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FEDERAL LEGISTLATIVE UPDATE

Federal Legislative Update February 18, 2011

In this update:

 

  • Federal Appropriations & Budget Update
  • AAP Presents on Disaster Preparedness at Capitol Hill Briefing
  • AAP Testifies on Lead in Children's Products before the CPSC
  • AAP Crib Safety Study Influences CPSIA Hearing
  • AAP Member Named Branch Chief of EMSC and Injury Prevention
  • 2010 National Vaccine Plan Released
  • Health Reform Implementation Update

Federal Appropriations & Budget Update

 

Federal Appropriations

 

Very late tonight or early tomorrow morning, the U.S. House of Representatives is expected to vote on a long-term Continuing Resolution (CR) bill to keep the federal government funded through the remainder of the current Fiscal Year 2011 (FY11), which began on Oct. 10, 2010 and ends on Sept. 30 of this year. The current short-term CR expires March 4, 2011.

The CR progressed through the House this week under an open rule, resulting in close to 600 amendments offered. The bill contains $61 billion in proposed cuts from current federal spending (and over $100 billion in cuts to the President’s FY11 budget request).

 

The AAP released a press statement condemning the CR’s proposed cuts to vital children’s programs. The long-term CR bill is expected to pass the House with an amendment from Rep. Denny Rehberg (R-Mont.) that would effectively delay all implementation of the Affordable Care Act.

 

If approved by the House, the bill will then move to the U.S. Senate for consideration the week of Feb. 28, once Congress returns from next week’s President’s Day recess. The Senate is not likely to approve a line of such extensive cuts, leading to more negotiations between both chambers of Congress when the current short-term spending measure expires on March 4. If Congress fails to act by this date, the federal government would no longer be funded, and thus be forced to shut down until appropriations legislation is passed.

The House needs to hear from you TODAY as they debate the CR.

Visit the Department of Federal Affairs Advocacy Action Center to contact your U.S. representative and urge the House to “do no harm” to kids in federal appropriations.

All members of the House and Senate will be in their home districts on recess next week, February 22-25.

 

·         Please consider scheduling in-person district meetings with your U.S. representative and U.S. senators next week in your home state:

o        Encourage the Senate to strike down the House’s long-term CR bill with proposed cuts to children’s programs when it moves to their chamber for a vote the week of Feb. 28.

o        Encourage the House to “do no harm” to children as they await further review of appropriations legislation from the Senate.

·         Use this one-page appropriations overview to help guide your discussions and to leave with your U.S. representative’s staff for reference.

·         Visit this resource page and Action Center on FederalAdvocacy.aap.org for updated information on the federal appropriations process.

Federal Budget


On Monday, President Barack Obama also released his budget recommendations for the next Fiscal Year, 2012. While the AAP supports President Obama’s budget requests to expand the primary care workforce, advance life-saving research, increase access to preventive health services, and work to ensure food and product safety for kids, it is disappointed in his decision to end federal investments in children’s hospitals graduate medical education. The AAP released a press statement on the topic earlier this week.

 

AAP Presents on Disaster Preparedness at Capitol Hill Briefing

 

On Monday, Daniel Fagbuyi, MD, FAAP, presented on the subject of disaster preparedness at a standing-room only Capitol Hill briefing sponsored by Trust for America's Health. Dr. Fagbuyi educated the audience, which consisted of Congressional staff and advocacy organizations, on the physiological, anatomical, and developmental differences between children and adults. He also highlighted the "benign neglect" of children that occurs during disaster planning in the United States. 

 

Calling on his experience during the H1N1 outbreak, Dr. Fagbuyi made several recommendations for moving forward, including reauthorizing the Pandemic and All-Hazards Preparedness Act, which addresses the unique needs of children during natural disasters. Dr. Fagbuyi is the Medical Director of Disaster Preparedness and Emergency Management at Children’s National Medical Center in Washington, DC, and an Assistant Professor of Pediatrics and Emergency Medicine at The George Washington University School of Medicine.

 

AAP Testifies on Lead in Children's Products before the CPSC

 

On Wednesday, Dana Best, MD, MPH, FAAP, former member of the Council on Environmental Health, testified before the Consumer Product Safety Commission (CPSC) at a hearing regarding the upcoming reduction of permissible levels of lead in children's products from 300 parts per million (ppm) to 100ppm. 

 

In 2008, Congress passed the Consumer Product Safety Improvement Act (CPSIA), which instituted limits on total lead content of children's products for the first time ever. Under the law, lead content in children's products was initially set at 600ppm, then dropped to 300ppm one year after passage. In August 2011, the limit will drop to 100ppm unless the CPSC determines that such a limit is not "technologically feasible."  This hearing was established to gather input from industry groups, public health experts, laboratories, and scientists as to whether a 100ppm lead limit can be achieved.

 

Dr. Best strongly urged the Commission to limit lead content in children's toys to 100ppm, as Congress intended, and explained that even small amounts of lead can result in brain damage, loss of IQ points, and other negative physical, behavioral, and mental health effects for children. Dr. Best also discussed the long-term public health impacts of both acute and chronic lead exposure, and urged the Commission to place child health as the highest priority in determining allowable lead content in children's products.

