September 9, 2019

What You Need to Know

Congress is back in session today following its August recess, and lawmakers face significant pressing legislative priorities in the weeks ahead. Congress has only 13 working days before federal funding expires on September 30. If Congress fails to act before this deadline, funding for programs of importance to the osteopathic medical education (OME) community, such as the crucial Teaching Health Center Graduate Medical Education (THCGME) Program, will lapse.

AACOM will be calling on its membership to present a strong, unified voice in support of THCGME and federal financial aid and loan repayment programs leading up to and during its upcoming COM Day on Capitol Hill and Virtual Hill Day on October 17. With the possibility of a Higher Education Act reauthorization bill being introduced this month, ensuring Congress is considering the needs of the OME community is critical. Save the date and stay tuned for additional information.

Mary-Lynn Bender
Interim Vice President of Government and Public Relations



icon-1    On The Hill



U.S. Representatives Tim Ryan (D-OH) and Raúl Grijalva (D-AZ) reintroduced and are working to garner support for H.R. 1888, the Expansion of Nutrition’s Role in Curricula and Healthcare Act, an AACOM-supported bill that would enable U.S. medical schools to establish or expand nutrition curricula to highlight the role that nutrition and diet play in the prevention and management of obesity and cardiovascular disease, diabetes, and cancer. AACOM supported this bill in a prior Congress.

President Signs Budget and Debt Ceiling Bill

Last month, the Senate passed and President Trump signed into law H.R. 3877, the Bipartisan Budget Act of 2019 (BBA), to suspend the debt ceiling through July 2021 and raise discretionary spending limits by $321 billion over two fiscal years (FYs). The BBA allocated $632 billion in FY20 and $634.5 billion in FY21 to non-defense discretionary (NDD) funding, which supports public health, education, scientific research, and other programs and efforts vital to OME. The $2.7 trillion budget package came after U.S. Treasury Secretary Steven Mnuchin warned congressional leaders that the nation could have reached its borrowing limit early this month, several weeks earlier than previously estimated. Without an agreement to raise the budget caps, defense spending would have been slashed by $71 billion, while non-defense spending would have faced a $55 billion cut. In a joint letter, the Coalition for Health Funding, of which AACOM is a member, urged Congress to vote in favor of the BBA to increase NDD program funding and end sequestration’s steep spending cuts.

Congress must still pass, and the President must sign into law, 12 FY20 appropriations bills before government funding runs out on September 30. While the House has passed 10 of the 12 spending bills, the Senate has not introduced any, making it likely that a short-term continuing resolution (CR), or spending extension, will be required to prevent a government shutdown. Next week, the House will consider a CR to fund the government until November 22. The Senate Appropriations Committee will mark up its Labor, Health and Human Services, Education, and Related Agencies spending measure in subcommittee tomorrow and in full committee Thursday; the legislation will include funding for both the U.S. Departments of Health and Human Services (HHS) and Education (ED). AACOM will continue to advocate for programs of importance to OME throughout the FY20 appropriations process.



icon-2    Advocacy


Save the Date: Join AACOM in Supporting the NIH

AACOM will be participating in the 7th annual Rally for Medical Research National Day of Action on Thursday, September 19. The first Rally for Medical Research was hosted in April 2013 to raise awareness of the pivotal need for an increased and consistent investment in the National Institutes of Health (NIH). Research funded by the NIH leads to important medical discoveries regarding the causes, treatments, and cures for common and rare diseases, as well as disease prevention. AACOM has submitted testimony to House and Senate Appropriations Subcommittees in support of a strong federal investment in the NIH, and encourages our membership to join patients, survivors, patient advocates, researchers, physician scientists, and others in urging lawmakers to support sufficient NIH funding by reaching out to Congress on September 19. Follow @AACOMGR on Twitter and @RallyMedRes on Facebook to get involved.

Federal v. Private Loans: The Importance of Keeping Federal Loan and Repayment Programs Intact

Paul Garrard, Founder and President of PGPresents, LLC, an independent student loan consulting company, has guest authored an ED to MED blog post about why medical students should consider keeping their loan portfolios in the federal sector. He describes benefits such as income-driven repayment plans and access to loan forgiveness programs afforded to federal borrowers that are not available in the private loan market and explains why Congress should continue supporting both the Grad PLUS Loan and Public Service Loan Forgiveness Programs. Mr. Garrard will also be discussing loan repayment strategies for osteopathic physicians in an AACOM-hosted webinar on September 18.



