Announcements:Needs Assessment Task Force Seeking Volunteers New Summer Scholarship Program for Medical Students USMLE Comprehensive Review Update posted on the USMLE web site discussing the previously reported themes that emerged in the review committee's deliberations, next steps in the review process, and--most importantly--some of the key topics have already been identified for early review. Click here for more information. Prosthetics & Orthotics Master of Science in Health and Rehabilitation Science is now being offered by the University of Pittsburgh. This 2-year program designed to prepare students to be certified prosthetists and orthotists for positions of leadership in health care. The first class of students begins in August 2008. They accepting applications at this time, and will continue to do so until July. Click here for more information. Ethical Issues in Rehabilitation Research: Applying Principles of Research Integrity News:National Registry for Society-Recommended Reviewers Physiatrist Volunteerism To PM&R Departments Member Benefit Update ISPRM is in official relation with WHO and more specific, with the DAR Team (Disability and Rehabilitation Team). In May 2007, the DAR team has for the first time issued a newsletter on Disability and Rehabilitation. Any person may register to receive the newsletter by contacting Ms. Noriko Saito at WHO or by the website. Educational Programs:Rehabilitation
Medicine Scientist Training Program (RMSTP) Program for Academic Leadership (PAL) Career Opportunities:The Department of Physical Medicine and Rehabilitation at the Medical College of Wisconsin seeks an outstanding pediatric physiatrist to join our service at Children’s Hospital of Wisconsin. Fellowship Profiles: |
Physiatry is the Medical Specialty of Physical Medicine and Rehabilitation
Currently there are approximately 7,500 board certified physiatrists in the United States who are trained to diagnose, treat, and direct a rehabilitation plan that provides the best possible patient outcomes. The physiatrist directs a comprehensive rehabilitation team of professionals that may include physical therapists, occupational therapists, recreational therapists, rehabilitation nurses, psychologists, social workers, speech-language pathologists, and others.
In addition to directing inpatient rehabilitation services, physiatrists treat neurological rehabilitation conditions including stroke, brain injury, and spinal cord injury. Physiatric scope of practice also includes the treatment of musculoskeletal injuries, pain syndromes, and sports injuries.
The Association of Academic Physiatrists (AAP) is an organization of faculty, researchers, and others interested in supporting academic medicine. The Association currently has 1,300 members. It has an official journal, American Journal of PM&R, and holds an annual meeting. The Association is involved in a number of projects to support and enhance academic PM&R.
The content of the website is designed to be user friendly and to offer information about the organization, the field of PM&R, and information related to education and research. It is hoped you find this site useful and informative.
Carolyn L. Braddom-Ritzler, EdD
Executive Director
AAMC Report on Medical School Faculty Salaries, 2006-2007
The latest AAMC Report on Medical School Faculty Salaries (2006-2007) is now available in the Members-Only section of the AAP Web site. This publication is the AAMC's 43rd review of full-time faculty compensation. The Report includes 33 tables that present the total compensation attributable to teaching, patient care, or research for 84,239 full-time medical school faculty. Fiscal year 2007 data was submitted by all of the 125 accredited medical schools in the United States that were administered the 2007 Faculty Salary Survey, and cover all sources of compensation: fixed/base salary, medical practice supplement, bonus/incentive pay, and uncontrolled outside earnings. The publication reports total compensation statistics for six faculty ranks in 79 departments/specialties. The tables provide the 25th percentile and 75th percentile as well as the mean and median for each combination of faculty rank and faculty department/specialty. The number of faculty in each total compensation statistic is given also.
Please note access to the AAMC’s Report on Medical School Faculty Salaries is an exclusive courtesy provided to the membership of the AAP. Members of the AAP must not post, publish, or distribute the information anywhere else nor provide the information to any other individual or organization. Click here to review the latest survey results.
