The Nurse Reinvestment Act supports the recruitment of new nursing students through public service announcements and career partnerships between health care facilities and schools. The bill also establishes a fast?track faculty development program to ensure there are professors to teach the students we recruit. The bill provides educational support for students who need help getting-up to speed on math, science and medical English, and daycare and transportation for single moms and dads with children who need a hand.

The Nurse Reinvestment Act reinvests in nurses who are already practicing by providing education and training at every step of the career ladder. Our bill also helps colleges and universities develop curriculum in gerontology and long-term care to prepare nurses to treat our aging population. Finally, the bill authorizes, for the first time in history, a National Nurse Service Corps to administer scholarships to students who commit to working in a health care facility or area that is experiencing a shortage of nurses.

FMAP Amendment
During the Finance Committee mark-up of the Economic Recovery and Assistance for American Workers Act on November 8, a Kerry-Rockefeller Amendment to increase the
FMAP was accepted by the Chairman, and passed out of committee. The amendment increased the federal Medicaid matching rate by 1.5% for all states and 3% for high unemployment states, ensuring that adequate funding existed to provide serious fiscal relief to states that support health coverage for low-income Americans during the recession. No further Senate action has yet occurred on the economic stimulus package, however.

Letter to President Bush on Stem Cell Research
On July 19, JK sent a letter to the President, for which he secured the signatures of 58 of his Senate colleagues, urging Bush to allow federal funding for embryonic stem cell research. On July 20, Senator Specter held a press conference (JK was in Boston) to highlight the Kerry letter and majority Senate support for stem cell research. In August, President Bush announced his decision to allow the use of federal funds to conduct studies only on existing stem cell lines. Federal funds would be prohibited from being used for the creation or destruction of new embryos as sources of cells. Thus, Bush adopted a restricted version of the stem cell research policy Kerry had advocated.

PENDING JK LEGISLATION
During the first session of the 107th Congress, JK introduced several health care bills which were poised for Senate consideration, but ultimately not acted upon prior to adjournment. A few of these bills are likely to be considered in the second session.

o Medicare Appeals, Regulatory and Contracting Improvements Act (MARCIA)

Last March, JK joined Senator Murkowski in introducing the Medicare Education and Regulatory Fairness Act (MERFA), a bill to reform CMS regulation of Medicare providers. The bill was reintroduced as MARCIA (S.1738) in November, with Senators Baucus and Grassley joining JK and Murkowski as lead sponsors. Prior to adjournment, MARCIA companion legislation was passed in the House.

MARCIA has five primary components. First, it relieves burdens on beneficiaries and providers by requiring the Centers for Medicare and Medicaid Services (CMS) to issue rules and policies in an orderly and reasonable manner. Second, it provides appeals protections for all Medicare fee-for-service providers and beneficiaries. Third, it allows CMS to use competition to select the best available administrative contractors to serve beneficiaries and providers. Fourth, it requires Medicare contractors and CMS to place a greater emphasis on provider education and outreach. Finally, it makes the Medicare overpayment collection and extrapolation process more fair. The bill accomplishes all of these objectives without undermining the False Claims Act or other Medicare fraud recovery efforts, and I urge my colleagues to join with me to secure its passage.

o S.1686, Safe Nursing and Patient Care Act of 2001

This bill improves working conditions for nurses and, in turn, the quality of care they are able to provide patients. It limits the ability of hospitals and other health care providers to require nurses to work mandatory overtime. The restrictions are enforced through Medicare's provider agreements.

o S. 1304, Medicare coverage of oral phosphate-binding drugs for kidney dialysis patients. Patients with end-stage renal disease (ESRD) cannot eliminate dietary phosphorus and, without a kidney transplant, often develop hyperphosphatemia. This condition - and the hospitalization that accompanies it - can be prevented through the use of phosphate-binding drugs, which reduce the absorption of phosphorus in the body. Medicare coverage of phosphate binders makes both medical and economical sense. Not only does the medication improve the quality of life for patients with kidney failure, but it stands to reduce overall Medicare costs associated with treating hyperphosphatemia.

o S. 1303, The Kidney Patient Daily Dialysis Quality Act of 2001. This bill will update the Medicare program's dialysis coverage policy by eliminating the limitation on the number of sessions now covered by Medicare. Specifically, this bill will move Medicare beyond its conventional coverage of three dialysis sessions per week to provide coverage of more frequent dialysis - as defined by at least five times a week at a dialysis facility or in the home - if determined appropriate by a patient's physician. More frequent dialysis stands to save the Medicare program between $120 million and $620 million per year.

o S. 841, The Medicare Mental Illness Non-Discrimination Act. This bill will repeal the 50% copayment for outpatient mental health services and replace it with the standard 20% copayment for which all other outpatient services are assessed. Under the current system, if a Medicare patient sees an endocrinologist for diabetes treatment, an oncologist for cancer treatment, a cardiologist for heart disease treatment or an internist for treatment of the flu, the co-payment is 20% of the cost of the visit. If, however, a Medicare patient visits a psychiatrist for treatment of mental illness, the co-payment is 50% of the cost of the visit. This disparity in outpatient co-payments represents discrimination against Medicare beneficiaries with mental illness.