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Category: Health/Medical

House Considers VA Conference Report

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Both the House and Senate intend to bring to the floor this week a conference agreement to reform the Veterans Health Administration (VHA) and increase transparency and services in the Department of Veterans Administration (VA). The House will be the first to consider, what has been a delicate and sometimes contentious agreement to create, the conference committee report this afternoon. 

The legislation (conference report to accompany H.R. 3230, the Veterans’ Access to Care through Choice, Accountability, and Transparency Act of 2014) primarily deals with care at veteran medical facilities.

Provisions of interest to UW include:

  • The conference report requires the VA to establish medical residency programs, or to ensure that sufficient residency positions exist at facilities with programs in specialties facing a shortage of physicians or located in a community that is designated as a health professional shortage area. It increases by up to 1,500 the number of graduate medical education residents over a five-year period, with a priority for primary care, mental health and other specialties as VA determines is appropriate.
  • It also expands certain educational benefits to the spouses of servicemembers who die in the line of duty, including those who died since the 9/11 terrorist attacks, and it requires colleges and universities to provide in-state tuition to veterans under the Post-9/11 GI Bill regardless of how long they have lived in the state.

After whistleblowers revealed that some employees of the Veterans Affairs (VA) Department were falsifying wait-time records for medical appointments and keeping many patients on unofficial waitlists to create the appearance that they were reaching wait time targets, there has been nearly universal Congressional support to make the VA more accountable.

A Congressional Budget Office estimate released late Tuesday stated the agreement would be a net increase to the deficit by about $10 billion through FY 2024.

The House is expected to pass the measure today and the Senate is expected to consider it later in the week.

This Week in Congress

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Today the Senate reconvenes at 2 p.m. and is in a period of morning business until 6 p.m. No votes are expected.

In the other chamber, the House reconvenes at 2 p.m. for legislative business and is expected to begin consideration of a number of bills, including HR 5016, which would make appropriations for financial services in FY 2015. Roll call votes will be postponed until 6:30 p.m.

Here’s what we’ll be paying attention to in committee this week:

TUESDAY, JULY 15

Senate Appropriations Committee
Fiscal 2015 Appropriations: Defense
Subcommittee Markup
10 AM; 192 Dirksen Senate Building

House Appropriations Committee
Fiscal 2015 Appropriations: Interior-Environment
Full Committee Markup
9 AM; 2359 Rayburn Building

THURSDAY, JULY 17

Senate Appropriations Committee
Fiscal 2015 Appropriations: Defense
Full Committee Markup
10:30 AM; 106 Dirksen Senate Building

Senate Commerce, Science & Transportation Committee
Research and Development Investments
Full Committee Hearing
2 PM; 253 Russell Senate Buliding

House Energy & Commerce Committee
Technological Advancements in Health Care
Subcommittee Joint Hearing
9:30 AM; 2123 Rayburn House Building

House Science, Space & Technology
Innovative Medical Achievements
Subcommittee Hearing
9 AM; 2318 Rayburn House Building
 

Senate Confirms Burwell

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Today, the Senate voted 78-17 to confirm Sylvia Mathews Burwell as secretary of Health and Human Services. Burwell replaces Kathleen Sebelius, who stepped down earlier this year. 

Possible New Funding to Train Primary Care Physicians

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On Tuesday, President Obama will release his FY2015 budget request to Congress. We learned yesterday – while we were on Capitol Hill advocated for more Graduate Medical Education funding to train primary care physicians – that the President’s budget proposal will include:

• $5.23 billion over 10 years to train 13,000 primary care residents in high-need communities, and in team-based care, such as an accountable care organization.

• Higher payments to Medicaid providers, including physician assistants and nurse practitioners, by one year at a cost of about $5.44 billion.

• $3.95 billion over the next six years in the National Health Services Corps to support growing the program from 8,900 primary care providers in 2013 to at least 15,000 annually starting in the 2015 fiscal year.

The proposal will also address a shortage of mental health providers by offering new residency opportunities for psychiatrists, psychiatric nurse practitioners, and other mental health providers as part of the team-based approach.

We look forward to seeing more details next week, but this is the first encouraging news in a long while related to training more primary care physicians.

July Federal Update

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FY14 APPROPRIATIONS

The path to enacting FY14 appropriations measures is paved with legislative friction as Congress is showing no signs of undoing the sequester and the House and Senate chambers are working on vastly different overall budget numbers. At this point, there are three budgets — House, Senate, and White House — all of which assume no sequestration, but include different ways to account for the cuts in later years.

The House is advancing its FY14 appropriations bills at a $967 billion overall spending cap, while the Senate is working with a $1.058 trillion cap, which does not take into account the sequester. Ironically, both the House and Senate plans would trigger a new round of across-the-board spending reductions under sequestration because they violate the caps set by the 2011 Budget Control Act (PL 111-25). But the House GOP plan busts the caps in defense and other security measures while the Senate is expected to bust the caps in both defense and non-defense (domestic) bills. All of this is leading to a big fight on spending, which will certainly culminate in a continuing resolution (CR) before the federal fiscal year ends September 30th. Continue reading “July Federal Update”