Washington Highlights: June 27,
2008
Contents
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Congress Passes Bill Extending Medicaid Moratorium
The Senate June 26 voted 92-6
to adopt the House-passed FY 2008 emergency supplemental appropriations
bill (H.R.
2642), which includes AAMC-supported provisions prohibiting
until April 1, 2009, any CMS action related to the Medicaid GME
proposed rule, the Medicaid final rule on cost limits/units of government
(the "IGT rule"), and four other Medicaid regulations.
The spending bill also includes the House-passed language providing
$400 million in FY 2008 science funding, including $150 million
for the National Institutes of Health [see Washington
Highlights, June 20].
In a June 19 Statement of Administration Policy, President Bush
indicated that he will sign the supplemental appropriations bill
into law.
Information:
Christiane Mitchell, Senior Legislative Affairs Manager
AAMC Government Relations
cmitchell@aamc.org
(202) 828-0526
Senate, Administration Reject Legislation Averting
Medicare Physician Payment Cuts
Senate Majority Leader Harry Reid (D-Nev.) June 26 attempted
to invoke cloture and adopt a House-passed Medicare
package (H.R.
6331) that would avert the 10.6 percent cut in Medicare physician
payments scheduled for July 1. Unable to secure the three-fifths
majority necessary to prevent a filibuster, Sen. Reid withdrew the
bill from consideration. The Senate is expected to leave for its
July 4 recess without taking further action to prevent Medicare
cuts.
The House June 24 passed H.R. 6331, 355-59.
The legislation, which was introduced by Ways and Means Committee
Chair Charles Rangel (D-N.Y.) and Energy and Commerce Committee
Chair John D. Dingell (D-Mich.), would extend the current Medicare
physician payment update (0.5 percent) through Dec. 31, 2008 and
establish a 1.1 percent update for calendar year 2009. It would
also extend the availability of incentive payments for physician
quality reporting through 2010. The cost of the bill is partially
offset by a phase-out of IME payments made to Medicare Advantage
plans. The cuts do not affect the IME payments made directly to
teaching hospitals that treat Medicare Advantage beneficiaries.
In anticipation of the House and Senate votes, the AAMC June 23
sent letters
to the leadership of the Finance, Ways and Means, and Energy and
Commerce Committees, urging "swift passage" of physician
payment relief. The Administration June 24, and again June 26, threatened
to veto H.R. 6331, largely because it contained significant payment
reductions for Medicare Advantage plans.
Reacting to the failed cloture vote, Sen. Reid stated that "seniors
and the health care providers who care for them have only Senate
Republicans to blame when Medicare payments are cut and other key
protections expire." He added that "Senate Republicans
insist on standing with President Bush to protect insurance companies
at the expense of patients and providers. This is nothing short
of putting politics above the seniors and people with disabilities
who depend on Medicare."House roll call vote posted at: http://clerk.house.gov/evs/2008/roll443.xml
Information:
Christiane Mitchell, Senior Legislative Affairs Manager
AAMC Government Relations
cmitchell@aamc.org
(202) 828-0526
Travis W. Crytzer, Legislative Associate
AAMC Health Care Affairs/Government Relations
tcrytzer@aamc.org
(202) 828-0418
Senate Panel Approves HHS Funding
The Senate Appropriations Committee June 26 approved its FY 2009
Labor-HHS-Education appropriations bill
on a 26-3 vote. The $153.1 billion measure provides $30.255
billion for the NIH, an increase of $1.025 billion (3.5 percent)
over the FY 2008 funding level and the President's FY 2009 budget
request. Senator Tom Harkin (D-Iowa), chair of the Labor-HHS-Education
Appropriations Subcommittee, July 24 released a statement following
the subcommittee's passage of the bill that says, "The Subcommittee's
increase will allow the NIH to award the highest number of new research
project grants in its history and keep up with the biomedical inflation
rate for the first time in six years."
The committee adopted an amendment by Senators Harkin and Wayne
Allard (R-Colo.) that would require NIH to monitor more closely
possible conflicts of interest among extramural grantees. The amendment
calls for the Secretary of Health and Human Services to issue a
proposed rule, with an opportunity for public comment, within 6
months of the spending bill's enactment.