 

AAP Crib Safety Study Influences CPSIA Hearing

 

On Thursday, the House Energy and Commerce Committee held a hearing to examine implementation of the entire CPSIA. A Pediatrics study, "Injuries Associated with Cribs, Playpens, and Bassinets Among Young Children in the United States, 1990-2008," was released on Thursday morning in advance of the hearing. The study was mentioned by numerous members of Congress within the context of the CPSC's efforts to protect all consumers, including infants and children, from dangerous products. The AAP will continue to closely monitor any attempts by Congress to reverse or impede important gains in children's product safety.

 

AAP Member Named Branch Chief of EMSC and Injury Prevention

 

On Monday, the Health Resources and Services Administration announced that Elizabeth Edgerton, MD, MPH, FAAP, will be the new Branch Chief for Emergency Medical Services for Children (EMSC) and Injury Prevention within the Division of Child, Adolescent, and Family Health of the Maternal and Child Health Bureau. Dr. Edgerton is a member of the Academy’s Committee on Bright Futures as well the Sections on Transport Medicine, Epidemiology, Injury, Violence & Poison Prevention, and Emergency Medicine. Dr. Edgerton is a previous EMSC Targeted Issues grantee and recipient of the 2004 National Heroes Award for Outstanding EMSC Research Project. She is also a past Director of Clinical Prevention for the U.S. Preventive Services Task Force.

 

2010 National Vaccine Plan Released

 

On Wednesday, the U.S. Department of Health and Human Services (HHS) released its 2010 National Vaccine Plan to enhance coordination of all aspects of federal vaccine and immunization activities. This is the first update of the National Vaccine Plan since the original version in 1994.

 

Next steps include a series of regional meetings with stakeholders in the spring and summer of 2011, which will focus on how to implement the strategies laid out in the National Vaccine Plan. The final implementation plan will be completed by the end of 2011.

 

The AAP supports the goals outlined in the Plan and continues to advocate for improved vaccine payment for pediatricians.

 

Health Reform Implementation Update

 

Children with Pre-Existing Conditions

 

On Thursday, the Office of Insurance Programs in the Centers for Medicare and Medicaid Services’ Center for Consumer Information and Insurance Oversight issued important new guidance on a recently implemented eligibility clarification for the Pre-existing Condition Insurance Plan (PCIP) program. The guidance comes after much advocacy from the AAP, including a recent meeting with Richard Popper, who oversees the federally-administered PCIP program. During the meeting, the AAP explored ways that PCIPs could benefit children in markets where child-only plans have been dropped by insurance companies.

 

The guidance creates flexibility for enrolling children under age 19 in the PCIP program by outlining new ways to satisfy the pre-existing condition eligibility requirement. These options include allowing pediatricians to write a “doctor’s note,” or letter explaining that the child has a condition that was present before the date of enrollment.

 

State Waivers and Maintenance of Effort

 

On Monday, the AAP, along with 31 other national groups, sent a letter to HHS Secretary Kathleen Sebelius expressing concern about Arizona’s recent waiver request to reduce Medicaid eligibility for low-income childless adults by 280,000 individuals.

 

On Tuesday, Secretary Sebelius sent a letter to Arizona Governor Jan Brewer stating that the maintenance of effort provision in the Affordable Care Act does not require Arizona to renew, beyond the expiration date of Sept. 30, 2011, the demonstration waiver it enacted in 2000 to cover low-income childless adults in the state. Should Arizona let this expansion expire, 250,000 Medicaid beneficiaries in the state who do not have children would not longer be eligible for coverage. Another 30,000 parents whose annual incomes are higher than $10,830 would also lose coverage.

 

Five other states currently provide coverage for childless adults through demonstration waivers, which are scheduled to expire on a rolling basis over the next three years.

 

Grants for Early Innovators

 

On Wednesday, HHS announced awards totaling $241 million for select states to design and adopt the infrastructure needed to run health insurance exchanges. The awards were announced under the agency's "Early Innovators" initiative, in which states are selected to serve as models for the design and implementation of the information technology infrastructure that will run state insurance exchanges under the Affordable Care Act.

 

The funding primarily will be used to build existing frameworks already in place in each state. According to HHS, the recipients of Early Innovators grants will share models that can be "adopted and tailored" by other states.

 


IN-AAP Legislative Update February 25, 2011

This has been a crazy week for the Indiana Legislature. As of right now, there is no new legislative update. Twenty three bills that passed out of House committees earlier are now dead since committee reports could not be approved on the floor of the House. This includes our Farm to School bill, the Outpatient Treatment requirements bill, some of the texting bills and many others. If Democrats choose to return on Monday, there is a slight possibility that bills that are up for second and third readings could be heard but there is no guarantee that will happen.  The Senate was done for the week by Tuesday and will reconvene next week. Therefore some rules will have to be suspended in order to have the close of the first half of session to end on March 4, rather than today. Hopefully by Monday we will have more information and we will be able to give a complete update on where our legislation now stands by next Friday.


Legislative Update for the Week of 2/28

Legislative Update for the Week of 2/28

Below, you will find a brief overview of each bill that had movement this week or that is

scheduled for a committee hearing next week. For the complete text of the bill, please

go to http://www.in.gov/lsa/session/billwatch/billinfo and search using the bill number

(ie, HB1070).

 

I am sure you are probably aware that the House Democrats still have not returned to Indiana; hence nothing is moving on their calendar at this time.  Below are the IN-AAP interested bills that have passed out of the Senate and are now waiting to be heard in the House upon their return. In addition, I have included an update on the Indiana Smoke-free legislation and Texting bill HB 1129. I have also attached a list of all IN-AAP priority bills that are still alive in spite of the walk-out.

