September 29, 2000
WEEKLY UPDATE for September 29, 2000
***LEGISLATIVE UPDATE 1) Balanced Budget Act
"Giveback" Bill (H.R. 5259) 2) Patients' Bill of
Rights ***REGULATORY UPDATE 1) OIG Issues Final
Compliance Program Guidance for Physicians 2) OIG
Reports that Medicare Payments to Managed Care
Organizations are Adequate ***WELCOME TO THE 911
LEGISLATIVE NETWORK! ***WE HOPE TO SEE YOU AT ACEP's
SCIENTIFIC ASSEMBLY!!!
LEGISLATIVE UPDATE
Ushering in the new fiscal year yesterday, a
continuing resolution extended government funding until
October 6. This leaves Congress with 4 working days to
finish the remaining 11 appropriation bills needed
before they can return home to campaign. Negotiations
between Republicans and the White House have stalled,
leaving the final adjournment date of the 106th Congress
up in the air. Future short-term measures are expected
to keep the government going until the passage of all FY
2001 appropriation bills. Most Members believe that it
will take another 3 weeks to wrap up their work.
1) Balanced Budget Act "Giveback" Bill (H.R.
5259)
H.R. 5259, the "Beneficiary Improvement and
Protection Act" (BIPA), the latest version of the
Balanced Budget Act "giveback" bill, began its journey
through the legislative process Tuesday. Most analysts
believe that the final bill will allocate between
$21-$30 billion among hospitals, skilled nursing
facilities, HMO's, and home health agencies. It is
unlikely physicians will be included among the providers
receiving additional funds.
ACEP is working on a proposal developed by the
Practice Expense Coalition and endorsed by the AMA to be
incorporated into the House Ways & Means Committee
version of BIPA. The provisions would place a 2-year
moratorium on the HCFA practice expense transition. With
the proposal, emergency physicians stand to gain about 3
percentage points each year over the current HCFA
transition formula.
If this amendment is to move forward, it is important
for ACEP members to contact Ways & Means Committee
Members as well as their own elected officials in the
House and Senate. The bill is due to mark up on Tuesday,
October 3. The Senate is believed to be ready to proceed
later in the week. Due to this short timeframe, a quick
turnaround is needed. Perhaps the best way to get the
Members attention is to fax your correspondence. You may
also wish to contact your Member by telephone. Talking
points and a suggested letter are available at: http://www.acep.org/library/files/pdf/practice_expense.pdf.
2) Patients' Bill of Rights
House Speaker Dennis Hastert (R-IL), Reps. John
Dingell (D-MI), Bill Thomas (R-CA) and Charlie Norwood
(R-GA) continue their efforts to reach a compromise with
Senate Republicans and the White House. Meanwhile, Sen.
John McCain (R-AZ) has signaled his intention to attach
the new version of the Norwood-Dingell patients' bill of
rights on any legislation moving through the Senate.
Sen. McCain believes he now has enough votes to pass the
measure and is hoping to push the Senate into
considering the bill. However, Senate Assistant Majority
Leader Don Nickles (R-OK) renewed his opposition in
passing the House version of Norwood-Dingell. Sen.
Nickles asserted that he does not support any bill that
would increase costs or increase the ranks of the
uninsured. "I am willing to compromise but not to
capitulate," he stated during a conference at the U.S.
Chamber of Congress.
Dueling media ads on the patients' bill of rights are
appearing all over the county. The insurance industry
and business community recently increased media efforts
to defeat the bill while the AMA has targeted its media
campaign towards vulnerable Members up for re-election
who have opposed the bill. Despite the dollars spent on
behalf of the bill and the energy spent lobbying for it,
the outlook remains 50:50 for a patients' bill of rights
to be signed into law this year.
REGULATORY UPDATE
1) OIG Issues Final Compliance Program Guidance for
Physicians
On September 25, the Office of Inspector General
issued final compliance guidance for individual and
small group physicians. The guidance was posted on the
OIG's web site and will be published in the Federal
Register within the next week or two. The OIG stressed
that its guidance is voluntary and should be implemented
"in a manner that fits with the practice's existing
operations and resources."
The final guidance identifies four specific
compliance risk areas for physicians: proper coding and
billing; ensuring that services are reasonable and
necessary; proper documentation; and avoiding improper
inducements, kickbacks and self-referrals. The guidance
includes an appendix of additional risk areas. These
topics include reasonable and necessary services,
including issues related to advance beneficiary notices;
physician relationships with teaching hospitals,
including the physician role in EMTALA and teaching
physicians; and physician billing practices, including
third party billing services.
The OIG accepted many of ACEP's July 2000 comments in
response to the draft compliance guidance. The
compliance guidance is available on the OIG's web site
at: http://www.hhs.gov/oig/new.html.
