Washington Highlights: October 24,
2008
Contents
Prior Issues
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AAMC Submits ICD-10 Comment Letter
The AAMC Oct. 10 submitted a comment
letter (PDF, 1 page) on a Department of Health and Human Services (HHS) 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. According to HHS, the
move is necessary because the ICD-9 code set is "outdated,
with only a limited ability to accommodate new procedures and diagnoses."
The department also noted that the ICD-10 code set would support
comprehensive reporting of quality data and ensure more accurate
payments for new procedures.
The AAMC comment letter acknowledges the need to move to ICD-10,
but emphasizes the significant challenges and costs (for both hospitals
and physicians) associated with this change. The letter urges HHS
to include in the final rule a definitive list of governmental outreach
activities that it would undertake as well as to announce publicly
and specifically its level of financial commitment to this initiative.
As did other commenters, the AAMC stated that the proposed Oct.
1, 2011, implementation date is "unrealistic" and urged
that the timeframe be revised. In addition, the association asked
the department to pay particular attention to major teaching hospitals
and their associate physician practices to ensure that any unique
needs of these institutions are addressed expeditiously.
Information:
Karen Fisher, Sr. Director, Health Care Affairs
AAMC Health Care Affairs
kfisher@aamc.org
(202) 862-6140
Ivy Baer, Director & Regulatory Counsel
AAMC Health Care Affairs
ibaer@aamc.org
(202) 828-0490
CMS Issues Annual Actuarial Report on Medicaid
The Centers for Medicare and Medicaid Services (CMS) Office of
the Actuary Oct. 17 issued its first annual "Actuarial Report
on the Financial Outlook for Medicaid." The new report
follows a format similar to the annual update released by the Medicare
Board of Trustees. A CMS press
release states that future issues of the Medicaid actuarial
report will "expand on content to include long-range projections
and more extensive analysis."
According to the newly issued report, combined state/federal spending
on Medicaid benefits will grow by an annual rate of about 7.9 percent
over the next 10 years (OMB projects that annual GDP growth will
average about 4.8 percent). By 2017, Medicaid expenditures will
total nearly $674 billion, with the federal share exceeding $383
billion. In 2006, Medicaid represented 14.8 percent of the nation's
total health care spending. Under current law, the Medicaid program
is projected to account for 8.4 percent of the entire federal budget
by 2013, a 1.4 percent increase from 2007.
Information:
Christiane Mitchell, Senior Legislative Analyst
AAMC Government Relations
cmitchell@aamc.org
(202) 828-0526
APHIS Proposes Requiring Contingency Planning
for Research Animals
The USDA's Animal and Plant Health Inspection (APHIS) Service
Oct. 23 published in the Federal Register a proposed rule to amend
the Animal Welfare Act (AWA) regulations to require research facilities
and others covered by the AWA to develop contingency plans and related
training of personnel. In an Oct. 23 press
release, APHIS stated that it believes "all licensees and
registrants should develop a contingency plan for all animals regulated
under the [AWA] in an effort to better prepare for potential disasters."
APHIS is proposing that mandatory elements in the contingency plan
include:
- Identify situations the facility might experience that would
trigger the need for a contingency plan;
- Outline specific tasks required to be carried out in response
to the identified emergencies;
- Identify a chain of command and who (by name or by position
title) will be responsible for fulfilling these tasks; and
- Address how response and recovery will be handled in terms
of materials, resources, and training needed.
In addition, APHIS indicated it also is considering the development
of a guidance document or other resources to provide examples of
elements that may be included in contingency plans. The agency is
seeking comment on issues related to developing such guidance. Comments
on the proposed rule are due on or before Dec. 22.
Information:
Tony Mazzaschi, Interin Chief Scientific Officer, Senior Director
AAMC Scientific Affairs
tmazzaschi@aamc.org
(202) 828-0059
Issue Brief Outlines Challenges to Adoption of
Health Information Technology
According to an October 2008 issue brief from the non-partisan,
non-profit Alliance for Health Reform, privacy worries, investment
costs, and a lack of electronic standards remain obstacles to the
wide-spread adoption of health information technology (HIT). The
issue brief, "Health
Information Technology: More than the Money" (PDF, 4 pages), features
examples of public and private "innovation and experimentation"
to promote HIT adoption, including state electronic prescribing
initiatives and provider partnerships with Google and Microsoft.
According to the issue brief, many policy experts continue to believe
the federal government should consider "financial incentives
to drive broader scale HIT adoption." It states that small
financial incentives may not be effective, but advises that "larger
incentives" could prove "too costly to the government."
Sens. John Rockefeller (D-W.V.) and Susan Collins (R-Maine) serve
as honorary co-chairs of the Alliance for Health Reform. Among the
Alliance's board members are Robert Graham, M.D., Professor and
the Robert and Myfanwy Smith Chair in the Department of Family Medicine,
University of Cincinnati College of Medicine; James Tallon, Jr.,
United Hospital Fund of New York; Nancy Dickey, M.D., President,
Texas A&M University Health Science Center; William Novelli,
Chief Executive Officer, AARP; and Reed Tuckson, M.D., Executive
Vice President and Chief of Medical Affairs, UnitedHealth Group.
Information:
Christiane Mitchell, Senior Legislative Analyst
AAMC Government Relations
cmitchell@aamc.org
(202) 828-0526
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