Federal Legislative Watch

CHC Appropriations
An increase of $248 million in FY2009 is being requested to stabilize existing centers, expand access to new communities and bring high-quality medical, dental, and behavioral health care to over one million new patients in need. The Pallone/Deal Letter, calling for the community health center (CHC) increase, was circulated in the House, and the Stabenow/Bond Letter was circulated in the Senate.

Support Letters 2008: The final Pallone/Deal Letter was sent to the House Subcommittee on Labor, Health and Human Services, Education and Related Agencies' Chairman David Obey and Ranking Member James Walsh on April 7 with 214 signatures, which included Oklahoma Congressman Frank Lucas and Congresswoman Mary Fallin. The final Stabenow/Bond Letter was sent to the Senate Subcommittee on Labor, Health and Human Services, Education and Related Agencies' Chairman Tom Harkin and Ranking Member Arlen Specter on April 4 with 66 signatures, which was not signed by Oklahoma's senators.

Update: June 4 and 5 Senate and House legislators passed a FFY (Federal Fiscal Year) 2009 budget resolution (conference report). Subsequently, the Labor, HHS, Education and Related Agencies appropriation bill markup was conducted by the House Subcommittee on Labor, HHS Thursday, June 19. In the markup, legislators included a $100 million increase for community health centers to serve an additional 330,000 individuals. [Recent] The Senate Health, Education, Labor, and Pensions Committee marked up their version of the bill, Senate Committee Report for S.3230 (p.43/330pp. - introduced July 8), that included a $250 million increase for community health centers of which $62 million would be for base grant adjustments to account for increased costs of providing services.
Reauthorization of the Health Center Program
The Federal Health Centers Program is overdue for reauthorization to preserve its core elements that include the following: 1) Must serve areas of highest need, 2) Be governed by a community board of which 51% of the board are health center patients, 3) Provide comprehensive primary health care with supportive services as needed by the community, and 4) Provide services available to all with fees adjusted based on ability to pay.

Update: Senate Bill 901 - unanimously passed by the HELP committee March 12; [NEW!] However, a hold had, thereafter, been placed on the bill. That hold was removed after a significant grassroots effort from health center advocates mid-July. The bill (~45KB) subsequently passed the Senate by Unanimous Consent July 21. The Senate bill provides a straight reauthorization of the health center program with authorization for annual appropriation increases, requires separate studies related to school-based health centers and health care quality, reauthorizes the National Health Service Corps program with equal annual increases, and reauthorizes rural health care programs.

Previously, on Wednesday June 4, House Bill 1343 overwhelmingly passed the full House 393-24 with all of Oklahoma's Representatives voting in favor of the measure. The House Energy and Commerce Committee had unanimously passed the bill Wednesday, May 7. The bill would maintain the current program, authorize appropriations for five years, add new liability protections for volunteer providers, and include language related to emergency situations. To thank your Oklahoma Congressperson click here.
Strengthen Workforce
Reauthorization of the National Health Service Corps (NHSC) is requested plus increasing funding for the NHSC program, revitalization of the Health Professions Programs, funding for Title VII and VIII Health Professions programs including AHECs. Language was included in the Senate version of the Health Center Renewal Act, S. 901, to reauthorize the NHSC through 2012 (see reauthorization update above).

On May 21, the U.S. House of Representatives unanimously passed an extension of the "Conrad 30" program that allows states to have a limited number of J-1 Visa providers - graduates of U.S. medical schools originated from foreign countries - who agree to serve medically underserved areas in H.R. 5571. The House bill was assigned to the Senate Judiciary Committee on June 2. Sen. Kent Conrad, also introduced a related measure, S.2672, in February. This bill is also assigned to the Senate Judiciary Committee.
Medicare Reform and Medicaid Payment Systems
Congress is requested to 1) improve the FQHC Medicare payment mechanism and update the Medicare FQHC benefit package to include all Medicare covered ambulatory care services; 2) restructure health center to State Children's Health Insurance Program (SCHIP); and 3) broaden access to care for farmworkers.

Medicare Reform Update: Senator Max Baucus (D-MT), Chairman of the Senate Finance Committee, had planned to take a Medicare reform bill to the Senate floor for consideration in mid-May. However, thereafter, with the pending Memorial Day recess, an announcement by the Senate Finance Committee Chairman was made that additional time was be needed to come to a bipartisan agreement. Senators are expected to consider a measure by the end of this month, as the current law relating to physician payments expires June 30. A cloture vote failed in the Senate June 12 to bring a version of a Medicare bill, S.3101, up for consideration on the floor. Subsequently, the House overwhelmingly passed (355-59) HR6331 on June 24 that included provisions to increase the Medicare FQHC upper payment limits (UPLs) by $5 above that otherwise applicable in 2010 and require a study of the adequacy of the Medicare FQHC UPLs. The Senate lacked one vote to invoke cloture and vote on the House version of a Medicare bill by Friday, June 27. However, the Senate returned and voted 69-30 to invoke cloture and consider the bill July 9. The bill passed by unanimous consent without amendment. [NEW!] The President then vetoed the bill, and Congress overrode his veto making the bill law July 15.

Medicaid Update: House Energy and Commerce Health Subcommittee approved HR 5613 to put a one-year moratorium on seven regulations that would cut federal Medicaid funding for safety net providers, rehabilitation for people with disabilities and other programs. The House subsequently passed the bill April 23 with a 349-62 vote. In late May, HHS Secretary Mike Leavitt announced that he would delay two of the Medicaid regulations. However, the Senate passed a moratorium on the seven Medicaid provisions in the Military Construction and Veterans Affairs and Related Agencies Appropriations Act, 2008, H.R. 2642. The move provides a delay of the regulations until 2009. The President signed H.R.2642 into law June 30.
Health Center Facilities Improvement
Enact legislation to allow health centers to reduce capital project costs through the HUD Mortgage Insurance Program (S.2270)

Update: The House Ways and Means Committee passed the Housing Assistance Tax Act (H.R. 5720) includes a provision that would allow Federal Home Loan Banks to issue letters of credit for tax exempt bonds. The bill was reported out of committee April 24 and is currently on the Union Calendar.

S.2270 remains assigned to the U.S. Senate Committee on Banking, Housing, and Urban Affairs.
Notice of Proposed Rulemaking for Shortage Designations
After a decade of debate over the shortage designations process, the Department of Health and Human Services (HHS) released the notice of proposed rulemaking methodology in the February 29, 2008 Federal Register. At the time of notice issuance, only 60 days were allowed for public comment. However, intense impact analyses was needed to make informed comments. With public demand, HHS subsequently extended the comment period from 60 days to 90 days with all comments due by May 29, 2008. Many Primary Care Associations and health centers submitted comments by that deadline.

Update: After the first extension deadline had passed (June 2 Federal Register), HHS again extended the deadline for public comments about the proposed rulemaking to June 30.

Updated: July 23, 2008