 

SB0093 - Concussions and head injuries in student athletes: The bill originally passed out of the Senate by a vote of 46-4. Now we are waiting for the House to reconvene in order to hear the bill. The bill requires the department of education, consulting with an athletic association to develop and disseminate guidelines, information sheets, and forms to inform and educate coaches, student athletes, and parents of student athletes of the nature and risk of concussions and head injuries.

 

SB0127 - Driver education - The bill originally passed out of the Senate by a vote of 44-5. This bill is waiting to be heard once the House reconvenes. We are actively trying to kill this bill due to the lowering of the driving age from 15 ½ to 15 years of age.

SB0101 - Driver education issues - The bill originally passed out of the Senate by a vote of 41-8. This bill is also waiting to be heard once the House reconvenes. We continue to support this bill because of the need for driving age students to have qualified driving instructors.

SB0552 - Pulse oximetry screening of newborns- The bill passed out of Senate by a vote of 45-4. This bill is waiting to be heard once the House reconvenes. The bill should have no problem passing through the House because there is no opposition to legally requiring hospitals to give infants a pulse oximetry screening examination to detect for low oxygen levels at birth.

SB0328 - Abortion matters and physician privileges – The bill passed out of the Senate by a vote of 39-9 and this bill is also waiting to be heard once the House reconvenes. The bill specifies additional information that must be given to a pregnant woman by the physician in order for consent to an abortion to be voluntary and informed.

 

SB 590 - Immigration Matters – The bill passed out of the Senate by a vote of 31-18 and is now eligible to be heard by the House. We are actively opposing the bill and we could possibly see some amendments coming soon.  The bill makes various changes concerning enforcement of federal immigration laws such as checking the citizenship or immigration status of individuals and requiring that only English be used by officers and employees of state or political subdivisions in performing their duties.

 

SB 178 - Outpatient treatment requirementsThe bill requires the health finance commission to study possible prohibitions on certain insurer and health maintenance organization activities related to outpatient benefits. The bill passed out of the Senate by a vote of 47-2 and is now eligible to be heard by the House. Recently Rep. T. Brown has been added as author.

HB1018 - Smoking ban in public places The bill prohibits smoking: (1) in public places; (2) in enclosed areas of a place of employment; (3) in certain state vehicles; and (4) within 12 feet of a public entrance to a public place or an enclosed area of a place of employment. The bill is currently waiting to be heard in the Senate Public Policy Committee. It should hopefully get a hearing by next week and then move on to a vote on the Senate floor.

HB1129 - Use of telecommunications device while driving. – On Tuesday, March 1, the bill passed out of the Senate Corrections Committee with a vote of 7-2. Recently Senator Holdman has been added as author. The bill states that it is a Class C infraction if a person uses a telecommunications device to type, transmit, or read a text message or electronic mail message while operating a moving motor vehicle. It also allows a person to use hands free or voice operated technology to transmit a text message or electronic mail message while operating a moving motor vehicle. The Insurance Institute of Indiana, State Farm Insurance, local residents, IU-Health and IN-AAP all testified in support of the bill. Even though the bill passed, the committee chairman as well as other members feels the bill should be amended to also include a ban on talking on a cell phone while driving as well as texting while driving. Senator Taylor might amend the bill before it goes to the Senate floor for a vote.




Federal Legislative Update March 2, 2011

March 4, 2011

Federal Legislative Update 

In this update:
 
On Wednesday, President Obama signed into law a new two-week extension bill passed by Congress that will fund the federal government through March 18, 2011. This new short-term Continuing Resolution (CR) continues to fund most federal programs at Fiscal Year 2010 levels and cuts $4 billion in discretionary spending by targeting unspent earmarks and program cuts proposed in the President’s Fiscal Year 2012 budget request.  
 
Congress will continue to negotiate a longer term CR to fund the federal government once the current short-term measure expires on March 18. The House-passed cuts to critical child health programs remain part of the negotiations between the House and Senate for funding the rest of this fiscal year. 
 
Urgent action is still needed. Contact your federal legislators today!
 
Visit the Department of Federal Affairs Advocacy Action Center to urge your U.S. senators and representative to “do no harm” to kids as they craft long-term federal appropriations legislation.
 
Seven pediatric organizations joined this week with the National Association of Children’s Hospitals and other hospital groups to support funding for the Children's Hospital Graduate Medical Education (CHGME) program. CHGME provides critically important federal GME support for the training of pediatricians and pediatric specialists at freestanding children’s hospitals. The program has been zeroed out in President Obama's Fiscal Year 2012 budget. The groups sent letters to Senate leadership and Secretary Sebelius urging support for the program. The AAP joined the letters, along with the Academic Pediatric Association, the American Pediatric Society, the Association of Medical School Pediatric Department Chairs, the Council of Pediatric Subspecialties, and the Federation of Pediatric Organizations, and the Society for Pediatrics.
 

On Tuesday, the Partnership for Primary Care Workforce held a Congressional briefing entitled, “Primary Care: Where Are We Today and Where Do We Need to Go?” Tina Cheng, MD, MPH, FAAP, member of the Academy’s Committee on Pediatric Research, was one of three expert panelists discussing the importance of ensuring a robust primary care workforce to meet our nation’s health needs.