The bill also provides $135 million for the National Health Service
Corps, an increase of $11.5 million (9.3 percent) over FY 2008 and
$14 million more than the President's budget. The bill freezes the
Agency for Healthcare Research and Quality (AHRQ) at the FY 2008
level of $334.6 million.
The committee has not yet filed the report and has released only
limited details on the funding levels in the bill. The bill is unlikely
to make it to the Senate Floor this summer. Senate Majority Whip
Richard Durbin (D-Ill.) told reporters June 26 that the Defense
appropriations bill would be the only one that Majority Leader Harry
Reid (D-Nev.) will bring to the Senate Floor in July.
Information:
Dave Moore, Senior Associate Vice President
AAMC Government Relations
dbmoore@aamc.org
(202) 828-0525
Tannaz Rasouli, Legislative Analyst
AAMC Government Relations
trasouli@aamc.org
(202) 828-0525
HHS Funding Bill Stalls in House Committee
The House Appropriations Committee June 26 abruptly cut short consideration
of its Labor-HHS bill after Republicans tried to force votes on
amendments related to expansion of domestic oil production. Efforts
by Republicans to force consideration of the Interior bill to address
rising fuel prices caused chaos and Democrats opted to vote to adjourn.
Concerned about continued Republican efforts to raise the energy
issue, House Appropriations Committee Chair David Obey (D-Wis.)
has threatened to shut down the appropriations process. He told
reporters June 26, "I think we probably had our last meeting
of the year, and this will probably go to a continuing resolution."
The bill, which was approved by the House Labor-HHS-Education Appropriations
Subcommittee on June 19, proposes $30.380 billion for NIH, an increase
of $1.150 billion (3.9 percent) over FY 2008 and the President's
budget, and $125 million more than the Senate bill. (see
related story)
The bill rejects the Administration's proposal to eliminate funding
for Title VII health professions education and provides $244.1 million,
a $50.2 million (25.9 percent) increase over last year. Within that
total, the Title VII Centers of Excellence (COE) and Health Careers
Opportunity Program (HCOP) each receive $28.4 million, increases
of $15.7 million (122 percent) and $18.6 million (189 percent) respectively.
The bill provides $36.9 million for the Title VII Area Health Education
Centers (AHEC), an $8.7 million (30.9 percent) increase.
The bill also provides $310 million for children's graduate medical
education, an increase of $8.4 million (2.8 percent). For the National
Health Service Corps, the bill provides $135 million, an increase
of $11.5 million (9.3 percent) over FY 2008 and equal to the Senate
bill. The bill also boosts the Agency for Healthcare Research and
Quality (AHRQ), providing $375 million in program level funding.
The funding level represents a $40.4 million (12.1 percent) increase
over FY 2008 and includes $50 million designated for clinical effectiveness
research, a $20 million (66.7 percent) increase.
Information:
Dave Moore, Senior Associate Vice President
AAMC Government Relations
dbmoore@aamc.org
(202) 828-0525
Tannaz Rasouli, Legislative Analyst
AAMC Government Relations
trasouli@aamc.org
(202) 828-0525
House Committee Approves VA Appropriations
The House Committee on Appropriations June 24 approved its FY 2009
Military Construction and Veterans Affairs spending bill. According
to a Committee press
release, the bill includes "$30.9 billion, $1 billion above
the President's request and $2.8 billion [6.2 percent] above 2008"
for VA Medical Services. The bill includes $5 billion for VA Medical
Facilities, an increase of $900 million (22 percent) over FY 2008
and $339 million over the President's request. For VA Research,
the Committee approved $500 million, a $20 million (4.2 percent)
increase over FY 2008 and $58 million more than the President's
request. The Senate is expected to consider its VA spending bill
when they return from the July 4 recess.
The Friends of VA Medical Care and Health Research (FOVA) recommend
$555 million for VA research in FY 2009, a $75 million (15.6 percent)
increase over FY 2008. The AAMC is a member of the FOVA executive
committee.
Information:
Matthew Shick, Legislative Analyst
AAMC Government Relations
mshick@aamc.org
(202) 828-0525
House Panel Approves NSF Increase
The House Appropriations Committee June 25 approved an FY 2009
spending bill that reportedly matches the President's requested
$6.854 billion for the National Science Foundation (NSF). The funding
level represents a $789.1 million (13 percent) increase over the
funding provided in the FY 2008 Consolidated Appropriations Act.
