AANA Federal Government Affairs
HOTLINE
Number 2005-20, Week of Monday, August 1, 2005


In This Issue:

* House and Senate Approve $1.5 Billion in Supplemental Funds for the VA
* Representative Johnson (R-CT) Introduces Physician Fee Fix
* Medical Malpractice (HEALTH Act) Passes House Again
* House Passes Bill to Create National Medical Error Database
* House Passes Association Health Plan (AHP) Legislation
* Amendments




>> House and Senate Approve $1.5 Billion in Supplemental Funds for the VA

On Friday (July 29th), the Senate voted 99-1 to approve the fiscal year 2006 Interior-Environment appropriations bill (HR 2361), which includes $1.5 billion in supplemental funds for Department of Veterans Affairs (VA) healthcare programs (Washington Post, 7/30), clearing it for the President's signature into law. The provision is important to CRNAs, in that the mammoth VA health system is among the largest single employers of CRNAs in the US. House and Senate negotiators last week agreed to add $1.5 billion to the legislation for VA healthcare programs (San Francisco Chronicle, 7/29). The VA would use the funds to address a budget deficit in FY 2005 and help address an expected deficit of at least $2.6 billion in FY 2006.
 
Read more, http://www.washingtonpost.com/wp-dyn/content/article/2005/07/29/AR2005072901942.html

Also see, http://www.sfgate.com/cgi-bin/article.cgi?f=/n/a/2005/07/29/national/w091139D61.DTL




>> Representative Johnson (R-CT) Introduces Physician Fee Fix


On Thursday (July 28th), House Ways and Means Health Subcommittee Chairwoman Nancy Johnson (R-CT) introduced the Medicare Value-Based Purchasing for Physicians' Services Act of 2005 (HR 3617) that would repeal the existing formula for calculating Medicare's physician payments and replace it with a system linking payments to quality. Knowing that CRNAs are paid on the physician fee schedule, and that any cuts will directly affect payments to CRNAs, AANA President Frank T. Maziarski, CRNA, MS, CLNC, sent a letter to Congresswoman Johnson expressing support for the legislation. The measure, which seeks to preempt a scheduled 4.3% cut in Medicare physician payments in January, could become part of this fall's budget reconciliation package (CongressDaily, 7/28). At a press conference to announce the introduction of her bill, Johnson said it is "extremely important" that Congress not continue to "kick the can down the road" by enacting a temporary payment fix to avoid the scheduled cut, as it has done in years past. The $30 billion to $40 billion costs of such fixes should go toward a permanent change in the Medicare doctor payment system. Her proposal would eliminate the existing sustainable growth rate (SGR) formula and replace it with a system under which annual payment increases would be based on the growth of the Medical Economic Index (MEI). MEI tracks the cost of providing physician care. The bill calls for a 1.5% payment increase in 2006. MEI-based payment increases, which would start in 2007, would be reduced by one percent that year and in 2008 if doctors fail to report data on the quality of care they provide. However, the legislation does not include "gainsharing" provisions, which allow doctors and hospitals to share savings if they develop ways to improve the efficiency of treatments.

Visit the House Ways and Means Website, http://waysandmeans.house.gov

View the bill, http://thomas.loc.gov "Type in HR 3617"




>> Medical Malpractice (HEALTH Act) Passes House Again


On Thursday (July 28th), the House voted 230-194 to approve a medical malpractice reform bill, the Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2005 (HR 5). While nurse anesthesia has not seen the dramatic increase in liability premiums that are blanketing physicians and other medical specialties, reform of the marketplace has been an AANA advocacy priority because it is integral to ensuring CRNAs' ability to practice. The legislation sponsored by Representative Phil Gingrey (R-GA), would limit noneconomic damages to $250,000 and punitive damages to $250,000 or two times the economic
damages, whichever is greater. The measure also would limit the amount a plaintiff's attorney could charge in contingency fees. The bill is identical to legislation that the House approved twice during the 108th Congress but died in the Senate. The current measure will now move to the Senate where success is not assured.

