TO: Board of Directors
FR: Kevin J. Burke
Director, Division of Government Relations
CC: Doug Henley
Todd Dicus
Rosi Sweeney
RE: State and Federal Legislative Update (Week of May 9)
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May 20, 2005
MEMORANDUM
Graduate Medical Education
Senators Susan Collins (R-ME) and Dick Durbin (D-IL) are circulating a letter to be sent by the Senate to CMS administrator McClellan urging an administrative resolution to the volunteer faculty in residency training in non-hospital settings. By Thursday, May 19, they had 31 Senators cosigning the letter. The letter recommends an extension of the moratorium and a collaborative effort to:
- analyze the current financial arrangements among teaching hospitals, non hospital facilities, and supervisory physicians in those settings; and
- study the potential impact of any revisions to the current policy; and clarify the definition of "all or substantially all" of the costs associated with training residents in non hospital settings.
Tax Credits for Rural Physicians
Sen. Conrad Burns (R-MT) introduced the Health Care Access Improvement Act (S. 824). The legislation would provide a tax credit of $1,000 per month to primary health care providers who establish practices in designated health professional shortage areas (HPSAs). The program would be available to physicians, physician assistants, and nurse practitioners.
To qualify, a health professional must provide substantially all of his or her primary health services full time in a federally designated HPSA. Individuals may receive the tax credit for 60 months (5 years). Individuals receiving scholarships or loan repayment from the National Health Service Corps (NHSC) or Indian Health Service (IHS) are not eligible for the tax credit. Additionally, individuals who have defaulted on their obligations to the NHSC or IHS are ineligible.
To qualify, a health professional must provide substantially all of his or her primary health services full time in a federally designated HPSA. Individuals may receive the tax credit for 60 months (5 years). Individuals receiving scholarships or loan repayment from the National Health Service Corps (NHSC) or Indian Health Service (IHS) are not eligible for the tax credit. Additionally, individuals who have defaulted on their obligations to the NHSC or IHS are ineligible.
Medicare Physician Payment
On Thursday, May 19, Senators Jon Kyl (R-AZ) and Debbie Stabenow (D-MI) introduced the Preserving Patient Access to Physicians Act (S. 1081). The bill would mandate an increase of at least 2.7 percent in the Medicare physician reimbursement rate for 2006 and a payment in 2007 that reflects physician practice cost inflation, which is estimated to be 2.6 percent. Unless Congress acts to change the formula that controls the reimbursement rate, physicians are likely to experience a decrease of 4.3 percent next year with several years of similarly declining rates.
Next Week in Congress
- The Oversight and Investigations Subcommittee of the House Energy and Commerce Committee will hold a hearing on Wednesday, May 25, on the issues and opportunities associated with Community Health Centers.
- The Health Subcommittee of the House Energy and Commerce Committee will hold a hearing on Thursday, May 26, on the threat of pandemic flu and federal planning efforts in response to the threat.
- On Tuesday, May 24, the Federal Financial Management, Government Information, and International Security Subcommittee of the Senate Homeland Security and Governmental Affairs Committee will hold a hearing on the financial benefits for Medicare of specialty hospitals.
STATE ACTIVITY
As of May 16, legislatures in 21 states have adjourned with 29 states and the District of Columbia still in session. States adjourned are Alabama, Arkansas, Colorado, Florida, Georgia, Hawaii, Idaho, Indiana, Kentucky, Maryland, Mississippi, Montana, New Mexico, North Dakota, South Dakota, Tennessee, Utah, Virginia, Washington, West Virginia and Wyoming.
Medical Malpractice and Liability
- District of Columbia: The Health Care Reform Act of 2005, introduced by Mayor Anthony Williams (D), is intended to reduce medical malpractice jury awards and address increasing malpractice insurance premiums. The mayor cites DC as “having among the highest medical liability insurance premiums in the nation." Similar to legislation proposed in 2004, the bill proposes caps on non-economic damages of $250,000 for a single physician, $500,000 in cases involving one hospital and $1 million in chases with multiple defendants; extends civil immunity to those who provide charity care beyond OB/GYN to include physicians, registered nurses and nurse midwives; develops a medical error reporting system; and institutes insurance reform.
- West Virginia: Gov. Joe Manchin (D) signed the Innocent Prescribers Act, which provides immunity to health care providers where an injury results from a prescribed drug or medical device when the medication or device has been approved by the Food and Drug Administration (FDA). The governor also signed a bill that allows providers to express sympathy without it being construed as an admission of liability. This type of legislation is a growing trend in response to research suggesting that, when adverse medical outcomes occur, an apology may effectively resolve legal disputes and avoid large damage awards.
- Pennsylvania: The Pennsylvania Health Care Cost Containment Council (PHC4) released a report showing the 182 general acute-care hospitals spent $636 million on medical malpractice insurance in 2004. PHC4 is an independent state agency that tracks the cost and quality of health care in the state. The report demonstrates that $2.67 of every $100 paid for patient care goes toward medical malpractice expenditures. In response, the Pennsylvania Medical Society stated the report highlights the urgent need for state and federal legislative action to lower insurance costs which would allow hospitals to redirect more of the $636 million spent on liability coverage towards patient care, updated technology and health care quality initiatives.
Other State Activity
- Georgia: Governor Perdue (R) signed into law SB 90 implementing a statewide public smoking ban for all indoor public places including bars and restaurants that serve or employ anyone under the age of 18. While the bill does include some exemption language, the restrictions become effective July 1, 2005. The Georgia Academy of Family Physicians provided testimony in support of the bill as well as conducting a grassroots campaign to urge the governor to sign the bill.
2005 Archives
Year End Summary (Members Only)
November 2005 Report (Members Only)
September 2005 Report (Members Only)
July 2005 Reports (Members Only)
May 20, 2005
April Federal Legislative Report (Members Only)
March Federal Legislative Report (Members Only)
