Renal Policy Express
- March 2003 -
Publisher: American Society of Nephrology       Email: email@asn-online.org
Welcome to March's Renal Policy Express
The start of the Fiscal Year (FY) 2004 (FY04) appropriations process has begun and the prospects for adequate increases in health and biomedical research funding is ominous. The House and Senate Budget Committees recently approved their respective FY04 budget resolutions, which call for minimal increases in both discretionary and mandatory spending.

The House resolution provides $775.4 billion in discretionary spending budget authority for FY04, a 1.3 percent increase over FY03. For non-defense discretionary spending, the House resolution includes $375 billion, a $1.6 billion (0.4 percent) increase; however, non-defense, non-homeland security funding is cut by 1 percent. Most troubling is the 2.8 percent or $1.4 billion cut in the budget function for health. Specifically, the budget assumes $27.9 billion for the National Institutes of Health (NIH) in FY04, which falls short of the $30 billion total advocated for by the biomedical research community and further exacerbates the cut on other discretionary health programs.

The Senate resolution is not as troubling for health funding. Overall, the Senate proposal provides a total of $784.5 billion, an increase of $18.7 billion (2.4 percent) in discretionary spending and $49.62 billion for the health budget function, which represents a 0.3 percent increase. The Senate resolution also assumes $27.9 billion for FY04 NIH funding.

This sobering picture for FY04 health and biomedical research funding is being further debated, since the House and Senate began floor consideration of their respective resolutions this week. The ASN will work closely with the entire biomedical research community urging Congress that support for medical research be sustained, so that foundations of future progress and discovery enhanced during the past five years are not eroded.

Clearly, health and biomedical research greatly impact the renal community. This edition of Renal Express also addresses other significant issues, including the annual Renal Coalition meeting, National Donate Life Month, and new house bills HR 1004 and HR 5. I hope this issue provides you with a quick and effective means of learning more about the policy issues affecting the members of ASN.

As always, please feel free to contact me if you have questions, comments, or suggestions by email or by phone at 202-416-0646.

Sincerely yours,



Paul C. Smedberg



The ASN and PKD Express Concern to FDA
The ASN and the Polycystic Kidney Disease (PKD) Foundation recently wrote a letter to the Food and Drug Administration (FDA) expressing concern about the marketing practices and promotional materials associated with the System 100 console (S-100), marketed by CHF Solutions, which claims to aid patients in extracorporeal therapy. In our opinion, the S-100 device, which the Food and Drug Administration approved for specific use by cardiologists and their staff who have no formal training in the performance of extracorporeal therapy, is being marketed in a manner not consistent with safe and effective patient care. Learn more. Read our letter to the FDA.



Renal Coalition Meeting Update
Paul Smedberg, ASN's Director of Policy and Public Affairs attended the Renal Coalition Meeting on Thursday, March 14. Agenda items included updates on Coalition members' current policy activities, as well as new and future bills that are important to the renal community. The Renal Coalition Annual Meeting will take place Friday, March 21 in Washington, DC at 3:00pm.

National Donate Life Month
Health and Human Services (HHS) Secretary, Tommy G. Thompson, recently announced that April will be National Donate Life Month. National Donate Life Month is intended to raise public awareness of the pressing need to increase organ, tissue, marrow and blood donations. Read the HHS newsletter and its press release to learn more about National Donate Life Month.



Introduction of HR 1004
Recently, Congressman Jim McDermott (D-WA) and Congresswoman Jennifer Dunn (R-WA) introduced the “Kidney Patient Daily Dialysis Quality Act of 2003.” Once passed, this legislation will move Medicare beyond the current one-size fits-all End Stage Renal Disease (ESRD) reimbursement method. Currently, Medicare only covers three hemodialysis treatments each week. This bill would allow the Medicare program to pay for more frequent hemodialysis treatments, as defined by at least five times a week, provided in the home or in a dialysis facility. For more information about the bill, read HR 1004 and the letter Congressman McDermott sent to the House.



House Passes Malpractice Reforms
On March 13, the House of Representatives passed medical liability reform legislation ("HEALTH Act," H.R. 5), which would cap jury awards for medical malpractice. The House legislation closely parallels reform goals endorsed by President Bush. Representatives Jim Greenwood (R-PA) and Christopher Cox (R-CA) introduced the bill in February 2003.

The key provisions of the House medical liability include: a $250,000 cap on awards for non-economic damages ("pain and suffering"); it sets punitive awards at the greater of $250,000 or twice economic damages; limits the time a plaintiff has to file suit; and allows defendants to introduce evidence of plaintiffs receiving compensation for losses from outside sources. Intensive advocacy efforts by the American Medical Association, American Hospital Association, Association of American Medical Colleges, United States Chamber of Commerce, insurers, and numerous members of the healthcare community in support of the legislation preceded the vote. The legislation also allows states to set their own cap on non-economic damages, regardless of whether they exceed or fall below $250,000.

House Democrats strongly opposed passage of H.R. 5, arguing that it failed to hold medical device companies, HMOs, and drug companies accountable. Medical liability legislation in the Senate faces a much stronger challenge. Learn more about the bill; read HR 5.



ASN Staff Attend ANNA Summit
On Friday, March 14, ASN's Executive Director, Karen Campbell and Paul Smedberg, Director of Policy and Public Affairs, attended the American Nephrology Nurses' Association's (ANNA) Invitational Summit. The purpose of the Summit was to address the workforce issues facing nurses in the nephrology field. More than 50 participants attended, including representatives from the Centers for Medicare and Medicaid Services (CMS), providers, nephrology nurse representatives, industry representatives, and renal organizations.



Creation of Bilingual Helpline
On Wednesday, March 12, Health and Human Services (HHS) Secretary Tommy G. Thompson announced the recent creation of the "Su Familia" National Hispanic Family Health Helpline. The helpline will enable Hispanic families to obtain basic health information to help them prevent and manage chronic conditions. The helpline will also refer them to local health providers and federally supported programs.

Su Familia is supported by HHS' Health Resources and Services Administration and HHS' Office of Minority Health. The helpline was developed and is operated by the National Alliance for Hispanic Health. The toll-free helpline, (866)783-2645/ (866)SU-FAMILIA is open Monday through Friday from 9:00am to 6:00pm Eastern Time.

American Society of Nephrology
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