September 15, 2000
WEEKLY UPDATE for September 15, 2000
LEGISLATIVE UPDATE Patient Protections-the
President's Move Balance Budget
Act/Reconciliation Health Care Safety Net Oversight
Act (S. 3035) National Practitioner Data Bank Public
Disclosure Meeting Resistance (H.R. 5122)
LEGISLATIVE UPDATE
Patient Protections-the President's Move
The first real sign of compromise on health issues
sparked as Pres. Clinton, the AMA, and Families USA
gathered Thursday at the White House urging Senate
Republicans to bring bipartisan support to a revised
Norwood-Dingell patient protection bill. The new version
addresses Republican concerns on state's rights to
implement their own health insurance programs and
jurisdiction for litigation against managed care
providers. The language permits states to appeal to the
Department of Labor for state programs that regulate
health insurance and stipulates those lawsuits to be
filed in state and federal courts. "Time is running out
in Congress and there is no more-important piece of
unfinished business," Clinton stated.
Clinton also stated privately to Republican leaders
that he would not consider any appropriation bills until
an acceptable version of the patients' bill of rights is
passed into law. The new Norwood-Dingell bill includes
ACEPs emergency services provision!
Balance Budget Act/Reconciliation
The political jockeying over the Balanced Budget Act
of 1997 (BBA) "giveback" preoccupied legislators and the
President last week. President Clinton proposed spending
$21 billion over five years for hospitals, nursing
homes, home health agencies, and health care plans, and
other providers. A House Republican draft alternative
would allocate $10 billion over five years for hospitals
and $3.2 billion for health plans. A compromise bill
with funding levels somewhere in between is expected to
pass either as a freestanding bill or part of a larger
omnibus bill.
ACEP is working for the inclusion of a small change
in the to the BBA Medicare law regarding graduate
medical education. In the BBA of 1997, Congress capped
the number of graduate medical residents per teaching
facility. In publishing the implementing rule, HCFA
arbitrarily chose August 5th 1997 as the date when the
census of Medicare funded medical residents was taken.
This date excluded programs that were in the process of
applying for accreditation. The legislative change
sponsored by ACEP permits several residency training
programs including an emergency medicine in Michigan to
be considered for funding as if they were included in
the original caps. Reps. Camp (R-MI) and Barcia (D-MI)
are leading the effort in the House and Sens. Abraham
(R- MI) and Levin (D-MI) are sponsoring the measure in
the Senate.
Health Care Safety Net Oversight Act (S. 3035)
On September 12th, Sen. Max Baucus (D-MT) and Sen.
Charles Grassley (R-IA) introduced the "Health Care
Safety Net Oversight Act of 2000," also known as SNOPAC.
Reps. Carolyn McCarthy (D-NY) and Connie Morella (R-MD)
introduced the companion bill in the House. The bill
amends the Social Security Act to create an independent,
nonpartisan commission to assess the health care needs
of the uninsured and to monitor the stability of the
nation's health care safety net. The bill for the first
time recognizes emergency physicians in the definition
of "core safety net provider." The bill is expected to
be included in a larger omnibus bill at the end of the
session.
National Practitioner Data Bank Public Disclosure
Meeting Resistance (H.R. 5122)
The "Patient Protection Act of 2000," sponsored by
House Commerce Committee Chairman Tom Bliley (R-VA)
which permits public access to the National Practitioner
Data Bank met strong opposition from the AMA. "To us, it
looks like retribution for our work on the Patients'
Bill of Rights," former AMA President Thomas Reardon
observed. The bill duplicates similar systems hosted in
28 states, providing information on physicians to
citizens. Rep. John Cooksey (R-LA), an ophthalmologist,
is leading the charge against the bill. A hearing on the
bill is scheduled for September 20th. |