Washington Highlights: November
30, 2007
AAMC Signs Group Letter Urging Extension of Medicaid
Moratorium
Contents
Prior Issues
 |
The AAMC signed a Nov. 20 group letter
urging Congress to "take whatever steps it considers necessary
before the December recess" to prevent implementation of recently
issued Medicaid rules that include the elimination of federal matching
payments for graduate medical education (GME). The letter went to
members of the House Oversight and Government Reform Committee as
a follow-up to Nov. 1 testimony by the AAMC and other organizations
opposing the Medicaid rules [see Washington
Highlights, Nov. 2]. Other witnesses signing the letter
included: American College of Emergency Physicians; Child Welfare
League of America; National Association of Public Hospitals and
Health Systems; National Association of School Nurses; and National
Council for Community Behavioral Healthcare.
The Nov. 20 letter advises that the rules discussed at the hearing
will "affect all Americans (regardless of coverage status)
by eroding payments to public and teaching hospitals that maintain
critical health care services unavailable elsewhere in the community."
The letter also notes that eliminating federal Medicaid GME payments
would "jeopardize the nation's capacity to care for all Americans
by limiting their ability to train new doctors for years to come
- just as we prepare to address a national physician shortage."
Also receiving copies of the letter were Reps. Eliot Engel (D-N.Y.)
and Sue Myrick (R-N.C.), who have sponsored AAMC-supported legislation
(H.R.
3533) to extend by 1 year the current moratorium on implementation
of the GME proposed rule (as well as the final rule on cost limits
and units of government).
Information:
Atul Grover, M.D., Ph.D., Chief Advocacy Officer
AAMC Government Relations
agrover@aamc.org
(202) 828-0410
Christiane Mitchell, Director, Federal Affairs
AAMC Government Relations
cmitchell@aamc.org
(202) 828-0526
FOVA Urges Enactment of FY 2008 VA Appropriations
The Friends of VA Medical Care and Health Research (FOVA) coalition
Nov. 30 urged
the House and Senate Appropriations Committees to work with the
Administration to enact the conference agreement on the "FY
2008 Military Construction and Veterans Affairs Appropriations Act"
(H.Rept.
110-424), which provides $480 million for VA research. FOVA
has recommended $480 million for VA research in FY 2008. The AAMC
is a member of the FOVA Executive Committee.
As a result of the current continuing resolution (CR, P.L.
110-116), VA research is operating at a funding level lower
than its FY 2006 spending level [see Washington
Highlights, Nov. 16]. In FY 2007, Congress provided a total
spending level of over $466 million, yet the current CR funds VA
Medical and Prosthetic Research at an annual rate of $411 million,
a 7.9 percent cut. The letter notes, "when available research
awards decline as a function of budgetary policy, the VA risks losing
physician-researchers and other clinical investigators who are integral
to providing direct care for our nation's veterans and for sustaining
its quality."
Information:
Matthew Shick, Senior Legislative Analyst
AAMC Government Relations
mshick@aamc.org
(202) 862-6116
CMS Submits Value-Based Purchasing Plan to Congress
The Centers for Medicare and Medicaid Services (CMS) Nov. 21 submitted
to Congress its "Plan
to Implement a Medicare Hospital Value-Based Purchasing Program."
The "Deficit Reduction Act of 2005" (DRA, P.L.
109-171), required CMS to develop and present to Congress a
value-based purchasing plan that could be implemented in FY 2009.
The proposed plan changes the current pay-for-reporting program
to add a pay-for-performance component and increases the financial
risk by shifting the incentive payment from a percentage of the
annual payment update to a percentage of the Diagnosis-Related Group
(DRG) payments. Congress will need to approve legislation for CMS
to implement the plan.
CMS conducted two public listening sessions and developed two options
papers
to solicit input and feedback from hospitals and related stakeholders.
The final plan does not differ significantly from the options paper
prepared for the second CMS listening session, which contains most
of the original recommendations. However, the plan is not prescriptive,
and some questions regarding specific implementation details are
still to be decided.
