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Second Opinion

Learn about policy issues important to medical schools and teaching hospitals, with Chief Public Policy Officer Atul Grover, MD, PhD

White House Announces $1 Billion for Cancer Moonshot

February 5, 2016—President Obama and Vice President Biden Feb. 1 convened the first meeting of the White House Cancer Moonshot Task Force [see Washington Highlights, Jan. 29].

Following opening remarks from the president and vice president, participants discussed the Moonshot’s principles and pillars and federal efforts that can support the Cancer Moonshot, including updates on federal research and treatment development, data sharing, and technical and computational capabilities.

The White House also announced the administration is launching the National Cancer Moonshot with a $1 billion initiative to provide the funding necessary for researchers to accelerate the development of new cancer detection and treatments.

According to a White House fact sheet, this funding includes:

  • $195 million in new cancer activities at the National Institutes of Health (NIH) in fiscal year (FY) 2016; and
  • $755 million in mandatory funds for new cancer-related research activities at both NIH and the Food and Drug Administration proposed in the president’s FY 2017 budget.

Within the Department of Health and Human Services, these investments will support cutting edge research opportunities such as:

  • Prevention and Cancer Vaccine Development;
  • Early Cancer Detection; 
  • Cancer Immunotherapy and Combination Therapy;
  • Genomic Analysis of Tumor and Surrounding Cells; 
  • Enhanced Data Sharing: 
  • a virtual Oncology Center of Excellence at FDA; 
  • Pediatric Cancer; and
  • the Vice President’s Exceptional Opportunities in Cancer Research Fund, which will focus on high-risk, high-return research identified by the collaborative work and new ideas stimulated by the research community as part of this work.

In addition, the White House said the departments of Defense and the Veterans Affairs are increasing their investments in cancer research, including through funding Centers of Excellence focused on specific cancers, and conducting large longitudinal studies to help determine risk factors and enhance treatment.

Contact:

Dave Moore
Senior Director, Government Relations
Telephone: 202-828-0559
Email: dbmoore@aamc.org

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AAMC Submits Letter to CMS on Notice of 0.2 Percent Reduction to IPPS Rates

February 5, 2016—The AAMC Feb. 2 submitted comments to the Centers for Medicare and Medicaid Services (CMS) regarding a Dec. 1, 2015 notice that outlined the basis for a 0.2 percent payment reduction in Inpatient Prospective Payment Systems (IPPS) rates to account for expenditures resulting from the two-midnight policy [see Washington Highlights, Dec. 4, 2015].

The AAMC urges CMS to restore the 0.2 percent ($220 million) payment reduction to IPPS rates that began in fiscal year (FY) 2014. The reduction was the result of a CMS estimate that the two-midnight policy, also implemented in FY 2014, would lead to a net increase in inpatient stays, thereby increasing Medicare spending. CMS was ordered to issue the notice by a Federal Court in the case of Shands Jacksonville Medical Center, Inc., et al. v. Burwell.

The AAMC further identifies flaws in calculations and assumptions, and therefore concludes there is no justification for the payment reduction imposed by CMS. The letter also recommends additional criteria and analysis to refine CMS’s method. The AAMC urges CMS to restore the reduction for FY 2014 and all subsequent payment years. At a minimum, the 0.2 percent reduction should be restored beginning in FY 2017. CMS is expected to release a final notice on March 18.

Contact:

Susan Xu, M.P.A, M.S.
Lead Research Analyst
Telephone: 202-860-6012
Email: sxu@aamc.org

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AAMC Comments on the EHR Certification Requirements

February 5, 2016—The AAMC Feb. 4 submitted a comment letter on the Centers for Medicare and Medicaid Services’ (CMS) Request for Information (RFI) on Certification Frequency and Requirements for the Reporting of Quality Measures under CMS Programs, including the Inpatient Quality Reporting (IQR) and Physician Quality Reporting System (PQRS) programs.

The AAMC provided broad comments on the RFI, including a request that CMS implement an administrative process to ensure that Electronic Health Records (EHR) vendors expeditiously update their systems to incorporate new data elements, and to ensure that electronic clinical quality measures (e-CQMs) can be exchanged, captured, and transmitted through an EHR.

Noting the time and cost burden to test the collection and submission of new e-CQMs, the association also recommends that CMS only include changes to e-CQMs once per year and allow for flexibility regarding which measures to report.  

In its comments, the AAMC supports certification standards regarding connecting EHRs with registries. While CMS has encouraged providers to use registries as a mechanism for reporting on quality in its programs, many EHR vendors are not transmitting data with registries. Certification standards will help reduce additional burden on providers.

Contact:

Scott Wetzel, M.P.P.
Senior Specialist, Health Care Affairs
Telephone: 202-828-0495
Email: swetzel@aamc.org

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MACPAC Releases Report on Medicaid DSH Payments

February 5, 2016—The Medicaid and CHIP Payment and Access Commission (MACPAC) Feb. 1 released its first Report to Congress on Medicaid Disproportionate Share (DSH) Hospital Payments. The report calls for better targeting of Medicaid DSH payments to hospitals with a high share of low-income patients and high levels of uncompensated care.

