Washington Highlights: January 30,
2009
House Approves Economic Recovery Package
Contents
Prior Issues
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The House of Representatives Jan. 28 approved, 244-188, its version
of an economic recovery package that includes $3.9 billion for the
National Institutes of Health (NIH) and additional funding for other
Public Health Service agencies, a retroactive moratorium on the
FY 2009 Medicare indirect medical education (IME) adjustment made
under the capital reimbursement system, a short-term extension of
the current "Medicaid Moratorium," and state Medicaid
relief.
Upon passage of the "American Recovery and Reinvestment Act"
(H.R.
1), AAMC President and CEO Darrell G. Kirch, M.D., praised
the House for "including critical health care provisions to
improve and protect the health of all Americans" in the package
[see Washington Highlights,
Jan. 23]. The statement thanks the House for "a critical
down payment" toward "robust budget growth for the NIH
that is sustainable and predictable." Dr. Kirch also expressed
appreciation for the Medicare IME provision, describing it as "an
important first step by House members to halt the elimination of
these adjustments, scheduled for October."
Prior to the vote, the AAMC sent a Jan. 27 letter
commending House Speaker Nancy Pelosi (D-Calif.) for the bill's
"recognition of the role of America's medical schools and teaching
hospitals in the nation's fiscal health."
Both the statement and the letter also laud the bill's "significant
financial resources dedicated to Health Information Technology (HIT),"
while expressing concern that some of the bill's privacy provisions
may have "unintended, negative effects on the day-to-day operations
of teaching hospitals and health systems."
The Senate has crafted its own version of the bill (see related
stories). President Obama and Congressional
leadership have stated they aim to complete work on the legislation
by the week of Feb. 16.
Information:
Dave Moore, Senior Director
AAMC Government Relations
dbmoore@aamc.org
(202) 828-0525
Christiane Mitchell, Director, Federal Affairs
AAMC Government Relations
cmitchell@aamc.org
(202) 828-0526
Tannaz Rasouli, Senior Legislative Analyst
AAMC Government Relations
trasouli@aamc.org
(202) 828-0525
Senate Panel Approves Economic Recovery Spending
Bill
The Senate Appropriations Committee Jan. 27 approved the discretionary
spending portion (S.
336) of the Senate's economic recovery package, the "American
Recovery and Reinvestment Plan." The bill includes additional
funds for the National Institutes of Health (NIH) and funding to
address health professions workforce shortages, among other items.
As drafted, the bill provides $3.5 billion to NIH, with $2.7 billion
to remain available until Sept. 20, 2010, through the NIH's Office
of the Director (OD). Of the OD funding, $1.35 billion is to be
transferred to NIH Institutes, Centers, and the Common Fund in proportion
to the FY 2009 appropriation. The bill also provides $500 million
designated for improvements to buildings and facilities on the NIH
campus and $300 million to the NIH's National Center for Research
Resources (NCRR) for "shared instrumentation and other capital
equipment."
Additionally, the bill provides $700 million to the Agency for
Healthcare Research and Quality (AHRQ) for comparative effectiveness
research (CER), with $400 million to be transferred to the NIH OD
to conduct or support comparative effectiveness research. As in
the House version of the recovery package, the bill provides an
additional $400 million for CER, to be allocated at the discretion
of the Secretary of Health and Human Services (HHS).
At the mark-up, Senate Labor-HHS-Education Appropriations Subcommittee
Ranking Member Arlen Specter (R-Pa.) announced plans to introduce
an amendment to add $6.5 billion to the NIH total during floor consideration
of the bill. He stated that he originally had planned to offer the
amendment, which would provide a total of $10 billion to the NIH,
in committee.
In addition to research funding, the bill provides $600 million
to the Health Resources and Services Administration (HRSA) via transfer
from the Public Health and Social Services Emergency Fund (PHSSEF),
to remain available through Sept. 30, 2011. The bill directs that
the funding be used to address health professions workforce shortages
through scholarships and loan repayment, as well as "grants
to training programs for equipment and activities to foster cross-state
licensure agreements."
Specifically, the bill indicates funding may be used for the National
Health Service Corps, Title VII Scholarships for Disadvantaged Students,
Title VII Faculty Loan Repayment, Title VIII Nursing Loan Repayment
and Scholarships, and such programs and activities authorized through
the community health center program. The bill also directs $200
million of the funding be used "for extending service contracts
and the recapture and reallocation of funds in the event that a
participant fails to fulfill their term of service." Accompanying
report language
recommends that up to $5 million of the funds be used for cross-state
licensing and telemedicine initiatives.
