Washington Highlights: September
12, 2008
AAMC Joins Medical Associations Comment Letter
to Department of Education
Contents
Prior Issues
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The AAMC Aug.14 joined almost 100 medical organizations in a comment
letter to the
Department of Education in response to a notice of proposed rulemaking,
to implement the "College Cost Reduction and Access Act of
2007" (P.L.
110-84) [See Washington Highlights,
July 11]. The letter thanks the Department for its work in the
negotiating sessions and urges it "to reinstate the 20/220
pathway permanently or provide an equivalent funding mechanism for
loan deferments so that medical residents continue to have an option
to postpone loan payments, without facing financial penalties, during
a crucial time in their training."
Effective July 1, 2009, the proposed regulations eliminate the
"20/220 pathway" of the economic hardship deferment, which
allows medical residents to postpone repayment of their student
loans for up to 3 years without the additional interest of forbearance.
The new regulations also define public service for a new loan forgiveness
program and implement the income-based repayment program authorized
by the legislation.
The public comment period for the proposed rule ended Aug. 15.
A final rule is expected to be published in November.
Information:
Matthew Shick, Senior Legislative Analyst
AAMC Government Relations
mshick@aamc.org
(202) 862-6116
Emergency GME Regulations Finalized in Inpatient
Final Rule
The Centers for Medicare and Medicaid Services (CMS) Aug. 19 included
previously "interim final" regulations issued in 2006
and 2007 in the FY 2009 Medicare inpatient final rule. These regulations
address continuation of direct Graduate Medical Education (GME)
and Indirect Medical Education (IME) payments when hospitals located
in emergency or disaster areas must temporarily suspend operations
(73
Fed. Reg. 48638). As finalized, the emergency GME regulations
allow affected hospitals to enter into GME resident cap affiliation
agreements and transfer their caps to any other hospital in the
country, thus bypassing the geographic requirements contained in
the non-emergency cap affiliation agreements. The hospitals involved
also do not need to have shared residency rotational arrangements,
another requirement of the non-emergency regulations.
CMS had originally issued interim final regulations in early 2006
to help teaching hospitals located in New Orleans and other areas
affected by hurricanes Rita and Katrina. Without a provision to
allow for the affected hospitals to transfer their resident cap
slots to other teaching hospitals, hospitals that were at their
cap maximums but still took on the additional residents would not
receive the IME and GME payments associated with the additional
residents.
The new regulations will be published in the Oct. 1, 2008, version
of volume 42 of the Code of Federal Regulations, sections 413.75(b)
and 413.79(f).
Information:
Karen Fisher, Sr. Director, Health Care Affairs
AAMC Health Care Affairs
kfisher@aamc.org
(202) 862-6140
CMS Posts Evidentiary Priorities for the Elderly
Population
The Center for Medicare and Medicaid Services (CMS) Aug. 8 posted
on its website "Evidentiary
Priorities for the Elderly Population" identifying the
top priorities for the research community in the domain of eldercare.
This is the first time that such a list has been provided to the
public on the CMS Coverage website.
A workshop of participants from 13 of the National Institutes of
Health, the Centers for Disease Control, the Agency for Healthcare
Research and Quality, and CMS worked in collaboration with a panel
of the Medicare Evidence Development & Coverage Advisory Committee
(MedCAC).
CMS grouped the Medicare Evidentiary Priorities into three categories:
Diagnostics and Screening, Interventions, and Policy Issues. The
agency encourages researchers to consider these research priorities
when designing studies that directly affect the health of the elderly.
Additional information including the full listing of research priorities
can be found of the CMS website.
Information:
Will Dardani, Constituent Services Specialist
AAMC Health Care Affairs
wdardani@aamc.org
(202) 828-0541
CMS Publishes ICD-10 Proposed; Electronic Transaction
Rules
The Centers for Medicare and Medicaid Services (CMS) Aug. 22 published
a proposed
rule that would replace the current ICD-9 codes set, used to
report health care diagnoses and procedures on health care transaction
claims, with a new version, known as ICD-10. If finalized, hospitals,
physicians and other entities would be required to use the new code
set effective Oct. 1, 2011.
