Washington Highlights: February
26, 2010
AAMC Report Highlights
How ARRA Funds Are Fueling Research and Driving Economic Growth
Contents
Prior Issues
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The AAMC Feb. 22 released a new report
detailing how the nation's medical schools and teaching hospitals
are advancing science, improving health, and stimulating economic
growth with funding provided to the National Institutes of Health
(NIH) through the American Recovery and Reinvestment Act (ARRA,
P.L.
111-5).
The report, "From Recovery to Discovery - ARRA Funding and
Medical Research," features 83 letters from leaders at AAMC-member
institutions. Addressed to the president and members of Congress,
the letters highlight how NIH ARRA grants have been used to advance
scientific and medical innovation, improve the health of local communities,
and stimulate economic growth.
In the report's cover letter, AAMC President and CEO Darrell G.
Kirch, M.D., noted, "Investment in medical research is not
only an important part of the nation's economic short-term recovery
plan, it also is an essential element in creating long-term investments
in innovation that improve the nation's health."
Contact:
Dave Moore, Senior Director
AAMC Government Relations
dbmoore@aamc.org
(202) 828-0525
AAMC Submits Letter to MedPAC on DGME and IME
Policies
The AAMC Feb. 17 submitted a letter
to the Medicare Payment Advisory Commission (MedPAC) making several
recommendations to support direct graduate medical education (DGME)
and indirect medical education (IME) policies that would help sustain
the missions of teaching hospitals and medical schools.
In the letter, the AAMC expresses concern about signs indicating
an erosion of support by the Medicare program for the educational,
research and patient care missions of teaching hospitals. This concern
is further increased by the instability of the Medicaid programs,
which has led a number of states to eliminate or reduce GME payments
to teaching hospitals.
The letter points out that in spite of a decreased level of support,
many academic medical centers are working to improve their delivery
system to increase quality. In addition they are spending significant
institutional resources to improve residency training by incorporating
new educational strategies into their curricula.
The letter specifically recommends the commission:
- Endorse the current IME payment level;
- Recommend that Congress lift Medicare's resident limits;
- Expand current levels of funding for the special missions
of teaching hospitals by calling for support from all payers;
- Request CMS to analyze whether a teaching adjustment is needed
in the outpatient prospective payment system;
- Urge Congress to reaffirm Title VII health professions programs
through reauthorization and increased appropriation levels;
- Recommend that CMS support policies that enhance training
in nonhospital settings;
- Recommend counting all resident training time in the DGME
and IME payment methodologies; and
- Recommend that CMS assign residents' initial residency periods
in their second year of training.
Contact:
Karen Fisher, J.D., Sr. Director, Health Care Affairs
AAMC Health Care Affairs
kfisher@aamc.org
(202) 862-6140
Diana Mayes, Specialist
AAMC Health Care Affairs
dmayes@aamc.org
(202) 828-0498
HHS, NIH and FDA Announce New Regulatory Science
Initiatives
Secretary of Health and Human Services Kathleen Sebelius, Director
of the National Institutes of Health (NIH) Francis S. Collins, M.D.,
Ph.D., and Commissioner of the Food and Drug Administration (FDA)
Margaret Hamburg, M.D., Feb. 24 announced
new collaborative initiatives by the NIH and the FDA to promote
regulatory science.
The secretary announced a new NIH-FDA Joint Leadership Council
to foster collaborative efforts to "help ensure that regulatory
considerations form an integral component of biomedical research
planning, and that the latest science is integrated into the regulatory
review process."
In addition, the NIH and the FDA Feb. 23 issued
a joint request for applications titled, "Advancing Regulatory
Science through Novel Research and Science-Based Technologies."
The agencies are making available $6.75 million over three years
for work in regulatory science which, according to the NIH and the
FDA, "should add to the scientific knowledge base by providing
new methods, models or technologies that will inform the scientific
and regulatory community about better approaches to evaluating safety
and efficacy in medical product development."
Contact:
Tony Mazzaschi, Senior Director
AAMC Scientific Affairs
tmazzaschi@aamc.org
(202) 828-0059
NIH Announces Seven New Common Fund Initiatives
Director of the National Institutes of Health (NIH) Francis Collins,
M.D., Ph.D., Feb. 25 announced
seven new scientific initiatives that will be funded through the
NIH Common Fund. The Fund was created to encourage collaborative
research programs across the NIH institutes and centers and to accomplish
work that no single institute could do alone.
The seven initiatives all are scheduled to begin during FY 2010
and are estimated to utilize a total of $17.8 million from the Common
Fund in FY 2010, with additional funds likely to be allocated in
future years.
