Washington Highlights: January 9,
2009
HELP Committee, Daschle Highlight Need to Bolster
NIH, Health Professions Training
Contents
Prior Issues
 |
The Senate Committee on Health, Education, Labor, and Pensions
Jan. 8 held the first confirmation hearing
of President-elect Obama's nominee for Secretary of Health and Human
Services, Tom Daschle. Much of the hearing focused on improved coordination
across the department and increased support for the National Institutes
of Health (NIH) and health professions training programs.
In his closing remarks, HELP Committee Chair Edward Kennedy (D-Mass.)
stressed the need for continued discussions about the NIH. In his
written testimony,
Secretary-designate Daschle stated, "NIH is a unique and prominent
agency, the major source of research intended to protect the nation's
health, stimulate the economy with high-tech job creation across
the country, make discoveries that fuel the biotech and pharmaceutical
industries, and train biomedical scientists for the future. However,
NIH has been flat-funded in recent years, which has produced a 17
percent loss of 'buying power' since 2003."
Several committee members expressed concerns about shortages of
health professionals in their communities, and Secretary-designate
Daschle agreed that workforce is an important factor, noting, "We
almost understate the problem of access if all we do is limit it
to the number of uninsured." Instead, he proposed increasing
incentives for physicians and "alternative providers"
such as nurses, physician assistants, and pharmacists, to enter
primary care, describing payment reform and tuition assistance as
potential tools. Sens. Lisa Murkowski (R-Alaska) and Bernie Sanders
(I-Vt.) praised Daschle for highlighting the National Health Service
Corps (NHSC) as "a tremendous investment" and for agreeing
that increased NHSC "funding is a good way to start."
Sen. Patty Murray (D-Wash.) encouraged the nominee to pursue ways
to persuade younger students to consider health professions careers.
Likewise, Sen. Jack Reed (D-R.I.) noted that the Title VII health
professions training programs have been "chronically underfunded"
and urged the Secretary-designate to "pay particular attention
to Title VII" as budget and health care reform proposals are
considered.
The committee did not vote on Daschle's nomination. The Finance
Committee, which has jurisdiction over his appointment because it
oversees Medicare, will hold its own confirmation hearing and vote
to advance his nomination to the full Senate.
Information:
Tannaz Rasouli, Senior Legislative Analyst
AAMC Government Relations
trasouli@aamc.org
(202) 828-0525
Matthew Shick, Senior Legislative Analyst
AAMC Government Relations
mshick@aamc.org
(202) 862-6116
AAMC Comments on Healthcare-Acquired Conditions
The AAMC Dec. 31, 2008, submitted a comment letter
to the Centers for Medicare and Medicaid Services (CMS) on Healthcare-Acquired
Conditions in response to the Dec. 18, 2008, CMS Listening Session
on the same topic.
The listening session provided an opportunity for public comment
on the implementation of the current Hospital-Acquired Condition
(HAC) program as well as the proposed expansion of the program to
the hospital outpatient setting. The AAMC letter expresses support
for programs' aim of reducing harm and negative outcomes, but outlines
several concerns with the way the current program has been structured.
Key areas of concern include the inability to account for high-risk,
complex patients; the resources required to ensure proper coding
procedures are followed; and the rapid rate of expansion of selected
conditions. The AAMC recommends that CMS neither move forward in
the expansion of the HAC program to the hospital outpatient setting
nor add any additional condition areas to the inpatient program
prior to a formal evaluation of the program.
The "Deficit Reduction Act of 2005" (P.L.
109-171) required the implementation of a Hospital Acquired
Condition program designed to withhold payment to hospitals for
certain conditions occurring during a hospital stay that were not
present on admission.
Information:
Jennifer Faerberg, Director, Health Care Affairs
AAMC Health Care Affairs
jfaerberg@aamc.org
(202) 862-6221
AAMC Comments on Physician Resource Use Reports
The AAMC Dec. 23, 2008, submitted a comment letter
to the Centers for Medicare and Medicaid Services (CMS) regarding
measuring physician resource use. The "Medicare Improvement
for Patients and Providers Act of 2008" (P.L. 110-275) requires
CMS to provide confidential reports to physicians on their resource
use starting Jan. 1, 2009. In the final 2009 Medicare Physician
Fee Schedule rule (released in November 2008), CMS outlined a pilot
project, conducted by Mathematica Policy Research, that will evaluate
multiple methods for reporting resource use. CMS requested comments
on a series of issues related to the project including feedback
on attribution methodologies and benchmark selection.
The AAMC letter states that the reporting program should consider
the mission of academic medicine and to adjust for the impact of
teaching residents, conducting research, and for providing specialized
services.
CMS considers resource use reporting a component of a Physician
Value-Based Purchasing plan [see Washington
Highlights, Dec.
19, 2008].
Information:
Mary Patton, Senior Specialist
AAMC Health Care Affairs
mpatton@aamc.org
(202) 862-6297
House Democrats Convene Forum on Economic Recovery
House Democrats Jan. 7 heard testimony that an investment in science
and innovation is essential to ensuring a consistently healthy economy.
Norman R. Augustine, lead author of the National Academies report
Rising Above the Gathering Storm and former Lockheed Martin
chairman and CEO, and Massachusetts Institute of Technology geophysics
professor Maria Zuber, Ph.D., joined 3 other panelists in a forum
on economic recovery convened by Speaker of the House Nancy Pelosi
(D-Calif.) and the House Democratic Steering and Policy Committee.
