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FEDERAL HEALTH UPDATE

April 11, 2008

Produced by Kate Connelly Theroux in collaboration with the U.S. Medicine Institute for Health Studies (USMI)

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Congressional Schedule

  • The House passed S. 793, the Reauthorization of the Traumatic Brain Injury Act on April 8, 2008.  This legislation provides for the expansion and improvement of traumatic brain injury programs.
  • On April 8, 2008, the House passed H.R.2464, the Wakefield Act, which amends the Public Health Service Act to provide a means for continued improvement in emergency medical services for children. The House passed H.R. 5501, the Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act, on April 2, 2008.  This legislation authorizes appropriations for fiscal years 2009 through 2013 to provide assistance to foreign countries to combat HIV/AIDS, tuberculosis, and malaria, and for other purposes.
  • On April 9, 2008, the Senate Veterans Affairs Committee held an oversight hearing to examine the challenges facing the Department of Veterans Affairs to attract and retain health care providers.  Witnesses addressed current shortcomings and suggested ways to improve recruitment, retention and service quality.  Locality pay for nurses, and support for education incentives were among the issues discussed. 

    The committee communicated its hope that effective use of existing methods of recruiting will attract the best and brightest health care professionals to VA and ensure that they choose to stay.  It promised to continue to seek to identify new approaches to attract health care professionals to VA.

  • On April 10, 2008, the Senate Appropriations Committee held a hearing to examine proposed budget estimates for fiscal year 2009 for the Department of Veterans Affairs.  VA Secretary James B. Peake testified.

Military Health Care News

  • On April 4, 2008, TRICARE Management Activity announced that more civilian providers are accepting new TRICARE Standard patients, according to a recently released survey. 

    The findings, part of the Department of Defense (DoD) Survey of Civilian Physician Acceptance of TRICARE Standard, show that in Fiscal Year (FY) 2007, almost 93 percent of responding physicians in 53 hospital service areas (HSAs) were aware of the TRICARE program, with 84 percent of physicians in those 53 HSAs accepting new TRICARE Standard patients. 

    The 2007 survey was the final installment of a three-year national effort to measure awareness of TRICARE and to determine the number of physicians who accept new TRICARE Standard patients.  DoD randomly surveyed physicians in 20 states in both FYs 2005 and 2006.  The 10 remaining states and Washington, DC, were surveyed in FY 2007.  Physicians in local HSAs were also surveyed each year.  Approximately 40,000 physicians from a variety of medical specialties were randomly picked.

    The aggregate results show that civilian provider awareness and acceptance is generally high, but may vary depending on location.  In addition, the survey revealed a need for increasing both TRICARE awareness and acceptance among psychiatrists—a specialty critical in meeting the behavioral health needs of veterans of the conflicts in Iraq and Afghanistan. 

    Specifically, the three-year findings across all states and HSAs show: 

    • Approximately 87 percent of all physicians surveyed are aware of the TRICARE program.
    • About 81 percent of physicians who accept new patients also accept new TRICARE Standard patients. 
    • Of those accepting new TRICARE Standard patients, almost 91 percent do so for all patients, rather than on a case-by-case basis. 
    • Reimbursement rates were among the most commonly cited reasons for not accepting TRICARE Standard.

    While active duty service members receive most of their medical care at one of the more than 500 military treatment facilities, family members, National Guard and Reserve members and retirees often rely on civilian physicians for their health care needs. 

    The DoD acknowledges that in some locations, access to TRICARE Standard providers remains a major concern for family members and retirees as some doctors limit or refuse to care for TRICARE Standard patients.     

    States showing a need to increase acceptance and awareness of TRICARE include Alaska, Maryland, Colorado, Hawaii, Oklahoma, New York, New Jersey, and Texas. Hospital service areas with lower than average TRICARE acceptance include Washington, DC; Raleigh, N.C.; Seattle and Olympia, Wash.; Lihue/Kealakekua/Wailuku, Hawaii; Dallas, Texas; and Falls Church, Va.

