Washington Highlights: September
11, 2009
Contents
Prior Issues
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Finance Chair Releases Framework for Reform, Plans
Sept. Markup
Senate Finance Committee Chair Max Baucus (D-Mont.) Sept. 9 announced
that he plans to release health care reform legislation during the
week of Sept. 14, with a mark-up anticipated during the week of
Sept. 21. In conjunction with the announcement, Chairman Baucus
released a "framework"
of the legislation, which is based on a bipartisan agreement negotiated
with five of his colleagues: Sens. Kent Conrad (D-N.D.) Jeff Bingaman
(D-N.M.), Charles Grassley (R-Iowa), Olympia Snowe (R-Maine), and
Mike Enzi (R-Wyo.). Reportedly, the committee will move forward
on the legislation regardless of whether the package has broad bipartisan
support.
The conceptual framework outlines several issues of concern to
medical schools and teaching hospitals, including the redistribution
of unused residency training slots to new or existing primary care
programs, the resolution of regulatory barriers related to training
residents in outpatient settings, and the preservation of training
slots at closed hospitals. Several proposals are similar to those
included in the July 8 health reform agreement struck by the White
House, Chairman Baucus, the American Hospital Association, and others
[see Washington Highlights,
July 10], including annual market basket reductions, Medicare
and Medicaid Disproportionate Share Hospital (DSH) payment cuts
that are linked to rates of coverage expansions, and reduced reimbursements
for certain hospital readmissions.
For "certain high-cost and common conditions," the framework
establishes a Medicare "payment penalty" for hospitals
in the top 25th percentile for rates of "hospital acquired
conditions" and also establishes Medicare hospital value-based
payments that are tied to performance on quality measures. The framework
directs hospitals to list publicly "standard charges"
for all services and Medicare Diagnosis Related Groups (DRGs) and
excludes new specialty hospitals from participation in the Medicare
program.
Under the framework, the CY 2010 Medicare physician payment update
is set at 0.5 percent. Unlike the health care reform bills passed
in the House, the Baucus framework does not address the long-term
future of physician payments. It establishes a 10 percent bonus
payment for primary care providers and general surgeons who practice
in health professions shortage areas; however, half of the bonus
payments are financed by a 0.5 percent cut to all other physician
services. In CY 2011, all Medicare physicians must participate in
the Physician Quality Reporting Initiative. Additionally, the framework
includes "penalties" for physicians who "utilize
significantly more resources than their peers."
The Finance document creates an Independent Medicare Advisory Commission
(IMAC) that would "submit proposals to Congress to extend Medicare
solvency and improve quality in the Medicare program." Congress
could "amend the proposal or pass an alternative proposal,"
but would have to identify an "equivalent amount of budgetary
savings" elsewhere in the system. The framework also requires
drug and medical device manufacturers to report payments that are
made to physicians and teaching hospitals. The information would
be made publicly available by the Secretary of Health and Human
Services.
According to the framework document, Members may suggest "whole
or partial counters to specific provisions." However, any modifications
must be budget neutral.
Information:
Christiane Mitchell, Director, Federal Affairs
AAMC Government Relations
cmitchell@aamc.org
(202) 828-0526
Len Marquez, Director
AAMC Goverment Relations
lmarquez@aamc.org
(202) 862-6281
Hoyer Says Continuing Resolution Likely
Democratic leaders have acknowledged they will fall short of their
goal of completing all 12 FY 2010 spending bills by the Oct. 1 start
of the federal fiscal year. Although the House passed all 12 bills
prior to the August recess, only four bills have made it through
the Senate floor, and none has gone to conference. Senate Majority
Leader Harry Reid (D-Nev.) hopes to finish seven or eight spending
bills by Sept. 30, while House Majority Leader Steny Hoyer (D-Md.)
has said the House probably will have to pass a continuing resolution
by the end of the month to keep the federal government running past
Oct. 1.
One of the bills awaiting Senate consideration is the Labor-HHS-Education
bill (H.R.
3293), which the House passed on July 24 [see Washington
Highlights, July 24]
and the Senate Appropriations Committee approved on July 30 [see
Washington Highlights,
July 31]. This bill traditionally is one that invokes considerable
attention on the Senate floor, and this year promises more of the
same, as the Republicans have vowed to offer a litany of amendments.
