News in brief - March 24/31, 2008

Senate passes Indian Health Service bill with physician bonuses

The U.S. Senate last month passed a bill updating the Indian Health Service for the first time in 16 years.

The Indian Health Care Improvement Act Amendments of 2008 would allocate $35 billion from 2008 to 2017 for the IHS.

The act would establish recruitment and retention bonuses of up to $25,000 for physicians and spend $1 billion on new health care facility construction.

The House has not yet voted on its version of the measure.

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Economy trumps war, health care in voter poll

The economy surged past the war in Iraq and health care to become the No. 1 issue that voters want presidential candidates to talk about, according to the Kaiser Health Tracking Poll done by the Kaiser Family Foundation.

Forty-five percent of voters said the economy is their top concern, compared with 32% for the war in Iraq and 28% for health care.

The telephone poll, conducted Feb. 7-16, involved a nationally representative sample of 1,770 registered voters and had a sampling error rate of 3% in either direction.

As recently as October 2007, 45% of respondents in the same poll series said the war in Iraq was the top issue, 39% of respondents cited health care and only 19% pointed to the economy.

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Army makes progress in helping disabled soldiers

The Army significantly improved its treatment and support of disabled soldiers in the past year but still faces challenges reaching its goals, according to a Government Accountability Office report.

The report followed up on a series of Washington Post articles in February 2007 revealing substandard care at Walter Reed Army Medical Center in Washington, D.C.

In response to the scrutiny, the Army established Warrior Transition Units, which assign a team of medical staff to each eligible soldier. It has increased key staffing of these positions by almost 75% since September 2007 but hasn't filled every position due to a competitive market for medical personnel, wrote the GAO.

The departments of Defense and Veterans Affairs piloted a streamlined disability evaluation process but have not finalized the criteria for expanding it outside the Washington area.

Overall, the Army should be commended for its response but needs to sustain its efforts, concluded the report, which lawmakers discussed at a Feb. 27 House Committee on Oversight and Government Reform subcommittee hearing.

Rep. John F. Tierney (D, Mass.), who chairs the National Security and Foreign Affairs subcommittee, promised to monitor the Army's progress and hold additional hearings if necessary.

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States say Medicaid rules could cost them $50 billion

States estimate that seven Medicaid regulations that have been imposed in recent months or are scheduled to go into effect this year will shift $50 billion in federal health spending to the states over five years.

This figure is $35 billion more than estimated by the Centers for Medicare & Medicaid Services, according to a March 3 report by the House Oversight and Government Reform Committee.

The rules implemented so far limit federal funding for targeted case management services and reduce state taxes on net patient revenues, among other changes. Congress delayed until later this year the implementation of rules that would end federal Medicaid matching dollars for graduate medical education, for juvenile justice and for administrative expenses in schools, such as certain program outreach efforts.

The delayed rules also would limit federal Medicaid matching funds for government-owned hospitals to the actual cost of services. The report can be found online oversight.house.gov/story.asp?id=1778.

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