    TRICARE leaders, with support from their managed care support contractors, are working to overcome these challenges through an outreach program. 

    The outreach is reported to show promising results.  For example, the Oregon legislature approved incentives including a one-time tax credit for new providers in the TRICARE network, plus an additional annual credit for treating patients enrolled in TRICARE.  Since 2004, Oregon’s TRICARE provider network has increased by 35 percent.

    In addition, the governors of 20 Western states have supported TRICARE’s efforts to encourage more health care providers to accept new TRICARE patients. Their combined efforts led to an overall increase in western region TRICARE network doctors from approximately 80,000 in 2004 to more than 125,000 today. http://www.tricare.mil/pressroom/news.aspx?fid=382

  • The TRICARE Management Activity (TMA) published a news release outlining its behavioral health care initiatives to assist service members, families, health care providers and military leaders. 

    The release, “TRICARE Builds Strong Behavioral Health Support,” highlights the Behavioral Health Provider Locator and the Appointment Assistance Service, which are available in all U.S. TRICARE regions for active duty service members and their enrolled family members who need help locating and making appointments with behavioral health care providers. 

    TRICARE also provides resources and information regarding behavioral health benefits on the Mental Health and Behavior Web page, where beneficiaries can access information on conditions, providers, treatments and learn how to get care.  A new section on the site can help with suicide prevention.

    The release describes TRICARE’s efforts to educate non-active duty beneficiaries on the self-referral option through newsletter articles, bulletins and press releases. 

    In addition to TMA’s efforts, the managed care support contractors for the three TRICARE regions have developed programs and services to help beneficiaries with behavioral health concerns.

    To help educate medical professionals, TriWest Healthcare Alliance and the Department of Veterans Affairs hosted a “Combat Stress-Related Disorders” video conference in South Dakota to bring together nearly 150 community-based physicians, nurses, psychiatrists and other health care professionals that care for service members and their families.  The conference was simultaneously broadcast to 12 locations, providing education and discussion on the symptoms and treatment of PTSD, traumatic brain injury and other combat stress disorders.

    TriWest continues to provide 24/7 telephone access and crisis intervention services.  Service members and their families in the TRICARE West region can request assistance with a mental health crisis or with simple requests for behavioral health information by calling (866) 284–3743.   
      
    Military leadership is often the first to become involved when families have been notified of a loss.  For this reason, a program teaching leaders how to communicate with grieving families has been successful in the TRICARE West region.  “Grief Solutions” provides military commanders and senior noncommissioned officers with a deeper understanding of how to support and assist survivors. 

    Health Net Federal Services, TRICARE’s MCSC for the North region, provides an on-line “Behavioral Health Resource Center”, which is available in both English and Spanish.  The resource center is designed to help beneficiaries balance work, family and life by  providing comprehensive articles, information sheets, quick tips and additional resources on dozens of emotional health issues and more. 

    Humana Military Healthcare Services offers “AchieveSolutions,” an on-line resource offering TRICARE beneficiaries a secure, safe environment to seek information, educational materials and self-assessment tools in the South region.  It can be accessed through the behavioral health link on Humana’s Web site at www.humana-military.com. 

  • On April 9, 2008, Col. Vivian Hutson received the inaugural 2008 Department of Defense Female Trailblazer Award in recognition for her pioneering roles in the Army Medical Corps. Hutson, stationed at Munson Army Health Center (MAHC) at Fort Leavenworth, Kansas, was the first officer from the Army Medical Specialist Corps (she is a dietitian) to serve as a permanent deputy commander for administration at a military treatment facility and one of the few minority women to do so.

    Hutson was the first dietitian to serve as a senior health policy analyst in the TRICARE policy division of the Army Office of the Surgeon General, and the first to work as a planner with the Department of Health and Human Services.  To read more about Col. Hutson, please visit http://www.ftleavenworthlamp.com/articles/2008/04/10/news/news2.txt

  • TRICARE Management Activity (TMA) honored military children in a news release “A Month All Their Own: America, TRICARE honor the Military Child,” on April 10, 2008.