The seven new scientific initiatives are:
- Library of Integrated Network-based Cellular Signatures Program
- Protein Capture Reagents Program
- Knockout Mouse Phenotyping Program
- Science of Behavior Change Program
- NIH Induced Pluripotent Stem (iPS) Cell Center
- Global Health Program
- Regulatory Science Program
Contact:
Tony Mazzaschi, Senior Director
AAMC Scientific Affairs
tmazzaschi@aamc.org
(202) 828-0059
NIH Moves to Amend Stem Cell Guidelines on Definition
Issue
The National Institutes of Health (NIH) Feb. 23 announced
in the Federal Register it is requesting public comment on
a revision to the definition of human embryonic stem cells (hESCs)
in the Guidelines
it issued on July 7, 2009, to "establish policy and procedures
under which the NIH will fund such research..." [see Washington
Highlights, July
10, 2009].
In the final Guidelines, hESCs are defined as: "...cells that
are derived from the inner cell mass of blastocyst stage human embryos,
are capable of dividing without differentiating for a prolonged
period in culture, and are known to develop into cells and tissues
of the three primary germ layers." The definition in the draft
version of the Guidelines did not reference the inner cell mass
of blastocysts.
NIH has determined that the definition in the final Guidelines
"had the unintended consequence of excluding certain hESCs
which may otherwise be appropriate for Federal funding. For example,
the current definition excludes hESCs from an embryo which fails
to develop to the blastocyst stage."
NIH is proposing the following new definition: "For the purpose
of these Guidelines, 'human embryonic stem cells (hESCs)' are pluripotent
cells that are derived from early stage human embryos, up to and
including the blastocyst stage, are capable of dividing without
differentiating for a prolonged period in culture, and are known
to develop into cells and tissues of the three primary germ layers."
Three previously approved stem cell lines have been placed on administrative
hold pending final approval of the new definition.
Comments on the change are being accepted for 30 days, ending March
25, 2010.
Contact:
Tony Mazzaschi, Senior Director
AAMC Scientific Affairs
tmazzaschi@aamc.org
(202) 828-0059
White House Holds Health Reform Summit
In an effort to revive health care reform, President Obama, Vice
President Biden, Secretary of Health and Human Services (HHS) Kathleen
Sebelius, Senate and House leadership, and designated
Members of Congress Feb. 25 convened at a White House health care
reform summit
[see Washington Highlights,
Feb. 19] to discuss "ideas for making our health care system
work better for the American people." The televised discussions
focused on controlling costs, insurance reforms, reducing the deficit,
and expanding coverage.
In his opening remarks, President Obama said, "focus not just
on where we differ but focus on where we agree." House and
Senate leaders, in their opening statements, agreed upon the urgent
need to reform the health care system, but continued to differ on
the appropriate way to move forward. During the summit, several
Republicans raised concerns over the proposed Medicare cuts and
the absence of a permanent fix to the current Medicare physician
payment system. Additionally, the discussion focused on the need
to bend the cost curve by reducing medical errors, coordinating
doctor care, and improving prevention and wellness. As a way to
reduce fraud and abuse in Medicare spending, President Obama reiterated
the importance of the proposed independent payment advisory board
[see Washington Highlights,
Jan. 22] included in the Senate-passed health care reform bill
(H.R.
3590).
At the conclusion of the summit, President Obama stated, "starting
over is not possible." The president encouraged summit attendees
to find ways to "bridge the gap" between the proposed
ideas while expanding coverage to those with preexisting conditions
and to those without health insurance.
Contact:
Travis W. Crytzer, Legislative Analyst
AAMC Government Relations
tcrytzer@aamc.org
(202) 828-0418
House VA Health Subcommittee Examines FY 2011
Budget
The House Veterans Affairs (VA) Subcommittee on Health held a Feb.
23 hearing
on the FY 2011 Veterans Health Administration budget. Witnesses
focused on the VA major and minor construction accounts to improve
critical VA infrastructure [see Washington
Highlights, Feb. 5].
Blake C. Ortner, Senior Associate Legislative Director, Paralyzed
Veterans of America (PVA), testified on behalf of the Independent
Budget and echoed recommendations of the Friends of VA Medical
Care and Health Research (FOVA). Mr. Ortner highlighted the degrading
VA research infrastructure and the lack of a direct funding mechanism
that causes this neglect. In his testimony Mr. Ortner notes that
VA has found "a clear need for research infrastructure improvements
throughout the system, including many that impact on life safety."
PVA, in concert with the Independent Budget and FOVA organizations,
recommends "an appropriation in FY 2011 of $300 million dedicated
exclusively to renovating existing research facilities to address
the current and well-documented shortfalls in research infrastructure."
The AAMC is a member of the FOVA executive committee.
Contact:
Matthew Shick, Senior Legislative Analyst
AAMC Government Relations
mshick@aamc.org
(202) 862-6116
House Science and Technology Committee Holds Hearings
on Scientific Research
The House Science and Technology Committee Feb. 23 and 24 heard
testimony on a wide range of issues relating to the biomedical research
community as part of the committee's effort to reauthorize the America
COMPETES Act (P.L.
110-69) [see Washington Highlights,
Jan.22].
