October 13, 2000
WEEKLY UPDATE for October 13, 2000
***LEGISLATIVE UPDATE 1) FY 20001 Appropriation
Bills 2) Balanced Budget Act "Giveback" Bill (H.R.
5291 & S. 3165) 3) Patients' Bill of
Rights ***REGULATORY UPDATE 1) HCFA Delays
Implementation of OPPS EMTALA Provisions 2) HCFA
Physician Encounter Data Requirements Begin This
Month ***PUBLIC RELATIONS UPDATE See ACEP's
Conference "Preserving America's Health Care Safety
Net" ***911 LEGISLATIVE NETWORK UPDATE Great
Events at Scientific Assembly! We want to see you in
Philadelphia!
LEGISLATIVE UPDATE
Despite optimistic plans early in the week to end
this congressional session on Saturday, Republican
leaders acknowledged that they would need at least
another week complete funding bills. The House and
Senate are expected to pass a third continuing
resolution that will keep the federal government
operating at fiscal 2000 levels through October 20.
1) FY 20001 Appropriation Bills
At the end of the second week of fiscal 2001 only 3
of the 13 spending bills are signed into law. At least 3
additional measures are cleared for vote next week and 3
more are still in negotiations. House Republican leaders
indicated their intention to reserve the
Labor/HHS/Education bill as the foundation for an
end-of-year "catch all" package; the Senate disagreed.
Appropriators said that the Labor/HHS/Education package
would be filed as early as October 17, making it
eligible for a vote thereafter.
2) Balanced Budget Act "Giveback" Bill (H.R. 5291
& S. 3165)
In a letter to House Speaker Dennis Hastert (R-IL),
President Clinton criticized Republicans for giving
between 40%-55% of the Medicare "giveback" monies to
HMOs, while simultaneously being unwilling to support
patients' rights legislation that would hold insurers
accountable. Current estimates show that HMOs will get
at least $8 billion in direct payments and an additional
several billion in indirect payments. The overall
measure is estimated to cost $28 billion over 5 years
primarily due to payments to HMOs, hospitals, home
health agencies, and skilled nursing homes.
3) Patients' Bill of Rights
Partisan tensions continue to cause gridlock on the
final version of the Republican patients' bill of
rights. Rep. Charlie Norwood (R-GA) and Sen. John McCain
(R-AZ) introduced a new version of the bill that limits
punitive damages in federal court at $5 million and
toughens provisions for the types of injuries a patient
must have in order to file a lawsuit. Previous
Democratic proponents of the original Norwood-Dingell
bill, Sen. Ted Kennedy (D-MA) and Rep. John Dingell
(D-MI), did not endorse the new McCain version. The new
bill however did gain the endorsement of Sen. John
Ashcroft (R-MO) who is locked in a tight reelection
battle. His support increases to 51 the number of
supporters in the Senate who favor the Norwood-Dingell
measure.
House leaders met throughout the week with medical
specialty societies, including ACEP, to establish a
workable compromise that Speaker Hastert will bring to
Sen. Trent Lott (R-MS) for Senate consideration. Reps.
Norwood and Dingell have been included in this process.
With time running out, a clear Senate strategy has yet
to emerge.
REGULATORY UPDATE
1) HCFA Delays Implementation of OPPS EMTALA
Provisions
On October 3, the Health Care Financing
Administration published a notice in the Federal
Register, delaying the effective date of several
provisions of the Medicare hospital outpatient
prospective payment system. The provisions, which were
scheduled to be effective on October 10, 2000, will be
effective on January 10, 2001. The delayed provisions
include the modifications made to the EMTALA
regulations, including the revised definitions; and the
requirements for determining provider-based status.
HCFA stated that it decided to delay implementation
of these provisions due to the need for additional
guidance from the agency and the dissemination of
additional training material. HCFA also plans to host a
town hall meeting in the near future to discuss specific
aspects of the provider-based regulations.
2) HCFA Physician Encounter Data Requirements Begin
This Month
The Balanced Budget Act of 1997 required the Health
Care Financing Administration to implement a risk
adjustment payment methodology for payment to
Medicare+Choice organizations that accounts for
variations in payment based on health status of the
organizations' enrollees. The new methodology is
intended to pay plans more accurately, according to the
health of their enrollees. Beginning October 1,
Medicare+Choice organizations must submit physician
encounter data to HCFA for services provided on or after
October 1. The encounter data includes both diagnostic
and procedure codes. In order for Medicare+Choice
organizations to submit the required information to
HCFA, physicians treating Medicare+Choice enrollees must
submit the data to the plans. HCFA is advising
physicians to consult with health plans to determine the
appropriate reporting forms.
PUBLIC RELATIONS UPDATE
The Kaiser Family Foundation filmed ACEP's September
19 conference, "Preserving America's Health Care Safety
Net" at the National Press Club in Washington, DC. Below
are the website addresses for each of the conference
presentations.
NOTE: You must have Real Audio
installed on your computer to view this
material.
- Welcome & Keynote Address
http://www.fednet.net/ram/kff/kff091900_panel1.ram
- Health Care System Infrastructure and the
Emergency Department as pat of the Health Care Safety
Net
http://www.fednet.net/ram/kff/kff091900_panel2.ram
- Defining the Safety Net
http://www.fednet.net/ram/kff/kff091900_panel3.ram
- Luncheon - The RIteCare Experience
http://www.fednet.net/ram/kff/kff091900_panel4.ram
- Delivering High Quality, Cost-Effective Care/
Economics of Emergency Medicine
http://www.fednet.net/ram/kff/kff091900_panel5.ram
- Access and Barriers to the Nation's Safety Net: A
Review/Analysis of Current Policy Proposals
http://www.fednet.net/ram/kff/kff091900_panel6.ram
- Where Do We Go From Here? & Concluding
Remarks
http://www.fednet.net/ram/kff/kff091900_panel7.ram
911 LEGISLATIVE NETWORK UPDATE
We look forward to seeing you all at ACEP's
Scientific Assembly in Philadelphia, PA! Below is the
list of political, legislative, and regulatory events.
Please stop by with questions or just to say hello to
your public affairs staff!
- NEMPAC 20th Anniversary Celebration!
Sunday,
October 23, 2000 — 6:00 pm to 7:30 pm in Room 407-409
Philadelphia Marriott
- NEMPAC Invitational Dinner
Sunday, October 23,
2000 — 7:30 pm to 9:30 pm in Room 414-415 Philadelphia
Marriott
- 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
- 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
- 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 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
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