    Each April since 1986, the Department of Defense has celebrated the “Month of the Military Child” in recognition of the many challenges the nearly 2 million children face by having a parent or parents serve in the uniformed services.  

    Army Maj. Gen. Elder Granger, TMA deputy director, highlighted the impact technology, such as the Internet, has had on the ability of children to connect with loved ones overseas.

Veterans Health Care News  

  • The Department of Veterans Affairs (VA) will install a rooftop photovoltaic (PV) system at the Loma Linda, Calif., and Dallas VA medical centers this summer to provide clean, natural, sun-powered electricity.

    By using sunlight, a free renewable fuel, these systems will reduce the medical centers’ electricity costs and provide environmental benefits to the medical center, VA and the community. 

    With large amounts of sunshine available year-round, plenty of roof space and an attractive state-level incentive in California, the Loma Linda and Dallas sites quickly rose to the top of VA’s list of candidate locations for PV pilot projects.  

    As part of a comprehensive department-wide energy management plan, last year VA screened its major facilities for not only PV potential, but the potential to use wind, geothermal and biomass energy and to use solar energy for water heating, as well.  The evaluation helped VA identify 16 candidate sites for solar PV projects, 15 for solar water heating, six for wind, and two for direct geothermal energy systems.

    Solar hot water energy system work is underway at the Dallas facility and at VA’s West Los Angeles medical center, and two facilities in Arizona have added solar water heating to the list of energy-efficient measures they plan to implement.  

    VA plans to award a contract for a wind energy pilot project at its medical center in St. Cloud, Minn., by the end of this June and a contract for a geothermal energy pilot project at the Boise, Idaho, VA Medical Center by the end of September.  Both the wind and geothermal systems will be installed by September 2009. http://www1.va.gov/opa/pressrel/pressrelease.cfm?id=1487

  • The Department of Veterans Affairs (VA) announced it has reduced premiums for veterans and military personnel with life insurance policies, thanks to improved investment earnings and a reduction in non-combat claims.

    The premium cuts affect military personnel covered by Servicemembers’ Group Life Insurance (SGLI) and veterans covered by the Veterans’ Group Life Insurance (VGLI).

    On July 1, 2008, the premiums for basic SGLI will be 6.5 cents per month for $1,000 of coverage, down from seven cents per month for $1,000.  This translates into a seven percent savings.  

    Servicemembers with the maximum $400,000 of coverage will see their monthly premium reduced from $28 to $26.  Servicemembers are also covered against severe traumatic injury for an additional dollar each month.

    The reduction in SGLI premiums is made possible by lower, non-combat-related claims and increases in investment earnings.  VA officials believe this premium reduction will help maintain the nearly universal participation in the program. 

    VGLI provides renewable term policies for people after their discharges from the military.  Veterans pay premiums according to their age for this coverage.

    On July 1, 2008, VGLI premium rates will be reduced for veterans aged 30 to 64, who make up 85 percent of those insured under the program.  Premium rates for those under age 30 are already competitive.

    Premium reductions, ranging from 4 percent to 12 percent, are a result of fewer claims being received.  The reductions will ensure that VGLI remains highly competitive with similar insurance offered by commercial insurers. 

  • Veterans Affairs Secretary Dr. James B. Peake announced creation of a Veterans Employment Coordination Service to oversee the Department’s program to recruit new veterans into the VA workforce, especially recently disabled combat veterans.

    The new office will work with military transition programs, veterans service organizations and other VA programs to promote careers in the VA workforce.  The program will also work with VA managers and human resource offices to ensure supervisors are aware of programs for hiring veterans.  Efforts to assist severely injured veterans have already begun with the Department’s participation in local career fairs targeting veterans of Iraq and Afghanistan.

    In November 2007, VA announced plans to hire 10 full-time regional veterans employment coordinators who provide hands-on assistance to veterans interested in careers at the Department.  The new office will oversee the regional coordinators.  

