1. Presentation by Marsha Simon, Ph.D.
Key Health and Human Services Legislation in the First Session of the 111th Congress
Presentation by
Marsha Simon, Ph.D.

2. 111th Congress Senate Democrats - 58 Seats (50)
Republicans - 41 Seats (49)
1 seat still undecided, but likely will be Democrat, Al Franken (D-MN)
House of Representatives
Democrats (235)
Republicans (199)
2 Vacancies
Rahm Emanuel (D), Illinois 5th District
Kirsten Gillibrand (D), New York 20th District

3. New Leadership Chairman, Senate Health, Education, and Labor Committee
Edward Kennedy (D-MA) Tom Harkin (D-IA) or Chris Dodd (D-CT)
Chairman, House Energy and Commerce Committee
John Dingell (D-MI) Henry Waxman (D-CA)

4. Legislative Agenda for the 111th Congress
Children’s Health Insurance (CHIP) Program Reauthorization
Stimulus/Economic Recovery
Fiscal Year 2009 Health Appropriations - This Week
Health Reform - ???
Medicare Physician Payment Fix - By End of Calendar Year 2009

5. Committees of Jurisdiction
House
Appropriations - discretionary funding (annual appropriations)
Ways and Means - tax provisions, Medicare, Unemployment Insurance
Energy and Commerce - Medicaid, Medicare, CHIP
Senate
Appropriations - discretionary funding
Finance - Ways and Means, and Energy and Commerce mandatory/entitlements programs above

6. HHS Key Appointments Key Terms
HHS- Department of Health and Human Services
CDC - Center for Disease Control and Prevention
CMS - Center for Medicare & Medicaid Services
FDA - Food & Drug Administration
HRSA - Health Resources and Services Administration

7. Stimulus/Economic Recovery
Medicaid
4.9 percentage point increase ($87 billion) with other adjustments in federal matching funds for Medicaid in the House
$8.6 billion for Medicaid coverage for the unemployed, 100% federal match in the House
5.6 percentage point increase with other adjustments in the Senate (also $87 billion)
Conference Agreement: $87 billion, split over two years between 65% across the board increase and 35% targeted unemployment

8. Health Information Technology (HIT)
Discretionary Appropriations for the Office of the National Coordinator for Health Information Technology (ONCHIT)
$2 billion in the House
$3 billion in the Senate
Conference Agreement: $2 billion
Discretionary Appropriations for the National Institutes of Health
Conference Agreement: $10 billion

9. Mandatory HIT $17.1 billion net in the House and Senate
Medicare bonus payments to hospitals and physicians beginning in 2011 for “meaningful EHR user”
Medicare payment reductions beginning in 2016 for non-adopters
Medicaid bonus payments, but no penalties, to health providers, 100% federal match
Medicaid 90% enhanced match for HIT related administrative costs
$19 billion net ($12 billion savings, $31 billion gross spending estimate)

10. Electronic Health Record (EHR) Meaningful User
EHR meaningful users qualifying for incentives must include:
Clinical Decision Support
Computerized Physician Order Entry
Ability to Capture Health Care Quality Data
Support the Exchange of Clinical Data with Other Organizations

11. Comparative Effectiveness Research*
$1.1 billion in discretionary appropriations in the House and Senate
House: entire amount goes to Agency for Healthcare Research and Quality (AHRQ)
Senate: funding goes to AHRQ ($300 million), the National Institutes of Health ($400 million), and the HHS Office of the Secretary ($400 million)
Conference Agreement: Follows the Senate
* Health services research assessing the comparative outcomes, effectiveness, and appropriateness of health care treatment and strategies

12. Prevention and Wellness Fund
Discretionary Appropriations
$3 billion in the House: Including $1 billion for childhood immunizations, $300 million for the preventative health and health services block grant, $545 million for a new program to carry out chronic disease, health promotion and genomics programs, $345 million for HIV/AIDS, Hepatitis, STD and Tuberculosis prevention, $60 million for environmental health programs, $50 million for injury prevention and control, $30 million for public health workforce development, and $40 million for the National Institution for Occupational Safety and Health, $40 million for National Center for Health Statistics, $150 million to implement a national action plan to prevent healthcare associated infections

13. Prevention and Wellness Fund
$5.8 billion in the Senate: Including $750 million for childhood immunizations, $600 million for workforce development, $75 million for smoking cessation, $1 billion for screening and education especially for diabetes, $60 million for evaluation, $400 million for HIV and STD prevention, and $400 million for Healthy Communities
Conference Agreement: $1 billion for new Prevention and Wellness Fund, broad discretion - does not include additional funding for biopreparedness and avian flu vaccine development