Washington Highlights: May 25, 2007
Congress Passes Supplemental Spending Bill
Contents
Prior Issues
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Congress May 24 approved a $120 billion FY 2007 supplemental spending
package (H.R.
2206), sending the bill to the President, who is expected to
sign it. In addition to providing funding for the war in Iraq and
Afghanistan and for disaster relief activities, the legislation
also includes a number of provisions of significance to academic
medicine.
The legislation prohibits for one year the Secretary of Health
and Human Services (HHS) from taking any action to "finalize
or otherwise implement" the January 1 Medicaid proposed rule
regarding cost limits and "units of government." The prohibition
is effective upon enactment of H.R. 2206. The bill also prohibits
for one year the promulgation or implementation of "any rule
or provisions" restricting Medicaid payments for graduate medical
education.
H.R. 2206 includes up to $650 million in additional allotments
for certain states facing FY 2007 shortfalls in State Children's
Health Insurance Program (SCHIP) funding. The funds "remain
available until expended."
The supplemental provides nearly $1.8 billion in additional FY
2007 funding for the Department of Veterans Affairs, much of which
is specifically targeted to the treatment of veterans from Iraq
and Afghanistan. The VA funding includes $467 million for medical
services, $250 million for medical administration, $595 million
for medical facilities, $32.5 million for medical and prosthetics
research, $35 million for information technology, and $290 million
for minor construction.
The supplemental also includes language transferring $49.5 million
from the National Institute of Allergy and Infectious Diseases,
and $49.5 million from National Institutes of Health, Office of
the Director, to the Office of the Secretary, Public Health and
Social Services Emergency Fund, to support advanced research and
development of biodefense countermeasures.
The supplemental does not include $625 million in pandemic preparedness
funds for HHS, as included in previous versions of the bill.
Information:
Dave Moore, Senior Director
AAMC Government Relations
dbmoore@aamc.org
(202) 828-0525
Christiane Mitchell, Director, Federal Affairs
AAMC Government Relations
cmitchell@aamc.org
(202) 828-0526
Matthew Shick, Senior Legislative Analyst
AAMC Government Relations
mshick@aamc.org
(202) 862-6116
Congress Passes Moratorium As CMS Issues Medicaid
GME Proposed Rule
On May 24, as part of the supplemental spending bill (see related
story), Congress approved a 1-year delay of "any rule or provisions"
restricting Medicaid payments for graduate medical education (GME).
A day earlier, May 23, the Centers for Medicare & Medicaid Services
(CMS) published a proposed
rule that would "clarify" that costs and payments
associated with GME programs would not be eligible for Federal matching
payments under state Medicaid programs. Given passage of the moratorium,
it is unclear how CMS will proceed.
The proposed rule, if finalized, would have a large impact on many
states and teaching hospitals. A 2006 AAMC report containing survey
results from all 50 states indicated that 47 states and the District
of Columbia made direct GME or IME payments under their state Medicaid
programs. According to the proposed rule, estimated federal savings
from the rule would be $140 million in 2008 and up to $460 million
in 2012.
Information:
AAMC Government Relations
Karen Fisher, Sr. Director, Health Care Affairs
AAMC Health Care Affairs
kfisher@aamc.org
(202) 862-6140
GAO Appoints Three New MedPAC Commissioners
The Comptroller General May 21 appointed three new members and
reappointed four members to the Medicare Payment Advisory Commission
(MedPAC), an independent federal body that advises Congress on issues
affecting the Medicare program.
The newly appointed members are:
- Thomas M. Dean, M.D., a board-certified family physician in
South Dakota and former president of the National Rural Health
Association.
- Jack C. Ebler, a consultant in health care policy, focusing
on the federal policy environment and the changing health care
marketplace. Previously, he served as president and CEO of the
Alliance of Community Health Plans, which advocated performance
measurement and payment for quality in Medicare.