Dr. Cheng detailed a number of successful primary care workforce development programs, such as Title VII and the National Health Service Corps, and provided recommendations for how to continue to promote primary care as Congress develops the federal budget. Other panelists at the briefing included Stephen Shannon, DO, MPH, President and CEO of the American Association of Colleges of Osteopathic Medicine, and Roland Goertz, MD, MBA, FAAFP, President of the American Academy of Family Physicians.
 
 
Earlier this week, the Food and Drug Administration (FDA) took action against companies that manufacture, distribute or market certain unapproved prescription oral cough, cold and allergy products. Unapproved prescription cough, cold and allergy drug products have not been evaluated by the FDA for safety, effectiveness and quality. The FDA's action covers extended-release, tannate and immediate-release drug products that are available in oral form and labeled for prescription use. 
 
The FDA estimates that at least 500 drugs are affected by the enforcement action. Companies whose products are subject to the action by the FDA are expected to cease manufacturing them within 90 days and stop shipping them within 180 days.
 
For more information about the FDA's enforcement action, including a complete list of the affected products, please see www.fda.gov.
 
 
Legislative Conference March 13-15, 2011
 
U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius will be a keynote speaker at the 2011 Legislative Conference in Washington, DC!
 
The AAP designates the Conference for a maximum of 13.25 AMA PRA Category 1 CME Credits.
 
There are still spots available to attend the three-day Conference March 13-15, 2011. The Conference is an opportunity for all AAP members to learn about the Academy's federal policy priorities, attend interactive skills-building workshops and trainings, hear from Washington insiders, and participate in meetings with federal legislators and their staff on Capitol Hill.
 
Time is running out: Visit FederalAdvocacy.aap.org/LegCon2011 to register today!
 
Advocacy Day May 6, 2011
 
On May 6, 2011, the AAP Department of Federal Affairs is hosting a daylong advocacy training session in Washington, DC. This session will provide a federal policy overview of a timely child health topic and an in-depth advocacy training session on that issue. Participants will then conduct in-person visits with their federal legislators' offices on Capitol Hill. RSVP today by emailing kids1st@aap.org!
 
 
Last weekend, the National Governors Association (NGA) held its annual winter meeting in Washington, DC. During a speech to the governors, President Obama announced his support for a Congressional proposal to allow states flexibility from the provisions of the Affordable Care Act by 2014 instead of 2017. This flexibility would be conditioned on whether the state can grant coverage for at least as many people as would be covered under the current law, as affordably and comprehensively, but without increasing the federal deficit.
 
This idea was contained in a bill introduced in November, the Empowering States to Innovate Act, by Senators Scott Brown (R-Mass.) and Ron Wyden (D-Ore.).
 
On Tuesday, three governors, Gary Herbert (R) of Utah, Deval Patrick (D) of Massachusetts, and Haley Barbour (R) of Mississippi, testified before the House Energy and Commerce Committee at a hearing on Medicaid and health reform. Timed to coincide with the NGA meeting, the hearing echoed calls by many state governors for repeal of the health reform law’s Medicaid maintenance of effort requirement. Many governors are also asking for the Medicaid program to be funded through a block grant. The AAP, along with more than 130 other national organizations, signed a letter to members of Congress outlining support for continued stability of Medicaid and Children’s Health Insurance Program (CHIP) coverage requirements.
 
On Friday, the Administration announced that it will allow states facing budget shortfalls to raise premiums at the same rate as inflation and drop Medicaid eligibility for non-disabled, non-pregnant adults whose annual incomes are higher than $14,484. Cindy Mann, Director of the Center for Medicare and Medicaid Services’ Center for Medicaid, CHIP, and Survey and Certification, sent a letter to state Medicaid directors on Friday indicating that states can raise the amount parents pay to cover their children under CHIP.



INAAP Legislative update March 7th

 

IN-AAP Legislative Update for the Week of 3/7/2011

Below, you will find a brief overview of each bill that had movement this week or that is

scheduled for a committee hearing next week. For the complete text of the bill, please

go to http://www.in.gov/lsa/session/billwatch/billinfo and search using the bill number

(ie, HB1070).

 

Another week has passed with out House Democrats therefore nothing is moving on their calendar at this time. Below are the IN-AAP interested bills that were heard by the Senate this week. I have also attached a list of all IN-AAP priority bills that are still alive in spite of the walk-out.

 

HB1121 – Unused Medication– On Tuesday, March 8th, the Senate Health and Provider Services Committee heard HB1121. This House bill requires the Board of Pharmacy to adopt rules concerning the return of unused medication. Two amendments were heard again. The first amendment clarified that public and private entities were not required to participate, the program would be completely voluntary. The second amendment did not require the Board of Pharmacy to accept the return of mail order medications that were bought online instead of through a pharmacy but only required that the Board must apply the same guidelines to accepting those drugs as they would medications bought from a pharmacy. The bill had no opposition and the Attorney General’s Office, Board of Pharmacy, Indiana State Medical Association, Indiana Retail Council and Indiana Healthcare Association all testified in favor of the bill. The Committee held the bill until further notice.

