AST in DC – What Happened in the 112th Session of Congress?

As we begin the New Year, it’s a fitting time to update the Society on our robust advocacy activities. Public policy remains a key priority and there have been significant advancements this past year, largely thanks to the energy and passion of our team. While we’re heartened by this positive momentum, many challenges remain.

I’ve made six trips to DC since June and can attest that during that time the normal process for advancing priorities in Congress was extremely challenging. In visiting lawmakers to discuss our many issues, the single topic that overshadowed all the others was the so-called ‘fiscal cliff.’ Even in the face of its many unfinished and pending legislative priorities, the Lame Duck Congress managed zero action before the holidays, returning just days prior to hammer out a last-minute short-term fix to address looming fiscal issues. The limited package included:

•  One-Year delay of the January 1 Medicare Physician Fee Schedule cuts (27-30 percent)
•  Two-month delay of the across the across the board "Sequestration" cuts

What does this mean moving forward?

Despite the frustrating paralysis on Capitol Hill, there remains a steady stream of newly emerging proposed rules and legislation that impact the field of transplantation. While we’ve managed to remain proactive and unified as a transplant community by maintaining our strong presence at the policy tables, it is crucial that we continue to do so. We cannot wade slowly into the 113th Session of Congress and most of our core priorities remain ongoing within the legislative and regulatory branches, including:

• AST has been lobbying both independently and in coalitions with other organizations to educate Congressional leaders that sequestration, though temporarily delayed, would have a devastating impact on NIH and medical research if it goes through.
• Last week ASTS and AST submitted joint official comments to HHS addressing the ACA healthcare reform Essential Health Benefit (EHB) and the role of transplantation. As implementation of the ACA moves ahead there will surely be many other areas that will impact the field of transplantation. We need to remain vigilant and take advantage of our DC presence to make sure AST’s voice is heard as policy is developed.
• We are continuing to advocate for the Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act and will further these efforts in 2013. Our Society penned an open letter to lawmakers in The Hill Newspaper asking them to take final action. We refuse to quit when lives are at stake, and we still need your support as we enter another session of Congress. There is widespread bi-partisan support for this legislation and we will push even more vigorously for its passage once Congress returns to work as usual.
• In addition to patient legislative challenges, AST has been working daily with Congress and the many Executive Branch agencies (HHS, FDA, CDC, HRSA, CMS, NIH, IRS and SSA) to influence a variety of key regulatory policies with a direct impact on our field of practice and the patients that we serve.
• AST continues to weigh in on the development of the final HHS PHS Guideline for Reducing the Transmission of Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) through Organ Transplantation in an aggressive, yet thoughtful, manner. This includes regular meetings and an ongoing dialogue with HHS Secretary Sebelius, Assistant Secretary Dr. Koh and all levels of Deputy Assistant Secretaries, as well as others within HRSA, CDC (including Director Dr. Tom Frieden). We expect to see another draft of these guidelines very soon.
• AST has been working closely with HHS, HRSA, CMS and SSA to assist in developing a solution (regulatory or legislative) to the new SSA Social Security Death Master File (SSDMF) Privacy Rules – rules that would significantly restrict access for transplantation to SSDMF data. This obviously has negative repercussions for both clinical and research transplant arenas.
• A few weeks ago, AST and ASTS leaders traveled to FDA headquarters in Silver Spring, MD to meet with key Agency leaders regarding the topic of generics and transplant immunosuppressive medications. This is an important and ongoing dialogue that continues to evolve with the FDA.
• Congressional offices on Capitol Hill have been working with AST and the transplant community to develop a living donor's legislative "Bill of Rights." This process has involved a variety of meetings that will likely result in new legislation being introduced in the first quarter of 2013.
• The Society has been actively working with Congressional Appropriators and the research community quite a bit during the past two years in support of increased NIH resources. At present, our AST Community of Basic Scientists (COBS) is developing educational advocacy materials for the new Congress that will focus on illustrating the history, success and future promise of transplant research.

AST continues to view challenges as opportunities. This is why we exist – to advance transplantation in both good and challenging times. In 2013, AST will be once again act as host for Capitol Hill receptions and Congressional awards gatherings. Our leadership, committee chairs and others continue to meet regularly with Congress and targeted government officials. We will be inside the beltway and on the Hill, fighting on behalf of our community in the year ahead.

Have questions? Let us know. We’d love to hear from you.

- Roz