icon-3    Administration & Federal Agencies


ED Releases Final Rule Regarding Borrower Defense and Financial Responsibility

On August 30, ED released the long-awaited final regulations that update the process for adjudicating borrower defense to repayment (BDR) claims and relevant financial responsibility provisions. AACOM commented on ED’s proposed rule last year, which followed the work of a negotiated rulemaking committee. The final regulations also amend the pre-dispute arbitration and class actions waiver enrollment conditions and notifications, allowing institutions to impose mandatory arbitration agreements and waivers as a condition of enrollment so long as the disclosures of these provisions are stated in plain language. The new regulations revise the standards that ED will use to adjudicate BDR claims and will take effect for all new loans first disbursed on or after July 1, 2020. However, the regulations related to financial responsibility will be available for immediate implementation. AACOM is thoroughly assessing the rule, and an analysis on provisions of interest is forthcoming.

CMS Finalizes GME Provision in FY20 IPPS Final Rule

On August 2, the Centers for Medicare & Medicaid Services (CMS) released the final rule for inpatient prospective payment systems. The final package includes, among other updates, a provision related to Medicare graduate medical education (GME) for teaching hospitals and payments to critical access hospitals (CAHs). AACOM commented in support of this proposal that would change how full-time equivalent (FTE) resident time may be counted when residents train at CAHs. Previously, CAHs were not considered nonprovider sites for the purposes of direct GME and indirect medical education payments, which created barriers to training residents in rural areas and hindered efforts to increase the practice of physicians in rural areas. Therefore, beginning October 1, 2019, a hospital may include FTE residents training at a CAH in its FTE count as long as it meets the nonprovider setting requirements.

U.S. Senator Jon Tester (D-MT) previously introduced the AACOM-endorsed Restoring Rural Residencies Act of 2019(S. 1240), which would provide a similar fix. AACOM thanks Sen. Tester for his commitment and leadership in introducing this vital legislation.

Administration to Forgive Federal Student Loan Debt for Totally and Permanently Disabled Veterans

On August 21, President Trump signed a Presidential Memorandum to implement a process called Total and Permanent Disability (TPD) Discharge, which will eliminate federal student loan debt for totally and permanently disabled veterans. The TPD discharge process will automatically discharge eligible veterans’ student loan debt, unless they decide to opt out of the process within 60 days of notification of their eligibility. ED established a data matching process with the U.S. Department of Veterans Affairs to identify totally and permanently disabled veterans who are eligible for student loan relief. ED is currently in the process of notifying eligible veterans and will continue the discharge process on a quarterly basis. Eligible veterans who do not opt out of the TPD discharge process will have their remaining student loan balance discharged and will be reimbursed for payments made following the date of their disability discharge.

DOJ Files DACA Brief with the U.S. Supreme Court

On August 18, the U.S. Department of Justice (DOJ) filed a Supreme Court brief in support of President Trump’s order to rescind the Deferred Action for Childhood Arrivals (DACA) Program. In the DOJ’s brief, Solicitor General Noel Francisco argued that the 2017 rescission of DACA was a legal discretionary action that was not subject to judicial review under the Administrative Procedures Act. Currently, two nationwide preliminary injunctions issued by lower courts have required the U.S. Department of Homeland Security to continue to allow DACA Program renewals for nearly two years. The Supreme Court announced that it will hear oral arguments on DACA on November 12, with a decision on the case possible in June or July 2020.

Thomas Engels Named Acting Administrator for HRSA

On August 1, Thomas J. Engels became the Acting Administrator for the HHS’ Health Resources and Services Administration (HRSA). As Acting Administrator, Mr. Engels will oversee the execution of HRSA’s annual budget, part of which provides grants to state and local governments, health care providers, and health professions training programs to expand access to quality health care. Mr. Engels will also continue to advance HHS priorities such as addressing the opioid epidemic through the integration of behavioral health into primary care and HIV care settings, growing the behavioral health workforce, increasing access to evidence-based prevention and treatment services, and increasing access to health care services in rural areas. Prior to working at HRSA, Mr. Engels was the Deputy Secretary of the Wisconsin Department of Health Services. 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.

HHS Announces $1.8 Billion in Funding to Combat the Opioid Crisis

HHS recently announced $1.8 billion in nationwide funding, divided between programs in the Centers for Disease Control and Prevention (CDC) and the Substance Abuse and Mental Health Services Administration (SAMHSA), to help continue to address the opioid epidemic. CDC awards support state and local health departments and help with overdose prevention efforts while SAMHSA awards fund state governments participating in the State Opioid Response grant program, which supports prevention, treatment, and recovery efforts in states. Learn more.