- Bruce Stuart, Ph.D., professor and executive director of the
Peter Lamy Center on Drug Therapy and Aging at the University
of Maryland, Baltimore. His term expires in 2009 because he was
appointed to complete the term of Douglas Holtz-Eakin, who resigned
from the Commission in May 2007.
Of the six members whose terms expired in April, four were reappointed:
- John M. Bertko, F.S.A., M.A.A.A., vice president and chief
actuary, Humana, Inc.
- Francis J. Crosson, M.D., executive director, the Permanente
Federation, LLC.
- Arnold Milstein, M.D., M.P.H., medical director, Pacific Business
Group on Health.
- William J. Scanlon, Ph.D., a health policy consultant.
Sheila P. Burke, M.P.A., R.N., F.A.A.N., deputy secretary and chief
operating officer of the Smithsonian Institution and Ralph Muller,
M.A., chief executive officer of the University of Pennsylvania
Health System, left the commission after serving two consecutive
terms.
The commission comprises 17 members who bring diverse expertise
in the financing and delivery of health care services. Commissioners
serve 3-year, part time terms (generally subject to a 3-year renewal)
and appointments are staggered so the terms of five or six commissioners
expire each year.
Information:
Diana Mayes, Specialist
AAMC Health Care Affairs
dmayes@aamc.org
(202) 828-0498
House Subcommittee Approves FY 2008 VA Appropriations
The House Appropriations Subcommittee on Military Construction
and Veterans Affairs (VA) May 22 approved a draft spending bill
for FY 2008. According to a press
release by Subcommittee Chair Chet Edwards (D-Texas), "the
total budget for VA medical accounts exceeds the Independent Budget
[IB] prepared by veterans' service organizations by $294 million."
The IB recommends $36.3 billion for FY 2008.
The bill provides $480 million for the VA Medical and Prosthetic
Research program, a $66.3 million (16 percent) increase over the
FY 2007 joint funding resolution. However, an additional $32.5 million
for VA research is included in the FY 2007 Emergency Supplemental
(H.R.
2206), (see related story) bringing the FY 2007 total to $446.2
million. The AAMC, as an executive member of the Friends of VA Medical
Care and Health Research coalition, recommends $480 million for
VA research and $45 million for research facilities upgrades under
the minor construction account.
The full Appropriations Committee is expected to consider the bill
after the Memorial Day recess.
Information:
Matthew Shick, Senior Legislative Analyst
AAMC Government Relations
mshick@aamc.org
(202) 862-6116
House Approves New VA Research Centers
The House May 23 passed, 421-0, the "Traumatic Brain Injury
Health Enhancement and Long-Term Support Act of 2007" (H.R.
2199). The bill authorizes $70 million for FYs 2008-2011 to
establish up to five new Veteran Affairs (VA) traumatic brain-injury
research centers, including funds for education and training of
health care professionals [see Washington
Highlights, May 18].
VA facilities wishing to host the proposed centers must develop
"an arrangement with an accredited medical school that provides
education and training in traumatic brain injury care." The
bill will establish a peer review panel to "assess the scientific
and clinical merit of proposals."
Information:
Matthew Shick, Senior Legislative Analyst
AAMC Government Relations
mshick@aamc.org
(202) 862-6116
NCRR Announces Chimp Breeding Moratorium
The NIH's National Center for Research Resources (NCRR) announced
May 22 it will continue a moratorium on breeding chimpanzees owned
or supported by NCRR, citing financial constraints and budget responsibilities
to other programs and resources. NCRR will maintain the federal
sanctuary for chimpanzees retired from biomedical research, and
other existing chimpanzee facilities.
A breeding moratorium was implemented in 1995 and was extended
most recently through December 2007. The Chimpanzee Management Plan
(ChiMP) Working Group, established upon a 1997 recommendation of
the National Academy of Sciences, periodically advises NIH on matters
related to the moratorium. The Working Group met in March to reassess
the moratorium and presented its report
at the May 22 meeting of the National Advisory Research Resources
Council.
