Washington Highlights: April 4,
2008
Contents
Prior Issues
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AAMC Sends Comment Letter in Support of Conrad
30 Reauthorization Bill
AAMC President and CEO Darrell G. Kirch, M.D., sent an April 2
comment letter
to Sen. Kent Conrad (D-N.D.) in support of the "Conrad State
30 Improvement Act" (S.
2672). The bill, introduced Feb. 27 by Sen. Conrad, would permanently
reauthorize the Conrad State 30 J-1 visa waiver program [see Washington
Highlights, Feb. 29].
The letter notes AAMC's support for many facets of the bill including
the increased annual per state allotments; a green card cap exemption
for physicians who have completed the Conrad 30 program; and increased
"flex-slots" for physicians employed at facilities not
located in an underserved area, as long as such facilities treat
patients who live in underserved areas. The letter states, "The
AAMC supports your proposed reforms for the Conrad 30 program that
will help address the program's current inefficiencies as well as
the deficiency of physicians to provide care for our nation's underserved."
The letter also cautions that there will continue to be greater
incentives for international medical graduates to enter on H-1b
visas than on J-1 visas.
Information:
Matthew Shick, Senior Legislative Analyst
AAMC Government Relations
mshick@aamc.org
(202) 862-6116
Senate Judiciary Panel Approves False Claims
Act Amendments
The Senate Judiciary Committee April 3 approved by voice vote an
amended version of legislation
to amend the federal False Claims Act (FCA). According to a summary
released by the Judiciary Committee, the "False Claims Act
Correction Act of 2008" (S.
2041) is intended to correct recent decisions by various federal
courts that have limited the scope and application of the FCA through
interpretations that are contrary to the original congressional
intent of the 1986 amendments to the FCA.
The AAMC joined 16 other organizations in an April 2 letter
opposing S. 2041. The letter, organized by the U.S. Chamber of Commerce
Institute for Legal Reform, states, the revisions proposed in the
legislation would "dramatically expand the scope of liability
under the statute, increase its financial penalties, and remove
safeguards against unfounded qui tam lawsuits." The
letter continues, "these amendments are unnecessary and will
impose enormous burdens on non-profits, universities, hospitals,
and small businesses, as well as virtually any organization that
does business with the Federal government."
S. 2041 was introduced on Sept. 12, 2007, by Senators Charles Grassley
(R-Iowa), Dick Durbin (D-Ill.), Patrick Leahy (D-Vt.), Arlen Specter,
R-Pa.), and Sheldon Whitehouse (D-R.I.). Leahy and Specter are the
chair and ranking member, respectively, of the Senate Judiciary
Committee.
While its cosponsors describe the legislation as "technical
correction" amendments to the federal False Claims Act (FCA),
S. 2041 would have a significant impact on medical schools and teaching
hospitals, which are the recipients of billions of dollars in Federal
grants and contracts and prime targets of FCA suits brought both
by the Department of Justice and by faculty, employees, and others.
Information:
Dave Moore, Senior Director
AAMC Government Relations
dbmoore@aamc.org
(202) 828-0525
Ways and Means Subcommittee Hearing Discusses
2008 Medicare Trustees Report
Centers for Medicare and Medicaid Services (CMS) Chief Actuary
Richard S. Foster April 1 presented
key findings of the 2008 Medicare Trustees
Report to the House Ways and Means Health Subcommittee [see
Washington Highlights,
March 28]. Mr. Foster stated
the financial outlook for the Medicare program is slightly better
than last year's projections.
Mr. Foster informed the panel that beneficiary premiums and general
revenue funding has increased substantially from 2004 to 2007, and
that Part B funds were restored to "an adequate level at the
end of 2007." While he reported that Part B funds would, under
current law, continue to increase, he advised that enactment of
legislation to override a 10.6 percent reduction in the physician
payment update scheduled July 1, 2008, would slow that growth.
