Washington Highlights: June 5, 2009
AAMC Cosponsors Hill Briefing on Recovery Act
Funds
Contents
Prior Issues
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The AAMC June 1 cosponsored the first in a series of congressional
briefings on how the National Institutes of Health (NIH) is investing
federal support provided by the American Recovery and Reinvestment
Act (ARRA,
P.L. 111-5) to advance medical research. Anthony Fauci, M.D.,
director, National Institute of Allergy and Infectious Diseases
(NIAID), outlined for a standing-room only audience plans for three
NIAID Signature Projects directed at stopping the HIV pandemic,
advancing immunology and vaccine development, and addressing biodefense
and emerging infectious diseases. A Web cast of the briefing and
Dr. Fauci's slides are available online.
The Ad Hoc Group for Medical Research is hosting this series in
conjunction with the Congressional Biomedical Research Caucus. Other
co-sponsors include the American Heart Association, American Society
of Nephrology, Association of Independent Research Institutes, Coalition
for Life Sciences, Federation of American Societies for Experimental
Biology (FASEB), Research!America, and the Society for Neuroscience.
The AAMC is a member of the Ad Hoc Group steering committee. Thomas
Insel, M.D., director, National Institute of Mental Health, is scheduled
to speak at the next briefing, planned for July 10.
Information:
Dave Moore, Senior Director
AAMC Government Relations
dbmoore@aamc.org
(202) 828-0525
Tannaz Rasouli, Senior Legislative Analyst
AAMC Government Relations
trasouli@aamc.org
(202) 828-0525
AAMC Comments on OHRP Advanced Notice of Proposed
Rule Making
The AAMC June 3 submitted comments
on an HHS Office of Human Research Protection (OHRP) Advanced Notice
of Proposed Rule Making that would enable the office to hold external
Institutional Review Boards (IRB) directly accountable for meeting
regulatory requirements of the department's regulations for the
protection of human subjects.
The AAMC comment letter supports an expansion of OHRP's regulatory
oversight from its current exclusive focus on the institution engaged
in human subjects research to the external IRB (and the organization
of which it is a part) that has the responsibility for reviewing
that research. The AAMC believes the change would provide more encouragement
to institutions to implement a variety of cooperative IRB review
arrangements, without being forced to retain regulatory liability
even where regulatory responsibilities have been appropriately assigned
to an external IRB.
Information:
Susan Ehringhaus, Sr. Director & Regulatory Counsel
AAMC Biomedical Health Sciences Research
sehringhaus@aamc.org
(202) 828-0543
Irena Tartakovsky, Senior Science Policy Analyst
AAMC Biomedical and Health Sciences Research
itartakovsky@aamc.org
(202) 862-6134
Budget Committees Give Appropriators More Funds
The House and Senate Budget Committees June 3 released revised
FY 2010 allocations for the Appropriations committees that will
result in an additional $3.8 billion in discretionary spending.
The Budget committees increased the overall FY 2010 allocation for
the 12 annual appropriations bills to $1.086 trillion as a result
of the Congressional Budget Office re-estimating the costs of programs
in the President's budget. The revision was necessary because the
President had not released the full details of his budget when Congress
approved the FY 2010 budget resolution (S.
Con. Res 13) April 29.
Information:
Dave Moore, Senior Director
AAMC Government Relations
dbmoore@aamc.org
(202) 828-0525
NHSC Creates New Application Cycle for Recovery
Funding
The National Health Service Corps (NHSC) June 2 announced
that it would begin accepting applications for loan repayment using
funds provided by the American Recovery and Reinvestment Act (ARRA,
P.L.
111-5). ARRA provides an additional $300 million for the NHSC
to be spent in FYs 2009 and 2010.
As of June 2, the NHSC will accept loan repayment applications
continuously until ARRA funds are expended or Sept. 30, 2010, whichever
comes first. For the first time, clinicians do not need to be employed
in an approved site in a Health Professional Shortage Area when
applying, but must be available to begin work within 30 days of
being notified that their application has been accepted. NHSC anticipates
most applications will be processed within eight weeks of the submission
of a complete application.
