federal advocacy
Government Relations Committee
GME is a payment to teaching hospitals for the costs of medical education. Direct medical education (DME) pays for the direct costs related to teaching programs including salaries, space for teaching, etc. Indirect medical education (IME) refers to the extra costs associated with having a teaching program such as extra tests ordered. AMSNY continues to be concerned about a regulation that would complete the elimination of Capital IME payments in Fiscal Year (FY) 2010. Elimination of the Capital IME adjustment will result in a negative impact for both the teaching of residents and the capital margins for teaching hospitals.
Academic medical centers, with our inter-related and unique missions of exemplary medical education and training, cutting edge biomedical and public health research and high quality, standard setting patient care are integral to the success of any health care reform package. In recognizing the importance of these centers, the late New York Senator, Daniel Patrick Moynihan aptly called them, “the jewels in the crown” of a health care delivery system. The academic medical center serves as an incubator for innovation, creativity and intellectual capital in all areas of patient care, treatment modalities, research and medical education. It is crucial that any health care reform package preserve the fiscal viability of academic medical centers so these missions can continue to flourish with the goal of improving the health and well being of all of our citizens.
Title VII authorizes a variety of grants for students, programs, and institutions to improve racial and ethnic diversity, geographic distribution, and the quality of the health care workforce. The health professions programs, authorized under Titles VII of the Public Health Service Act, are essential components of the nationwide health care safety net, bringing health care services to our rural and underserved areas. The Title VII health professions programs are critical to helping institutions and programs respond to current and emerging challenges and to insure that all Americans have access to appropriate and timely health services.
After relatively flat funding levels between 2004 and 2008, the Recovery Act provides an unprecedented increase for NIH. With this new funding, the NIH will better be able to pursue its mission of developing groundbreaking therapies that will lead to better health outcomes for all Americans. NIH accomplishes this goal through a robust program of intramural and extramural research, education, and training conducted or sponsored by 27 Institutes and Centers. The injection of funding in the ARRA will bring to life many new research initiatives that hold substantial long-term promise. This funding could also represent a turning point in the field by attracting and retaining more young investigators to our institutions and others across the country. This opportunity will be lost, however, if funding for biomedical research does not increase in 2010 and in future years.
Medicare physician reimbursement program affects faculty practices and doctors all over the country. Without Congressional action the proposed policies on Medicare physician payment will restrict physicians from making vital investments in patient care. Last year, the Medicare Improvements for Patients and Providers Act (MIPPA) replaced the scheduled 10.6 percent Medicare cut with a 1.1 percent increase allowing medical school faculty practices to continue providing high quality care to Medicare beneficiaries. Despite these actions, Medicare reimbursement rates for physician services have fallen woefully short of the increased cost of delivering quality services to patients. The current reimbursement formula indicates that next year we face a 21 percent cut. Accurate updates based on anticipated costs for providers should be incorporated into the federal budget in lieu of SGR-related cuts for Medicare payment updates.
AMSNY supports Senator Charles Schumer and Congressman Joseph Crowley for introducing landmark legislation that increases the number of residency positions eligible for Medicare direct graduate medical education (DGME) and indirect GME (IGME) support by 15 percent above the current level. “The Resident Physician Shortage Reduction Act of 2009” (S.973) was introduced in the Senate on May 5, 2009 by Senators Charles Schumer (D-NY), Bill Nelson (D-FL), and Senate Majority Leader Harry Reid (D-NV). Senator Kirsten Gillibrand (D-NY) was added as a Senate co-sponsor on May 14, 2009. A companion bill was introduced in the House of Representatives by Joseph Crowley (D-NY), Eliot Engel (D-NY). Kendrick Meek (D-FL), and Kathy Castor (D-FL) on May 5, 2009.
AMSNY applauds Congress and the Obama administration for supporting and promoting federal funding for stem cell research. On March 9th, 2009, President Obama issued an Executive Order (EO) repealing President Bush’s August 9th 2001 policy on federal funding of embryonic stem cell research. With this EO, President Obama paved the way for the National Institutes of Health (NIH) and other federal agencies to fund research involving embryonic stem cells.
