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Congressional Report: Congress Has Some Unfinished Business as New Term Begins AAMC Efforts Help Roll Back CMS Paperwork Requirements Innovations in Medical Education: Doctors-in-Training Learn How to Tell Stories Healing Deep Wounds: Program at Bellevue / NYU Provides Care for Torture Survivors Nursing Shortage Prompts Creative Solutions Author Q&A: 'Sometimes Wrong, Never in Doubt' 'Flagging' Debate Continues; Data Show Score Fluctuations A Word from the President "A Day in the Life of a Medical Student"
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Congressional Report: Congress Has Some Unfinished Business as New Term BeginsAlthough the 107th Congress approved a handful of bills addressing important aspects of the nation's healthcare delivery system, the past congressional year ended with some unfinished business in this area. Hopes that Congress would complete work on the FY 2003 appropriations bills before the end of 2002 ended when the Senate, prior to adjourning, passed a continuing resolution (CR) Nov. 19 to fund federal programs at the FY 2002 level through Jan.11. Some House and Senate members remain skeptical that Congress will complete any of the 11 remaining FY 2003 appropriation bills before February or March, a delay that could result in diminished funding for federal healthcare initiatives if congressional conservatives push for a year-long CR or funding reductions. Funding increases proposed for programs like those under the National Institutes of Health (NIH) also could be affected. Preliminary indications suggest that Rep. C.W. "Bill" Young (R-Fla.) and Sen. Ted Stevens (R-Alaska), chairs of the House and Senate Appropriations Committees, may be close to an agreement with the White House on an overall discretionary spending level for FY 2003. If so, the chairs will be able to determine subcommittee allocations and could permit staff to begin finalizing the 11 appropriations bills not yet enacted. The goal appears to be to wrap all 11 bills into an omnibus package that would be approved before President Bush's State of the Union address this month. Provider relief concernsOne area of major concern for the AAMC not yet addressed by Congress is provider payment relief for both hospitals and physicians. Because Congress left this item to this year's agenda, Medicare Indirect Medical Education (IME) payment relief for teaching hospitals - critical reimbursements that help pay for the myriad patient care missions of these institutions - might be reduced by 15 percent in FY 2003 as outlined in the Balanced Budget Act of 1997. The AAMC supports passage of The American Hospital Preservation Act, which maintains IME payments at current levels (6.5 percent) and provides a full inflation update for Medicare inpatient services. The 107th Congress did not grant Medicare relief to physicians, either. The AAMC has pursued legislative and administrative fixes to the physician payment update to provide long- and short-term relief from the scheduled Medicare payment reductions specified in Title XVIII of the Social Security Act. The association supports the Medicare Physician Payment Fairness Act, which halts the 5.4 percent reduction in the 2002 Medicare conversion factor update for physician services. The House passed legislation granting the Centers for Medicare and Medicaid Services (CMS) the legal authority to revise errors and make changes in the physician update. A legal analysis released by the AAMC and several groups last May indicated that CMS has the authority to make these changes. Senate Finance Committee Chairman Max Baucus (D-Mont.), however, announced his opposition to the legislation in November, arguing that it did not grant the Bush administration the explicit authority to fix the errors CMS made in its 1998 and 1999 physician payment sustainable-growth-rate calculations. Now, the good newsThe Health Care Safety Net Amendments of 2002 became law last October. Provisions include automatic designation of federally qualified health centers and rural health clinics as health professional shortage areas for the purpose of National Health Service Corps (NHSC) participation if other cost-sharing requirements are met. The legislation also expands the NHSC to include certain mental health professionals and establishes a demonstration project for chiropractors and pharmacists. The president signed the bioterrorism authorization legislation into law, "to improve the ability of the United States to prevent, prepare for, and respond to bioterrorism and other public health emergencies," as stated in the purpose of the measure. The law reconciles differences between the Bioterrorism Preparedness Act and the Public Health Security and Bioterrorism Response Act. The $4.6 billion bill includes $1.15 billion for stockpiling vaccines and antibiotics, authorizes increased protection of the food supply, and establishes new federal oversight of drinking water treatment plans, among other things. The Nurse Reinvestment Act authorizes a number of programs designed to increase the number of nurses and nurse faculty to alleviate the nationwide nurse shortage. It creates a National Nurse Service Corps, based on the NHSC, to provide scholarships to nursing students who agree to serve two years in facilities with a shortage of nurses. It also includes grants to enhance nurse education and improve retention through collaboration among nurses and other healthcare professionals. - Suria Santana, ssantana@aamc.org |
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