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January 6, 2012


Washington Letter
January 6, 2012
Newsletter of the American Thoracic Society's Washington Office

1150 18th Street NW
Suite 300
Washington, D.C. 20036
Telephone:(202) 296-9770


Congress Passes Last Minute SGR Patch – SGR Cut Delayed Until March

After an intense round of political brinksmanship, the House of Representatives finally agreed to the Senate-passed legislative package of tax and Medicare provisions that provide a two month reprieve from the 27.4 percent cut in Medicare physician reimbursement. The looming cut is caused by a flawed sustainable growth rate factor (SGR) used to calculate the annual Medicare physician payment update. 

For January and February, physicians will receive a zero percent update in the Medicare payments.  However, all other actions in the CMS Medicare Physicians Fee Schedule final rule for 2012 will be implemented.  Due to other changes in the 2012 Medicare physician fee schedule final rule, the 2012 conversion factor will increase from $33.9764 for 2011 to $34.0376 for 2012.  For more details on how the final rule will impact pulmonary, critical care and sleep medicine please see the December issue of the ATS Coding and Billing Quarterly newsletter.

When Congress returns from the winter recess, one of its priority agenda items will be to enact a year-long fix to the SGR. The SGR legislation will also include other “must pass” tax provisions that Congress is expected to address early in 2012. 
While prospects for a permanent SGR solution are dim for this Congress, the physician community continues to push Congress to stop the endless stop-gap solutions and enact a permanent fix to the SGR formula.


Court Stays EPA Cross State Air Pollution Rule

Just before the New Year, the D.C. District Court of Appeals issued a preliminary injunction to stop the EPA from enforcing the recently finalized rule to reduce downwind air pollution.  The EPA rule, known as the Cross State Air Pollution Rule (CSAPR), calls for reduced sulfur and nitrogen emissions from industrial sources that travel “downwind” to cause air pollution problems in neighboring states.

Opponents of the CSAPR celebrated the preliminary injunction, noting that the courts typically do not grant stays unless the court feels the petitioner’s case has strong legal merit.  However, supporters of the CSAPR pointed out that several previous EPA rules which have been challenged in court, while receiving initial stays, were ultimately upheld by the court.

In an ironic legal twist, until the legal challenge to CSAPR is resolved, the EPA will continue to enforce the previous rule on downwind pollution issued during the Bush Administration, known as the Clean Air Interstate Rule, which was struck down by the courts in 2008.


ATS & Partners Convene Meeting to Advance Pediatric TB Advocacy

This week, the ATS and coalition partners Treatment Action Group (TAG), the Infectious Diseases Society of America (IDSA) and ACTION held a meeting in Washington to promote awareness of and mobilize advocacy efforts around the issue of tuberculosis in children. Globally, at least one million cases of TB occur annually among children, but it is believed that the true burden of TB in children in unknown because of a lack of child-appropriate diagnostic tests and inadequate surveillance and reporting of childhood TB cases.

The meeting featured presentations by ATS member Jeffrey Starke, M.D., professor at Baylor College and director for the Children’s TB Clinic at Texas Children’s Hospital, the mother of a baby with drug resistant TB meningitis and pediatric TB researchers. Dr. Starke discussed the epidemiology of childhood TB and the reasons why childhood TB is a neglected public health issue, which include the difficulty in diagnosis and the fact that because most TB in children is extrapulmonary, it is often not as infectious as TB in adults.

The meeting concluded with an advocacy panel of ATS, IDSA and Doctors Without Borders policy staff and a group discussion of funding for TB control and strategies for prioritizing childhood TB on the global public health agenda. One of the meeting’s main outcomes is the formation of a childhood TB workgroup, which the ATS will help lead, that will continue to work on the issue.





The Washington Letter is written by the American Thoracic Society government relations office and emailed to all ATS members living in the United States. The letter keeps clinicians, scientists, and patients abreast of legislative, judicial, and regulatory issues in pulmonary, critical care, and sleep medicine. Each week's edition is archived on the ATS Web site, www.thoracic.org. If you have any questions or one more information about becoming involved in advocacy, please contact the ATS Washington office at 202-296-9770.