The forum was designed to discuss the economic outlook and critical
components of an economic recovery plan.
Speaker Pelosi noted that Congress must pass an economic stimulus
package no later than mid-February, and the panel repeatedly emphasized
the urgent need to act very quickly, both to reinvigorate the economy
and to restore public confidence. Panelists also agreed that a substantial
package - ranging from at least $750 billion to $900 billion over
two years, balanced between federal spending and tax cuts - would
be appropriate. It was suggested that criteria for including an
item in the package should assess whether there is an "exit
strategy," so that the influx of additional funding does not
create a dynamic in which additional spending is expected indefinitely.
While everyone agreed that the funding should have an immediate
impact, it also was noted that the funding should have an additional
longer-term effect. Mr. Augustine pointed out that when funding
for short-term projects in the recovery package expires in two years,
many Americans will again be unemployed unless Congress crafts the
package in a way that addresses the nation's continued fiscal health.
He proposed doubling the federal investment in basic research to
reverse years of relatively flat funding and to spur innovation.
The panel also discussed the need to invest in science infrastructure,
since enhancements in labs and instrumentation can be made very
quickly and have multiplicative benefits for the public.
Other panelists included Mark Zandi, chief economist and cofounder
of Moody's economy.com; Robert Reich, former Secretary of Labor
and professor of public policy at the University of California at
Berkeley; and Martin Feldstein, professor of economics at Harvard
University and President Emeritus of the National Bureau of Economic
Research. Panelists also recommended additional mortgage relief,
funding to help states resolve budget shortfalls and maintain public
programs and services, and expanded unemployment insurance.
More than 100 Members of Congress attended the forum, but questions
were limited to chairs of the House Committees on Appropriations,
Ways and Means, Budget, Energy and Commerce, Transportation, Science
and Technology, and Small Business, and the co-chairs of the policy
and steering committee.
Information:
Tannaz Rasouli, Senior Legislative Analyst
AAMC Government Relations
trasouli@aamc.org
(202) 828-0525
HHS Releases Action Plan for Healthcare-Associated
Infections
The Department of Health and Human Services (HHS) Jan. 6 released
an Action
Plan to Prevent Healthcare-Associated Infections (HAIs). This
action plan was spurred on by a Government Accountability Office
(GAO) report that encouraged HHS and inter-related agencies to take
a more proactive role in addressing the issue of HAIs. The Action
Plan establishes national goals and outlines key actions necessary
to achieve those goals.
HHS selected a set of top tier priority areas to be addressed in
this initial phase including surgical site infections, central line-associated
bloodstream infections, ventilator-associated pneumonia, and catheter-associated
urinary tract infections. HHS also included two organism specific
priorities; Clostridium difficile and Methicillin-resistant
Staphylococcus aureus (MRSA). Within each priority area,
the Action Plan develops key metrics and 5-year national prevention
targets.
The Action Plan puts forward several priority recommendations including:
- Increase and better coordinate HAI research within HHS;
- Increase providers', consumers', the media's, and the general public's
knowledge and awareness of prevention practices;
- Accelerate the transition to electronic reporting by healthcare facilities;
and
- Continue to incorporate measures of infection prevention and outcomes
into Hospital Value-Based Purchasing (VBP) Plan methodology.
The prevention activities focus on the acute care setting; however,
HHS will expand to include other care settings in future iterations
of this plan.
Information:
Jennifer Faerberg, Director, Health Care Affairs
AAMC Health Care Affairs
jfaerberg@aamc.org
(202) 862-6221
Department of Education Announces HEA Negotiated
Rulemaking Committees
The Department of Education Dec. 31, 2008 published a Federal
Register notice that it would form five negotiated rulemaking
committees to develop regulations based on the "Higher Education
Opportunity Act" (P.L.
110-315). These regulations will wrap up the first complete
reauthorization of the Higher Education Act (HEA) since 1998.
The negotiated rulemaking committees are divided into the following
"teams:"
- Team I-Loans-Lender/General Loan Issues;
- Team II-Loans-School-based Loan Issues;
- Team III-Accreditation;
- Team IV-Discretionary Grants; and
- Team V-General and Non-Loan Programmatic Issues.
A detailed account of the issues these committees will review is
presented in the Federal Register notice.
Of importance to medical education, the 2008-2009 negotiated rulemaking
sessions will address increased Perkins loan limits, maintenance
of state education funding, loan forgiveness for medical specialists,
workforce shortage-based Graduate Assistance in Areas of National
Need (GAANN) grants, and new financial aid oversight regulations.
The AAMC plans to nominate a financial aid administrator to represent
academic medicine as well as the graduate education community as
a whole.
Information:
Matthew Shick, Senior Legislative Analyst
AAMC Government Relations
mshick@aamc.org
(202) 862-6116
On the Hill...
Colorado Gov. Bill Ritter (D) Jan. 3 appointed Denver Public Schools
Superintendent Michael Bennet to fill the Senate vacancy that will
be created by the appointment of Sen. Ken Salazar (D) to Secretary
of the Interior.
The House Appropriations Committee Democrats Jan. 7 announced subcommittee
assignments for the 111th Congress. Rep. James Moran (Va.) will
join the Subcommittee on Labor, Health and Human Services, Education
and Related Agencies. The committee Republicans Jan. 8 named Rep.
Todd Tiahrt (Kan.) as the ranking member of that subcommittee.
|
