WASHINGTON WIRE
September 4, 2009
Issue 212
Congress Returns from Recess, Continues Debate on Healthcare Reform
PPSV Obtains Judgment Requiring Research Time to Be Included in IME FTE Count
PPSV Obtains Reprieve for 340B Hospitals
Top Story
Congress Returns from Recess, Continues Debate on Healthcare Reform
Both the Senate and House of Representatives will return from recess next Tuesday, September 8. After a month of town hall events and meetings on healthcare reform, members return to DC to continue debating what shape, if any, healthcare reform legislation should take. The House Energy and Commerce Committee are expected to continue its mark-up of their bill later this month, after which the House Rules Committee is expected to merge the three House versions of HR 3200. A bill is also expected out of the Senate Finance Committee. It is unclear if bipartisan negotiations by the "gang of six" in the Senate - led by Finance Chairman Max Baucus (D-MT) - will continue.
President Obama is scheduled to address a joint session of Congress on Wednesday, September 9. Obama is expected to outline the White House's position on the essential elements in any reform legislation. Many supporters of healthcare reform are hoping the President's speech can revive some of the momentum that was lost over the summer when opponents protested the healthcare reform efforts in Congress.
Health Care News
PPSV in the News
PPSV Obtains Judgment Requiring Research Time to Be Included in IME FTE Count
The U.S. District Court for the Northern District of Illinois in August ruled in favor of the University of Chicago Medical Center (“UCMC”) in an important case governing Medicare payments for indirect medical education (IME.) The Medicare program pays teaching hospitals for the direct and indirect costs of training physician interns, residents and fellows. The IME payment is determined, in part, by the count of full-time equivalent interns, residents and fellows (“FTEs”).
When calculating UCMC’s IME payment for fiscal year 1996, the Secretary of Health and Human Services removed educational research time from the IME FTE count. The Secretary argued that only direct-patient-care activities may be included in the IME FTE count, and any educational research that did not involve the care of individual patients could not be included in the count.
PPSV attorneys Ronald S. Connelly and Mary Susan Philp argued on behalf of UCMC that the plain language of both the Medicare IME statutory provision and the IME regulation requires the Secretary to include educational research in the FTE count. In addition, the Secretary has no longstanding policy to exclude research time, and Congress intended all educational activities to be included in the count.
In ruling for UCMC, the court held that the plain language of the IME regulation determines the FTE count based upon the residents’ location, not on the functions that they perform. Thus, all time spent in educational activities must be included in the FTE count if the residents are assigned to allowable areas of the hospital. Click here for the full decision.
PPSV Obtains Reprieve for 340B Hospitals
At least 50 hospitals that had been scheduled for disenrollment from the 340B pharmacy discount program on September 1 were given a reprieve thanks to the efforts of PPSV attorney Bill von Oehsen. Von Oehsen met with officials from the Office of Pharmacy Affairs on Friday, August 28, on behalf of the Safety Net Hospitals for Pharmacy Access, an association representing hospitals in the 340B program. The OPA disenrollment letters were based on faulty CMS data indicating that the hospitals' disproportionate share hospital percentages had fallen below the qualifying percentage for participation in 340B. SNHPA, through von Oehsen, alerted OPA about the questionable data and OPA posted a notice on its website to give all hospitals until December 1 to submit documentation demonstrating that they qualify for the 340 program.
Upcoming Events
Hearings
Wednesday, September 9
Ryan White Extension Act of 2009: Discussion Draft Legislation
Subcommittee on Health
11:00 AM, 2123 Rayburn House Office Building
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