 

HB1221 - Life insurance and Medicaid: On Tuesday, March 8th, the Senate Health and Provider Services Committee also heard this bill. This House bill allows the state to use federal or state Medicaid funds to pay life insurance premiums and expenses for a Medicaid applicant or recipient who has named the state as the beneficiary of a life insurance policy or assigned a life insurance policy to the state. Once the person dies Medicaid can collect on the policy. The added amendments clarify that the life insurance policy must be in force at the time of the individual’s death, that Medicaid could only recover the costs for expenses that were spent and if there was any money left over then it must go to the individual’s beneficiary and that the bill only applies to people 55 and older or who are institutionalized. The bill had no opposition and only FSSA testified. They stated they were undecided about the bill because they were unsure Medicaid could cover the up-front costs of implementing the program.  The Committee held the bill until further notice.

 

 

 Please click here to review the Alive Priority Bills

 


IN-AAP Legislative Update for the Week of March 14th

As week four of the walk out continues, everything is still up in the air. As of this point, there is no new legislative update. The only thing that is on the legislators’ minds is the passing of a new budget. House republicans met in caucus today and announced that there was no end in sight for the walk out.  Speaker of House Brian Bosma and President Pro Tem Senator David Long also decided today to raise the fines on missing democrats from $250 per day to $350 and they planned to proceed for the rest of the General Assembly's session without the House Democrats.  If the Democrats do not return before session ends then the Senate could take steps to pass the budget by themselves without the House. The Senate would more than likely attach their version of the budget on a House bill that already passed and vote on it in the Senate. However, if the session adjourns due to a walk out without a budget, then everyone will have to reconvene in a special session to get a budget passed by June 30. If they can not pass a budget by June 30, then the executive branch is only authorized to spend state monies on essential state services as defined in the state constitution which includes the Indiana State Police, the Indiana Department of Correction, and state health institutions but everything else would shut down. Hopefully by Monday we will have more information and we will be able to give a complete update on where this legislative session now stands by Friday.


INAAP Legislative Update 2/14/2011

Please click here to read the update.

Legistlative Update 01/28/11

January 28, 2011

 

Federal Legislative Update

 

In this update:

 

  • President Obama Delivers State of the Union Address Winning the Future” and Investing in Children
  • House Republicans Begin Hearings on Affordable Care Act
  • AAP Member Appointed to National Biodefense Science Board

 

President Obama Delivers State of the Union Address: “Winning the Future” and Investing in Children

President Obama delivered his State of the Union address Tuesday evening in Washington, DC, which focused on “winning the future.” In his remarks, the President highlighted several priorities to help make the country stronger, including education reform, reducing the deficit and investing in alternative energy and infrastructure.

 

Many of the priorities President Obama emphasized in his speech were issues of importance to the Academy and to America’s children:

 

·         The President not only spoke of prioritizing education reform inside the classroom, but also highlighted ways parents and communities can “do what’s necessary to give every child a chance to succeed.”

 

·         President Obama also focused on the rights of immigrant children, vowing to take on the issue of immigration reform and ensure that the “hundreds of thousands of students excelling in our schools who are not American citizens” are able to excel in this country. He specifically mentioned the children of undocumented workers and students who come to America to study abroad, emphasizing how these “talented, responsible young people…could be staffing our research labs or starting a new business…and further enriching this nation.” 

 

·         When addressing the need for a renewed focus in American advances in research and development, the President referenced his budget, expected to be presented to Congress next month. He specifically called out biomedical research as an area of federal investment, along with information technology and clean energy technology.

 

“We measure progress by the success of our people. By the jobs they can find and the quality of life those jobs offer. By the prospects of a small business owner who dreams of turning a good idea into a thriving enterprise. By the opportunities for a better life that we pass on to our children.” 

~ President Obama, State of the Union address, 1.25.11

 

Improving the Affordable Care Act

 

During the State of the Union, President Obama expressed willingness to amend certain provisions of the Affordable Care Act (ACA), including working with Republicans to address medical malpractice reform and to repeal the ACA’s 1099 tax reporting requirement. A bill (S 18) was introduced on Tuesday by Sens. Mike Johanns (R-Neb.) and Joe Manchin (D-W.Va.) to repeal this provision.

 

The ACA’s tax reporting mandate, scheduled to take effect in 2012, requires businesses, not-for-profits and government offices to file 1099 forms with the Internal Revenue Service when they purchase $600 or more in goods or services from another business in a given year. The law previously required 1099 forms only for services above that amount. Estimates predict the provision would raise $19.2 billion in revenue, though critics of the requirement cite the unfair administrative burden it would place on businesses, including pediatric practices. The Johanns-Manchin measure has garnered strong bipartisan support, with 45 Republican and 15 Democratic co-sponsors so far.

In addition to offering ways to work with Republicans to amend the ACA, the President also cited the health reform law’s many benefits—such as preventing children with pre-existing health conditions from being denied insurance coverage—and strongly discouraged its repeal. The U.S. Department of Health and Human Services (HHS) released a report today that found individuals and families who purchase insurance coverage through the law’s authorized state-based health insurance exchanges in 2014 will spend 14% to 20% less than they would have if the ACA was not enacted.

 

Proposed Cuts to Federal Health Care Spending & AAP Advocacy Efforts

 

In his address, the President also vowed to reduce the federal deficit and lower overall health care spending, referencing Medicare and Medicaid specifically as “the single biggest contributors to our long-term deficit.” In addition, he promised to veto any federal legislation that includes earmarks should it reach his desk, and reiterated his request for a five year freeze on domestic discretionary spending.