The Protecting Access to Medicare Act of 2014 (P.L. 113-93) requires MACPAC to report annually on Medicaid DSH payments and to provide state-specific analyses of the following data elements: changes in the number of uninsured individuals, the amount and sources of hospitals’ uncompensated care costs, and the number of hospitals with high levels of uncompensated care that also provide access to essential community services for low-income, uninsured, and vulnerable populations. The report finds there is little meaningful relationship between state DSH allotments and any of these factors.

The report also finds that more than one-third of Medicaid DSH payments are made to hospitals that do not meet the statutory criteria for receiving these payments. As such, the commission calls for targeted DSH payments and greater transparency in how hospitals are paid.

The commission specifically recommends, “The Secretary of the U.S. Department of Health and Human Services should collect and report hospital-specific data on all types of Medicaid payments for all hospitals that receive them. In addition, the Secretary should collect and report data on the sources of non-federal share necessary to determine net Medicaid payment at the provider level.”

In 2014, Medicaid made $18 billion in Medicaid DSH payments to provide support to safety-net hospitals by helping to offset uncompensated care costs for Medicaid and uninsured patients. Medicaid DSH allotments are scheduled to be reduced by 16 percent beginning in fiscal year (FY) 2018 with reductions increasing to 55 percent by FY 2025.

Contact:

Jason Kleinman
Sr. Program & Policy Specialist, Govt Relations
Telephone: 202-903-0806
Email: jkleinman@aamc.org

Scott Wetzel, M.P.P.
Senior Specialist, Health Care Affairs
Telephone: 202-828-0495
Email: swetzel@aamc.org

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On The Agenda

Feb. 9: HELP Committee Executive Session on Pending Health Care Legislation
10 a.m.; 430 Dirksen Senate Office Building, Washington, D.C.
The Senate Committee on Health, Education, Labor and Pensions (HELP) will hold an Executive Session to discuss various pieces of health care legislation.

Feb. 10: Senate VA Committee Hearing on VA Budget Request
10 a.m.; 418 Russell Senate Office Building, Washington, D.C.
The Senate Veterans’ Affairs (VA) Committee will hold a hearing on the Department of Veterans’ Affairs Budget Request for fiscal year 2017.

Feb. 10: Senate Finance Committee Hearing on the President’s Budget Proposal
10 a.m.; 215 Dirksen Senate Office Building, Washington, D.C.
The Senate Committee on Finance will hold a hearing on the president’s budget proposal for fiscal year 2017. The Honorable Sylvia Mathews Burwell, Secretary of Health and Human Services, will testify.

Feb. 10: E&C Health Subcommittee Hearing on Medicaid and CHIP  
10 a.m.; 2123 Rayburn House Office Building, Washington, D.C.
The House Energy and Commerce Health Subcommittee will hold a hearing to examine the Medicaid and Children's Health Insurance Program (CHIP) medical assistance percentage. Witness testimony will be posted to the committee’s website when available.

Feb. 10: House VA Committee Hearing on VA Budget Request
10 a.m.; 334 Cannon House Office Building, Washington, D.C.
The House Veterans Affairs (VA) Committee will hold a hearing on the Department of Veterans Affairs fiscal year 2017 budget request. Witness testimony will be posted to the committee’s website when available.

Feb. 10: Senate Finance Committee Hearing on Revenue Proposals in President’s Budget
10:30 a.m.; 215 Dirksen Senate Office Building, Washington, D.C.
The Senate Committee on Finance will hold a hearing on the president’s budget proposal for fiscal year 2017. The Honorable Jacob Lew, Secretary of The Treasury will testify.

Feb. 10: Ways and Means Committee Hearing on HHS Budget Request
2 p.m.; 1100 Longworth House Office Building, Washington, D.C.
The House Ways and Means Committee will hold a hearing on the Department of Health and Human Services’ (HHS) fiscal year 2017 budget request. The Honorable Sylvia Mathews Burwell, Secretary of Health and Human Services, will testify.

Feb. 11: House VA Health Subcommittee Hearing on Choice Consolidation
10 a.m.; 334 Cannon House Office Building, Washington, D.C.
The House Veterans Affairs (VA) Health Subcommittee will hold a hearing to discuss Choice Consolidation’s Community Care billing and reimbursement. Witness testimony will be posted to the committee’s website when available.

Feb. 11: Ways and Means Committee Hearing on the President’s Budget Proposal
10 a.m.; 1100 Longworth House Office Building, Washington, D.C.
The House Committee on Ways and Means will hold a hearing on the president’s budget proposal for fiscal year 2017. Department of Treasury Secretary, Jacob J. Lew, will testify.

Feb. 12:  HIT Standards Committee Meeting
10 a.m.; Webinar
The Office of the National Coordinator (ONC) Health Information Technology (HIT) Standards Committee will meet via webinar to discuss recommendations on the Precision Medicine Task Force.

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Washington Highlights, a weekly electronic newsletter, features brief updates on the latest legislative and regulatory activities affecting medical schools and teaching hospitals.



For More Information

Dave Moore
Senior Director, Government Relations
Telephone: 202-828-0559
Email: dbmoore@aamc.org