Washington Highlights: July
6, 2007 AAMC Comments
on CMS Clinical Research Policy
ContentsPrior Issues  |
The AAMC June 27 sent a second letter
to the Centers for Medicare and Medicaid Services (CMS) regarding the agency's
proposed clinical research policy (CRP). The AAMC believes the proposed CRP "will
impose a barrier to Medicare beneficiaries' access to clinical trials and will
put institutions that conduct the trials at risk of violating Medicare payment
rules." The letter reflects additional concerns noted in an informal survey
of the AAMC membership. AAMC encourages CMS to clarify current policy and allow
"for payment of 'standard of care' services to beneficiaries enrolled in
clinical trials even if those trials do not meet the criteria that would qualify
them for Medicare payment for routine costs." The AAMC May 8 previously
commented on the proposed CRP [see Washington
Highlights, May 18]. Information:
Ivy Baer, Director & Regulatory Counsel
AAMC Health Care Affairs
ibaer@aamc.org
(202) 828-0490
IRS Issues Proposed Revisions to Form 990The
Internal Revenue Service (IRS) June 14 released for public comment a draft of
a redesigned
Form 990, filed by many tax exempt organizations. The AAMC is reviewing the
revisions and plans to submit comments. Hospitals that file a Form 990
will be required to complete a new Schedule H, which attempts to collect for the
first time information on the community benefit that the hospitals provide. Under
this provision, "health professions education" and "research"
are considered community benefits. Schedule H also requests information
on: - billing and collection practices;
- management
companies and joint ventures;
- general information on exempt activities
and community needs assessment; and
- identification of all the facilities
an organization operates for the provision of hospital or medical care.
Among
other schedules of interest are a revised Schedule J, which would require additional
information from highly compensated individuals, and the new Schedule K for tax
exempt bonds, which adds use and investment of proceeds information and relationships
with outside advisors. Medical schools that currently file a Form 990 under Part
V of Schedule A will now file under an identical Schedule E. In a May 25
letter to Treasury Secretary Henry Paulson, Senate Finance Committee Chair Max
Baucus (D-Mont.) and Ranking Member Charles Grassley (R-Iowa) urged the Treasury
Department to update the Form 990 as part of an effort to improve transparency
in the nonprofit sector [see Washington Highlights,
June 1]. The IRS intends to
finalize the forms later this year and have them ready for use for the 2008 filing
year (returns filed in 2009). Comments must be received by Sept. 14. Information:
Ivy Baer, Director & Regulatory Counsel
AAMC Health Care Affairs
ibaer@aamc.org
(202) 828-0490
CMS Releases Proposed 2008 Medicare Physician Fee ScheduleIn
its proposed
rule for the 2008 Medicare Physician Fee Schedule, released July
2, the Centers for Medicare and Medicaid Services (CMS) estimates that the
2008 conversion factor used to calculate payments for physician and other services
will decrease by 9.9 percent. Fee schedule payments are calculated using geographic-adjusted
relative value units (RVUs) for physician work, practice expense, and malpractice
expense base units and multiplying the sum of RVUs by the dollar-based conversion
factor. The formula for calculating updates to the conversion factor is set in
law and cannot be modified without legislative action by Congress. For the
2007 fee schedule, CMS performed a mandated 5-year review of the physician work
RVUs. Due to an increase in total work RVUs and the requirement to maintain budget
neutrality, CMS deflated the new work RVU values by 10.1 percent for payment calculations.
In the 2008 proposed rule, CMS has accepted revised work values for services previously
deferred for additional review. Among the new changes, work value units associated
with anesthesia services increase 32 percent. Because of an additional increase
to the physician work RVUs, CMS proposes to increase the work RVU adjustment deflation
factor from 10.1 percent to 11.8 percent to maintain budget neutrality. Other
items in the rule include: - updates to the geographic cost
price index (GPCI) resulting from a 3-year mandated review; and
- funding
for 2008 physician payment and quality initiatives using the $1.35 billion pool
created in the Tax Relief and Health Care Act of 2006 (P.L.
109-432).
CMS will accept comments on the rule until Aug. 31. Information:
Denise Dodero, Sr. Director, Health Care Affairs
AAMC Health Care Affairs
ddodero@aamc.org
(202) 828-0493
Mary Patton, Senior Specialist
AAMC Health Care Affairs
mpatton@aamc.org
(202) 862-6297 Senate Panel Approves
Bill to Rename NIAAA, NIDA, NICHDThe Senate Committee on Health, Education,
Labor, and Pensions (HELP) June 27 approved a bill (S.
1011) to rename three institutes of the National Institutes of Health (NIH).
In an effort to recognize addiction as a chronic disease, the bill renames the
National Institute on Alcohol Abuse and Alcoholism (NIAAA) as the "National
Institute on Alcohol Disorders and Health." Additionally, the bill proposes
that the National Institute on Drug Abuse (NIDA) change to the "National
Institute on Diseases of Addiction." The committee also adopted an amendment
to rename the National Institute of Child Health and Human Development (NICHD)
as the "Eunice Kennedy Shriver National Institute of Child Health and Human
Development," in recognition of Mrs. Shriver's role in the creation of NICHD.
The bill was introduced March 28 by Sens. Joe Biden (D-Del.), Edward Kennedy (D-Mass.),
Michael Enzi (R-Wyo.), and Tom Harkin (D-Iowa). A companion bill (H.R.
1348), sponsored by Reps. Patrick Kennedy (D-R.I.) and John Sullivan (R-Okla.),
awaits consideration by the House Committee on Energy and Commerce. The House
bill redesignates NIAAA and NIDA. Information: Dave Moore, Senior Director
AAMC Government Relations
dbmoore@aamc.org
(202) 828-0525
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