Featured Federal Resources and COM Engagement

CUSOM Awarded $1.8 Million HRSA Grant: Victoria Kaprielian, MD, Associate Dean for Faculty Development & Medical Education and Professor of Family Medicine at the Campbell University Jerry M. Wallace School of Osteopathic Medicine, was awarded a $1.8 million, five-year grant from HRSA to fund a Primary Care Champions Fellowship aimed at strengthening primary care and the workforce delivering it. “This is all about empowering [providers] to be able to make changes in their practices,” says Dr. Kaprielian. “[It creates a positive environment] that can incorporate learners, improve quality of care, and keep the clinicians thriving and happy—and their patients well-served—while training more clinicians to come to those communities.” Learn more.

Naushira Pandya

Naushira Pandya, MD, CMD, Professor and Chair of the Geriatrics Department at NSU-KPCOM and Project Director of NSU’s Florida Coastal Geriatric Resources, Education, and Training Center

KPCOM Awarded HRSA Geriatrics Grant: With the leadership of Naushira Pandya, MD, CMD, Professor and Chair of the Geriatrics Department at the Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine (NSU-KPCOM) and Project Director of NSU’s Florida Coastal Geriatric Resources, Education, and Training Center, NSU-KPCOM was awarded a $3.5 million HRSA grant to fund a Geriatrics Workforce Enhancement Program (GWEP). The GWEP is designed to educate and train the primary care and geriatrics workforce to provide integrated, interprofessional care to older adults. “With an aging population, it’s vital that those in the health care profession work together to ensure they provide the best care possible for their patients,” said Dr. Pandya. Learn more.


VCOM-Carolinas HRSA Fellows and Faculty Attend Training in DC: HRSA fellows and faculty from the Edward Via College of Osteopathic Medicine, Spartanburg, SC (VCOM-Carolinas) attended the first annual HRSA Primary Care Training and Enhancement (PCTE) Program meeting in Washington, DC on August 12. PCTE fellows from around the country gathered at the nation’s capital to present transformational projects and exchange ideas. The PCTE grant VCOM-Carolinas received extends funding through 2023, providing training for five different cohorts of fellows.

WesternU Receives $2.8 Million NIH Grant: Western University of Health Sciences Senior Vice President of Research Devendra K. Agrawal, PhD, MBA, has been awarded a $2.8 million, four-year grant from the NIH. Dr. Agrawal’s project, “Novel Molecular Target to Prevent Maturation Failure of Arteriovenous Fistula,” will investigate whether inhibiting a molecule in pigs will lead to improved kidney failure interventions. Learn more.

Georgia Governor Brian Kemp
Georgia Governor Brian Kemp

GA Governor Speaks at PCOM South Georgia: Last month, Georgia Governor Brian Kemp attended a ribbon-cutting ceremony for PCOM South Georgia, the first four-year medical school in the Southwest Georgia region. “I know that this facility will be at the forefront of improving the quality of life for hard-working Georgians here in South and Southwest Georgia,” said Governor Kemp. Learn more.

NIH Fall Regional Seminar: The NIH will host the Fall 2019 Regional Seminar on Program Funding and Grants Administration November 6 – 8 in Phoenix, Arizona. The two-day workshop will provide health care professionals interested in applying for NIH grants with information regarding the grant application process.

September NIAMS Advisory Council Meeting: The next meeting of the NIH National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Advisory Council will be Tuesday, September 10, beginning at 8:30 AM ET. The Council meeting will also be available for live viewing through the NIH videocasting service. The Council works to provide input on the NIAMS research portfolio and other issues regarding science policy, and conducts a secondary review of grant applications that have been recommended for funding by a scientific peer group. Learn more.

CMS Listening Session on Opioids: On Tuesday, September 17 from 4:30 PM – 6:00 PM ET, CMS will host a listening session for prescribing clinicians to share feedback on how the federal government should implement Section 6065 of theSubstance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act signed into law last year. Section 6065 requires CMS to engage directly with opioid prescribers who have prescription patterns that are considered “outliers” compared to their peers. The webinar was announced in the CMS MLN Connects, of which AACOM serves as a partner organization.

Copyright ©2019 American Association of Colleges of Osteopathic Medicine. All Rights Reserved.


Check out the latest issue of Inside OME!

Don't get Inside OME? Subscribe for free today!

American Association of Colleges of Osteopathic Medicine
Office of Government Relations
500 New Jersey Avenue NW, Suite 380, Washington, DC 20001

Contact the editors: aacomgr@aacom.org

Subscribe | Manage my subscriptions

Not a Washington Insider subscriber?

It's free and you may cancel at any time.