April 11, 2008

1. Congress Acts to Stop Medicaid GME Funding Cut

2. VA Requests Proposals for New Residency Positions

1. Congress Acts to Stop Medicaid GME Funding Cut

The effort to extend the moratorium on implementation of a regulation that would cut federal Medicaid matching funds for graduate medical education (GME) is attracting bipartisan attention and support in Congress. Senate Finance Committee member John D. Rockefeller IV (D-WV) introduced the Economic Recovery in Healthcare Act of 2008 (S 2819) Thursday, April 3, 2008. The House Energy and Commerce Subcommittee on Health passed by voice vote the Protecting the Medicaid Safety Net Act of 2008 (HR 5613). Both bills aim to extend the moratorium on Medicaid GME funding cuts.

HR 5613, introduced mid-March by House Energy and Commerce Committee Chair John D. Dingell (D-MI), has garnered 150 cosponsors and was passed by the House Energy and Commerce Subcommittee on Health with minor revision (AAIM Connection, March 28, 2008). Representative Dingell assuaged Republican committee member concerns by clarifying the bill’s intent to block only seven new Medicaid regulations that lawmakers oppose rather than future regulations. The full committee’s ranking Republican Representative Joe L. Barton (R-TX) said he would support the bill and urged the White House to pass it. During the bill’s mark-up, Representative Barton said he was reasonably confident the administration would accept his request and not veto the bill.

In the Senate, Senator Rockefeller, with cosponsors Olympia Snowe (R-ME) and Edward Kennedy (D-MA), introduced S 2819, to extend the moratorium on cuts to Medicaid payments for GME through April 1, 2009,. The House and Senate bills must be passed by the respective chamber and reconciled if Congress wants to address the issue of funding for Medicaid GME before the moratorium ends May 23.

2. VA Requests Proposals for New Residency Positions

The Department of Veterans Affairs (VA) Office of Academic Affiliations (OAA) released three requests for proposals (RFPs) March 10, 2008, to VA facilities that want to apply for additional residency positions for the 2009-2010 academic year (AY). The RFPs cover three areas of training: critical needs and emerging specialties; new affiliations and new VA sites of care; and educational innovation. The deadline for proposals is July 2, 2008.

The RFPs are part of the third phase of an initiative to increase VA-funded residency and fellowship positions as proposed by the Advisory Committee on Veterans Health Administration Resident Education. This increase would add approximately 400 permanent VA-funded training positions nationwide in AY 2009-2010. VA medical centers may have the opportunity to apply for additional positions in the following two to three academic years depending on funding for VA. VA facilities responding to the current solicitation may obtain specific eligibility criteria and all application materials, including a comprehensive outline of the OAA RFPs, at the OAA website beginning May 1, 2008.

In 2004, VA commissioned an advisory committee of national leaders in residency and fellowship education to evaluate VA resident education. The committee was charged with examining the operations of VA residency training positions, including the geographic distribution and specialty composition of positions, and assessing the effect of graduate medical education programs on the future of veterans’ health care. The committee’s full report is located at www.va.gov/oaa/archive/FACA_Report_2005.pdf; phases one and two of the initiative awarded 594 new, permanent positions to VA facilities that responded in AY 2006-2007.

The Alliance for Academic Internal Medicine—the nation’s largest academically focused specialty organization—consists of the Association of Professors of Medicine, the Association of Program Directors in Internal Medicine, the Association of Subspecialty Professors, the Clerkship Directors in Internal Medicine, and the Administrators of Internal Medicine.

Please contact AAIM Vice President for Policy Charles P. Clayton (cclayton@im.org), AAIM Policy Coordinator Nicole V. Baptista (nbaptista@im.org), or AAIM Policy Assistant Jessica L. O'Hara (johara@im.org) at (202) 861-9351 with questions or comments about this week’s Merlin.