 

While all of these measures have could potentially involve cuts to Medicaid and other federally funded children’s programs, the AAP will continue to advocate to federal agencies and members of Congress to “do no harm to kids” when it comes to federal funding for children’s programs. The topic was the focus of an advocacy training session held today in Washington, DC by the AAP Department of Federal Affairs. Fifty AAP residents, medical students and young physicians participated in an advocacy training session and lobbied the importance of children’s health funding on Capitol Hill. Last Friday, the AAP sent a letter to members of the House Appropriations Committee with the same message.

 

House Republicans Begin Hearings on Affordable Care Act

 

On Wednesday, Republicans in the U.S. House of Representatives continued their efforts to investigate the ACA’s implementation and develop replacement legislation, holding the first two of several committee hearings on the law. In this week’s hearings, the House Budget and Ways and Means Committees questioned officials from the White House and the Centers for Medicare and Medicaid Services about the law's provisions and benefits.

The hearings are a result of the new Republican House majority’s vow to “repeal and replace” the ACA. Last week, the House approved a bill (HR 2) to repeal the reform law, and then passed a resolution (H Res 9) that would guide the panels on how to develop alternative guidelines to replace the ACA. While it remains highly unlikely that the repeal measure will make it past the Senate, House Republicans are proceeding with Congressional hearings in an attempt to call into question various provisions of the ACA and make the case for its repeal.


AAP Member Appointed to National Biodefense Science Board

 

The National Biodefense Science Board (NBSB) is a federal advisory committee that provides expert advice to HHS Secretary Kathleen Sebelius and HHS Assistant Secretary for Preparedness and Response (ASPR) Nicole Lurie, MD, MSPH, on preventing, preparing for and responding to public health emergencies. In January, six new experts were appointed to the Board, including Daniel Fagbuyi, MD, FAAP, who was sworn in this week to a three-year term.


Dr. Fagbuyi is a member of the AAP’s Disaster Preparedness Advisory Council and the Section on Emergency Medicine. Andrew T. Pavia, MD, FAAP, has cycled off of the NBSB.

 

The NBSB was created under the Pandemic and All-Hazards Preparedness Act in 2006 and chartered in May 2007. Since then, the Board has provided recommendations, such as how to improve the management of the research and development of medicines, vaccines and equipment for pandemic diseases. These and many other recommendations were included in the Public Health Emergency Medical Countermeasures Enterprise Review, released by Secretary Sebelius in August.


Legislative Update 1/21/11

January 21, 2011

 

Federal Legislative Update

 

In this update:

 

  • House Attempts to Repeal Affordable Care Act
  • U.S. Surgeon General Releases Call to Action to Support Breastfeeding
  • U.S. Supreme Court to Hear California Case on Medicaid Payment Cuts
  • AAP Submits CHIPRA Comments to AHRQ
  • Upcoming Advocacy Opportunities with the Department of Federal Affairs

 

House Attempts to Repeal Affordable Care Act

On Wednesday evening, the House voted 245-189 to pass HR 2, a two-page measure that would repeal the Affordable Care Act. Rep. Gabrielle Giffords (D-Ariz.), who is still recovering from injuries following a deadly shooting in Arizona earlier this month, was the only representative who did not vote. Every House Republican voted for the repeal bill, which also garnered the support of three Democrats—Dan Boren of Oklahoma, Mike McIntyre of North Carolina and Mike Ross of Arkansas. Ten other Democrats who had voted against the Affordable Care Act last year voted against repealing it Wednesday evening.

 

The AAP released a statement in support of preserving and strengthening the Affordable Care Act. AAP Iowa Chapter Past President Jody Murph, MD, FAAP, also wrote an op-ed in the Des Moines register in support of health reform for Iowa’s children. In addition, the House’s Committee on Energy and Commerce produced an online resource on the district-by-district impact of repealing the Affordable Care Act.

 

Senate Majority Leader Harry Reid (D-Nev.), has stated that he will not move to consider HR 2, and President Obama has pledged to veto any repeal measure should it reach his desk.

 

In addition, on Thursday, House Republicans voted 253-175 to support a resolution (H Res. 9) directing four committees—Education and the Workforce, Energy and Commerce, Judiciary, and Ways and Means—to draft and consider replacement legislation for the Affordable Care Act. The legislation would be guided by 13 directives, including overhauling the medical liability system, lowering health care premiums, and providing people with pre-existing conditions access to affordable health coverage. The resolution does not specify a deadline for action, and was supported by 14 Democrats.

U.S. Surgeon General Releases Call to Action to Support Breastfeeding

 

Yesterday, U.S. Surgeon General Regina M. Benjamin, MD, MBA, released a comprehensive report, “Call to Action to Support Breastfeeding,” which outlines evidence-based steps that communities can take to remove obstacles faced by women who wish to breastfeed their babies.

 

The AAP released a statement supporting the report, and AAP Immediate Past President Judith S. Palfrey, MD, FAAP, and Lori Feldman-Winter, MD, MPH, FAAP, attended an event in Washington, DC on the report’s recommendations. D.C. Breastfeeding Coalition president Sahira Long, MD, FAAP, spoke at the event about her work to increase breastfeeding rates in the District of Columbia.


The Call to Action outlines innovative ways that mothers, their families, local communities, health care providers and employers can support breastfeeding. Some of the key recommended action steps include:

 

·         Give mothers the support they need to breastfeed their babies, and develop programs to educate fathers and grandmothers about breastfeeding.