CMS suggests a phased-in approach to transition from the current
pay-for-reporting program to value-based purchasing. The suggested
plan initially utilizes the new financial incentive (percentage
of DRG payment), based solely on pay-for-reporting and not on performance
levels. This would give hospitals an opportunity to familiarize
themselves with how the program works without large financial risk.
The second year of the program bases 50 percent of payment on reporting
and 50 percent on performance, while the third year and every year
thereafter bases 100 percent of payment on performance.
The proposed plan will measure hospitals' performance on levels
of attainment and improvement. Hospitals will be scored by measures
in each category and those scores will translate into a percentage
of the incentive payment a hospital will receive. The measures that
will be considered for the plan are a subset of the measures currently
reported on the Hospital
Compare website. CMS provides two options for the basis of the
incentive payment: a percentage of the base DRG payment or a percentage
of the full DRG payment including IME, DSH payments, and outliers.
The plan shows a preference for utilizing the percentage of the
base DRG payment as well as suggesting a range of 2-5 percent for
incentive payments.
Information:
Jennifer Faerberg, Director of GME Track/Health Care Quality Liaison
AAMC Division of Health Care Affairs
jfaerberg@aamc.org
(202) 862-6221
FDA Announces Reagan-Udall Foundation Board
The Food and Drug Administration (FDA) Nov. 16 announced
the board members of the Reagan-Udall Foundation, the independent,
non-profit organization established by the "Food and Drug Administration
Amendments Act of 2007" (FDAAA, P.L.
110-85) to advance the FDA's mission by modernizing product
development and enhancing product safety through public-private
partnerships [see Washington
Highlights, Sept. 28]. Former FDA commissioner and former
Administrator of the Centers for Medicare and Medicaid Services
Mark McClellan, M.D., Ph.D., will chair the foundation. Dr. McClellan
currently serves as director of the Engleberg Center for Health
Care Reform at the Brookings Institution.
As required by the FDAAA, the 14-member board includes 3 representatives
from academic research organizations: William Brody, M.D., Ph.D.,
President of The Johns Hopkins University; Michael Doyle, Ph.D.,
Regents Professor and Director of the Center for Food Safety at
the University of Georgia; and Phillip A. Sharp, Ph.D., Institute
Professor at the Massachusetts Institute of Technology's Center
for Cancer Research. The law requires four government health care
officials - the commissioner of the FDA, the director of the National
Institutes of Health (NIH), the director of the Centers for Disease
Control and Prevention, and the director of the Agency for Healthcare
Research and Quality - to appoint the board members; the FDA commissioner
and NIH director will serve as non-voting members. A complete list
of board members and more information about the foundation is available
on the FDA website.
Information:
Tannaz Rasouli, Senior Legislative Analyst
AAMC Government Relations
trasouli@aamc.org
(202) 828-0525
On the Hill
Senate Minority Whip Trent Lott (R-Miss.) Nov. 26 announced he
will retire from the Senate by the end of the year, 5 years before
his term expires. Gov. Haley Barbour (R) is expected to appoint
a temporary successor within 10 days of Sen. Lott's official resignation
before calling a special election to coincide with the general elections
in Nov. 2008.
Rep. Dennis Hastert (R-Ill.), who served as Speaker of the House
from 1999 to 2007, Nov. 26 submitted his resignation from the House
of Representatives effective immediately. Illinois law requires
Gov. Rod Blagojevich (D) to schedule a special election within 120
days of the vacancy.
Rep. Bobby Jindal (R-La.) announced he will resign from the House
of Representatives effective Jan. 14, 2008, the same day he is to
be inaugurated as governor. Current Gov. Kathleen Blanco (D) has
scheduled for May 8, 2008 a special election to fill the vacancy.
Rep. Julia Carson (D-Ind.) Nov. 26 announced she will not seek
reelection in 2008. Rep. Carson recently disclosed that she has
terminal lung cancer.
| 