At the meeting, NCRR Director Barbara Alving, M.D., acknowledged
the importance of chimpanzees to biomedical research, but also highlighted
the high cost of care and long lifespan of chimpanzees currently
owned or supported by NCRR. The meeting was Dr. Alving's first as
NCRR director. She has been serving as acting director since Judith
Vaitukaitis, M.D., stepped down in 2005.
Information:
Stephen Heinig, Lead Science Policy Analyst
AAMC Biomedical Health Sciences Research
sheinig@aamc.org
(202) 828-0488
House Panel Passes NSF Funding for HIS Education
and Training
The House Science and Technology Committee May 23 passed legislation
establishing National Science Foundation (NSF) grant programs to
promote "education and training" in health care information
systems (HIS). The "10,000 Trained by 2010 Act" (H.R.
1467) authorizes $14.6 million in competitive grants to fund
basic research on "innovative approaches" to improve HIS
(e.g., data security, population informatics). Higher education
institutions could apply for the grants, which would be available
between FY 2008 and FY 2011.
H.R. 1467 also authorizes $18.6 million over 4 years for multi-year
competitive NSF grants in support of new "Centers for Informatics
Research." The centers will work toward developing "innovative
approaches" to HIS improvement. Their research programs must
promote "active collaboration" among various professionals,
including health professionals, information technology experts,
administrators, and social science researchers.
The bill authorizes $37.2 million through 2011 in competitive "capacity-building"
grants for institutions of higher education to: establish/improve
undergraduate and master's degree HIS programs; increase the number
of students in such programs; provide such students with related
government and/or industry experience; and utilize distance learning.
The funds may be used to "enhance the ability of an institution"
to provide HIS education and recruit/retain students (eg, improving
undergraduate curricula, establishing HIS degree programs, equipment
acquisition, enhancing collaborative educational efforts within
the community).
H.R. 1467 also authorizes $29.2 million in capacity-building grants
via the Scientific and Advanced Technology Act of 1992 (P.L.
102-476). However, these grants would be restricted to health
information-related education.
Information:
Tannaz Rasouli, Senior Legislative Analyst
AAMC Government Relations
trasouli@aamc.org
(202) 828-0525
House Passes Omnibus Competitiveness Bill
The House May 21 approved by voice vote an omnibus bill (H.R.
2272) incorporating language from several competitiveness bills
previously passed individually by the House [see Washington
Highlights, April 27].
The measure includes a bill to reauthorize the National Science
Foundation (NSF) through FY 2010, with funding increases of 7 percent
each fiscal year (H.R.
1867); a bill increasing authorizations for the NSF's Robert
Noyce Scholarship Program (H.R. 362); a bill allocating 3.5 percent
of NSF's research funds to a grant program for early career researchers
(H.R. 363); a bill reauthorizing the National Institute of Standards
and Technology (NIST) through FY 2010 (H.R.
1868); and a bill revising program requirements for the National
High-Performance Computing Program (H.R.
1068).
The bills were merged into the larger package to accommodate conference
negotiations with the Senate, which passed its own omnibus bill
(S.
761) on April 25.
Information:
Tannaz Rasouli, Senior Legislative Analyst
AAMC Government Relations
trasouli@aamc.org
(202) 828-0525
President Nominates Holsinger for Surgeon General
President Bush May 24 nominated James W. Holsinger, Jr., M.D. to
be the 18th Surgeon General of the U.S. Public Health Service. A
cardiologist, Dr. Holsinger has served as the Secretary for Health
and Family Services for the Commonwealth of Kentucky, the Chancellor
of the University of Kentucky Medical Center and held numerous academic
and administrative appointments. Dr. Holsinger's 26-year career
with the U.S. Department of Veterans Affairs culminated in appointment
as Under Secretary for Health in 1992. In addition, Dr. Holsinger
served over 30 years in the U.S. Army Reserve, retiring with the
rank of Major General in 1992. Dr. Holsinger's nomination must be
confirmed by the Senate.
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