·         Use community-based organizations to promote and support breastfeeding.

·         Create a national campaign to promote breastfeeding.

·         Include basic support for breastfeeding as a standard of care for midwives, obstetricians, family physicians, nurse practitioners and pediatricians.

·         Work toward establishing paid maternity leave for all employed mothers.

·         Develop a national monitoring system to improve the tracking of breastfeeding rates as well as the policies and environmental factors that affect breastfeeding.

·         Create a federal interagency work group on breastfeeding to enhance coordination and collaboration across agencies to improve support for breastfeeding.

 

An executive summary and fact sheet of the Call to Action are available on the U.S. Surgeon General’s website.

 

U.S. Supreme Court to Hear California Case on Medicaid Payment Cuts

 

On Tuesday, the U.S. Supreme Court agreed to review California's proposals to cut Medicaid payments to physicians, dentists, pharmacies, health clinics and other medical providers. The court consolidated three California cases on the topic into one hour-long oral argument to be heard later this year.

 

The cases brought by the Independent Living Center of Southern California, the California Pharmacists Association and Santa Rosa Memorial Hospital raise the legal question of whether Medicaid beneficiaries and physicians have the right to sue over the proposed payment reductions. The Supreme Court will not rule on California's authority to impose cuts, just on whether or not pediatricians and other medical providers can seek legal action should Medicaid payment rates be significantly cut or eliminated.

 

Twenty-two states have sided with California to restrict the kinds of private lawsuits that can be filed over public benefits. The Ninth Circuit of Court of Appeals previously rejected California's proposed payment cuts.

 

The AAP weighed in on the issue to the Office of the Solicitor General, arguing that more than half of Medicaid recipients are children, and that cutting already low Medicaid physician payments would make it impossible for pediatricians to treat some of the nation’s most vulnerable children.

 

AAP Submits CHIPRA Comments to AHRQ

 

On Jan. 14, the AAP submitted comments to the Agency for Healthcare Research and Quality (AHRQ) on which priority topics should be emphasized within the Children’s Health Insurance Program Reauthorization Act’s (CHIPRA) pediatric quality measures program.

 

Provisions within CHIPRA direct U.S. Secretary of Health and Human Services Kathleen Sebelius to consult with a broad range of stakeholders in establishing a pediatric quality measures program to improve and strengthen child health care quality measures; expand on existing pediatric quality and advance the development of new quality measures; and increase the portfolio of evidence-based pediatric quality measures.

 

In its comments, the AAP emphasized the priority topics within the medical home, including well-child and adolescent well-care visits and mental/behavioral health and substance abuse services, among many other recommendations. The AAP also urged the AHRQ to adapt the National Priorities Partnership framework, which addresses key challenges in the health care system and sets forth six priorities: patient and family engagement; population health; safety; care coordination; overuse; and palliative and end-of-life care. The AAP highlighted the importance of well-child and well-adolescent visits in preventive pediatrics overall, and recommended that oral care be added to the priority topics list.  

 

Upcoming Advocacy Opportunities with the Department of Federal Affairs

 

On Jan.28, 2011, the AAP Department of Federal Affairs is hosting a daylong advocacy training session in Washington, DC. This session will provide a federal policy overview of a timely child health topic and an in-depth advocacy training session on that issue. Participants will then conduct in-person visits with their federal legislators' offices on Capitol Hill. There are only a few spots left! RSVP today by e-mailing kids1st@aap.org!

 

March 13-15, 2011 is a three-day Legislative Conference in Washington, DC. The conference is an opportunity for residents, young physicians and AAP members new to federal advocacy to learn about the Academy's federal policy priorities, attend interactive skills-building workshops and trainings, listen to guest keynote speakers, and participate in in-person meetings with federal legislators and their staff on Capitol Hill.

 

There is also a pre-conference obesity prevention workshop on how to advocate for community-level policy changes to promote healthy, active living for children and families.

Visit FederalAdvocacy.aap.org/LegCon2011 to register today!

 


Federal Legislative Update 01/07/2011

 

January 7, 2011

 

Federal Legislative Update

 



In this update:

 

  • House of Representatives Passes Budget Rules Package
  • Vote to Repeal Affordable Care Act Set for Next Wednesday
  • HHS Adjusts Fluoride Recommendations in Drinking Water
  • Registration Opens for Medicare and Medicaid EHR Incentive Programs
  • Pediatrician Joshua Sharfstein Announces Departure from FDA
  • Office of Consumer Information and Insurance Oversight Moves to CMS
  • Upcoming Advocacy Opportunities with the Department of Federal Affairs

House of Representatives Passes Budget Rules Package

 

With the swearing in of the 112th Congress of the United States on Wednesday, the new Republican House majority adopted a set of rules that will impact the budget and appropriations process for Fiscal Year 2011 (FY11) and beyond.

 

One "special order" rule requires the Chairman of the Budget Committee, Rep. Paul Ryan, (R-Wisc.), to submit spending levels for FY11 through FY15 to the Congressional Record in lieu of the House’s failure to pass a FY11 concurrent budget resolution. Thus, Chairman Ryan will be allowed to set FY11 spending limits without a committee vote.

 

A separate rule replaces the “pay-as-you-go” measure implemented by the Democratic House majority in the previous 110th and 111th Congresses. The new rule, deemed “cut-as-you-go,” requires all new mandatory spending to be offset with reductions to existing programs, though the rule does not apply to tax cuts or select other priorities of the new majority.

