Washington Highlights: September
26, 2008
Congress Approves Continued Funding for Fiscal
Year 2009
Contents
Prior Issues
 |
Congress Sept. 27 completed legislation to provide stop-gap funding
for federal programs in the new fiscal year, which begins Oct. 1.
The House voted (370-58) Sept. 24 and the Senate voted (78-12) Sept.
27 to approve the continuing resolution (CR) that will fund much
of the federal government, including the NIH and Title VII health
education programs, at the current FY 2008 levels through March
6. The CR was passed as an amendment to H.R.
2638, the FY 2008 homeland security spending bill, to permit
it to bypass committee action on several portions of the package.At
press time, the Senate continued to debate the CR but is not likely
to vote on it before Sept. 27. Senate Majority Leader Harry Reid
(D-Nev.) said he will move to limit debate, setting up a vote on
cloture Sept. 27.
The CR was necessary because none of the 12 individual FY 2009
appropriations bills - which account for about 40 percent of the
total federal budget - had been enacted into law. The CR includes
the full FY 2009 spending bills for defense, homeland security,
and military construction-VA. This portion of the package includes
$40.4 billion for VA medical care, an increase of $3.46 billion
(9.4 percent), and $510 million for VA research, a $30 million (6.3
percent) increase over FY 2008.
The CR includes a $22.9 billion disaster relief package and additional
funding above the FY 2008 levels for a select number of programs,
such as low-income energy assistance, Nutrition for Women, Infants
and Children (WIC), and Pell Grants.
The White House has not issued an official reaction to the CR.
The Administration had previously stated a preference for a CR through
mid-November.
Summaries of the various parts of the legislative package, as well
as the text of the legislation, are available on the House Appropriations
Committee website.
Information:
Dave Moore, Senior Director
AAMC Government Relations
dbmoore@aamc.org
(202) 828-0525
Senate Rejects Economic Stimulus Plan
The Senate Sept. 26 rejected a proposal
for a $56.2 billion economic recovery package that would have increased
funding for medical and scientific research and public health. The
package (S. 3604), released Sept. 25 by Senate Majority Leader Harry
Reid (D-Nev.) and Senate Appropriations Committee Chairman Robert
C. Byrd (D-W.Va.), also included $19.6 billion to reduce the states
share of Medicaid costs by increasing the federal share by 4 percent.
The Senate vote of 52-42 on a motion to proceed with consideration
of the proposal fell 8 votes short of the 60 needed for passage.
Meanwhile, House Democrats released their own stimulus
plan (H.R. 7110) Sept. 26 that focuses on creating jobs and
funding infrastructure projects. The House proposal includes additional
Medicaid funding for states but does not provide additional funding
for research or public health. The House Rules Committee Sept. 25
approved by voice vote a rule that would permit the House to consider
the package on Sept. 26.
The Reid-Byrd "Economic Recovery Act of 2008" included
an additional $1.2 billion for NIH. According to a summary released
by Senators Reid and Byrd, these funds would "restore some
of the purchasing power of NIH that was lost because of inflation
in the past five years and allow NIH to award at least 3,300 new
research project grants." The Senate package also included
$150 million for the Department of Energy's Office of Science, $46
million for the CDC for combating infectious diseases and investigating
disease clusters and $905 million for the Public Health and Social
Services Emergency Fund (PHSSEF) to enhance the Nation's preparedness
to cope with a potential pandemic flu outbreak or the use of a biological
weapon.
Information:
Dave Moore, Senior Director
AAMC Government Relations
dbmoore@aamc.org
(202) 828-0525
AAMC Asks HHS to Withdraw Provider Conscience
Rule
The AAMC Sept. 23 submitted a comment letter
to the Department of Heath and Human Service (HHS) in response to
the proposed rule, "Ensuring That Department of Health and
Human Services Funds Do Not Support Coercive or Discriminatory Policies
or Practices in Violation of Federal Law" (73 Fed Reg
50274). The AAMC letter strongly urges the department to withdraw
the rule, which seeks to ensure that HHS funds "do not support
morally coercive discriminatory practices or policies in violation
of already existing federal laws," as the department has produced
no evidence that it is needed.
In its comment letter, the AAMC acknowledges that ethical and moral
issues within the context of health care require a careful balance
between the rights of the health care professional to avoid behavior
that violates his/her moral or ethical code, and the right of a
patient to receive legal health care services that are medically
appropriate. However, the rights of the patient, who is in a more
vulnerable position, must be given precedence. The letter indicates
that view is woven into a physician's education, beginning in medical
school and continuing throughout residency training.
Information:
Ivy Baer, Director & Regulatory Counsel
AAMC Health Care Affairs
ibaer@aamc.org
(202) 828-0490
AAMC Submits Comment Letter on DEA e-Prescribing
Proposal
The AAMC Sept. 25 submitted a comment letter
in response to a Drug Enforcement Administration (DEA) proposed
rule, "Electronic Prescriptions for Controlled Substances,"
(73 Fed Reg 36772). The rule would set requirements for practitioners
that use electronic prescriptions for controlled substances. The
AAMC letter expresses reservations about the proposal and questions
whether the requirements can be met given the current state of electronic
health records.
The AAMC comment letter also suggests that the DEA establish a
stakeholders group comprised of representatives of hospitals, physicians,
pharmacies, electronic health records vendors, CMS staff, and other
interested parties to develop a regulation that is consistent with
existing federal and state requirements, relies on proven technologies
currently in use, and acknowledges the wide variations in medical
practice patterns.
