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ASA NEWSLETTER
 
 
May 1997
Volume 61
Number 5
 
WASHINGTON REPORT

Early FY98 Budget Deal Doubtful as Congress Takes Spring Recess

Michael Scott, Director
Governmental and Legal Affairs



Following an embarrassing last-minute glitch in the House, Congress recessed in late March for two weeks without any clear blueprint in hand for achieving a budget agreement with the Administration. The glitch was created by the defection of 11 conservative GOP members from the leadership's bill on financing of House operations (including the planned investigation of campaign finance abuses). Differences were resolved only after a fairly ugly display of varying viewpoints within the GOP rank and file, and a public characterization by one of its members of Speaker Newt Gingrich (R-GA) as "road kill."

Although the major newspapers report the existence of a budget-related dialogue among the President, House Ways and Means Chair Bill Archer (R-TX) and Senate Majority Leader Trent Lott (R-MS), it is clear that at the time of the recess, the two sides remained far apart both philosophically and as to actual numbers. With respect to Medicare budget savings, the President appears principally interested in a "fix" lasting throughout the remainder of his term and slightly beyond, while GOP congressional leaders want to focus, now, upon fundamental reforms of the program.

At the time of the recess, there was some talk in GOP circles of splitting up the budget reconciliation process into three parts, with Medicare budget reconciliation coming first, as early as May or June. This approach would be designed to force the President either into a politically painful veto of a moderate bill designed to save the solvency of the program, or approving a bill going further in terms of budget savings than at least the liberal portion of his constituency would like.

There is by no means uniform GOP acceptance of this approach and the situation remains fluid, the only certainty being that both sides truly want to find a way to make a deal. This is the kind of situation that frequently leads to nonpublic deal-making among the principals and too little or no real opportunity for those affected by the deal to attack it.

For this reason, ASA has taken advantage of the congressional recess to meet on treatment of the anesthesiology conversion factor with a large number of staffers for members of the three committees critical to Medicare issues, House Ways and Means, House Commerce and Senate Finance. ASA's position on this issue appeared in the last issue of the NEWSLETTER, and by the time this column appears, many participants in the ASA Legislative Conference held on April 13-15 in Washington, D.C., will also have met with their legislators to advance the ASA position.


Resource-Based Practice Expenses: The Beat Goes On, and Gets Louder

In late March, the surgeon-led Practice Expense Coalition gave the amplifier another turn louder at hearings of the Ways and Means health subcommittee and the Practicing Physicians Advisory Council dealing with the status of efforts by the Health Care Financing Administration (HCFA) to develop defensible resource-based practice expenses by next January 1, the implementation date Congress set four years ago. The coalition now seeks to persuade Congress to suspend the January 1 effective date indefinitely and send HCFA back to the drawing board to develop more credible data than it preliminarily published last January. The American Medical Association (AMA) is on record as favoring a one-year delay in the effective date in order to permit HCFA to develop better data.

A member of the Coalition, ASA has supported the Coalition's view, and the ASA Administrative Council has authorized the contribution of funds by ASA in support of the Coalition's lobbying efforts. As previously reported in this column, ASA is conducting its own survey of direct and indirect anesthesiology practice expenses with the assistance of Abt Associates Inc. and will use the results of that survey to evaluate whatever recommendations HCFA develops for the specialty.


HCFA Sets Timetable for NPI Regulations

Acting pursuant to the mandate of last year's Health Insurance Portability and Accountability Act, HCFA has published its rule-making schedule for establishment of a unique health identifying number for each health care provider, known as the National Provider Identifier (NPI). Beginning December 1, 1997, Medicare claims submitted without an NPI will not be processed.

According to HCFA's current intention, all providers enrolled in the Medicare program will automatically receive NPIs soon after August 1. The system will allow NPIs of physicians in a group practice to be linked to the group's NPI. The NPI will be linked to a central database maintained by HCFA, which will contain substantial personal and professional information on each provider. The AMA has expressed concern as to the security of the database against unauthorized disclosure of information, and the upcoming HCFA regulations are expected to deal with this issue.


Managed Care Review Panel Appointed by President

On March 26, President Clinton announced appointment of a 34-member, blue-ribbon advisory commission to assess the need for federal regulation of private health care plans. The President previously had announced his intention to appoint such a commission during last fall's presidential campaign. Appointment of such a commission was favored by the Patient Access to Specialty Care Coalition, of which ASA is an active member.

The commission will be co-chaired by Health and Human Services Secretary Donna Shalala and Acting Labor Secretary Cynthia Metzler. It is expected to issue a report to Congress by March 30, 1998. Several bills are currently pending in Congress purporting to deal with a variety of managed care excesses, but in general, the GOP leadership tends not to favor federal regulation of private health maintenance organization practices. Whether the report of the commission will lend cohesion to the pending bills, all of which are opposed by the managed care industry in favor of its own self-policing efforts, remains to be seen next year.


June Dates Set for 1998 Legislative Conference

Because of continuing difficulties in recent years in obtaining congressional speakers and arranging Capitol Hill visits, the ASA Administrative Council has approved, as an experiment, moving the 1998 Legislative Conference from the traditional "Sunday through Tuesday" format to a "Monday through Wednesday" format. The dates for the 1998 Legislative Conference will be June 15-17, with most Hill visits planned for Wednesday, June 17.

Problems with the traditional format arise from the fact that Senators and Representatives frequently do not return to Washington from their home states until noon on Tuesday when the first votes for the week are often scheduled. Although this change in the Legislative Conference schedule calls for physicians to be away from their practices for one additional weekday, the one-day shift in the meeting format may serve to enhance the effectiveness of the conference and the advancing of ASA's legislative agenda.

Shortly following the 1998 meeting, the Administrative Council will assess the desirability of making the shift permanent, based upon comments of meeting participants and other relevant factors. At present, the meetings for 1999 and 2000 remain scheduled in a "Sunday through Tuesday" format, subject to possible change after the results of the 1998 meeting are known.


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The views expressed herein are those of the authors and do not necessarily represent or reflect the views, policies or actions of the American Society of Anesthesiologists.

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