Washington Highlights: October 2,
2009
Contents
Prior Issues
 |
Obama Tours NIH, Pledges "Historic Commitment
to Research"
President Barack Obama Sept. 30 praised
the "extraordinary groundbreaking research" at "the
National Institutes of Health and at universities and research institutions
across this country," as he and Secretary of Health and Human
Services Kathleen Sebelius toured NIH. Speaking to NIH scientists
and invited guests, including AAMC President and CEO Darrell G.
Kirch, M.D., President Obama reaffirmed
his administration's "historic commitment to research and the
pursuit of discovery" through $5 billion in NIH grants awarded
under the American Recovery and Reinvestment Act (ARRA, P.L.
111-5).
The president cited strides in research on cancer, autism, heart
disease, and potential for an HIV/AIDS vaccine, but also emphasized
that "these investments will save jobs, they'll create new
jobs - tens of thousands of jobs - conducting research, and manufacturing
and supplying medical equipment, and building and modernizing laboratories
and research facilities all across America." Describing NIH
as "the forefront of medical invention and innovation,"
he also acknowledged that "in recent years we've seen our leadership
slipping as scientific integrity was at times undermined and research
funding failed to keep pace."
His remarks highlighted the long-term economic and health dividends
of investments in medical research, as well as the sustained support
that science necessitates. "Progress takes time," he noted,
"it takes hard work; it can be unpredictable; it can require
a willingness to take risks and going down some blind alleys occasionally
… all of this needs the support of government. It holds promise
like no other area of human endeavor, but we've got to make a commitment
to it."
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
Rep. Schwartz Reintroduces Healthcare Innovation
Zone Legislation
Rep. Allyson Schwartz (D-Pa.) Sept. 29 reintroduced the AAMC-supported
"Healthcare Innovation Zone Program Act of 2009" as H.R.
3664 [see Washington
Highlights, July 17]. The reintroduced legislation clarifies
and expands several issues by modifying the definition of a healthcare
innovation zone (HIZ), creating and defining a "HIZ Coordinating
Entity" to receive and administer payments, and expanding a
waiver provision to include Medicaid and antitrust barriers, among
other changes.
Under the legislation, the HIZs would comprise integrated health
care delivery networks that include a medical school and/or teaching
hospital and provide a full spectrum of inpatient, outpatient, post-acute
and preventive care to individuals, including Medicare beneficiaries.
The bill authorizes the Secretary of Health and Human Services to
award between 10 and 25 planning grants ranging from $250,000 to
$1 million to entities for the purpose of designing an HIZ model.
The secretary will then test an unspecified number of planning grant
proposals, under a three-year HIZ demonstration project. The demonstration
project will waive/exempt participants from certain legal and regulatory
barriers preventing integration and alignment.
In a statement on the House floor Rep. Schwartz said, "Finding
a uniquely American solution to our nation's health care challenges
means expanding access to health coverage, containing costs, improving
quality, and achieving better health outcomes. To achieve these
goals we have to bridge the current system's fragmentation, encourage
coordination, and promote collaboration."
Information:
Len Marquez, Director
AAMC Government Relations
lmarquez@aamc.org
(202) 862-6281
Christiane Mitchell, Director, Federal Affairs
AAMC Government Relations
cmitchell@aamc.org
(202) 828-0526
Finance Committee Concludes Health Care Reform
Debate
The Senate Finance Committee Oct. 2 concluded debate on amendments
to its draft health care reform legislation, the America's Healthy
Future Act of 2009. Committee Chair Max Baucus (D-Mont.) will request
a revised Congressional Budget Office cost analysis of the amended
legislation before scheduling a vote on the measure. He has stated
that the committee vote may occur during the week of Oct.5. Once
passed by the committee, the package must be merged with the Affordable
Health Choices Act (S.
1679), the health care reform legislation adopted July 15 by
the Senate Health, Education, Labor and Pensions (HELP) Committee
[see Washington
Highlights, July 17].
During its second week of deliberations, the Finance Committee
rejected a Medicare physician payment amendment offered by Sen.