Information:
Dave Moore, Senior Director
AAMC Government Relations
dbmoore@aamc.org
(202) 828-0525
President Outlines Health Care Plan to Joint Session
of Congress
President Barack Obama Sept. 9 addressed
a joint session of Congress, outlining the framework of his administration's
health reform plan
and urging Republicans and progressive Democrats to "bring
the best ideas of both parties together… to deliver on health
care."
Citing a $900 billion price tag over 10 years for his plan, the
president focused on three themes: "consumer protections for
those with insurance, an exchange that allows individuals and small
businesses to purchase affordable coverage, and a requirement that
people who can afford insurance get insurance." Further, he
emphasized the need to curb rising costs by finding savings within
the health care system, pledging "spending cuts" if savings
do not materialize and promoting the establishment of an independent
commission of doctors and "medical experts" to identify
"waste."
President Obama also acknowledged the role that medical malpractice
reform could play in reducing defensive medicine practices and reining
in costs; he directed Secretary of Health and Human Services Kathleen
Sebelius to move forward with demonstration projects and a "range
of ideas" proposed by the Bush administration.
Information:
Tannaz Rasouli, Senior Legislative Analyst
AAMC Government Relations
trasouli@aamc.org
(202) 828-0525
Senators Introduce Bill on Biological and Other
Weapons of Mass Destruction
Senate Homeland Security and Governmental Affairs Committee Chair
Joe Lieberman (ID-Conn.) and Ranking Member Susan Collins (R-Maine)
Sept. 8 introduced
the Weapons of Mass Destruction Prevention and Preparedness Act
of 2009 (S.
1649), intended to improve security, particularly around the
use of dangerous pathogens.
The bill would represent a significant expansion of Homeland Security
into the regulation of biomedical research, including academic research.
The legislation creates a new designation of "tier I"
agents among the pathogens on the current select agents list that
are determined to be among the most dangerous and have the most
potential to be used in a biological attack. The measure authorizes
the Secretary of the Department of Homeland Security (DHS) to make
the new designation in consultation with the Department of Health
and Human Services (HHS). Currently, HHS and the Department of Agriculture
oversee select agents regulations. Among other provisions, the bill
also provides for further registration of laboratories or facilities,
extended background checks, and better information sharing on biosecurity
threats, and authorizes grants through DHS to academic institutions
and others to improve security at labs that handle tier I agents.
The bill responds in part to the recommendations released in 2008
by the congressionally mandated Commission on the Prevention of
Weapons of Mass Destruction Proliferation and Terrorism [see Washington
Highlights, Dec.
12, 2008]. The commission concluded that a terrorist attack
with WMDs is "more likely than not" to occur within five
years. The commission further concluded that a biological attack
is more likely than a nuclear attack, a conclusion reflected in
the bill's focus on biological research laboratories and facilities.
Information:
Stephen Heinig, Lead Science Policy Analyst
AAMC Biomedical Health Sciences Research
sheinig@aamc.org
(202) 828-0488
Tannaz Rasouli, Senior Legislative Analyst
AAMC Government Relations
trasouli@aamc.org
(202) 828-0525
Harkin to Chair Senate HELP Committee
Sen. Tom Harkin (D-Iowa) will succeed the late Sen. Ted Kennedy
(D-Mass.) as chair of the Senate Health, Education, Labor, and Pensions
(HELP) Committee, and will step down as chair of the Senate Committee
on Agriculture, Nutrition, and Forestry. Sen. Blanche Lincoln (D-Ark.)
will replace Sen. Harkin as chair of the agriculture committee.
Sen. Christopher Dodd (D-Conn.), the most senior member on the
HELP Committee, opted to retain chairmanship of the Senate Committee
on Banking, Housing, and Urban Affairs instead of leading the health
committee. Sen. Dodd had served as acting chair of the HELP Committee
in Sen. Kennedy's absence, as the committee considered its draft
health care reform bill [see Washington
Highlights, July 17]. The committee recently posted on its
Web site an
updated version of the draft bill that incorporates all of the amendments
approved during the committee mark up.
