Washington Highlights: October
26, 2007
Contents
Prior Issues
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Senate Passes HHS Funding Bill
The Senate Oct. 23 passed its FY 2008 Labor-HHS-Education appropriations
bill (H.R.
3043) by a veto-proof margin of 75-19, with five Democrats not
present to vote. A total of 29 Republicans voted for the bill. The
bill provides $149.9 billion in discretionary spending, which is
$5.4 billion over the FY 2007 level and $9.6 billion more than the
President's budget request.
The Senate bill is $1.9 billion less than the bill passed by the
House July 18 [see Washington
Highlights, July 20],
a difference that will have to be reconciled by the House and Senate
conferees on the bill. The President has stated that he will veto
both versions of the bill because tehy exceed his budget request.
The Senate bill includes $29.9 billion for the National Institutes
of Health (NIH), an increase of $1 billion (3.5 percent) over the
FY 2007 level, and $250 million over the House bill. However, the
Senate and the House both adopted the Administration's proposal
to increase the amount of the transfer from NIH to the Global HIV/AIDS
fund from $99 million in FY 2007 to $300 million for FY 2008. As
a result, the increase over FY 2007 in the NIH program level in
the Senate bill is $799 million (2.8 percent), compared to $549
million (1.9 percent) in the House bill.
The Senate bill essentially freezes funding for Title VII health
professions programs at the FY 2007 level, providing $189.7 million,
a $5 million (2.7 percent) increase. The bill increases the Title
VIII nursing programs by $20 million (13.4 percent) to $169.7 million.
An amendment offered by Sen. Wayne Allard (R-Colo.) proposed to
cut by 10 percent funding for any program deemed "ineffective"
by the Office of Management and Budget's Program Assessment Rating
Tool (PART), including Titles VII and VIII and a handful of other
programs. The amendment was defeated, 68-21.
Sens. Chuck Schumer (D-N.Y.) and Kay Bailey Hutchison (R-Texas)
sponsored an amendment to allow up to 61,000 foreign nurses to enter
the country as a means of relieving the nursing shortage. Sen. Dick
Durbin (D-Ill.) offered an amendment to modify the Schumer-Hutchinson
proposal to require employers (excluding those in health professions
shortage areas) petitioning for the nursing green cards to pay a
$1,500 fee; the revenues collected from the fees would fund nursing
education grants in the United States. Both amendments were adopted
by unanimous consent.
Sens. Charles Grassley (R-Iowa) and Bernard Sanders (I-Vt.) offered
an amendment to establish the "American Competitiveness Scholarship."
The program authorizes the Director of the NSF to make $15,000 scholarships
to individuals pursuing degrees in "mathematics, engineering,
computer science, nursing, medicine, or other clinical medical program,
or technology, or science program designated by the Director."
The amendment also increases the fee for H1-B visas from $1,500
to $3,500 to pay for the program. The amendment was adopted by unanimous
consent.
The bill cuts the Children's Hospitals Graduate Medical Education
program by $97 million (33 percent) to $200 million.
The Senate stripped a provision from the bill that would have expanded
federal funding for human embryonic stem cell research. Under the
Administration's current policy, federal funding is limited to stem
cell lines created before Aug. 9, 2001. The deleted provision would
have permitted funding for cell lines created before June 15, 2007.
The Senate also adopted (65-28) an amendment offered by Senator
Mike Enzi (R-Wyo.) to cancel a provision in the House bill to redistribute
FY 2007 funds for city HIV/AIDS programs to 10 locations across
the country. The House proposal would have been funded by reductions
in other national AIDS programs in FY 2008.
Prior to final passage of the bill, the Senate rejected (40-54)
a Republican amendment to recommit the bill to the Appropriations
Committee to be revised to provide no more than $140.9 billion in
discretionary funding.
Democratic staff in both the House and Senate report that Nov.
1 is the target date for holding the House-Senate conference on
the bill, with the conference report report going to the House and
Senate floors the week of Nov. 5. The congressional leadership has
not decided whether the Labor-HHS bill will be the first FY 2008
appropriations bill sent to the White House.
The Senate appointed the following Senators as conferees: Harkin
(D-Iowa), Inouye (D-Hawaii), Kohl (D-Wis.), Murray (D-Wash.), Landrieu
(D-La.), Durbin (D-Ill.), Reed (D-R.I.), Lautenberg (D-N.J.), Byrd
(D-W.Va.), Specter (R-Pa.), Cochran (R-Miss.), Gregg (R-N.H.), Craig
(R-Idaho), Hutchison (R-Texas), Stevens (R-Alaska), Shelby (R-Ala.)
and Domenici (R-N.Mex.)
Information:
Dave Moore, Senior Director
AAMC Government Relations
dbmoore@aamc.org
(202) 828-0525
Tannaz Rasouli, Senior Legislative Analyst
AAMC Government Relations
trasouli@aamc.org
(202) 828-0525
Senate Urges CMS to Continue Clinical Trial Reimbursement
The Senate Oct. 23 approved by unanimous consent an amendment (S.Amdt.
3401) to the FY 2008 Labor-HHS-Education appropriations bill
(H.R.
3043, see related article) offered by Senators Ben Cardin (D-Md.)
and Sam Brownback (R-Kan.) that expresses the sense of the Senate
that "the Secretary of Health and Human Services should maintain
'deemed status' coverage under the Medicare program for clinical
trials that are federally funded or reviewed as provided for by
the Executive Memorandum of June 2000." Though non-binding,
the amendment urges CMS to continue allowing reimbursement for services
rendered to Medicare beneficiaries enrolled in clinical trials.