    About 31 percent of VA’s 260,000 employees are veterans, and nearly 8 percent are service-connected disabled veterans.  VA ranks first among non-Defense agencies in the hiring of disabled veterans and is second only to the Department of Defense in the overall number of veterans on the workforce.  Last fiscal year, VA hired more than 9,000 veterans.  http://www1.va.gov/opa/pressrel/pressrelease.cfm?id=1488

Health Care News

  • Commissioner of Food and Drugs Andrew C. von Eschenbach, MD, announced the appointment of Frank M. Torti, MD, MPH, as the FDA's principal deputy commissioner and first chief scientist. The newly created chief scientist position stems from the Food and Drug Administration (FDA) Amendments Act of 2007.

    As chief scientist and a member of the agency's senior leadership team, Dr. Torti will support the launch of the FDA Fellowship Program, which has the potential to attract up to 2,000 professionals of varying disciplines for a two-year training program. The new office also will work to ensure the quality and regulatory focus of the intramural research programs of the agency, and place special emphasis on the importance of clinical research trials that are a part of the foundation of the FDA's regulatory structure.

    A prominent clinician, scientist and researcher in molecular oncology, Dr. Torti is currently serving as Charles L. Spurr Professor of Medicine, chair of the Department of Cancer Biology, and director of the Comprehensive Cancer Center at Wake Forest University School of Medicine in Winston-Salem, N.C.

    Dr. Torti received his bachelor's and master's from Johns Hopkins University, his medical degree from Harvard Medical School, and his Master of Public Health from Harvard School of Public Health. He served as an intern and resident at Beth Israel Hospital in Boston and a fellow of medical oncology at Stanford University where he subsequently joined the faculty and was tenured.

  • According to the Centers for Disease Control and Prevention (CDC), mothers who smoke early in pregnancy are more likely to give birth to infants with heart defects.

    The new CDC study, “Maternal Smoking and Congenital Heart Defects,” shows that women who smoked anytime during the month before pregnancy to the end of the first trimester were more likely to give birth to infants with certain congenital heart defects (CHDs) compared to women who did not smoke during this time period. The association was stronger for mothers who reported heavier smoking during this time period.

    The findings from the study were based on the National Birth Defects Prevention Study, which is the largest population-based study ever done on the causes of birth defects in the United States. Nine states participated in the study: Arkansas, California, Georgia, Iowa, Massachusetts, New York, North Carolina, Texas and Utah. This research included 3,067 infants with CHDs and a comparison group of 3,947 infants with no major birth defects.

    The study found that septal heart defects – a hole in the heart between the left and right heart chambers, which disrupts the flow of blood and oxygen to the body – were the most common defect found among infants who were born with a cardiac defect. Researchers also found conotruncal (poor blood circulation from lower heart chamber), right-side obstructive (blood is blocked from flowing freely from the right side of the heart) and left-side obstructive (blood is blocked from flowing freely from left side of heart) defects.

    CHDs are the most common type of birth defect, occurring in eight to 10 of every 1,000 live births in the United States. Many infants with CHDs die in the first year of life, and infants who survive often require numerous surgeries, lengthy hospitalizations and a lifetime of treatment for related disabilities.

    Women who smoke should know that in addition to smoking being a possible cause for heart defects, the following are also of concern:

    • Smoking makes it harder for a woman to get pregnant.
    • Women who smoke during pregnancy are more likely than other women to have a miscarriage.
    • Smoking during pregnancy causes major health problems for both mother and baby. For example, smoking is one of the causes of problems with the placenta — the source of the baby's nutrition and oxygen during pregnancy.
    • Smoking during pregnancy can cause a baby to be born too early and have low birth weight — making it more likely the baby will become sick or die.
    • Babies born to women who smoke are more likely to have a cleft lip or cleft palate — types of birth defects.
    • Smoking during and after pregnancy is one of the causes of Sudden Infant Death Syndrome (SIDS).
  • The Department of Health and Human Services (HHS) awarded more than $1.1 billion in grants to provide primary care, medications and services for low-income and underinsured people living with HIV/AIDS.