Latest Legislative Update
by Peter W. Thomas, Esq., AAP General Counsel and Emily Neiderman, Legislative Director -- Powers, Pyles, Sutter and Verville, P.C.
Congress adjourned this week, completing the first session of the 110th Congress. The last several days of the session proved to be the busiest of the year with numerous loose ends being tied up before Members of Congress went home. Of particular importance to AAP, Congress passed an omnibus spending bill this week which combined the 11 unfinished appropriations bills for fiscal year (FY) 2008, including the Labor-Health and Human Services-Education spending bill. Congress also passed a Medicare package driven by a short-term fix to a pending Medicare physician payment cut without cutting other providers as was expected.
Appropriations Update
This week, Congress approved its fiscal year (FY) 2008 omnibus spending bill. The bill compiles the 11 remaining spending bills for FY 2008, including the Labor-Health and Human Services-Education (L-HHS) appropriations bill, and enactment of the legislation completes Congress’ annual appropriations work.
Democratic leaders have been at odds with President Bush and many Congressional Republicans over the spending levels in the FY 2008 appropriations bills. While Democrats would have liked to increase spending on many domestic priorities including health, education and labor programs, the President vowed to veto any legislation that went beyond his $933 billion overall request for discretionary spending. Because the Democrats did not have the needed Republican support to override the President’s vetoes, the Congressional Majority was in the uncomfortable position of having to adhere to the President’s demands or adjourn for the year without completing its annual appropriations work.
Last year, the Republican Majority passed a short-term continuing resolution (CR) at the end of the second session of the 109th Congress, leaving final action on FY 2007 appropriations up to the new Democratic Majority. Democratic leaders enacted a long-term CR shortly after returning in January, funding most programs at the FY 2006 levels through September 30, 2007.
Labor- Health and Human Services – Education
In November, Congress sent a relatively generous L-HHS appropriations bill to the President, but, because the bill exceeded the Bush Administration’s discretionary budget request by $10 billion, the President vetoed the measure.
While the omnibus spending bill represents a major departure from the Democrats’ desired focus on domestic priorities, Democratic leaders did manage to shift funds between the 11 spending bills in order to provide about $600 million more in discretionary spending than the Departments of Labor, Health and Human Services, and Education received in FY 2007. However, the discretionary total of the L-HHS section of the omnibus bill is about $5.6 billion less than the spending bill vetoed in November, and this was accomplished primarily through an across-the-board spending cut of 1.747% to programs funded under this bill.
The L-HHS section of the omnibus bill totals $145.1 billion in discretionary spending, including $307 million that Democrats designated “emergency” spending which is not subject to budget caps. Under the Department of HHS, the National Institutes of Health (NIH) would receive approximately $29.2 billion, about $329 million over FY 2007 levels. Democrats were originally interested in increasing the NIH budget by nearly $850 million, and many consider the revised increase to be entirely insufficient to fund the research and development activities of the NIH.
The Centers for Disease Control and Prevention (CDC) would see an increase of nearly $110 million for a total funding level of $6.38 billion in FY 2008. Democrats had originally wanted to increase the CDC budget by over $200 million. Also under the Department of HHS, organ transplantation would receive a cut of $403,000 for a funding level of $22.65 million.
At the Department of Labor, the Office of Disability Employment Policy (ODEP) would have received level funding without the across-the-board cut, but instead received $27.2 million in FY 2008 under the omnibus bill.
At the Department of Education, special education programs under Part B of the Individuals with Disabilities Act (IDEA) would receive approximately $11 billion, an increase of $259 million over FY 2007 spending levels and approximately $550 million more than the Bush Administration requested. Projects with Industry would have received flat funding of $19.5 million, if not for the sweeping 1.747% cut which reduced the funding level by $341,000 from FY 2007. The President had proposed to eliminate this program in his FY 2008 budget request.