2) OIG Reports that Medicare Payments to Managed
Care Organizations are Adequate
A report issued recently by the Office of Inspector
General states that Medicare managed care organizations
receive "more than an adequate amount" to care for
Medicare beneficiaries. Although the managed care
industry continues to argue that implementation of the
Balanced Budget Act of 1997 has forced plans to reduce
benefits and pull out of markets, the OIG found that
both the BBA and the Balanced Budget Refinement Act of
1999 were beneficial to the industry. The report found
that Medicare managed care plans will receive about 95.5
percent of fee-for-service payments in 2000, instead of
the 90.5 percent they should receive. The OIG urged HCFA
to modify its payment structure. The report is available
on the OIG's web site at: http://www.hhs.gov/progorg/oas/reports/hcfa/b0000212.pdf.
WELCOME TO THE 911 LEGISLATIVE NETWORK!
Jim Hoekstra, MD, FACEP (Rep. John Kasich,
R-OH) Charles Maddow, MD (Rep. Danny Davis,
D-IL) Brian Zink, MD, FACEP (Rep. Debbie Stabenow,
D-MI)
WE HOPE TO SEE YOU AT ACEP's SCIENTIFIC
ASSEMBLY!!!
NEMPAC 20th ANNIVERSARY
CELEBRATION! Sunday, October 23, 2000 ---
6:00 pm to 7:30 pm in Room 407-409 Philadelphia
Marriott
Established in 1980, the National Emergency Medical
Political Action Committee (NEMPAC) is celebrating 20
years of political involvement on behalf of emergency
medicine! Working in conjunction with the 911
Legislative Network, NEMPAC serves as a critical
advocacy tool that helps to promote ACEP's legislative
agenda. NEMPAC is the third largest medical specialty
PAC raising and contributing over $400,000 to candidates
for federal office in the 1997-1998 election cycle. In
addition, one out of every four emergency physicians
contributes to NEMPAC on an annual basis! We hope that
all NEMPAC contributors will attend this reception and
celebrate 20 years of political effectiveness!
NEMPAC INVITATIONAL
DINNER Sunday, October 23, 2000 --- 7:30 pm
to 9:30 pm in Room 414-415 Philadelphia Marriott
NEMPAC has experienced tremendous growth in 2000! We
would like to show our appreciation to our generous
NEMPAC donors by hosting a by invitation only
dinner. Members contributing $250 or more will be
invited to this event as a special thank you
for encouraging this growth in NEMPAC and in emergency
medicine's political clout in Washington.
School of Political Advocacy -- Featuring
Michael Dunn Monday, October 23,
2000 --- 1:00 pm to 4:00 pm in Salon 1 at the
Philadelphia Marriott.
ACEP's School of Political Advocacy was established
in 1998. This year we are taking a fresh look at
advocacy and will have Michael Dunn, a dynamic
national speaker discuss the fundamentals of becoming a
successful "citizen lobbyist." The School offers you the
fundamentals of grassroots lobbying, techniques on
communicating with legislators in personal meetings and
by mail, hosting a fundraiser in your home, and serving
as an influential resource to your legislator.
Luncheon for New & Former Graduates of
the School of Political Advocacy-- Featuring Tucker
Carlson Tuesday, October 24, 2000 ---
11:15 am to 12:30 pm in Salon D at the Philadelphia
Marriott
Graduates of the School of Political Advocacy are
invited to join other members of the 911 Legislative
Network for a special luncheon. This event will
feature political commentator Tucker Carlson
who will provide insights into the current political
landscape and the upcoming elections. Mr. Carlson is the
political analyst for both ABC's Good Morning
America and CNN. He appears weekly on CNN's
Inside Politics and Late Edition with Wolf
Blitzer. The Award for the "Outstanding 911 Member"
will be announced.
Legislative and Regulatory Issues
Briefing Wednesday, October 25, 2000 ---
9:00 am to 11:00 am in Room 202 A&B at the
Convention Center
The practice of medicine is dramatically affected by
the legislation and regulations developed on the federal
level. Learn the latest about ACEP's legislative and
regulatory priorities and the issues that your
Washington ACEP staff are working to implement, modify,
or improve.
The Public Affairs Booth Monday
October 23 through Wednesday October 25 --- 9:30 am to
3:30 pm at the ACEP Resource Center in the Philadelphia
Convention Center
Stop by the booth and see how ACEP is advocating for
emergency physicians in the media, in Congress, and in
the federal agencies. Sign up to join the 911
Legislative Network, ACEP's premier grassroots network,
and learn how NEMPAC works to promote your practice.
Collect materials to start your own public safety
campaign in your emergency department and view Kaiser
Family Foundation's HealthCast of ACEP's successful
conference on Preserving America's Health Care
Safety
Net. |