Congress Approves FY 2005 Omnibus Spending Bill

[CAL/AAEM News Service]

Congress Approves FY 2005 Omnibus Spending Bill

Source: AAMC WASHINGTON HEADLINES, Legislative and Regulatory News, Association of
American Medical Colleges
Date: November 23, 2004


On Nov. 20, Congress approved a $388.4 billion omnibus spending package
that incorporates the nine regular FY 2005 appropriations bills not yet
enacted into law.  The House passed the conference agreement by a vote
of 344 to 51.  The Senate passed the package 65 to 30, after approving a
resolution to strike a provision from the conference agreement that
would have permitted the chairmen of the House and Senate Appropriations
committees or their staffs to view tax returns and face no penalty for
disclosing private financial information.  The House is expected to
approve this technical correction Nov. 24, clearing the omnibus bill for
the President.  Congress also approved another short-term continuing
resolution (H.J.Res. 114) to provide funding through Dec. 3 to permit
the President time to review and sign the omnibus spending bill.

The final spending package, which was incorporated into H.R. 4818, the
foreign operations appropriations bill, complies with the overall
spending target for FY 2005 agreed to by the Congress and the
Administration.  This represents a freeze in non-defense discretionary
spending.  Additional spending added to the conference agreement was
offset in part by an across the board cut of 0.83 percent in all
non-defense and non-homeland security spending. 

The following provisions cover programs of interest to medical schools
and teaching hospitals.  All funding totals presented in this summary
include the 0.83 percent across the board cut.

National Institutes of Health: The conference agreement appropriates
$28.363 billion for NIH, an increase of $563 million (2 percent) over
the FY 2004 level.  The bill provides $30 million through the National
Center for Research Resources (NCRR) for extramural research facilities
construction and renovation.  The House bill proposed no funding for
this program; the Senate bill included $119.2 million, the same as in FY
2004.   The conference agreement also provides $150 million through the
National Institute for Allergy and Infectious Diseases (NIAID) for
constructing BSL-3 laboratories.

The conference agreement retains the cap on extramural salaries for
NIH, as well as the Substance Abuse and Mental Health Services
Administration and the Agency for Healthcare Research and Quality, at
Executive Level I ($175,700 in 2004).

Health Professions: The final bill provides $299.5 million for the
Title VII health professions education programs for FY 2005, an increase
of 1.8 percent over last year. The only programs to receive an increase
are the primary care medicine and dentistry programs, which receive
$88.8 million, an 8.6 percent increase. All other programs, including
Scholarships for Disadvantaged Students, AHECs, geriatric training
programs, and workforce information and analysis received level funding.
The Title VIII nursing programs received $150.6 million for FY 2005, a
6.2 percent increase.

Children's Hospital's Graduate Medical Education: The children's
hospitals GME program is funded at $300.7 million, a 0.83 percent
decrease from FY 2004.

Council on Graduate Medical Education: The conference report includes
language to permit the Health Resources and Services Administration to
continue funding for COGME through FY 2005.

National Health Service Corps: The omnibus agreement provides $131.5
million for the National Health Service Corps, a reduction of $38.4
million (22.6 percent) from the previous year.  The accompanying report
language indicates that the reduction is not expected to result in fewer
awards because HRSA will no longer provide additional payments to cover
the tax burden associated with loan repayment awards.  The corporate tax
relief bill enacted earlier this year exempted such awards from federal
income taxes.

Agency for Healthcare Research and Quality: AHRQ is funded at $318.7
million for a $15 million increase (5 percent) over last year. Report
language dictates that the additional funds are to be used for clinical
effectiveness research, as authorized in the Medicare Modernization Act.
As all funds for AHRQ are derived from transfers from other Public
Health Service agencies, this funding is not subject to the 0.83
across-the-board cut. 

Centers for Disease Control and Prevention: The omnibus agreement
appropriates $4.496 billion for the Centers for Disease Control and
Prevention (CDC), an increase of $129 million (3.0 percent) over FY
2004.

Bioterrorism Preparedness: The final bill provides $1.163 billion for
the CDC ($57 million over FY 2004), which includes $396.7 million for
the Strategic National Stockpile, $926.2 million for state and local
preparedness, $141 million for upgrading CDC capacity, $79.3 million for
biosurveillance activities, and $16.7 million for anthrax vaccine
research. The HRSA Hospital Bioterrorism Preparedness program receives
$491.3 million, a $26.7 million (5.2 percent) decrease below FY 2004.
The curriculum development program receives $27.5 million, level with
last year. Another $47 million is directed to the NIH for research on
countermeasures.

Health Information Technology: The final conference agreement does not
include funds for Health Information Technology within the Secretary's
office. The Administration had requested $50 million, while the House
bill provided $25 million for this purpose. 

Veterans Medical Care:  The FY 2005 omnibus agreement includes an
appropriation of $28.09 billion for veterans medical care, an increase
of $1.25 billion (4.7 percent) over FY 2004.   The conference agreement
assumes an additional $2 billion in third-party collections.

Veterans Medical Research: The omnibus agreement provides $402.2
million for the VA Medical and Prosthetics Research program, a decrease
of $3.37 million (0.83 percent).

National Science Foundation: The omnibus agreement includes $5.471
billion for the National Science Foundation (NSF), a reduction of $106.7
million (1.9 percent) from FY 2004.  This total includes $4.219 billion
for NSF Research, a cut of $32.1 million (0.8 percent).
  
75 Percent Rule: Section 219 of the Labor-HHS portion of the bill
delays implementation of the April 30, 2004, Final Rule that revises the
criteria Medicare uses to classify hospitals as inpatient rehabilitation
facilities (the so-called "75 Percent Rule"). The revisions would
reduce Medicare payments for some rehabilitation facilities. The AAMC
and 29 other provider and patient advocacy organizations had supported
adoption of the delay, which would apply to IRFs certified on or before
June 30, 2004.

Under Sec. 219, the Secretary of Health and Human Services may not
expend funds to implement the Final Rule until the Government
Accountability Office (GAO) issues a study and recommendations regarding
"clinically appropriate standards for defining inpatient
rehabilitation services." Once the study is released, the Secretary
has 60 days to determine whether the Final Rule is consistent with the
GAO recommendations and to revise the IRF classification criteria
accordingly.


=====
Cyrus Shahpar & Brian Potts 
Managing Editors, CAL/AAEM News Service 
UC-Irvine



	
		
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