John Cornyn (R-Texas), which would have extended by two years the
single year of physician payment relief (0.5 percent update in 2010)
contained in the modified
chairman's mark. The cost of extending the fix, which committee
staff estimated at $28 billion, would have been offset by eliminating
the health insurance premium tax credit for families earning between
300-400 percent of the federal poverty level. While Chairman Baucus
agreed that Medicare's problematic physician payment formula must
be addressed, he advised that eliminating the tax credits "was
not the way to do it." He stated that he was "quite confident"
the physician payment issue would be resolved as part of health
care reform efforts.
Additionally, Sen. Michael Enzi (R-Wyo.), the ranking member of
the Senate HELP Committee, offered and withdrew an amendment striking
provisions that provide $230 million in Medicare Part A support
and grants through Title VII of the Public Health Service Act for
new "teaching health centers" [see Washington
Highlights, Sept. 25]. According to Sen. Enzi, the HELP
Committee, not the Finance Committee, has jurisdiction over matters
related to community health centers.
Sen. Jon Kyl (R-Ariz.) offered an amendment to strike language
establishing a 5 percent Medicare payment reduction for physicians
who are identified as high resource users when compared to peers
who care for "patients with similar conditions." Under
the modified chairman's mark, starting in 2015, physicians ranked
at or above the 90th percentile of national utilization would face
the cut. Calling the cut "arbitrary," Sen. Kyl expressed
strong concern that the policy could potentially discourage physicians
from providing necessary services. Sen. Kent Conrad (D-N.D.) agreed
and urged Chairman Baucus to consider removing the language from
the modified mark. The chairman agreed to further discussion of
the issue, but advised Sen. Kyl that accepting such a change would
require an additional $1 billion in savings elsewhere in the bill.
Information:
Christiane Mitchell, Director, Federal Affairs
AAMC Government Relations
cmitchell@aamc.org
(202) 828-0526
Len Marquez, Director
AAMC Government Relations
lmarquez@aamc.org
(202) 862-6281
President Signs Continuing Resolution with Legislative
Branch Appropriations
The president Sept. 30 signed a continuing resolution (CR) to keep
most of the federal government operating at FY 2009 funding levels
through the end of October, while Congress completes work on the
12 annual spending bills. The measure provides temporary increases
for the Veterans Health Administration and the Census during the
one-month extension.
The House and Senate approved the final bill Sept. 25 and Sept.
30, respectively. House and Senate negotiators on the FY 2010 Legislative
Branch spending bill (H.R.
2918) attached the stopgap funding measure to the bill before
approving the conference agreement Sept. 24 [see Washington
Highlights, Sept. 25].
To date, the House has approved all its spending bills, while the
Senate has approved six.
Information:
Tannaz Rasouli, Senior Legislative Analyst
AAMC Government Relations
trasouli@aamc.org
(202) 828-0525
President Signs SBIR Extension
President Obama Sept. 30 signed legislation (H.R.
3614) to provide another short-term extension of the Small Business
Innovation Research (SBIR) program. The measure extends the SBIR
and other programs under the Small Business Act and the Small Business
Investment Act of 1958 through Oct. 31, while House and Senate negotiators
continue to work on legislation to reauthorize the programs.
House-passed and Senate-passed reauthorization bills differ on
whether to increase the percentage of their budgets that major federal
research agencies must devote to the SBIR program. The Senate-passed
bill (S.
1233) includes a provision to increase the allocation for the
SBIR program from 2.5 percent to 3.5 percent of any federal agency
budget that provides more than $100 million for research, including
the National Institutes of Health. AAMC opposes increasing the allocation
[see Washington
Highlights, June 26].
Originally scheduled to expire July 31, Congress approved a two-month
extension of the SBIR program on July 29 [see Washington
Highlights, July 31].