Of the $300 million ARRA provides to the NHSC, $200 million is
expected to be used for more than 3,300 new loan repayment awards.
ARRA requires $75 million of the $300 million to remain available
through Sept. 30, 2011, for "extending service contracts and
the recapture and reallocation of funds in the event that a participant
fails to fulfill his or her term of service." ARRA also designates
20 percent of NHSC funds for field operations.
Information:
Matthew Shick, Senior Legislative Analyst
AAMC Government Relations
mshick@aamc.org
(202) 862-6116
PPAC Provides Recommendations on Time, Cost Burden
from Compliance with CMS Programs
Staff from the Centers for Medicare and Medicaid Services (CMS)
June 1 delivered testimony on programs of interest to physicians
at the quarterly meeting of the Practicing Physicians Advisory Council
(PPAC). The
meeting covered a variety of topics relevant to physicians, including
value-based purchasing programs and the Medicare Recovery Audit
Contractor (RAC) program.
Citing inequities between payments to hospitals and physicians,
PPAC recommended CMS reconsider non-payment for copy costs associated
with medical record requests, as CMS currently reimburses hospitals
but not physicians. Further, PPAC recommended CMS assess the costs
attributed to physician participation in the Physician Quality Reporting
Initiative (PQRI), e-prescribe and RAC programs, as PPAC members
expressed significant time and cost burdens associated with program
compliance.
PPAC members commented on the RAC program, which the Tax Relief
and Healthcare Act of 2006 (P.L.
109-432) requires to expand nationwide by January 2010. RACs
are tasked with reviewing Medicare Part A and B claims to detect
and correct improper payments, non-covered services, incorrectly
coded services, and duplicate services and are paid by CMS on a
contingency fee basis. According to CMS officials, RACs are slated
to begin claim reviews in a number of states this June.
PPAC is a mandated advisory body to HHS that provides input on
regulatory issues and carrier manual instructions.
Information:
Will Dardani, Constituent Services Specialist
AAMC Health Care Affairs
wdardani@aamc.org
(202) 828-0541
HHS Secretary Testifies on FY 2010 Budget
Secretary of Health and Human Services (HHS) Kathleen Sebelius
June 2 testified before the House Labor-HHS-Education Appropriations
Subcommittee about the department's FY 2010 budget request and the
administration's efforts on health care reform. Though her prepared
remarks did not focus on medical research, Committee Chair David
Obey (D-Wis.) and several members of the subcommittee questioned
Secretary Sebelius about the administration's request for the National
Institutes of Health (NIH). Full committee Ranking Member Jerry
Lewis (R-Calif.) also inquired about the administration's plan to
avoid an impending "cliff," once funds from the American
Recovery and Reinvestment Act (ARRA, P.L.
111-5) expire. Secretary Sebelius acknowledged the "enormous
dividends" that the ARRA investment in NIH will yield, and
pledged to work with the administration to develop a multi-year
plan to address NIH funding beginning in FY 2011.
Secretary Sebelius also emphasized the administration's emphasis
on strengthening the health care workforce and mitigating health
disparities.
Information:
Tannaz Rasouli, Senior Legislative Analyst
AAMC Government Relations
trasouli@aamc.org
(202) 828-0525
NIH Director's Advisory Committee Discusses Recovery
Funds
The National Institutes of Health (NIH) Advisory Committee to the
Director (ACD) June 4 convened to discuss, among other items, the
research community's response to new funding opportunities under
the American Recovery and Reinvestment Act (ARRA, P.L.
111-5). Acting Director Raynard Kington, M.D., Ph.D., noted
that applications received to date for ARRA's headline programs
are running far higher than many expected. For example, NIH has
received more than 20,000 applications for "Challenge Grants."
He noted that with contributions from NIH Institutes and Centers,
the funding total for these awards may exceed $400 million, double
NIH's original estimate.
