Important Federal Issues for the 113th Congress
National Institutes of Health (NIH) Funding
As the primary federal agency supporting medical research, the NIH is the source of more than 80% of the total federal research funding that University of Nebraska Medical Center (UNMC) obtains through competitive awards. Annual funding for NIH has lagged behind the rate of biomedical inflation, resulting in fewer research proposals being funded. The Administration has requested $31.3 billion in FY2014 for NIH.
UNMC supports the $31.3 billion request.
Institutional Development Award Program
More than 50% of all NIH awards go to institutions in 6 states. NIH’s Institutional Development Award Program (IDeA) provides opportunities for Nebraska and 22 other states to develop research infrastructure to improve their ability to compete for NIH funds. In 2011, NIH reorganized its institutes and moved the IDeA program under the Institute of General Medicine. The IDeA program provides about $15+ million annually to Nebraska for research centers and science workforce development. In FY2013, the IDeA budget was reduced by $51 million to $277. For FY2014 the Administration proposes reducing the IDeA program another $50.5 million to $225.4 million.
UNMC urges, at minimum, to maintain funding in FY2014 for the IDeA program at $277 million (the FY2012 level) and stop the Administration from reallocating IDeA funds to other areas of NIH.
Health Professions Education and Training (Title VII and VIII)
UNMC relies on Title 7 (health professionals) and Title 8 (nursing) funding from the Public Health Service Act to support educational programs that train professionals in areas where there are workforce shortages and to provide cost-effective care in underserved rural and some urban areas of Nebraska that lack sufficient health care services. In FY2012, Nebraska received $2.2 million in Title 7 funds, with about $733,000 dedicated to dentistry. Of that $733,000 about $247,000 is dedicated to pediatric dentistry. The rest of the Title 7 funds in Nebraska ($1.46m) were used for physician assistant training, public health training, Area Health Education Centers (AHEC) and graduate psychology programs. In FY2012 Nebraska obtained about $1.3 million in Title 8 (nursing) funds which went to nursing education, the nurse faculty loan program, and nurse anesthetist traineeships.
With the need to increase the healthcare workforce, UNMC urges supporting the Title 8 (Nursing) funding request of $251million in FY2014 and urges Congress to fund Title 7 (health professions) at the same level of $251 million.
Graduate Medical Education (GME)
The Administration's FY2014 budget calls for reducing funding for GME. GME supports the majority of medical residencies in the nation. At a time when it is universally acknowledged that there is a shortage of physicians, the nation should not be cutting the medical residency program. UNMC opposes decreasing the indirect payment of GME because it will reduce payments to the Nebraska Medical Center by at least $1 million annually and likely reduce the number of residencies available to graduating medical students. A negative consequence of fewer residencies in the state means more medical school graduates will be forced to leave the state for a medical residency which reduces the chance they will return to work in Nebraska.
UNMC urges Congress to maintain GME at its current FY2013 level.
Medicare and Medicaid
In February 2012, the Medicare physician reimbursement rate was extended to the end of the year. This action blocked the scheduled 27% cut in Medicare reimbursement payments scheduled for March 1, 2012. Congress continues to look for a permanent replacement payment system that reimburses physicians fairly for their costs to treat Medicare patients that does not reduce services for Medicare patients.
UNMC advocates for payments at the presequestration level until an equitable reimbursement plan creates a permanent fix.