    Funded under Part B of the Ryan White HIV/AIDS Program, the grants are awarded to all 50 states, the District of Columbia, Puerto Rico, Guam and the U.S. Virgin Islands. Also receiving grants are the U.S. Pacific Territories of American Samoa and Commonwealth of the Northern Mariana Islands; and the Associated Jurisdictions of the Republic of the Marshall Islands, Federated States of Micronesia, and Republic of Palau. HHS’ Health Resources and Services Administration (HRSA) manages the Ryan White program.

    The majority of the funding, $774 million, supports state AIDS Drug Assistance Programs (ADAPs) that provide prescription medications for HIV/AIDS patients. In 2006, almost 158,000 ADAP clients were served through state ADAPs.

    Part B awards also include formula base grants that can be used for home and community-based services, insurance continuation, ADAP assistance and other direct services. Fourteen states will also receive Emerging Community grants based on the number of AIDS cases over the most recent 5-year period.

  • The Centers for Medicare and Medicaid Services (CMS) announced that nearly $36 million will be distributed to State Health Insurance Assistance Programs (SHIPs) to help people with Medicare get more information about their health care choices. 

    This is the first installment of more than $50 million that will be provided to the SHIPs in 2008.  This $20 million increase in funding over fiscal year 2007 reflects more than $39 million in regular SHIP grants, performance-based grants to be awarded in September, and SHIP support, as well as an additional $15 million in supplemental funding that will be distributed on June 1.

    SHIPs are state-based programs that use community-based networks to provide Medicare beneficiaries with local, personalized assistance on a wide variety of Medicare and health insurance topics.  SHIPs have been instrumental in helping to educate many of the 39 million Medicare beneficiaries with prescription drug coverage about their prescription drug coverage options so that they can make a choice about their health care that best meets their needs.

    CMS expects the SHIPs to use the increased 2008 funding to conduct targeted community-based outreach to an increasing number of beneficiaries who may be unable to access other sources of information.

    SHIPs will continue their outreach and assistance to current and newly eligible Medicare beneficiaries and their caregivers, as well as reaching out to beneficiaries with limited incomes who may be eligible for the extra help. 

    CMS will continue to support the SHIPs in 54 states and territories with training and technical assistance.  This will help to ensure that the community network remains fully capable of accessing and using all of CMS’ regional offices and online tools at www.medicare.gov to provide assistance to beneficiaries. CMS NR 04-07-2008

  • According to USA Today, pharmacies and walk-in health clinics are opening at more airports in the USA, hoping to capture a sizable portion of travelers and airport employees who want access to basic primary health care and to fill their prescriptions at the last minute

    Such facilities are common at large foreign airports, but domestic airports have mostly focused on services that cater to travelers' immediate needs. Several entrepreneurs are betting that there is pent-up demand for such services at airports in the USA.

    While similar to primary care physician offices, walk-in clinics generally focus on a limited range of medical services and medications.  Nurse practitioners typically deliver the services.

    Harmony Pharmacy, which launched at Newark Liberty late last year, will open another airport shop at the much-anticipated JetBlue Terminal 5 at New York's John F. Kennedy airport in September.

    AeroClinic, which runs a walk-in clinic at Hartsfield-Jackson Atlanta, will open its second branch at Philadelphia International in the spring.

    Solantic, which operates walk-in clinics at several Wal-Marts, will expand into the airport market by opening at Orlando International later this year. Atlanta-based AirportMD opens its first store in Miami next month, followed by another in Minneapolis in the fall.

    Several factors are driving the trend:

    • Greater marketing emphasis.  Airports are increasingly looking for non-aviation revenue to offset discounts and promotions given to airlines to court new flights. As a result, a greater array of services and retail shops that consumers normally don't associate with flying are starting to appear between gates, including health and wellness services.
    • Longer waiting time.  About 1.2 billion people traveled through the top 20 airports last year, not including the 500,000 employees who work there. With more stringent security, fliers are arriving earlier, which gives them time to receive basic health services that wouldn't otherwise be feasible.
    • Growth of the retail clinics industry. Airports are a new market for an already fast-growing industry. According to the Convenient Care Association, there are about 950 clinics in the USA, and more than 500 more will open by the end of this year. Many of them are at strip malls or in big-box drugstores, but transportation hubs are seen as an attractive growth market.