According to a statement
released by the House Appropriations Committee, "this increase
would put NSF on track to see its funding doubled over ten years."
The bill reportedly provides $50 million more than the President's
requested $790 million for NSF education activities, a $115 million
(15.9 percent) increase over FY 2008. The House Commerce-Justice-Science
Appropriations Subcommittee approved the bill June 12.
The Senate Appropriations Committee approved its version of the
bill (S. 3182, S.Rept. 110-397) June 19 [see Washington
Highlights, June 20], also providing $6.854 billion for
NSF. Within that total, the Senate bill provides $5.527 billion
for research and related activities, a $772.5 million (16.2 percent)
increase as recommended by the President. The Senate bill also fulfills
the President's request of $790.4 million for science education
activities.
Information:
Tannaz Rasouli, Legislative Analyst
AAMC Government Relations
trasouli@aamc.org
(202) 828-0525
Energy and Commerce Subcommittee Approves HIT,
Privacy Measure
The House Energy and Commerce Subcommittee on Health June 25 approved
health information technology (HIT) and privacy legislation with
the understanding that some of the bill's privacy provisions will
be refined before full committee consideration.
The "Protecting Records, Optimizing Treatment, and Easing
Communication through Healthcare Technology Act of 2008," or
the PRO(TECH)T Act (H.R.
6357), was introduced June 24 by Committee Chair John Dingell
(D-Mich.), Committee Ranking Member Joe Barton (R-Texas), Subcommittee
Chair Frank Pallone (D-N.J.), and Subcommittee Ranking Member Nathan
Deal (R-Ga.). The measure aims to promote HIT adoption through improved
federal HIT standards, incentives to implement HIT, and new information
privacy and security protections.
Three amendments were offered and withdrawn at the mark-up, including
two by Rep. Mike Rogers (R-Mich.) that sought to avoid "unintended
consequences" that would result from "adding another layer"
to existing privacy protections in the Health Insurance Portability
and Accountability Act (HIPAA). Chairman Pallone agreed to discuss
the proposed amendments with Rep. Rogers, but cautioned that he
could not promise to change certain provisions since they had been
carefully negotiated with Rep. Barton. The third amendment, offered
by Rep. Henry Waxman (D-Calif.), would have enabled state attorneys
general to enforce civil penalties for HIPAA violations and other
privacy breaches.
The subcommittee had held a June 4 hearing to consider an earlier
draft of the measure [see Washington
Highlights,
June 6]. According to a summary prepared by committee staff,
the revised PRO(TECH)T Act responds to comments from various stakeholders.
In response to Rep. Rogers' urging that the subcommittee engage
in a dialogue with physicians, hospitals and others that would be
required to implement the bill's provisions, Chairman Pallone noted
that the subcommittee will continue to reach out to the full range
of stakeholders.
A section-by-section analysis of the bill, a summary of changes,
and an archived webcast of the mark-up are available on the Energy
and Commerce Committee website.
Information:
Tannaz Rasouli, Legislative Analyst
AAMC Government Relations
trasouli@aamc.org
(202) 828-0525
Congress Approves Temporary Extension of HEA
The Senate June 23 and the House June 25 approved a "clean"
one-month extension (S.
3180) of the Higher Education Act (HEA), making no policy changes
but allowing uninterrupted administration of the programs authorized
under the law. Congress last completed a full reauthorization of
HEA in 1998.
The AAMC May 15 sent a letter
to the House Committee on Education and Labor and the Senate Committee
on Health, Education, Labor, and Pensions regarding ongoing conference
of the "College Opportunity and Affordability Act of 2007"
(H.R.
4137) and the "Higher Education Amendments of 2007"
(S.1642).
The letter comments on provisions of the HEA reauthorization bills
that could affect medical education, including loan repayment, financial
aid, institutional grant programs, and accreditation [see Washington
Highlights,
May 16]
Information:
Matthew Shick, Legislative Analyst
AAMC Government Relations
mshick@aamc.org
(202) 828-0525
Correction: The June 20 Washington Highlights article
on the FY 2008 emergency supplemental should have stated the Medicaid
moratorium does not apply to the proposed rule affecting certain
outpatient clinic and hospital services.
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