Meanwhile, state lawmakers Sept. 9 held a public hearing about
legislation to allow Massachusetts Gov. Deval Patrick (D) to appoint
an interim senator until a permanent successor is elected in a Jan.
19 special election. The Massachusetts congressional delegation
- comprised entirely of Democrats - wrote a letter supporting the
proposal, and Sen. John Kerry (D-Mass.) and Rep. William Delahunt
(D-Mass.) both testified in favor of the legislation. Gov. Patrick
submitted written testimony supporting both the special election
and the interim appointment, and pledged to ensure that a temporary
appointee would not run in the special election. Republicans oppose
the measure.
On the Agenda in Washington
Sept. 14: Senate Labor-HHS-Education Appropriations Subcommittee
Hearing
2 p.m.; 138 Dirksen Building
The Senate Labor-HHS-Education Appropriations Subcommittee will
hold a hearing on the health effects of cell phone use.
Sept. 14: AIDS Research Advisory Panel
1 p.m.; Natcher Building, Conference Rooms E1/E2, National Institutes
of Health, Bethesda, Md.
The NIH National Institute of Allergy and Infectious Diseases' AIDS
Research Advisory Committee will meet
to hear reports from the division director and other staff.
Sept. 15: HIT Standards Committee Meeting
8:30 a.m. - 3 p.m.; Omni Shoreham Hotel, 2500 Calvert Street
NW, Washington, DC
The Health Information Technology Standards Committee will meet
to hear from the Committee's workgroups. The meeting will be webcast
on the committee Web
site.
Sept. 15: Interagency Autism Coordinating Committee's Services
Subcommittee
1 p.m.; Building 1,Wilson Hall, 3rd floor, National Institutes
of Health, Bethesda, Md.
The Services Subcommittee of the NIH's Interagency Autism Coordinating
Committee (IACC) will meet
to discuss the IACC Services town hall meeting on July 24, and to
hear a presentation from subcommittee members about programs for
children with autism supported by the Department of Education.
Sept. 15-16: Developments in and Plans for AIDS Vaccine Research
8:30 a.m.; Bethesda Marriott, 5151 Pooks Hill Road, Bethesda,
Md.
The NIH National Institute of Allergy and Infectious Diseases' AIDS
Research Advisory Committee will meet
with the AIDS Vaccine Research Subcommittee to discuss recent developments
in and plans for AIDS vaccine research, development, and clinical
testing.
Sept. 15-16: National Vaccine Advisory Committee Meeting
on Flu
Sept. 15: 9 a.m., Sept. 16: 8:30 a.m.; 800 Humphrey Building,
200 Independence Ave SW
The HHS National Vaccine Advisory Committee will hold a two-day
meeting
to discuss vaccine safety working group activity, the National Vaccine
Plan, implementation plans for recent committee recommendations,
financial considerations for adult immunizations, seasonal influenza,
and H1N1 influenza response and vaccine development. Pre-registration
is required; contact Andrea Krull at 202-690-5566 or nvpo@hhs.gov.
Sept. 17-18: Children's Health Care in Medicaid, Insurance
Programs
8 a.m.; Holiday Inn Capitol Hill, 550 C St. SW
The AHRQ National Advisory Council for Healthcare Research and Quality's
Subcommittee on Quality Measures for Children's Healthcare in Medicaid
and Children's Health Insurance Programs will meet
over two days.
Sept. 17-18: National Health Promotion, Disease Prevention
Objectives for 2020
9 a.m.; 800 Humphrey Building, 200 Independence Ave SW
The HHS Advisory Committee on National Health Promotion and Disease
Prevention Objectives for 2020 will meet
over two days to develop recommendations regarding implementation,
evidence-based actions, data, and priorities, and the application
of the social deteriments of health. Contact Emmeline Ochiai at
240-453-8259.
Sept. 18: HIT Policy Committee Meeting
10 a.m. - 3 p.m.; Omni Shoreham Hotel, 2500 Calvert Street NW,
Washington, DC
The Health Information Technology Policy Committee will meet and
take testimony regarding privacy and security issues. The meeting
will be webcast on the committee Web
site.
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