    These clinics typically focus on the most common requests among travelers, including ear infections, stomach aches, flu shots, antibiotics, asthma inhalers and heart medication. Many also offer some preventive care for people who have more time, including diabetes monitoring, cholesterol checking and drug testing.

  • The United States experienced its worst outbreak of the mumps in two decades in 2006, reports the New England Journal of Medicine. There were more than 6,500 cases that year, with most concentrated in the Midwest and more than three quarters of cases reported between March and May. Eighty-five patients required hospitalizations; none died.

    Researchers concluded that a more effective mumps vaccine or changes in vaccine policy may be needed to avert future outbreaks and achieve the elimination of mumps. Mumps had been mostly unheard of in the United States since the 1990s, when children began receiving a second dose of the measles-mumps-rubella vaccine. Most of those affected by the 2006 outbreak had received both doses of the vaccine.

  • The Centers for Medicare and Medicaid Services (CMS) released a final rule that will modernize the Medicare conditions for coverage for the nation’s dialysis centers and promote higher quality of care for patients receiving dialysis.

    The final regulation will enhance the quality of care available to more than 336,000 Medicare beneficiaries with End-State Renal Disease (ESRD) who receive dialysis treatment from more than 4,700 Medicare-approved renal dialysis facilities across the U.S.  The regulation reflects important clinical and scientific advances in dialysis technology and standards of care practices.  The regulation also updates the current requirements that were first published in 1976. 

    These regulations will serve as minimum standards that dialysis facilities must meet in order to meet to be certified under the Medicare program.  These conditions for coverage are part of the Medicare survey and certification process.

    The rule focuses on the importance of patient rights, patient safety and the patient’s participation in the development of his or her own plan of care.  Each facility is required to develop a quality assessment and performance improvement (QAPI) program that would track the facility’s performance in patient health outcomes.  This regulation also reduces the detailed and burdensome requirements that dialysis facilities had to meet previously and provides flexibility for facilities to use their resources to meet the needs of individual patients and achieve better outcomes of care.

Reserve/Guard

  • The total number of Guard and Reserve currently on active duty has increased by 3,172 from the last report to 101,856. The totals for each service are Army National Guard and Army Reserve, 77,928; Navy Reserve, 5,519; Air National Guard and Air Force Reserve, 9,488; Marine Corps Reserve, 8,576; and the Coast Guard Reserve, 345. www.defenselink.mil

Reports/Policies

  • The GAO published “Temporomandibular Joint and Muscle Disorders: NIH Supports a Wide Range of Research,” (GAO-08-454R) on April 4, 2008.  In this report, the GAO examined TMJD-related research activities that NIH supported from fiscal year 2002 through fiscal year 2006 and NIH's plans to support future research on TMJDs. http://www.gao.gov/new.items/d08454r.pdf
  • The GAO published “DoD Pharmacy Program: Continued Efforts Needed to Reduce Growth in Spending at Retail Pharmacies,” (GAO-08-327) on April 4, 2008. In this report, the GAO examined DoD's pharmacy benefits program.  In particular, the GAO examined DoD’s prescription drug spending trends from fiscal years 2000 through 2006 and DOD's key efforts to limit its prescription drug spending.  http://www.gao.gov/new.items/d08327.pdf
  • The GAO published “VA Health Care: Recruitment and Retention Challenges and Efforts to Make Salaries Competitive for Nurse Anesthetists,” (GAO-08-647T) on April 9, 2008.  This report identifies workforce challenges that VA medical facilities experience related to VA CRNAs and identifies a key mechanism that VA medical facilities have to help make VA CRNA salaries competitive and the extent to which VA facilities use this mechanism. http://www.gao.gov/new.items/d08647t.pdf