Read more, http://www.nj.com/search/index.ssf?/base/news-1/1122615717119280.xml?starledger?ntop&coll=1

View the bill at Thomas, http://thomas.loc.gov "Type HR 5"




>> House Passes Bill to Create National Medical Error Database


On Wednesday (July 27th) the House voted 428-3 to pass the Patient Safety and Quality Improvement Act of 2005 (HR 544) that would establish a national patient safety database to encourage voluntary reporting of medical errors (CongressDaily, 7/28). The legislation, which AANA and its members have advocated on behalf of for years, includes CRNAs specifically at AANA's request. The database will allow providers such as CRNAs to anonymously report medical errors without the fear of repercussion. The version of the legislation, sponsored by Senator Jim Jeffords (I-VT), was passed on July 21st. President Bush is expected to approve the measure. The bill would authorize the Department of Health and Human Services (HHS) to certify independent "patient safety
organizations," with a review of the certifications every three years (CQ Today, 7/27). Healthcare providers would report errors to the patient safety organizations, which would compile the information into the national database for analysis and make recommendations on ways to reduce errors (Las Vegas Sun, 7/27). The data would not identify specific patients, healthcare providers or individuals who report errors, and disclosure of such information would result in a $10,000 fine per violation. In addition, the information could not be used as evidence in malpractice lawsuits or other litigation, nor could it be used by an accrediting body or regulator to take action against a provider. The one exception would be if a judge in a criminal proceeding determines the information "contains evidence of a criminal act and that such patient safety work product is material to the proceeding and not reasonably available from any other source" (CQ Today, 7/27). The bill would not bar patients or their families from using other medical records as evidence in malpractice lawsuits (Los Angeles Times, 7/27). The bill would also prohibit employers from taking retaliatory action against employees who report medical errors. The system would cost about $58 million over the next five years, according to Congressional Budget Office (CBO) estimates (Las Vegas Sun, 7/27).

Read more, http://www.lasvegassun.com/sunbin/stories/thrive/2005/jul/27/072701753.html

Also see, http://www.latimes.com/news/nationworld/nation/la-na-errors28jul28,1,5009814.story

View the bill at Thomas, http://thomas.loc.gov  "Type HR 544"




>> House Passes Association Health Plan (AHP) Legislation


On Tuesday (July 26th), the House voted 263-165 to approve the Small Business Health Fairness Act of 2005 (HR 525) that would allow small businesses to form association health plans across state lines and would exempt the plans from a number of state laws that regulate health plans and require them to cover certain benefits (CQ Today, 7/26). Though some CRNAs might want to participate in Association Health Plans (AHPs), others might be concerned that their preemption of state patients' rights and practice protections imperil the reimbursement of CRNAs' services in some instances. The legislation would allow trade groups, chambers of commerce and other business organizations to arrange for coverage on behalf of small businesses. Under the bill, the Department
of Labor (DOL), rather than state insurance commissioners, would regulate Association Health Plans (AHPs). The focus now turns to the Senate where passage is uncertain.

Read more, http://www.washtimes.com/business/20050726-101300-6696r.htm

Learn about the Federal Employees Health Benefit Program (FEHBP), http://www.opm.gov/insure/health/index.asp




>> Amendments


* The House and Senate will not be in session for the entire month of August. Both the House and the Senate are on August recess until the beginning of September.

* CMS to Publish Physician Fee Schedule. About this time every year. The Centers for Medicare and Medicaid Services (CMS) publishes a physician fee schedule update. This year, there is a possibility that anesthesia teaching rules will also be addressed. We will be closely monitoring this again this year in an effort to ensure that AANA has the opportunity to comment.

* Hotline will not be published during the month of August. Hotline will be taking the August recess along with Congress and will not return until September 12th.

* Register for the Spy Museum Reception and Tour! For those of you attending the AANA Annual Meeting in Washington, DC, this year, make sure you register for the International Spy Museum Reception and Tour. The event will be held Tuesday, August 9th (8pm-10pm). Proceeds will benefit the CRNA-PAC. See the Meetings page at http://www.aana.com for more details.

* For up-to-date Congressional floor & committee schedule information, see http://thomas.loc.gov/.




>> For More Information


The AANA Federal Government Affairs Hotline is published for the nurse anesthetist members of AANA each week Congress is in session by the AANA
Office of Federal Government Affairs, Washington DC, 202-484-8400, info@aanadc.com, Frank Purcell, Senior Director. C 2005 American Association of Nurse Anesthetists.