December 3, 1999

House Passes AHCPR Reauthorization Ready to be Signed by President

The "Healthcare Research and Quality Act of 1999," S. 580, passed the House Nov. 18 and was presented to the president Dec. 1. The bill would reauthorize the Agency for Health Care Policy and Research through FY 2005 and change its name to the Agency for Healthcare Research and Quality (AHRQ). The final bill expands the agency's responsibilities by mandating:

• Establishment of an Office of Priority Populations to conduct research evaluations and demonstration projects with respect to health care for priority groups, such as low-income, minority, women, children, elderly, and those with special health care needs.
  
• In determining the allocation of training funds, the Director must consider the shortage of researchers who are members of priority populations.
  
• An annual report to Congress beginning in 2003 regarding the disparities in health care delivery related to priority populations.
  
• Promotion of evidence-based clinical practices for the examination and treatment of sexual assault victims the training of health professions to perform such exams and treatment.

Other provisions in the bill change the statute governing the agency, primarily to emphasize its role in examining the quality of health care. The bill rewrites the mission of AHCPR to identify specific areas in need of health care quality improvement. Additionally, the agency is directed to conduct a national survey on cost, use, quality of care, and access to care. This survey will provide information to states on these factors, and a report on the national trends in the quality of health care will be presented to Congress each year beginning in 2003. Also with regard to health care quality, the Director of AHRQ is directed to improve interagency coordination, strengthen research information infrastructure, and set goals for participating agencies and departments to ensure that federal health care quality improvement efforts are effective.

In an apparent response to controversy in the mid 1990's stemming from an issuance of AHCPR guidelines on back pain, a disclaimer included in the bill states that the agency shall not mandate national standards of clinical practice or health care standards. It is also stipulated that all recommendations coming out of the agency will include a corresponding disclaimer. All mention of developing, reviewing, or updating of guidelines and practice standards in the current statute is not included in the reauthorization language.

• Other provisions in the bill that do not pertain to the agency:
  
• Establish of a discretionary grant program to support graduate medical education at children's hospitals.
  
• Direct the Secretary of HHS to conduct a study on the shortage of licensed pharmacists.
  
• Direct the Secretary to conduct a study on telemedicine.
  
• Direct the Secretary to develop recommendations on the placement of automatic external defibrillators in federal buildings.

Information: Erica Froyd, AAMC Office of Governmental Relations, 202-828-0525.