The bill, introduced
by Senator Christopher Dodd (D-Conn.) March 29 and co-sponsored
by Senators John Kerry (D-Mass.), Richard Durbin (Dill), and Russ
Feingold (D-Wis.), would allow physicians to defer repayment of
their student loans while they complete their medical training.
Currently, the Economic Hardship Deferment allows physicians that
meet specific debt-to-income ratios to defer repayment of federal
educational loans for up to three years. S. 1066 would extend this
deferment to include the length of "post graduate medical or
dental internship, residency, or fellowship programs."
In total, 22 medical and dental organizations joined AAMC as original
endorsers of S.1066, including: American Academy of Dermatology
Association; American Association of Colleges of Osteopathic Medicine;
American Association of Neurological Surgeons; American College
of Cardiology; American College of Physicians; American College
of Surgeons; American Dental Education Association; American Geriatrics
Society; American Medical Student Association; American Osteopathic
Association; American Society for Investigative Pathology; American
Society of Addiction Medicine; American Society of Plastic Surgeons;
Association for Molecular Pathology; Association of Academic Health
Centers; Association of Pathology Chairs; Congress of Neurological
Surgeons; National Hispanic Medical Association; Society for Vascular
Surgery; Society of Gynecologic Oncologists; Society of Interventional
Radiology; and Society of Thoracic Surgeons.
Information:
Matthew Shick, Senior Legislative Analyst
AAMC Government Relations
mshick@aamc.org
(202) 862-6116
Trauma, Stroke, Genetic-Nondiscrimination Bills
Approved
The Senate March 29 passed by voice vote the "Trauma Care
Systems and Development Act" (H.R.
727), after it was approved by the House March 27. The bill
reauthorizes grants to states for enhancing their trauma care systems.
The President is expected sign the measure into law.
The House March 27 also approved the "Stroke Treatment and
Ongoing Prevention Act" (H.R.
477), which authorizes grants to educate health professionals
on the diagnosis and treatment of stroke [see Washington
Highlights, March 16].
Senators Thad Cochran (R-Miss.) And Edward Kennedy (D-Mass.) March
27 introduced a companion stroke bill (S. 999), with 7 other cosponsors.
The House Ways and Means Committee March 21 passed the Genetic
Information Nondiscrimination Act (H.R.
493), followed by House Energy and Commerce Committee passage
on March 23. The Ways and Mean Committee will reconcile the 3 different
versions of the bill passed by these committees and the Education
and Labor Committee, before it is sent to the floor.
Information:
Erica Froyd, Director, Public Health and Research Legislative Affairs
AAMC Government Relations
efroyd@aamc.org
(202) 828-0525
Supreme Court Issues Decision on "Original Source"
in Qui Tam Case
The Supreme Court March 27 issued a decision
clarifying a law that allows for an individual, or "relator,"
with knowledge of past or present fraud committed against the US
federal government to bring suit on its behalf under the False Claims
Act (FCA). In December 2006, the Supreme Court heard arguments in
an FCA case in which the AAMC submitted an amicus brief on behalf
of Rockwell International Corporation, a government contractor.
Although the case did not involve a health care organization, the
issues being considered are of great import to any entity that could
be the subject of FCA allegations.
The questions before the Supreme Court were jurisdictional; principally
what are the requirements for a qui tam relator to be considered
the "original source" of allegations, as required by the
FCA. In the amicus brief, the AAMC argued that a "clear, consistent
and strict 'original source' rule, applied in tandem with the [False
Claims] Act's other gatekeeping mechanisms, gives courts and defendants
a powerful tool to identify and ward off illegitimate qui tam strike
suits like those sometimes aimed at amici's members. The relators
who clear the False Claims Act's intentionally demanding gauntlet
will have had their bona fides established, while less principled
relators will be winnowed out."
The decision, written by Associate Justice Antonin Scalia, found
that:
- the relator must be the original source (i.e., have direct and
independent knowledge) of the information on which his/her allegations;
and
- that publicly disclosed allegations do not meet the "original
source" requirement.
In making this determination, the Supreme Court concluded that
a court should consider the allegations in the original complaint,
as amended.
Information:
Ivy Baer, Director & Regulatory Counsel
AAMC Health Care Affairs
ibaer@aamc.org
(202) 828-0490
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