In anticipation of the vote, the AAMC, the American Society of
Clinical Oncology, and the Association of American Cancer Institutes
sent an Oct. 23 letter to Sens. Cardin and Brownback in support
of the amendment. The letter states, "While we applaud the
agency's decision not to proceed with its draft policy, a message
from the Senate in opposition will help ensure that they do not
move forward with any change in status for federally funded or reviewed
trials."
Though the Oct. 17 CMS final decision on national coverage of clinical
trials decided to postpone any action [See Washington
Highlights,
Oct. 19], it is not clear if CMS will re-visit the issue in
the future.
Information:
Atul Grover, Director, Government Relations
AAMC Health Care Affairs/Government Relations
agrover@aamc.org
(202) 828-0666
Temporary Extension Could Delay HEA Reauthorization
The House Oct. 23 passed the "Third Higher Education Extension
Act of 2007" (H.R.
3927) to extend temporarily the Higher Education Act (HEA, P.L.
105-244) through April 30, 2008. Authority for the HEA expired
on Sept. 30, 2003; however, several extensions have been enacted,
making no policy changes but allowing uninterrupted administration
of the programs authorized under the law. The current extension
is set to expire Oct. 31.
The Senate July 24 passed the "Higher Education Amendments
of 2007" (S.
1642) to reauthorize the HEA for 5 years [See Washington
Highlights,
July 27]. House Education and Labor Committee Chair George Miller
(D-Calif.) is expected to introduce his own version of the reauthorization
bill later this session. During the Oct. 23 debate on the bill,
Education Subcommittee Chair Ruben Hinojosa (D-Texas) stated, "Given
the length of time that has lapsed between when the Higher Education
Act should have been reauthorized and now, we believed that it was
critical that the 110th Congress and the stakeholders in the higher
education community take a fresh look at the new law."
Information:
Matthew Shick, Senior Legislative Analyst
AAMC Government Relations
mshick@aamc.org
(202) 862-6116
Chairman Kennedy Requests Timeline for PSO Implementation
Senate HELP Committee Chair Edward Kennedy (D-Mass.) Oct. 18 sent
a letter
to Secretary of Health and Human Services Michael Leavitt requesting
by Nov. 2 a "detailed" timeline for implementation of
the AAMC-supported Patient Safety and Quality Improvement Act (P.L.
109-41). Enacted in July 2005, the law establishes "Patient
Safety Organizations" (PSOs) to collect and analyze confidential
patient safety data that are voluntarily submitted by providers.
"Extremely disappointed and troubled" that HHS has not
yet finalized regulations for the law, Chairman Kennedy states that
he is "committed" to full implementation of the law.
Information:
Christiane Mitchell, Senior Legislative Analyst
AAMC Government Relations
cmitchell@aamc.org
(202) 828-0526
Senate Judiciary Holds Hearing on University Research
and Patents
The Senate Judiciary Committee Oct. 24 held a hearing
on the "Role of Federally-Funded University Research in the
Patent System." Committee Chair Patrick Leahey (D-Vt.) introduced
the hearing as being occasioned by an earlier issue arising in the
operation of a government facility by a university contractor, but
the witnesses testified broadly on topics of university technology
transfer and the 1980 Bayh-Dole Act.
The witnesses included: Arti K. Rai, J.D., Professor of Law, Duke
University Law School; Elizabeth Hoffman, Ph.D., Executive Vice
President and Provost of Iowa State University; Robert Weissman,
Director, Essential Action (a public interest organization); and
Charles Louis, Ph.D., Vice Chancellor for Research, University of
California-Riverside. As with the similar hearing on Bayh-Dole held
in July by the House Judiciary Committee, the witnesses testified
that there was no need for a major overhaul of current law [See
Washington
Highlights,
July 20].
Weissman, the witness most critical of the status quo, focused
his written testimony on the government's "abrogation"
of responsibility to ensure that pharmaceuticals resulting from
federally funded research be more generally affordable and proposed
stronger exercise of "march-in" rights and other reforms.
Rai distinguished how Bayh-Dole's provisions may have different
effects on, for example, software development than on pharmaceuticals.
Rai did not recommend major revisions to Bayh-Dole, but proposed
closer examination of the provision for "determination of exceptional
circumstances" by which a Federal agency can alter the disposition
of property rights for particular research projects. Louis and Hoffman
were both strongly supportive of current law, noting examples of
socially beneficial products commercialized from university-based
research.
Information:
Stephen Heinig, Lead Science Policy Analyst
AAMC Biomedical Health Sciences Research
sheinig@aamc.org
(202) 828-0488
HHS Appeals Order to Release Claims Data
The Department of Health and Human Services (HHS) Oct. 19 filed
an appeal with the U.S. Circuit Court of Appeals for the District
of Columbia in the case Consumers' Checkbook/Center for the Study
of Services v. HHS. Consumers' Checkbook, a non-profit group,
had sued for the release of Medicare claims data under the Freedom
of Information Act to analyze the data and report metrics on physician
performance. HHS contends that release of the data, which includes
physician, but not patient, identifiers, violates the privacy of
physicians. In August, the U.S. District Court for D.C. rejected
the privacy argument and ordered HHS to release the information.
Information:
Mary Patton, Senior Specialist
AAMC Health Care Affairs
mpatton@aamc.org
(202) 862-6297
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