AACOM Washington Insider - December 3, 2019

President Signs Short-Term Spending Deal, AACOM Submits Comments to House Committee on Addressing Rural Health Inequities


December 3, 2019

What You Need to Know

As Congress returns to Washington, DC following the Thanksgiving recess, lawmakers will work to negotiate a federal funding deal for fiscal year (FY) 2020. With President Trump signing the continuing resolution (CR) into law on November 21, current federal funding levels of government programs and agencies have been extended through December 20. This short-term deal allows Congress more time to negotiate final spending allocations for the remainder of FY20. This, among other high-profile congressional priorities, will be the focus of Congress’ work as the holiday recess approaches. AACOM will continue to on behalf of the federal policies and programs vital to osteopathic medical education (OME) as funding discussions continue.

On The Hill

President Signs Short-term Continuing Resolution


On November 21, the President signed into law a CR to prevent a federal government shutdown, extending current funding through December 20 and buying time for Congress to continue negotiating all 12 appropriations bills before the new deadline. The package also includes short-term funding for several important health care programs, including the Teaching Health Center Graduate Medical Education Program, which was previously set to expire on October 1 before being until November 21.


House and Senate leadership are working to avoid a government shutdown this December, but disagreements over border wall funding and other issues continue to complicate negotiations. The Senate must pass the remaining eight of 12 spending measures, and the House its remaining two, before conference negotiations can begin between the two chambers. Although appropriations leadership reached a deal on November 23 to allocate funding among the dozen bills, the programmatic spending levels won’t be made public until all the spending measures are finalized. AACOM will continue to advocate for programs of importance to OME as Congress progresses through the FY20 appropriations process.

AACOM Joins Friends of AHRQ Letters to Congress in Support of FY20 AHRQ Funding


AACOM joined more than 150 national organizations in a letter to and Appropriations leadership, requesting a minimum of $358.2 million in FY20 funding for the Agency for Healthcare Research and Quality (AHRQ). This agency produces evidence to make health care safer, higher quality, more accessible, equitable, and affordable, and works with its partners to ensure evidence is communicated and understood. AACOM is a member of Friends of AHRQ, a voluntary coalition of organizations that advocate on behalf of AHRQ to Congress.

AACOM Joins Letter of Support for the Indian Health Service Health Professions Tax Fairness Act of 2019


AACOM 15 national organizations as a member of the American Indians/Alaska Native Health Partners in a letter to Congress in support of S. 2871, the Indian Health Service Health Professions Tax Fairness Act of 2019, which would amend the tax code to provide health care professionals who receive student loan repayments and scholarships from the Indian Health Service (IHS) the same tax-free status enjoyed by those who receive National Health Service Corps (NHSC) loan repayments. Under the IHS and NHSC programs, health care professionals provide needed care and services to underserved populations. AACOM also supported this legislation in and .

AACOM Provides Comments to House Ways and Means Rural and Underserved Communities Health Task Force


AACOM recently to the House Ways and Means Committee’s Rural and Underserved Communities Health Task Force’s request for information regarding priority topics that affect the health status and outcomes for populations living in rural and underserved communities. The Task Force was by the Committee in July to bring together Members and experts in the field to “discuss the challenges of delivering health care in rural and underserved areas and explore holistic bipartisan policy options that could improve outcomes and care in these communities.” AACOM looks forward to our continued work with the Task Force to develop and implement policies and programs to build a health care system that enables osteopathic physicians to provide the necessary care to meet the needs of our nation’s diverse patient populations.




ED to MED Thanks PSLF Champions


The Public Service Loan Forgiveness (PSLF) Program is essential to medical and other health professions students who are committed to public service, and is an important investment in the health, education, and safety of America’s communities. ED to MED thanks the PSLF and Tri-Caucuses, as well as individual Members of Congress, who have committed to protecting PSLF by offering their continued support for the program. .

AACOM to Participate in AAMC’s Opioid GME Day of Action


On December 5, AACOM’s Office of Government Relations will participate in the Association of American Medical Colleges’ 2019 Graduate Medical Education (GME) Day of Action as part of the GME Advocacy Coalition, which is composed of over 70 individual hospital, physician, and health care advocacy associations and societies. This advocacy event will focus on raising awareness of our country’s opioid crisis, emphasizing the importance of expanding GME training to treat patients with pain and substance use disorders. AACOM has endorsed the Opioid Workforce Act of 2019, which would provide Medicare support for an additional 1,000 GME positions over five years in hospitals that have, or are in the process of establishing, accredited residency programs in addiction medicine, addiction psychiatry, or pain medicine. The OME community may participate in this day of action through social media by using the hashtag .



Administration and Federal Agencies

AACOM Analysis of ED's 2019 Final Rule on Accreditation


On November 1, the U.S. Department of Education (ED) a final rule on accreditation and state authorization based on the of the 2019 negotiated rulemaking sessions. The new regulations have an effective date of July 1, 2020 and reform procedures governing the recognition of accrediting agencies and their operations in overseeing higher education institutions, among other revisions. AACOM has reviewed the rule and prepared an analysis of provisions of interest to OME. .