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
GAO Releases Report on Medicare Physician Services
The Government Accountability Office (GAO) Sept. 28 released a
report titled
"Medicare Physician Services: Utilization Trends Indicate Sustained
Beneficiary Access with High and Growing Levels of Service in Some
Areas of the Nation." According to a press release, Senate
Finance Committee Chair Max Baucus (D-Mont.) commissioned the report
and cited "new findings revealed disproportionate Medicare
spending and potentially dangerous overuse of services in certain
regions of the United States."
The report concluded that during the years 2000-2008 beneficiary
access "generally remained the same or increased." The
report also found that "some geographic areas of the country
experienced much higher levels of utilization of physician services
and much greater increases in utilization compared to the rest of
the nation." Additionally, Medicare's sustainable growth rate
(SGR) "does not account for geographic differences in utilization
rates."
In his press
release, Chairman Baucus said, "This report makes clear
that serious work remains in determining why the use of certain
services under Medicare is much higher in certain parts of the country
than others." He committed to continuing "to work with
Centers for Medicare and Medicaid Services (CMS) to assess its outcomes"
especially in light of the "potential abuse and excessive spending
revealed in this report."
Information:
Len Marquez, Director
AAMC Government Relations
lmarquez@aamc.org
(202) 862-6281
Travis W. Crytzer, Legislative Analyst
AAMC Government Relations
tcrytzer@aamc.org
(202) 828-0418
Congressional Briefing Examines Geographic Variation
and Health Care Reform
The University of California Sept. 29 held a congressional briefing
to discuss geographic variation and Medicare spending in health
care reform. Speakers at the briefing stressed that geographic differences
in Medicare are not a measure of "efficiency, nor of health
care spending overall" and that focusing on the "total
amount of health care spending, not just Medicare spending"
is critical. Panelists included J. Thomas Rosenthal, M.D., associate
vice chancellor and professor of urology, David Geffen School of
Medicine at UCLA, and chief medical officer, UCLA Healthcare; and
Richard A. Cooper, M.D., professor of medicine and senior fellow,
Leonard Davis Institute of Health Economics, University of Pennsylvania.
The presentation by Drs. Cooper and Rosenthal explained, "Payment
changes made according to geographic differences in Medicare spending
would result in major harm to the urban poor and others living in
areas of urban poverty." Additionally, the speakers suggested
that Congress should direct any future studies by the Institute
of Medicine (IOM) to examine the unintended consequences when "the
results of aggregate behavior (e.g., states, regions, counties)
are applied to individual patients."
The Medicare Payment Advisory Commission (MedPAC) recently conducted
its own analysis
that showed the magnitude of regional variation in service use is
lower than the magnitude of regional variation in spending [see
Washington
Highlights, Sept. 25].
Information:
Len Marquez, Director
AAMC Government Relations
lmarquez@aamc.org
(202) 862-6281
Christiane Mitchell, Director, Federal Affairs
AAMC Government Relations
cmitchell@aamc.org
(202) 828-0526
On the Agenda in Washington
Oct. 7: Senate HELP Confirmation Hearing
10 a.m.; 430 Dirksen Building
The Senate Health, Education, Labor, and Pensions (HELP) Committee
will hold a confirmation hearing
on pending nominations, including Regina Benjamin, M.D., to be surgeon
general.
Oct. 8: House Science and Technology Committee Hearing on
High-Risk Research
1 p.m.; 2318 Rayburn Building.
The Research and Science Education Subcommittee of the House Science
and Technology Committee will hold a hearing
on investing in high-risk research. Panelists include representatives
from the National Science Foundation, Carnegie Mellon University,
Rice University, and Howard Hughes Medical Institute.
Oct.8-9: Advisory Committee on Genetics, Health and Society
Oct. 8: 6 p.m., Oct. 9: 8 a.m.; Park Hyatt, 1201 24th Street
NW
The HHS Advisory Committee on Genetics, Health and Society will
hold a two-day meeting
that includes a review of three committee draft reports: a final
draft report and its recommendations on gene patents and licensing
practices along with comments received on the public consultation
draft circulated earlier this year; a public consultation draft
report on genetics education and training; and a revised draft paper
on direct-to-consumer genetic testing.
|