 

The new rules package did not include a ban on earmarks as an effort to restrict federal spending, though an earlier House Republican-imposed moratorium is expected to strip earmarks from the final FY11 appropriations package as it is finalized later this winter.

 

The AAP will be closely monitoring the appropriations process to protect programs vital to children and pediatricians. Stay tuned for future e-mail alerts to contact your members of Congress to support investments in children’s health and pediatrician workforce needs.

 

Vote to Repeal Affordable Care Act Set for Next Wednesday

 

Today, Republicans in the U.S. House of Representatives began debating legislation that would repeal the Affordable Care Act (ACA). A vote on this legislation is set for next Wednesday, Jan. 12, without open debate or the opportunity to propose amendments.

 

PICO, a national network of faith-based community organizations and a frequent AAP coalition partner, has initiated a petition against the repeal of health reform, which is open for individuals to sign.

 

On Monday, Senate Democrats sent a letter to House Speaker John Boehner (R-Ohio), indicating that they would not support the repeal if it passed the lower chamber. President Obama has also announced opposition to the House repeal effort, giving it limited chances for success beyond the House of Representatives.

 

The AAP strongly discourages repealing the ACA, which would deprive millions of children and families from increased access to care, guaranteed health insurance coverage with pediatric-specific benefits and more affordable insurance options. For more information on what the health reform law means for children and pediatricians, visit this resource page of FederalAdvocacy.aap.org.

 

HHS Adjusts Fluoride Recommendations in Drinking Water

 

The U.S. Department of Health and Human Services (HHS) is proposing a change to the recommendation for the optimal fluoride level in drinking water to prevent tooth decay. The new recommendation, 0.7 milligrams of fluoride per liter of water, replaces the previous recommended range of 0.7 to 1.2 milligrams per liter. The AAP supports this new recommendation and issued a statement commending the change, which will update and replace original recommendations provided in 1962 by the U.S. Public Health Service. The U.S. Centers for Disease Control and Prevention also released a question-and-answer guide on the recommendations.

 

Registration Opens for Medicare and Medicaid EHR Incentive Programs

 

Registration for Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs began this week. The programs will provide incentive payments to eligible professionals and hospitals as they adopt, implement, upgrade or demonstrate meaningful use of certified EHR technology. 

 

Registration for the program in Medicaid opened in Alaska, Iowa, Kentucky, Louisiana, Oklahoma, Michigan, Mississippi, North Carolina, South Carolina, Tennessee and Texas on Jan. 3, and registration will open in California, Missouri and North Dakota in February 2011. Other states will likely launch their Medicaid EHR Incentive Programs during the spring and summer of 2011. Information on when registration will be available for EHR programs in specific states is posted on the Center for Medicare and Medicaid Services’ (CMS) EHR program website.

 

Pediatrician Joshua Sharfstein Announces Departure from FDA

 

On Jan. 12, Food and Drug Administration (FDA) Principal Deputy Commissioner Joshua Sharfstein, MD, FAAP, will become the secretary of health and mental hygiene for the state of Maryland. Under Dr. Sharfstein and FDA Commissioner Margaret Hamburg’s leadership, the FDA has become more aggressive in regulating products on the market, including tobacco products, which were recently added to the FDA’s portfolio. The AAP collaborated with Dr. Sharfstein and the agency over the past two years to curtail the marketing and sale of tobacco products to children.


As Maryland’s secretary of health and mental hygiene, Dr. Sharfstein will decide how the state will carry out the new provisions of the federal health reform law and work on public health issues that he previously championed, such as reducing infant mortality and HIV rates.

 

Office of Consumer Information and Insurance Oversight Moves to CMS

 

Just months after creating the Office of Consumer Information and Insurance Oversight (OCIIO), HHS announced on Wednesday that it will move the agency to CMS. According to HHS, the effort will help the agency become more efficient as provisions of the federal health reform law take effect.

 

OCIIO was created to decide how certain provisions of health reform would be implemented, as well as to give consumers information to compare health plans, oversee the creation of state insurance exchanges and monitor health plan rate increases. Under CMS, OCIIO will be led by CMS Principal Deputy Administrator Marilyn Tavenner, Medicare's deputy administrator. Jay Angoff, who had been in charge of OCIIO since April, will become HHS Secretary Kathleen Sebelius' senior adviser. The agency's name also will change to the Center of Consumer Information and Insurance Oversight.

 

Upcoming Advocacy Opportunities with the Department of Federal Affairs

 

On Jan.28, 2011, the AAP Department of Federal Affairs is hosting a daylong advocacy training session in Washington, DC. This session will provide a federal policy overview of a timely child health topic and an in-depth advocacy training session on that issue. Participants will then conduct in-person visits with their federal legislators' offices on Capitol Hill. RSVP today by emailing kids1st@aap.org!

March 13-15, 2011 is a three-day Legislative Conference in Washington, DC. The conference is an opportunity for residents, young physicians and AAP members new to federal advocacy to learn about the Academy's federal policy priorities, attend interactive skills-building workshops and trainings, listen to guest keynote speakers, and participate in in-person meetings with federal legislators and their staff on Capitol Hill.

There is also a pre-conference obesity prevention workshop on how to advocate for community-level policy changes to promote healthy, active living for children and families. 

Visit FederalAdvocacy.aap.org/LegCon2011 to register today!


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