CMS Releases Final Rule for the 2020 Physician Fee Schedule


On November 15, the Centers for Medicare & Medicaid Services (CMS) published the for the calendar year 2020 Medicare Physician Fee Schedule. Among other updates, the package includes a provision stating that “the extent of the teaching physician’s participation in services involving residents may be demonstrated by notes in the medical records made by a physician, resident, or nurse.” AACOM previously submitted to CMS in support of the agency’s continued focus on reducing administrative burdens through the Patients Over Paperwork Initiative and provided recommendations regarding the review and verification of medical record documentation. The rule is effective beginning January 1, 2020.

Secretary DeVos Announces College Scorecard Data Rollout


ED Secretary Betsy Devos has the redesigned College Scorecard, an online tool created for students to compare the cost and value of higher education institutions in the U.S. The College Scorecard will now include median earnings and median debt of graduates based on field of study, rather than just institutional level data. The redesign also builds upon prior updates to include data on graduation rates for all students, including transfer and part-time students. The redesign is consistent with President Trump’s and expands upon ED’s updates from May 2019, which added information on 2,100 certificate-granting institutions.

Publication of Fall 2019 Unified Agenda of Regulatory and Deregulatory Actions


The White House Office of Management and Budget’s Office of Information and Regulatory Affairs recently released its . According to various laws and executive orders, agencies are required to publish semiannual agendas for regulatory actions that “may have a significant economic impact on a substantial number of small entities.” Notable upcoming regulatory actions include a Notice of Proposed Rulemaking (NPRM) to amend the Family Educational Rights and Privacy Act regulations, NPRMs on TEACH grants and faith-based entities based on ED’s consensus-backed held in early 2019, final action on to Title IX regulations, an NPRM on the Graduate Assistance in Areas of National Need Program, final action on Veterans Care Agreements, and final action on the Health Professional Scholarship Program through the U.S. Department of Veterans Affairs (VA). AACOM will continue to engage with the Administration and notify membership of the impact to the OME community as the regulatory process moves forward.

Appointment of Thomas J. Engels Appointed as HRSA Administrator


On November 21, 2019, Thomas J. Engels was as the Administrator of the Health Resources &and Services Administration (HRSA). As Administrator, Mr. Engels will oversee the execution of HRSA’s current $11.7 billion annual budget used to expand access to quality health care through an array of grants to state and local governments, health care providers, and health professions training programs. Mr. Engels had been serving as Acting Administrator since August. Prior to working at HRSA, Mr. Engels was the Deputy Secretary of the Wisconsin Department of Health Services where he managed a department with over 6,000 employees and oversaw a $12 billion budget. He was also an active member of the Governor’s Task Force on Opioid Abuse and chaired the Governor’s Human Resources Shared Services Executive Committee.

ED Issues Interim Final Regulations on Automatic Loan Forgiveness for Disabled Veterans


ED has three interim final regulations to revise regulations for “total and permanent” disability student loan discharges for veterans. Under the Higher Education Act, Congress authorized the discharge of Title IV student loans where the VA determined that a veteran is unemployable due to a service-connected disability. Previously, veterans were required to submit an application and supporting documents from the VA to receive a student loan discharge—a significant administrative burden that ED estimates may have prevented at least 20,000 veterans from obtaining discharges of their student loans. This summer, President Trump issued a directing ED to expedite the student loan discharge process “in a manner that is quick, efficient, and minimally burdensome.” Under the new regulations, ED will consider a borrower to be “totally and permanently disabled” based on data obtained from the VA. Such eligible veterans will no longer be required to submit additional documentation to benefit from a discharge of their loans. The interim final regulations are effective on July 1, 2020 with some provisions eligible for early implementation.

Featured Federal Resources and COM Engagement

AACOM Council on Diversity and Equity Member Receives Presidential Award: Jamboor R. Vishwanatha, PhD, Professor at the University of North Texas Health Center and member of AACOM’s , was with a Presidential Award for Excellence in Science, Mathematics and Engineering Mentoring (PAESMEM) for his work to expand science, technology, engineering, and mathematics through mentorship. Dr. Vishwanatha was one of 15 recipients of the PAESMEM and is the first member of an osteopathic medical school to receive this high honor. .

NIH Releases Draft Policy for Data Sharing and Management: Of interest to osteopathic medical schools, the National Institutes of Health (NIH) recently its draft Policy for Data Management and Sharing along with supplemental draft guidance. According to a authored by the NIH Associate Director of Science Policy Carrie Wolinetz, PhD, "The draft policy furthers NIH longstanding commitment to making available the results and products of the research we fund and conduct." NIH has established a where the public can provide their feedback by January 10, 2020.

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