Information:
Ivy Baer, Director & Regulatory Counsel
AAMC Health Care Affairs
ibaer@aamc.org
(202) 828-0490
Congress Passes NHSC Reauthorization
The Senate Sept. 24 and the House Sept. 25 approved by voice vote
a bill (H.R
1343) that reauthorizes the National Health Service Corps (NHSC)
through FY 2012. The "Health Care Safety Net Act of 2008"
authorizes initial funding from $131.5 million for NHSC increasing
each year to $185.6 million in FY 2012. The final package more closely
resembles the Senate companion bill (S.901)
than the original House legislation, which did not include a NHSC
reauthorization provision. The Consolidated Appropriations Act of
2008 provided $123.5 million for the NHSC.
The bill also removes the current provision that requires health
centers and clinics to demonstrate eligibility as a health professions
shortage area every 6 years. The legislation also requires that
each qualifying site demonstrate "willingness to support or
facilitate mentorship, professional development, and training opportunities
for Corps members," and directs the Secretary of Health and
Human Services to facilitate professional relationships among Corps
members and other health professionals. Specifically, the measure
emphasizes faculty appointments at health professions schools, and
relationships with hospitals, academic medical centers, and Title
VII Area Health Education Centers (AHEC) and Health Education Training
Centers (HETC).
The reauthorization is part of a package that also reauthorizes
the Community Health Centers Program and the Rural Health Care Programs.
Additionally, the measure includes a GAO study on the delivery of
care to medically underserved and underinsured populations and a
GAO study concerning the implications of extending Federal Tort
Claims Act coverage to health care professionals who volunteer to
furnish care to patients of health centers.
AAMC President and CEO Darrell G. Kirch, M.D., Aug. 7 sent a letter
to Congress in support of a $300 million NHSC authorization in the
final version of the reauthorization bills [see Washington
Highlights,
Aug. 8].
Information:
Matthew Shick, Senior Legislative Analyst
AAMC Government Relations
mshick@aamc.org
(202) 862-6116
House and Senate Pass Compromise Mental Health
Parity Legislation
The House and Senate Sep. 24 both passed compromise mental health
parity legislation, the "Paul Wellstone and Pete Domenici Mental
Health Parity and Addiction Equity Act of 2008" (H.R.
6983). The Senate voted 84-11 to add the legislation as an amendment
to the "Renewable Energy and Job Creation Act of 2008"
(H.R.
6049). With parity included, the package later passed 93-2.
The House passed the parity bill (H.R. 6983) 376-47 as a stand-alone
piece of legislation. The two chambers will now have to agree on
one vehicle for the legislation before it can be sent to the President.
The proposed mental health parity legislation attempts to prevent
discrimination in group health plans against people with mental
illness by closing loopholes included in the "Mental Health
Parity Act of 1996" (P.L.
104-204). The current proposed legislation would:
- apply to all group health plans that already provide mental
health coverage, but exclude plans offered by employers of less
than 50 people, as did the 1996 legislation;
- prohibit limitations on treatment and financial obligations
that are different than those applied for other medical or surgical
services; and
- eliminate loopholes that permit discrimination in terms of
co-pays, deductibles, maximum out of pocket expenses, and length-of-stay
and visit limitations that currently exist in health insurance
plans.
Information:
Abigail Schopick, Legislative Analyst
AAMC Government Relations
aschopick@aamc.org
(202) 828-0525
NCRR Advisory Council Rolls Out Strategic Plan
The National Institutes of Health's National Center for Research
Resources (NCRR) presented its new strategic
plan at the Sept. 16 meeting of the center's advisory council.
The plan, developed over the past year [see Washington
Highlights, April 25],
provides for NCRR's priorities and goals for research infrastructure,
informatics, and biomedical research workforce needs from fiscal
years 2009 to 2013. The NCRR is the only major component of the
NIH that provides for infrastructure and resource needs for all
areas of biomedical research.
The council meeting also included presentations on the Clinical
and Translational Science Awards (CTSA) program, including a presentation
by Daniel Ford, M.D., Vice Dean for Clinical Investigation at Johns
Hopkins School of Medicine, on efforts by CTSA institutions to improve
management of clinical trials.
In a Sept. 10, 2007, comment letter
[see Washington
Highlights,
Sept. 14, 2007], the AAMC urged the NCRR to emphasize initiatives
to overcome the so-called "second translational block;"
i.e., moving validated medical innovations into clinical practice.
The AAMC also urged development of mechanisms for facilitating collaborations
among academic institutions. Both recommendations are reflected
in the final strategic plan.
Information:
Stephen Heinig, Lead Science Policy Analyst
AAMC Biomedical Health Sciences Research
sheinig@aamc.org
(202) 828-0488
Dr. Zerhouni to End Tenure as NIH Director
Elias Zerhouni, M.D., Sept. 24 announced
that he will step down as the 15th Director of the National Institutes
of Health (NIH), effective in late October, 2008. Dr. Zerhouni said
he will pursue writing projects and explore other professional opportunities.
In a Sept. 24 statement
on Dr. Zerhouni's announcement, AAMC President and CEO Darrell G.
Kirch, M.D., noted "Since his appointment in 2002, Dr. Zerhouni
has tackled the dual challenges of leading the NIH during the final
years of the doubling and unprecedented investment in research,
and the difficult years that followed as the agency experienced
consistently flat funding….The nation's medical schools and
major teaching hospitals thank Dr. Zerhouni for his many contributions
and service to our country."
Dr. Zerhouni, a radiologist, was confirmed by the U.S. Senate as
NIH Director on May 2, 2002. Prior to joining the NIH, Dr. Zerhouni
served as executive vice-dean of Johns Hopkins University School
of Medicine, chair of the Russell H. Morgan department of radiology
and radiological science, and Martin Donner professor of radiology,
and professor of biomedical engineering.
Information:
Tony Mazzaschi, Senior Director
AAMC Scientific Affairs
tmazzaschi@aamc.org
(202) 828-0059
|