For pandemic influenza preparedness and response activities, the
bill provides $870 million via transfer from the PHSSEF to any HHS
account, "as determined by the Secretary to be appropriate."
The National Science Foundation (NSF) receives $1.2 billion for
research and related activities, as well as $150 million for major
research equipment and facilities construction and $50 million for
education and human resources. The NSF funding is to remain available
through Sept. 30, 2010.
The bill designates $430 million for the Department of Energy's
Office of Science through Sept. 30, 2010.
The Senate Finance Committee has jurisdiction over Medicare and
Medicaid provisions of the recovery package and also marked up recovery
legislation Jan. 27 (see related story).
The Senate is expected to combine the two bills before Senate floor
consideration, and before the Senate package can be reconciled with
the House version (see related story).
President Obama and Congressional leaders have stated that the House-Senate
compromise bill will be enacted by the week of Feb. 16.
Information:
Dave Moore, Senior Director
AAMC Government Relations
dbmoore@aamc.org
(202) 828-0525
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
IME Funds Restored Under Finance Committee's Economic
Recovery Package
The Senate Finance Committee Jan. 27 approved, 14-9, economic recovery
legislation that includes AAMC-supported language to reverse retroactively
the 50 percent cut to Medicare's Fiscal Year (FY) 2009 capital indirect
medical education (IME) payments. Contained in the committee's portion
of the "American Recovery and Reinvestment Act of 2009,"
the language would restore an estimated $175 million in FY 2009
funding for teaching hospitals. The IME provision was among several
"modifications" added to the "Chairman's Mark"
and was based on a bipartisan amendment
filed by Sens. Charles Schumer (D-N.Y.), Pat Roberts (R-Kan.), Ron
Wyden (D-Ore.), and Debbie Stabenow (D-Mich.).
A summary
of the legislation includes additional provisions of interest to
medical schools and teaching hospitals:
- A temporary (Oct. 1, 2008, to Dec. 21, 2010) 5.6 percent increase
in the federal medical assistance percentage (FMAP) for all states,
with additional funding available to certain states with high
unemployment rates;
- " A retroactive extension of the temporary increase in
disproportionate share hospital (DSH) allotments for "low-DSH"
states established by the "Medicare Prescription Drug, Improvement,
and Modernization Act (MMA) of 2003" [P.L.
108-173]; and
- " Nearly $20 billion in incentives to promote the adoption
and use of health information technology.
According to Finance Committee Chair Max Baucus (D-Mont.), the
Finance and Appropriations Committees' bills (see related
story) will be combined for consideration by the full Senate.
Information:
Christiane Mitchell, Director, Federal Affairs
AAMC Government Relations
cmitchell@aamc.org
(202) 828-0526
Senate Passes CHIP Reauthorization Legislation
The Senate Jan. 29 approved, 66-32,
an amended
version of the House's recently passed "Children's Health Insurance
Program Reauthorization Act of 2009" (H.R.
2) [see Washington Highlights,
Jan. 16]. This legislation reauthorizes the Children's Health
Insurance Program (CHIP) through Sept. 30, 2013. Current authorization
for CHIP expires on March 31, 2009.
The $32.8 billion legislation will continue to cover as many as
6.7 million children currently enrolled in CHIP and expand new health
coverage to an estimated 4.1 million additional low-income, uninsured
children. Senate Finance Committee Chair Max Baucus (D-Mont.) said
after the legislation passed, "CHIP works to get low-income,
uninsured kids to doctors' visits and medicines they need to stay
healthy, and approval of this bill opens the door of the doctor's
office to millions of children who live without proper health care
today."
The House and Senate now must merge their bills in conference,
with the major difference being a prospective prohibition on self-referrals
to physician-owned hospitals. Upon completion of this process, the
bill will be sent to President Obama, who has promised to sign the
CHIP bill into law.
Information:
Travis W. Crytzer, Legislative Analyst
AAMC Government Relations
tcrytzer@aamc.org
(202) 828-0418
On the Hill . . .
Vice President Joe Biden Jan. 27 administered the oath of office
to Sen. Kirsten Gillibrand (D-N.Y.). New York Governor David Paterson
appointed the second-term Congresswoman to fill the seat vacated
by former Sen. Hillary Rodham Clinton's appointment as Secretary
of State. Gov. Paterson will call a special election to determine
the successor to New York's 20th District House seat.
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