CMS continues to project annual physician payment reductions of
5 percent through 2016. However, Mr. Foster noted that, "We
should never kid ourselves or place too much reliance on what are
inherently uncertain projections." Subcommittee Chair Pete
Stark (D-Calif.) and Ranking Member Dave Camp (R-Mich.) expressed
continued interest in securing a bi-partisan agreement on the physician
payment issue.
Information:
Travis W. Crytzer, Legislative Associate
AAMC Health Care Affairs/Government Relations
tcrytzer@aamc.org
(202) 828-0418
NIH Council of Councils Meets for First Time
The National Institutes of Health (NIH) Council of Councils March
31 held its first official meeting, following a Nov. 8 "planning
meeting" [see Washington
Highlights, Nov.
9, 2007]. The council
was briefed on activities of the Office of Portfolio Analysis and
Strategic Initiatives' (OPASI) three divisions, including an initiative
within the Division of Resource Development and Analysis to measure
the economic and other burdens of various diseases in the U.S. population
and map "the multiple dimensions of public health need against
the NIH portfolio." The requirement for such analyses stems
from the "NIH Reform Act of 2006" (P.L.
109-482) [see Washington
Highlights, Dec. 15, 2006], the same act that created the
Council of Councils and the expanded analytical and coordination
capacity within NIH Director's office. NIH describes the council
as advising the NIH director "on cutting-edge trans-NIH priorities
and matters related to the policies and activities of the Division
of Program Coordination, Planning, and Strategic Initiatives and
OPASI." NIH further notes that the council will act as an external
advisory panel to the agency's institute and center directors during
the "concept approval stage of the review process for trans-NIH
initiatives."
Much of the meeting's discussion focused on the actual role the
council will play in making decisions about projects that have high-risk,
cross-cutting potential, in what NIH Director Elias Zerhouni, M.D.,
described as an "incubator space." Dr. Zerhouni offered
the Clinical and Translational Science Awards program, created under
the NIH Roadmap and eventually transferred to the NIH's National
Center for Research Resources, as an example of such a project.
Each of the council's 24 members, whose appointments were announced
March 24, sits on another NIH council and serves as liaison to their
respective institutes or centers. In his opening remarks, Dr. Zerhouni
reminded council members not to see themselves as representing a
separate institute, but as serving the NIH as a whole. The council
includes Robert Dickler, AAMC's Chief Health Care Officer, who serves
as liaison to the NIH Clinical Center.
Information:
Stephen Heinig, Lead Science Policy Analyst
AAMC Biomedical Health Sciences Research
sheinig@aamc.org
(202) 828-0488
Federal Court Upholds Tax Exception of Medical
Resident Stipends
The U.S. District Court for the District of Minnesota April 1 ordered
the Internal Revenue Service (IRS) to refund almost $1.1 million,
plus interest, to the University of Minnesota for Federal Insurance
Contributions Act (FICA) taxes paid on medical resident's stipends
during the second quarter of 2005.
Under the IRS rule for Student FICA Exceptions-effective for services
performed on or after April 1, 2005- residents are considered employees
rather than students and do not qualify for the exception. In an
earlier case involving the Mayo Clinic, the court found the IRS
rule to be invalid. The court's decision is unlikely to set a precedent
for courts outside the federal district covering Minnesota. To date,
no other court has invalidated the IRS rule. Though the federal
government has appealed the Mayo decision, at press time it had
not announced whether it will appeal the most recent decision.
Information:
Ivy Baer, Director & Regulatory Counsel
AAMC Health Care Affairs
ibaer@aamc.orc
(202) 828-0490
On the Hill...
Rep. Albert Wynn (D-Md.) March 27 announced his intent to resign
in June, before the end of his eighth term. Rep. Wynn lost the February
Democratic primary to Donna Edwards. It is unclear whether Gov.
Martin O'Malley (D) will declare a special election for the remainder
of the 110th Congress.
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