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Washington Highlights: April 6, 2007

AAMC Comments on Nonhospital Residency Training Rule

The AAMC March 26 submitted a comment letter to the Centers for Medicare and Medicaid Services (CMS) on a proposed rule that would modify current policies regarding Medicare direct graduate medical education (DGME) and indirect medical education (IME) reimbursement for residents training in nonhospital sites. The Medicare statute authorizes teaching hospitals to receive DGME and IME payments associated with residents training in nonhospital sites, such as physicians' offices, if the hospitals incur "all or substantially all" of the training costs. The proposal was included in the Feb. 1 long term care hospital proposed rule [see Washington Highlights, Feb. 9].

As described by CMS, the goal of the proposed rule is to be responsive to "concerns expressed by the teaching hospital community about the administrative burden" of complying with current policies, in particular the requirement that hospitals must pay physician supervisory costs at the nonhospital site. The AAMC letter notes that the proposed rule is not the "solution" that the academic medical community is seeking because it does not recognize that many physicians are willing to volunteer as supervisors and therefore there are no supervisory costs the hospital need pay.

However, the comment letter points out that the proposed rule has the potential to significantly reduce the administrative burden of compliance and provides significant comments about how the rule could be further improved.

Information:
Karen Fisher, Sr. Director, Health Care Affairs
AAMC Health Care Affairs
kfisher@aamc.org
(202) 862-6140

Senate Budget Resolution Includes Physician Training Fund

The FY 2008 Budget Resolution (S. Con. Res. 21) approved by the Senate March 23 includes a fund that would allow increased federal spending for physician training, provided the spending does not increase the deficit in fiscal years 2007-2012 [see Washington Highlights, March 30]. The fund was added to the budget resolution through a unanimously approved amendment offered by Senators Mark Pryor (D-Ark.) and Bill Nelson (D-Fla.).

Specifically, the fund would "provide additional training for physicians and attract more physicians in States that face a shortage of physicians in training." According to Senator Pryor's statement, the fund "does not impose a prescriptive solution but creates a deficit-neutral reserve fund the Finance Committee can use to find the best way to help ensure citizens and States will have the number of physicians they need over the long term."

Information:
Lynne Davis Boyle, Assistant Vice President
AAMC Government Relations
ldavisboyle@aamc.org
(202) 828-0526

Expedited Review for NIH New Investigators Extended

The National Institutes of Health (NIH) Center for Scientific Review (CSR) announced April 4 that it will extend and expand its pilot project providing new investigators the option of submitting a resubmission or amended R01 application for consideration in consecutive review cycles. This pilot project has shaved four months off the normal review cycle.

An additional 46 study sections are being added to the pilot, for a total of 108 study sections offering the expedited review option to new investigators. By the September and October 2007 meetings, all CSR study sections reviewing new investigator R01 applications will allow consecutive cycle resubmissions.

This pilot began in 2006 and was extended to 22 additional study sections in January 2007. During the three review cycles the pilot has been in place, approximately 13 percent of the eligible new investigators have used the option of next cycle submission. The project was developed because new investigators by definition do not have R01 support, and any delay in the ability to submit an amended application could have a negative impact on their careers.

Information:
Tony Mazzaschi, Senior Director
AAMC Scientific Affairs
tmazzaschi@aamc.org
(202) 828-0059

HRSA Offers Limited HCOP Extensions

The Health Resources and Services Administration (HRSA) April 5 announced it will offer no-cost extensions through September 2007 to the Title VII Health Careers Opportunity Programs (HCOPs) grants that were terminated in February 2007. Federal funding for the programs was eliminated in FY 2006 and was not restored in FY 2007.

Grantees with unexpended funds may request an extension by submitting a detailed explanation of the program budget and activities to HRSA by April 20. Rep. Joe Crowley (D-N.Y.) and Sen. Richard Durbin (D-Ill.) Feb. 16 sent letters, signed by 52 Representatives and 19 Senators, respectively, requesting a one-year extension of the HCOP and Title VII Centers of Excellence programs to Secretary of Health and Human Services Michael Leavitt and HRSA Administrator Elizabeth Duke, Ph.D. [see Washington Highlights, Feb. 23].

Information:
Tannaz Rasouli, Senior Legislative Analyst
AAMC Government Relations
trasouli@aamc.org
(202) 828-0525

NIH Announces New Institute Directors

The National Institutes of Health (NIH) Director Elias Zerhouni, M.D., announced April 2 the appointment of two new institute directors. Effective April 1, Griffin P. Rodgers, M.D., is the new director of the National Institutes of Diabetes and Digestive and Kidney Disorders (NIDDK). He has served as Deputy Director, as well as Acting Director and chief of NIDDK's Clinical and Molecular Hematology Branch. Dr. Rodgers received his medical degree from Brown University and completed his residency in internal medicine at Washington University School of Medicine in St. Louis.

Dr. Zerhouni also has announced the appointment of Barbara Alving, M.D., as director of the National Center for Research Resources (NCRR), effective April 1. Dr. Alving has served as Acting Director since March 2005. She previously had been Deputy Director and Acting Director of the National Heart, Lung and Blood Institute. Dr. Alving earned her medical degree from Georgetown University School of Medicine and completed her residency training at the Johns Hopkins Hospital.