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February 20, 2007

2007

February 20, 2007

HEADLINE

Legislation Introduced to Give FDA Authority to Regulate Tobacco

This week Sens. Kennedy (D-MA) and Cornyn (R-TX) and Reps. Waxman (D-CA) and Davis (R-VA) were joined by over 100 members of Congress in introducing legislation, the Family Smoking Prevention and Tobacco Control Act (S.625/H.R.1108), to grant the Food and Drug Administration (FDA) the authority to regulate tobacco.  The legislation will give the FDA the authority to:

  • Restrict tobacco advertising and promotions, especially to children.

  • Stop illegal sales of tobacco products to children

  • Ban candy-flavored cigarettes, which clearly are starter products for young new smokers

  • Require changes in tobacco products, such as the removal of harmful ingredients or the reduction of nicotine levels

  • Prohibit health claims about so-called "reduced risk" products that are not scientifically proven or that would discourage current tobacco users from quitting or encourage new users to start

  • Require tobacco companies to disclose the contents of tobacco products, changes to their products and research about the health effects of their products.

  • Require larger and more informative health warnings on tobacco products

  • Prohibit terms such as "light", "mild" and "low-tar" that have mislead consumers into believing that certain cigarettes are safer than others

Enactment for the legislation will likely be the most effective tool to prevent kids from starting to use tobacco.  Hearings in both the House and Senate are expected in the near future.

Swift enactment of a strong bill to give the FDA authority to regulate tobacco products is a high legislative priority for the American Thoracic Society.

RESEARCH

Senate Approves FY2007 Funding Increase for NIH

On February 13th, the Senate passed the Fiscal Year 2007 Funding Resolution that funds all government programs, including the National Institutes of Health (NIH).  The Senate approved the bill by a vote of 81-15. The funding resolution provides $28.9 billion for NIH in FY 2007, an increase of $620 million (2.2%) over FY 2006. Funding allocations for the individual NIH institutes will be determined within the next few weeks.

The House approved the funding resolution on Jan. 31, so the bill now goes to the President for signature into law, which he is expected to do. NIH has been funded under a continuing resolution (PL 109-383) that expired on February 15.

BUDGET

President Proposes Research Cut in FY08 Budget 

On February 5, President Bush released the Administration’s budget proposal for fiscal year 2008.  The Administration’s budget provides increases in defense, homeland security and physical science programs, while cutting or flat funding programs of interest to the respiratory community.

The budget would give the National Institutes of Health (NIH) a $310 million cut from the funding level in the final FY 2007 Joint Funding resolution passed by the Senate this week. CDC would receive a significant cut of over $309 million, which includes flat funding for the domestic TB program and a marginal funding increase for chronic disease prevention programs.

Below is the funding chart for federal programs of interest to the pulmonary and critical care medicine community:

National Institutes of Health (NIH)

(in millions)

Program

FY06 Estimate

FY07 Estimate

FY08 Proposed

% change

NHLBI

$2,951

$2,951

$2,925

- 1.0

NIAID

$4,383

$4,459

$4,592

+ 1.0

NIEHS

$636

$647

$637

 - 1.0

NINR

$137

$138

$138

    0

FIC

$66

$67

$67

    0

NIH Total

$28,587

$28,931

$ 28,621

- 1.7

 

Centers for Disease Control and Prevention (CDC)

(in millions)

Program

FY06 Actual

FY07 Estimate

FY08 Proposed

% change

Domestic TB

$136

$136

$136

    0

NIOSH

$262

$252

$252

- 1.0

Tobacco

$104

$104

$104

    0

Chronic Disease

$833

$834

$834

+ 1.0

CDC Total

$6,366

$6,366

$6,057

 - 0.95

 

Veterans Administration (VA)

(in millions)

 

Program

FY06 Actual

FY07 Estimate

FY08 Proposed

% Change

Research

412

412

411

0.24

 

The President’s budget is the first step in the annual budget process and it outlines the administration’s recommended funding levels, however, it is ultimately Congress that determines funding levels for discretionary programs.   FY 2008 is expected to be a tight budget year, but the Congress may restore some funding for health research and services programs as they did in the FY 2007 funding resolution passed by the House last week.

President Proposes Medicare Cuts

The Presidents budget also included a number of proposed cuts to the Medicare program, including reducing payments for “old” oxygen equipment to 13 months, while retaining the current 36 months of rental payments for “new” oxygen equipment.  Presumably “old” refers to oxygen systems that have been rented previously to a different patient, while “new” refers to the first time an oxygen system is used by a beneficiary.   However, the proposed Medicare language does not clearly define what is meant by “old” and “new.”

Missing from the President’s budget proposal are funds to fix the sustainable growth rate factor for 2008.  As you may recall, Congress enacted a 1-year fix to prevent cuts in Medicare payments to physicians.  However, Congress must again act to prevent 10 percent cuts in Medicare physician payments in 2008.  By not providing adequate funds in the budget proposal, the President complicates the ability of Congress to address this issue.

CLEAN AIR

ATS Comments on EPA Proposal to End Airborne Lead Monitoring

Last week, ATS Environmental Health Policy Committee member Dorr Dearborn, M.D. testified on behalf of the ATS at the Clean Air Scientific Advisory Committee in opposition to the Environmental Protection Agency’s (EPA) proposal to end national monitoring of airborne lead.  Dr. Dearborn’s testimony strongly opposed EPA’s proposal to end airborne lead monitoring, encouraged EPA to adopt a tighter blood-borne lead standard recommended by the Centers for Disease Control and Prevention (CDC) and called for more monitors be placed near known airborne lead polluting facilities. 

The Clean Air Scientific Advisory Committee (CASAC) is an expert panel convened by the EPA to provide scientific input to EPA in establishing national exposure limits for criteria pollutants.  CASAC provides recommendations to EPA.  EPA is under no obligation to adopt CASAC’s recommendations.

ATS Testifies at Senate Hearing on Clean Air Standard Process

ATS member John Balmes, M.D. testified before the Clean Air Subcommittee of the Senate Environment and Public Works Committee regarding administrative changes in the way EPA establishes exposure standards for airborne pollutants.  Dr. Balmes’ testimony strongly opposed the recent changes in the standard setting process that essentially diminishes the scientific input into the process.

The EPA recently implemented a number of sweeping changes in the airborne pollutant standard setting process that remove both internal EPA staff scientific input and external scientific community comment on the appropriate standard until the end of the process.  The new standard setting process gives political appointees in the EPA broader powers to establish airborne pollutant exposure standards.

CLINICAL PRACTICE

ATS Conducts RUC Survey on Smoking Cessation G-Codes

In March, the American Thoracic Society, in conjunction with the ACCP and other physician groups will be conducting a survey on two smoking cessation counseling codes - HCPCS G0375 and G0376.  These two codes will be transitioning into CPT for 2008 and we have agreed to participate in the American Medical Association's RVS Update Committee (RUC) survey process that will determine a recommended relative value unit (RVU) to CMS that will affect your future Medicare Reimbursement.

Please respond to Marla Brichta, ACCP at mbrichta@chestnet.org or Gary Ewart, ATS at gewart@thoracic.org if you are able to participate. The survey will take place in March and should take 15-30 minutes to complete.



Points of Contact

Gary Ewart Senior Director, Government Relations
Nuala Moore Senior Legislative Representative
Joe Kirby DC Office Administrator