Also, within the Department of Education, the National Institute for Disability and Rehabilitation Research (NIDRR) was scheduled to receive an increase of $900,000 in FY 2008 – the first increase for NIDRR in several years – to specifically fund two new Traumatic Brain Injury centers. Although the NIDRR budget for FY 2008 is subject to the 1.747% cut and will decrease by $964,000 for a total of $105.7 million, it appears that the two new TBI centers will still be established and all individual programs funded by NIDRR will receive a 1.747% cut in FY 2008.
Medicare Package
After months of debate and several veto threats, House and Senate leaders finally agreed to a so-called Medicare “extenders” package that not only prevents a scheduled 10% cut to physician payments for six months, but also includes several rehabilitation-related provisions.
The legislation temporarily averts the physician pay cut for six-months, providing doctors with a 0.5% reimbursement increase through June 2008. Democratic leaders had originally intended to pass a one- or two-year physician payment fix paid-for with cuts to Medicare managed care plans (Medicare Advantage) and other Medicare providers. However, after the President issued a veto threat on any legislation that would broadly cut Medicare Advantage, Congressional leaders chose to pass a short-term fix and will have to address the issue again in the New Year.
The bill also includes a permanent freeze on implementation of Medicare’s 75% Rule on inpatient rehabilitation hospitals and units at the 60% level. Additionally, the legislation preserves current treatment of comorbid conditions in terms of counting them toward the threshold. Finally, Congress requires that HHS study beneficiary access to inpatient rehabilitation services and make recommendations for classifying inpatient rehabilitation hospitals and units. While the inpatient rehabilitation industry will receive $1.5 billion in cuts in order to pay for the 75% Rule provisions as well as some of the doctors’ fix, generally this bill is a significant victory for inpatient rehabilitation stakeholders.
The legislation places a six-month moratorium on issuance of a final regulation to restrict allowable services under the Medicaid Rehabilitative Services Option. In August, the Bush Administration released a proposed regulation that would save $2.3 billion over five years by significantly curtailing services provided under this Medicaid option. AAP, through the Consortium of Citizens with Disabilities (CCD), opposed this proposed rule and have advocated for a legislative moratorium on implementation of a final regulation. While this six-month moratorium is not the longer-term moratorium advocates had hoped for, it constitutes a significant victory as it allows organizations additional time to work with Congress to prevent final implementation of this harmful regulation.
The legislation also provides a six-month extension of the current exceptions process for the Medicare outpatient therapy caps. Currently, Medicare places a monetary cap on outpatient physical rehabilitation services, occupational therapy, and speech pathology services; however due to a series of moratoriums and, more recently, an exceptions process, generally individuals requiring access to extensive outpatient rehab services have been able to receive them. The current exception process was set to expire at the end of this calendar year and the recent Medicare legislation would extend the exception process through June, 2008.
The Medicare package also includes an extension of the current State Children’s Health Insurance Program (SCHIP) through March, 2009. Many consider this extension of the current funding level to be a huge loss for Democrats who promoted reauthorization and expansion of SCHIP as one of their major priorities this year. However, the Administration stood firm on its opposition to additional funding being invested in the program, vetoing two SCHIP reauthorization/expansion bills this year. Democratic leaders did not have the necessary Republican support in Congress to override the vetoes.
The six-month provisions in the Medicare package indicate the Congress plans to work on another Medicare/Medicaid bill in the first several months of next year. This bill could serve as a possible vehicle for other AAP legislative priorities but it may be difficult for the Democratic Majority to move any large Medicare package in a partisan election year.
Conclusion
Overall, AAP priorities fared very well in the last legislative push this week. The inclusion of a permanent freeze in the 75% Rule in an otherwise short-term “extenders” bill is an important victory for inpatient rehabilitation hospitals and the people they serve. And, although, many of the discretionary programs of importance to AAP members did not see the spending increases that stakeholders had hoped for under a Democratic majority, Congress did manage to shift funding from other programs to several disability-related programs while working under the President’s austere budget restrictions.
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