The committee inquired about NIH's preparations for review and
management of these programs. Dr. Kington, Sally Rockey, Ph.D.,
Acting Deputy Director for Extramural Research, and other staff
noted that, in addition to NIH preparations-which the ACD generally
applauded- the Office of Management and Budget (OMB) is coordinating
reporting requirements for ARRA funding across federal agencies.
NIH will provide guidance to investigators and institutions for
providing information, but NIH will not be able to modify or revise
the reporting forms or other instructions issued by OMB. A recurring
message from ACD members was the importance of communication in
the research community on the broad scope of these activities and
the role of biomedical research in advancing the nation's immediate
and long-term economic interests.
Jeremy Berg, Ph.D., Director of the National Institute of General
Medical Sciences updated the ACD on support of new investigators.
Citing AAMC data, Dr. Berg underscored once again concerns about
an increasing gap, on average, from time of first faculty appointment
in medical school to subsequent application and receipt of a first
NIH research grant. Given already increased timelines for training
and faculty appointment, Dr. Berg noted that this additional gap
is further cause for concern that the nation's pool of biomedical
scientists is increasingly older and that young scientists will
be discouraged from careers in biomedical research. NIH has created
a new category of "early stage investigators" defined
as individuals who are new or first-time NIH investigators and who
also are within ten years of completing terminal degree (such as
Ph.D.) or within ten years of completing residency (or equivalent)
for physician or similar investigators.
Dr. Berg also presented data on applications and awards under the
National Academies' inspired "Pathway to Independence Awards"
(K99/R00), for which there were 910 applicants and 183 awardees
in FY 2007, and 816 and 180 respectively in FY 2008. The ACD noted
that relatively few (less than 10 percent) of applicants, and an
even smaller percentage of awardees, are physician scientists.
Information:
Stephen Heinig, Lead Science Policy Analyst
AAMC Biomedical Health Sciences Research
sheinig@aamc.org
(202) 828-0488
House Subcommittee Approves NSF Spending Bill
The House Commerce-Justice-Science Appropriations Subcommittee
June 4 approved by voice vote a draft of its FY 2010 spending bill.
According to a summary table
prepared by the subcommittee, the draft bill includes $6.94 billion
for the National Science Foundation (NSF), a $446 million (6.9 percent)
increase over FY 2009. The funding level falls $108.5 million short
of the President's recommended $7.05 billion for NSF.
Within the NSF total, the subcommittee provides $5.64 billion for
research and related activities, a $459 million (9 percent) boost
over the FY 2009 funding level, but $91.2 million less than the
President's budget. The full House Appropriations committee tentatively
is scheduled to consider the draft bill on June 9, with floor consideration
potentially occurring the week of June 15.
Information:
Tannaz Rasouli, Senior Legislative Analyst
AAMC Government Relations
trasouli@aamc.org
(202) 828-0525
On the Agenda in Washington . . .
June 9: HHS Secretary Sebelius to Testify before Senate Subcommittee
2:30 p.m., 124 Senate Dirksen Building
Secretary of Health and Human Services (HHS) Kathleen Sebelius is
scheduled to testify before the Senate Labor-HHS-Education Appropriations
Subcommittee on the department's FY 2010 budget request.
June 9: House Appropriations Committee to Consider 302(b)
Allocations, CJS Bill
Time TBA, Location TBA
The House Appropriations Committee tentatively is scheduled to consider
302(b) spending allocations and the FY 2010 Commerce-Justice-Science
Appropriations bill.
June 16: HIT Policy Committee to Meet
10 a.m. to 1 p.m., Hubert H. Humphrey Building (200 Independence
Ave., SW) or via Web
cast and teleconference
The Health Information Technology Policy Committee established by
the American Recovery and Reinvestment Act (ARRA, P.L.
111-5) is scheduled
to hold its second meeting. The meeting will be open to the public
and will include presentations by the committee's work groups.
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