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March 26, 2012


Washington Letter
March 26 , 2012
Newsletter of the American Thoracic Society's Washington Office

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

House Couples IPAB Repeal with Malpractice Reform

This week the House of Representatives passed legislation to repeal the Independent Payment Advisory Board (IPAB). Created by the Affordable Care Act, IPAB is an independent advisory board charged with providing recommendations for reducing Medicare expenditures. Unlike existing Medicare advisory panels, IPAB recommendations on provider payment cuts would be implemented, unless Congress enacted policy to achieve similar savings to the IPAB recommendations.

Many in Congress saw IPAB as an encroachment on Congressional authority to oversee the Medicare program, and bipartisan support was building to repeal the legislation. There was wide support in the physician community for IPAB repeal. However, as the bipartisan support for the bill was growing, the House leadership added medical practice reform, another high priority item for the physician community, to the IPAB repeal legislation.

Adding malpractice component will severely limit Democratic support and makes the fate of the IPAB repeal uncertain at best in the Senate.


Appeals Court Upholds FDA’s Authority to Regulate Tobacco Products

This week, the 6 th District Federal Court of Appeals upheld major sections of the law granting the Food and Drug Administration’s (FDA) authority to regulate tobacco products. The Court found that FDA had the authority to require large graphic warning labels on tobacco product packaging, prohibit tobacco companies from making health claims about tobacco products without FDA review, ban several forms of tobacco marketing that appeal to children, including brand name sponsorships, tobacco-branded merchandise such as caps and t-shirts, and free samples of tobacco products; and prohibit tobacco companies from making statements implying that a tobacco product is safer because it is regulated by the FDA.

The court’s decision is a major legal victory for tobacco control advocates. However, the court did rule against FDA’s authority to ban color and imagery in locations likely seen by a large number of youth. The court also ruled against FDA’s authority to ban tobacco companies from offering “free gifts” with the purchase of a tobacco product.

Despite the decision on color advertising and free gifts, the court’s decision is a major victory for tobacco control advocates and reaffirms FDA’s authority to regulate tobacco products.

In a related case, D.C. District Court Judge Richard Leon struck down FDA’s authority to require tobacco product warnings. Judge Leon’s decision is being appealed. This week’s decision by the 6 th District Court of Appeals provides a powerful refutation to the logic Judge Leon used to strike down FDA’s authority to require tobacco product warnings. The appeal of the Judge Leon decision will begin in April.

Director-General of WHO Delivers Talk on Galvanizing Efforts Against Big Tobacco

On March 20 th, Dr. Margaret Chan, Director-General of the World Health Organization, delivered the keynote address at the 15th World Conference on Tobacco or Health in Singapore. The theme of this year's conference was "Towards a tobacco-free world: planning globally, acting locally," highlighting the idea that for global plans to be effective, action needs to be adapted to the local needs of communities around the world.

In her talk, entitled “ The changed face of the tobacco industry: Galvanizing global action towards a tobacco-free world,” Dr. Chan describes tobacco industry efforts to undermine anti-tobacco campaigns and stresses the need to accelerate implementation of “a tool for fighting back” against the tobacco industry: the WHO Framework Convention on Tobacco Control, which is a working group on economically sustainable alternatives to tobacco growing. The group has 174 parties governing nearly 90% of the world’s 7 billion people committed to implementing the treaty’s articles and obligations.

“Full implementation of the WHO Framework Convention on Tobacco Control would deliver the single biggest preventive blow to heart disease, cancer, diabetes, and respiratory disease,” Dr. Chan said. She called on “heads of state and government to stand rock-hard against the despicable efforts of the tobacco industry to subvert this treaty.”

The full text of Dr. Chen’s speech is available here .


This week, ATS member Jeffrey Hales MD testified before the House Interior and Environment Appropriations Subcommittee regarding the fiscal year 2013 budget for the Environmental Protection Agency. The Interior and Environment Subcommittee funds the EPA. In his comments, Dr. Hales reminded the subcommittee about the seriousness of air pollution and its continued role as a major health threat in the US, encouraged the subcommittee to provide needed funds for the EPA budget, and urged Congress to stopping passing legislation that would stop, weaken, or delay EPA’s authority to propose and enforce meaningful air pollution control measures.


House TB Champions Form TB Elimination Caucus - ATS Convenes World TB Day Congressional Briefing

This week, the U.S. House of Representatives celebrated World TB Day in an exciting way through the formation of the House Tuberculosis Elimination Caucus. The Caucus, co-chaired by Representatives Eliot Engel (D-NY), Gene Green (D-TX) and Don Young (R-AK) aims to raise awareness of TB in the Congress and work to support funding for TB control and research through USAID, CDC and other federal programs.

The Caucus’ kickoff event was an educational briefing on March 21, convened in conjunction with the ATS, the Stop TB Partnership and other partners. Caucus co-chairs Reps. Engel, Green and Young opened the event. Calling for more attention and resources to fighting TB, Rep. Engel stated, “It is a sin that TB has not been eradicated.” The briefing was chaired by WHO Stop TB Dept Director Mario Raviglione, M.D. and featured a panel of speakers including ATS member and noted expert on pediatric TB, Jeffrey Starke, M.D., Ken Castro, Director of CDC’s Division of TB Elimination and patient advocate Rachel Orduno.

Dr. Raviglione noted that although we have made progress against TB by reducing mortality, serious challenges remain to eliminating the disease such as the continued spread of drug resistant TB and the lack of the prioritization and funding of the disease. Dr. Castro discussed the issues and challenges to TB elimination in the U.S., including a concern over a potential resurgence of the disease like the U.S. saw in the 1990’s. Dr. Starke surprised many in the audience with the large number of children treated for TB at his clinic at Texas Children’s Hospital in Houston, which is about 25 – 30 per year and he called for more research into diagnostics to accurately detect TB in children and development of child-friendly TB drug formulations. The closing speaker, Rachel Orduno spoke movingly about her struggle with TB and challenged the audience to engage in the fight against the disease. Following the briefing, the congressional TB Caucus co-chairs hosted a meeting with the briefing speakers and other TB advocates, where they pledged to protect funding for TB programs and work to prioritize the disease in global health policy.

Building a strong TB Caucus will be a key priority for the ATS. The more House members that join the TB Caucus, the more support there will be for funding for global and domestic TB programs and moving towards elimination of this disease! Urge your House Representative to join the TB Caucus now by clicking on the following link:



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 want more information about becoming involved in advocacy, please contact the ATS Washington office at 202-296-9770.