On Feb. 23 the Subcommittee on Research and Science Education held
a hearing
to examine the research and research training infrastructure of
universities and colleges. Subcommittee Chair Daniel Lipinski (D-Ill.)
recognized that "successful R & D takes more than intellectual
freedom and grant funding" and that "you also need state-of-the-art
lab space, networks, instruments, and computing facilities."
Chairman Lipinski also stated his concern that "unless we actively
modernize our R & D facilities, we could not only be spending
federal research dollars inefficiently, but we could lose our position
as scientific leaders."
Witnesses, including representatives from the Medical College of
South Carolina, the University of Arizona, Pennsylvania State University,
and the University of Illinois Urbana-Champaign, pointed out that
state support for research-related expenses has declined with the
economy, as has philanthropic giving and other sources of private
funding. They noted that global competitiveness will be difficult
to maintain, top faculty will be harder to recruit and retain, and
student education and readiness will continue to decline if a long-term
commitment to research infrastructure is not made.
On Feb. 24 the Subcommittee on Technology and Innovation heard
testimony regarding ways in which the National Institute of Standards
and Technology (NIST) could better serve the needs of the biomedical
research community. Subcommittee Chair David Wu (D-Ore.) commented
that, in light of the ongoing debate surrounding health reform,
discussion was needed to "examine how we can use science to
reduce health care costs while improving care for patients."
He also stated that "NIST needs to be more connected to industry
and academia to innovatively respond to the demands of this rapidly
changing industry."
Witnesses agreed that NIST needs to play a more active role in
the life sciences and that the institute needs to expand and re-organize.
The panel also testified about the lack of standards across different
labs and states. All witnesses agreed that NIST has tremendous capacity
to build standards for the community, but that doing so would require
expansion of NIST staff, development of an advisory board/panel,
and the possible establishment of joint university-NIST centers
for biomedical research.
The full Science and Technology Committee also heard testimony
regarding the administration's FY 2011 research and development
budget proposal in a separate hearing
Feb. 24 with Office of Science and Technology Policy Director John
Holdren.
Contact:
Shannon Curtis, Legislative Analyst
AAMC Government Relations
scurtis@aamc.org
(202) 828-0558
Senate Approves Job Creation Bill
The Senate Feb. 24 approved (70-28)
legislation that, among other provisions, temporarily would exempt
payroll taxes paid by employers on individuals hired in 2010. The
Hiring Incentives to Restore Employment Act, approved as a substitute
amendment (SA 3310) to H.R.
2847, also would provide additional business tax credits for
firms that retain new employees and increases allowable business
expense deductions. The legislation also includes a one-year extension
to the Highway Trust Fund. The scaled-down $15 billion package now
awaits House action.
Contact:
Travis W. Crytzer, Legislative Analyst
AAMC Government Relations
tcrytzer@aamc.org
(202) 828-0418
On the Hill . . .
Effective Feb. 28, Rep. Neil Abercrombie (D-Hawaii) will resign
his seat in the House of Representatives to run for governor. Hawaiians
will vote for his successor in a special election scheduled for
May 22. Rep. Abercrombie sits on the House Committees on Armed Services
and Natural Resources.
On the Agenda in Washington
March 2: Board of Scientific Counselors Advisory Committee Meeting
10 a.m.; Dial-In Only, 866-880-0098; access code: 9887280
The Board of Scientific Counselors, Coordinating Center for Infectious
Diseases will hold a meeting
via teleconference to discuss H1N1 influenza response and updates
from the Centers for Disease Control and Prevention.
March 3: House Education and Labor Committee FY 2011 Education
Budget Hearing
9:30 a.m.; 2175 Rayburn House Office Building, Washington, D.C.
The House Education and Labor Committee will hold a hearing
on the FY 2011 budget request for the Department of Education, focusing
on spurring innovation and change in the nation's education system
and how improved education can help the economy. Secretary of Education
Arne Duncan will provide testimony.
March 4: Office of the National Coordinator for Health Information
Advisory Committee Meeting
10 a.m.; Dial-In only. RSVP for call-in information.
Office of the National Coordinator for Health Information will hold
a meeting
to provide recommendations to the National Coordinator on a policy
framework for the development and adoption of a nationwide health
information technology infrastructure that permits the electronic
exchange and use of health information as is consistent with the
Federal Health IT Strategic Plan and that includes recommendations
on the areas in which standards, implementation specifications,
and certification criteria are needed. RSVP to Judy Sparrow at 202-205-4528
or judy.sparrow@hhs.gov.
March 5: Ad Hoc Group for Medical Research Briefing with
NIGMS Director
12:00p.m.; B-339 Rayburn House Office Building, Washington, DC
The Ad Hoc Group for Medical Research and the Congressional Biomedical
Research Caucus will host a Congressional luncheon briefing on Friday,
March 5, featuring Jeremy Berg, Ph.D., Director of the National
Institute of General Medical Sciences. RSVP to Hayzell Gollopp at
hgollopp@aamc.org.
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