Legislation

  • H.R.5721 (introduced April 8, 2008): To amend title XIX of the Social Security Act to provide for a DSH redistribution pool from unexpended Medicaid DSH allotments in order to increase Medicaid DSH allotments for low DSH States and to provide grants for health access networks serving the uninsured was referred to the House Committee on Energy and Commerce. 
    Sponsor: Representative John Sullivan [OK-1]
  • H.R.5729 (introduced April 8, 2008):  To amend title 38, United States Code, to direct the Secretary of Veterans Affairs to provide comprehensive health care to children of Vietnam veterans born with Spina Bifida, and for other purposes was referred to the House Committee on Veterans' Affairs. 
    Sponsor: Representative Brad Ellsworth [IN-8]
  • H.R.5730 (introduced April 8, 2008):  To direct the Secretary of Veterans Affairs to display in each prosthetic and orthotic clinic of the Department of Veterans Affairs an Injured and Amputee Veterans Bill of Rights was referred to the House Committee on Veterans' Affairs. 
    Sponsor: Representative Bob Filner [CA-51]
  • H.R.5736 (introduced April 9, 2008): To designate the Department of Veterans Affairs outpatient clinic in Gadsden, Alabama, as the Colonel Ola Lee Mize Veterans Clinic was referred to the House Committee on Veterans' Affairs. 
    Sponsor: Representative Robert B. Aderholt [AL-4]
  • H.R.5737 (introduced April 9, 2008): To amend the Internal Revenue Code of 1986 to provide for a deduction for travel expenses to medical centers of the Department of Veterans Affairs in connection with examinations or treatments relating to service-connected disabilities was referred to the House Committee on Ways and Means. 
    Sponsor: Representative Dean Heller [NV-2]
  • S.2824 (introduced April 7, 2008):  A bill to amend title 38, United States Code, to improve the collective bargaining rights and procedures for review of adverse actions of certain employees of the Department of Veterans Affairs, and for other purposes was referred to the Committee on Veterans' Affairs. 
    Sponsor: Senator John D. Rockefeller, IV [WV]
  • S.2835 (introduced April 9, 2008): A bill to amend the Internal Revenue Code of 1986 to allow the purchase of health insurance with pre-tax dollars, and for other purposes was referred to the Committee on Finance. 
    Sponsor: Senator Jim DeMint [SC]
  • S.AMDT.4518 to H.R.3221 (introduced April 9, 2008): To improve housing benefits for veterans was agreed to by unanimous consent.  
    Sponsor: Senator Christopher J. Dodd [CT]

Hill Hearings

  • The House Veterans Affairs Committee will hold a legislative hearings on April 15-16, 2008, to examine H.R. 2818, H.R. 5554, H.R. 5595, H.R. 4883, H.R. 4884, H.R. 4889, H.R. 4539, H.R. 3646, H.R. 5664, H.R. 3798, H.R. 3681, H.R. 3393, H.R. 3298, H.R. 3467, H.R. 3889, a bill expanding Spina Bifida program; and draft discussion authorizing VA to provide mental health treatment to families.
  • The House Veterans Affairs Committee will hold a field hearing in Sanford, Me. on April 21, 2008, to examine women, rural and special needs veterans.
  • The Senate Veterans Affairs Committee will hold an oversight hearing on April 23, 2008, to examine an update on the Veterans Affairs and the Department of Defense cooperation and collaboration. 
  • The Senate Veterans Affairs Committee will hold a hearing on May 7, 2008, to examine pending benefits legislation. 
  • The Senate Veterans Affairs Committee will hold a hearing on May 21, 2008, to examine pending health care legislation.

Meetings / Conferences


If you need further information on any of the items in the Federal Health Update, please contact Kate Connelly Theroux at (703) 447-3257 or by e-mail at kate@usminstitute.org. To subscribe, please visit http://usminstitute.org/subscriber.cfm. To unsubscribe, please send an email to update@usminstitute.org with UNSUBSCRIBE as the subject.

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