A primary reason for moving to ICD-10 is that the ICD-9 system
is running out of new codes, which are needed to accommodate advances
in medicine and medical technology; ICD-9 has 17,000 codes compared
to 155,000 codes in the ICD-10 system. CMS also states that the
ICD-10 code set would better support value-based purchasing and
quality initiatives. The costs associated with learning the new
codes and updating transaction software has been a chief concern
of providers, particularly physicians.
Also on Aug. 22, CMS published a separate proposed
rule that would require adoption of new electronic transaction
standards for health care and pharmacy claims. If finalized, this
requirement would be effective April 2010.
Comments on both proposed rules are due October 21.
Informaton:
Karen Fisher, Sr. Director, Health Care Affairs
AAMC Health Care Affairs
kfisher@aamc.org
(202) 862-6140
Patient Safety Common Formats Released
The Agency for Healthcare Research and Quality (AHRQ) Aug. 29 published
in the Federal Register the Common Formats, Version 0.1 Beta for
implementation of the "Patient Safety and Quality Improvement
Act of 2005" (P.L.
109-41). Requested by the Secretary of Health and Human Services,
the Common Formats provides a set of common definitions and reporting
requirements for standardized and uniform collection of patient
safety data that would allow for national aggregation.
AHRQ is soliciting comments
on the beta version of the Common Formats and has contracted with
the National Quality Forum (NQF) to assist with gathering and analyzing
input and feedback. This will allow for multi-stakeholder involvement
and input. AHRQ expects that a second version of the formats will
be released within 6 to 9 months based on the feedback received
and then updated on a yearly basis going forward.
The "Patient Safety and Quality Improvement Act," which
establishes a network of Patient Safety Organizations (PSOs) designed
to collected patient safety data, was enacted to help address the
barriers in analysis and implementation of improvement strategies
pertaining to patient safety nationwide. The PSOs will be designed
not only to assist hospitals, but to aggregate patient safety data
on a national level to identify and eliminate systemic errors across
the healthcare system.
Information:
Jennifer Faerberg, Director, Health Care Affairs
AAMC Health Care Affairs
jfaerberg@aamc.org
(202) 862-6221
AHRQ Seeks Comments on New Innovations Portfolio
The Agency for Healthcare Research and Quality (AHRQ) Aug. 15 published
in the Federal Register a notice seeking recommendations for priority
topics and activities to include as part of a new "Innovations"
research portfolio. According to the notice,
the new portfolio will support "high impact" research
projects "substantially different from those already being
pursued by AHRQ," with an aim of "problem solving"
in health care organization, delivery, and management.
Comments should be submitted to AHRQ by Oct. 14. AAMC member institutions
submitting comments are requested to also send a copy to the AAMC.
Information:
Tannaz Rasouli, Senior Legislative Analyst
AAMC Government Relations
trasouli@aamc.org
(202) 828-0525
NSF Reports "Unprecedented" Decline in Federal
Support for Research
The National Science Foundation (NSF) Aug. 27 issued a report
indicating that federal funding for scientific research and development
(R&D) at academic institutions has declined for the second consecutive
year, adjusting for inflation. According to the report, this is
the only instance in which federal support of academic R&D has
failed to keep pace with inflation for two years running since the
data series began in 1972.
According to NSF, federally funded academic R&D expenditures
rose in current dollars 1.1 percent in FY 2007 to $30.4 billion.
"After adjusting for inflation, this represents a 1.6 percent
decline from FY 2006 and follows a 0.2 percent decline from the
FY 2005 level." Overall, university R&D rose by 0.8 percent,
adjusting for inflation due to other sources of support, including
institutions' own funds. The federal government remains the largest
share (62 percent in FY 2007) of support for university research.
Medical and biological sciences continue to make up more than half
of all federal research expenditures, predominantly performed at
U.S. medical schools. The NSF also reports expenditures at minority
institutions, including for the first time at "high-Hispanic
enrollment institutions."
Information:
Stephen Heinig, Lead Science Policy Analyst
AAMC Biomedical Health Sciences Research
sheinig@aamc.org
(202) 828-0488
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