When Congress recessed on August 1, 2008, a number of outstanding items were left to be considered upon their return. That return will be brief, as Congress only plans to be in session September 6-26, 2008 before adjourning for the remainder of the year.

The outstanding health-related items are a second economic stimulus package, which includes funding for supplemental NIH grants, the Fiscal Year 2009 appropriations for FDA, NIH, and bills dealing with Health Information Technology Adoption.

NIH

Prior to their departure for August recess, Senate Appropriations Committee Chairman Robert Byrd (D-WV), on July 30, released details of a second $24.1 billion supplemental spending measure he hopes to bring to the floor in September. The bill includes $500 million for the National Institutes of Health. In conjunction with that release, Sen. Byrd stated, ”Even with the $150 million included in the first supplemental bill, NIH funding failed to keep up with biomedical inflation in FY 08 for the fifth year in a row, a trend that has discouraged many young scientists from this field and puts the Nation at risk of losing a generation of talented investigators. The second supplemental includes $500 million to restore some of the purchasing power of NIH that was lost because of inflation in the past five years and allow NIH to award at least 700 new research project grants that could lead to cures and treatments for cancer, Alzheimer’s, heart disease, and many other devastating diseases.”

House Speaker Nancy Pelosi (D-CA) has expressed interest in enacting a second economic stimulus package prior to Congress adjourning this year.

Regarding FY 09 NIH funding, Congress is expected to work on a Continuing Resolution of close to 2008 levels, due to difficult appropriations negotiations and the threat of a presidential veto.

FDA

 In the first FY 2008 emergency supplemental, the FDA received an additional $150 million in FY 08 funding. However the appropriations process for FY 09 continues to remain in a holding pattern. The Senate had passed its version of FY 09 appropriations bill with a $325 million increase for FDA funding, but due to unrelated challenges related to oil-drilling and energy policies, the House Appropriations Committee has yet to mark up its version of an appropriations bill.

Health IT

In the Senate, S. 1693, the WIRED for Health Care Quality Act, remains stalled because of two Senators’ concerns over the adequacy of the bill’s privacy provisions. The Heart Rhythm Society and several other medical groups are also concerned about a provision in the bill that would publicly release physician claims data, suggesting a linkage between claims data and physician practice quality — a faulty assumption.

In the House of Representatives, on July 23 the Energy and Commerce Committee approved H.R. 6357, the Protecting Records, Optimizing Treatment, and Easing Communication through Healthcare Technology Act of 2008 (PRO(TECH)T Act of 2008). The bill would encourage the adoption of electronic health records (EHRs) by hospitals and healthcare providers through provision of grants and loans. The bill also includes patient privacy protection provisions, and would require that the federal government develop uniform standards for EHRs.

Meanwhile, the Ways and Means Health Subcommittee, which has jurisdiction over Medicare-related issues, held a hearing on July 24 on the same issue, discussing potential revisions to the PRO(TECH)T Act, including the privacy protections.

Physician Disclosures

Senate Finance Committee Ranking Member Charles Grassley (R-IA) introduced S. 3343, the Medicare Imaging Disclosure Sunshine Act on July 26. This legislation would change the physician self-referral law, requiring physicians to disclose their financial interests in certain high-tech imaging equipment in order to bill Medicare for referrals for imaging procedures.

The previously introduced Physician Payments Sunshine Acts in the House and Senate, which would more broadly require industry to disclose payments to physicians, are still being considered as well.

FDA Regulation of Tobacco

 On July 30, 2008 the House passed H.R. 1108, the Family Smoking Prevention and Tobacco Control Act. The Heart Rhythm Society had supported this bill alongside 680 public health, medical, faith and other organizations. The bill’s provisions include the following:

• Grant the FDA authority to further restrict tobacco marketing to the full extent allowed by the First Amendment to the Constitution.
• Require tobacco companies to disclose the contents of tobacco products, changes to their products and research about the health effects of their products.
• Grant the FDA broad authority to require changes in tobacco products, such as the reduction or removal of harmful ingredients and the reduction of nicotine to non-addictive levels. This includes the authority to reduce or eliminate menthol in cigarettes.