Late on December 15, 2011, the House and Senate negotiators unveiled the final appropriations omnibus bill. The final package, which outlines funding for three‐fourths of the government, is comprised of three different pieces of legislation:

• House Report (H.R.) 112‐331 that contains FY 2012 funding for federal agencies under the remaining nine Appropriations bills, including: Defense, Energy and Water, Financial Services, Homeland Security, Interior/Environment, Labor/Health and Human Services/Education, the Legislative Branch, Military Construction/Veterans Affairs, and State/Foreign Operations;
• H.R. 3672 that provides funding for disaster aid and recovery assistance; and
• House Concurrent Resolution 94 that contains offsets for the disaster funding.

Averting a federal government shutdown, both the House and Senate passed the package on December 16, 2011 and President Obama signed it into law on Saturday, December 17.

Report Language
The Heart Rhythm Society worked with members of the Senate Appropriations Committee to add the following language to the Committee report:

Atrial Fibrillation [AFib].—The Committee is aware that AFib is the most common chronic cardiac arrhythmia, affecting an estimated 2.3 million Americans. The number of patients with AFib is likely to increase significantly, underscoring a substantial public health risk. Already, the disease accounts for approximately one third of hospitalizations for cardiac rhythm disturbances, costing $4,700 per patient annually. AFib also has significant morbidity and mortality consequences, increasing the risk of stroke approximately five-fold and causing an estimated 15 percent of all strokes in the United States. The Committee encourages CMS to consider targeting AFib patients in current and planned Medicare payment and quality improvement programs for the purpose of improving patient outcomes and reducing avoidable healthcare costs, including those associated with hospital admissions and readmissions for these patients. Such programs could include those pertaining to quality reporting, performance measurement, medication therapy management, wellness assessments, transitions of care, support services, and post-acute care.

The purpose of a Committee report that accompanies the Appropriation legislation is to strongly urge a federal agency's use of the Committee’s finding. The Agency will follow the recommendations in the Committee report. Adding this type of report language to appropriations legislation is often an important first step to elevating and highlighting an issue.

Highlights of the FY 2012 Appropriations

• Centers for Medicare and Medicaid Services (CMS) – The legislation contains $3.9 billion for CMS Program Management, which is $241 million over last year’s level and $517 million below the President’s request.
• National Institutes of Health (NIH) – The bill provides NIH with $30.7 billion in funding, which is $299 million above last year’s level and $758 million below the President’s request. This bill assumes NIH will support the same number of scientifically meritorious research project grants as last year.
• Centers for Disease Control and Prevention (CDC) – The legislation includes a program level of $6.1 billion for the CDC – an increase of $38 million above last year’s level and $269 million below the President’s budget request. Within this total, the legislation funds at $80 million, the Preventive Health and Health Services Block Grant which is a program that provides funding to  states to address critical public health needs.
• Health Resources and Services Administration (HRSA) – The bill funds HRSA at program level of $6.5 billion, which is $41 million below last year’s level and $848 million below the budget request. Within this total, Community Health Centers are funded at $1.6 billion – the same as last year’s level.

Other Health-Related Items

• Independent Payment Advisory Board (IPAB) – Under section 525, the bill rescinds $10 million of the $15 million appropriated for fiscal 2012 for the Independent Payment Advisory Board.
• Prevention and Public Health Fund – The bill would put new restrictions on the law’s Prevention and Public Health Fund. It would require the HHS secretary to create a website describing how its funds are being used and who receives them.
• Food and Drug Administration (FDA) – HR 2112, “Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, 2012,” was signed into law on November 18, 2011. H.R. 2112 funded the FDA at $2.4 billion (not including user fees), a $50 million increase over FY11. The Center for Device and Radiological Health (CDRH) will receive $323 million (not including the user fees) in FY 2012.