October 1, 1999
AHCPR Legislation Includes Authorization of GME Funding for Children's Hospitals
Free-standing children's hospitals would be authorized to receive $565 million over two years to finance Graduate Medical Education under legislation passed by the House Sept. 28. The amendment to the Agency for Health Care Policy and Research (AHCPR) reauthorization, H.R. 2506, was offered by Rep. Nancy Johnson (R-Conn.) and accepted by voice vote. The amendment is similar to Rep. Johnson's legislation, "The Children's Hospitals Education and Research Act of 1999," H.R. 1579.
The amendment authorizes $280 million in FY 2000 and $285 million in FY 2001 for direct graduate medical education and indirect medical education (IME) payments to children's hospitals. The amendment includes formulas based on a variation of the Medicare per resident amount. In determining the IME payment, the secretary would determine the formula with the requirement that she take into account the higher cost associated with teaching residents and taking care of more severely ill patients.
House Commerce Health Subcommittee Chair Michael Bilirakis (R-Fla.), whose committee has jurisdiction over AHCPR, said that while the amendment was not germane to the AHCPR legislation, "this authorization of appropriations will send an important message to the relevant appropriations committees that the Congress considers support of GME for doctors training in children's hospitals as a high, high priority."
Reps. Deborah Pryce (R-Ohio), John Larson (D-Conn.) Henry Waxman (D-Calif.), Karen McCarthy (D-Mo.), Spencer Bachus (R-Ala.), Ken Bentsen (D-Texas), Merrill Cook (R-Utah), Barbara Lee (D-Calif.), Bill Thomas (R-Calif.), Sherrod Brown (D-Ohio), Pete Sessions (R-Texas), Rob Portman (R-Ohio), David Hobson (R-Ohio), and Jennifer Dunn (R-Wash.) spoke in support of the amendment.
Said Rep. Bentsen, "I hope by passage of this amendment, and hopefully passage of this bill and funding of this bill, that we can go a step further, and when we look at the overall Graduate Medical Education program or the medical education program, we will look beyond just Medicare and understand that training doctors and training the other allied health positions is not just something that is benefited by the Medicare beneficiaries; but all of us, including our children, benefit from this; and, thus, we should take that into account in structuring the program."
Rep. Thomas, who said that the current GME financing system is in need of reform, referenced the variation of per resident amounts as well as the work of the National Bipartisan Commission on the Future of Medicare. "I believe we can provide a more secure funding structure [for GME] through a multiyear appropriation process because it provides a larger pool of resources: the General Fund. In addition, an appropriations process will provide needed oversight into the inequities that is lacking in the current entitlement structure."
Information: Lynne L. Davis, AAMC Office of Governmental Relations, 202-828-0526.
