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Performance Budget Submission for Congressional Justification

AHRQ Exhibits and Narrative

Appropriation Language—Agency for Healthcare Research and Quality

Healthcare Research and Quality

For carrying out titles III and IX of the Public Health Service Act, [and] part A of Title XI of the Social Security Act, and section 1013 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, amounts received from Freedom of Information Act fees, reimbursable and interagency agreements, and the sale of data shall be credited to this appropriation and shall remain available until expended. Provided, That the amount made available pursuant to section 937(c) of the Public Health Service Act shall not exceed [$334,564,000] $325,664,000.

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Language Analysis

Language Provision Explanation

"and section 1013 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003,"

Includes Section 1013 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 which authorizes AHRQ to conduct and support research with a focus on outcomes, comparative clinical effectiveness, and appropriateness of pharmaceuticals, devices, and health care services. From FY 2005 to FY 2007, AHRQ has spent $15 million annually for this program. In FY 2008 and FY 2009 this support increases to $30 million per year.

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Amounts Available for Obligation1

Department of Health and Human Services, Agency for Healthcare Research and Quality

Obligations 2007 2008 2009
Appropriation: Annual $0 $0 $0
Reduction pursuant to Section 122 of P.L. 108-447 $0 $0 $0
Subtotal, adjusted appropriation $0 $0 $0
Offsetting Collections from:
Federal funds pursuant to
Title IX of P.L. 102-410,
(Section 927(c) PHS Act)
HCQO $260,880,000 $276,564,000 $267,664,000
MEPS $55,300,000 $55,300,000 $55,300,000
Program Support $2,688,000 $2,700,000 $2,700,000
Subtotal, adjusted appropriation $318,868,000 $334,564,000 $325,664,000
Unobligated Balance Lapsing $115,000) --- ---
Total obligations $318,983,000 $334,564,000 $325,664,000

1. Excludes the following amounts for reimbursements:
FY 2007: $27,263,000 ($7,713,000 for National Research Service Awards [NRSAs] and $19,550,000 for other reimbursements).
FY 2008: $27,263,000 ($7,713,000 for NRSAs and $19,550,000 for other reimbursements).
FY 2009: $27,263,000 ($7,713,000 for NRSAs and $19,550,000 for other reimbursements).

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Summary of Changes

2008 Appropriation: $0
(Obligations): (334,564,000)

2009 Estimate: $0
(Obligations): (325,664,000)

Net change: $0
(Obligations): (-8,900,000)

Changes 2008 Current Budget Base Change from Base
Full Time Equivalent (FTE) Budget Authority (FTE) Budget Authority
Increases A. Built-in 1. Annualization of 2008 pay raise --
(--)
--
(41,229,000)
--
(--)
--
(+295,000)
2. January 2009 Pay Raise 2.9% for civilian & 3.4% for Commissioned Corps --
(--)
--
(41,229,000)
--
(--)
--
(+907,000)
3. Rental payments to General Services Administration (GSA)   --
(4,160,000)
--
(--)
--
(+97,000)
4. One Less Day of Pay   --
(41,229,000)
--
(--)
--
(-158,000)
5. Unified Financial Management System (UFMS) Tap Increase   --
(887,000)
--
(-)
--
(576,000)
6. Inflation Costs on Other Objects     --
(--)
--
(+404,000)
Subtotal, Built-in     --
(--)
--
(+2,121,000)
B. Program 1. Research on Health Costs, Quality and Outcomes; increase for Affordable Choices Decision Tool --
(277)
--
(276,564,000)
--
(+1)
--
(+6,201,000)
Subtotal, Program     --
(+1)
--
(+6,201,000)
Total Increases    --
(+1)
--
(+8,322,000)
Decreases A. Built-in 1. Absorption of the build-in increases     --
(--)
--
(-2,121,000)
Subtotal, Built-in     --
(--)
--
(-2,121,000)
B. Program 1. Research of Health Costs, Quality and Outcomes Program     --
(--)
--
(-15,101,000)
Subtotal, Program     --
(--)
--
(-5,165,000)
Total, Decreases     --
(--)
--
(-17,222,000)
Net change, Budget Authority
   Net change, Obligations
    --
(--)
--
(-$8,900,000)

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Budget Authority (BA) by Activity1

(Dollars in Thousands)

Activity 2007 2008 2009
FTE Amount FTE Amount FTE Amount
1. Research on Health Costs, Quality, & Outcomes BA 0 0 0 0   0
    PHS Evaluation [273] [260,983] [277] [276,564] [278] [267,664]
    Total Operational Level 273 260,983 277 276,564 278 267,664
2. Medical Expenditure Panel Surveys BA - 0 - 0 - 0
    PHS Evaluation - [55,300] - [55,300] - [55,300]
    Total Operational Level - 55,300 - 55,300 - 55,300
3. Program Support BA - 0 - 0 - 0
    PHS Evaluation [22] [2,700] [22] [2,700] [22] [2,700]
    Total Operational Level 22 2,700 22 2,700 22 2,700
Total, Budget Authority 0 0 0 0   0
Total PHS Evaluation [295] [318,983] [299] [334,564] [300] [325,664]
Total Operations 295 318,983 299 334,564 300 325,664

1. Excludes the following amounts for reimbursements:
FY 2007: $27,263,000 ($7,713,000 for NRSAs and $19,550,000 for other reimbursements).
FY 2008: $27,263,000 ($7,713,000 for NRSAs and $19,550,000 for other reimbursements).
FY 2009: $27,263,000 ($7,713,000 for NRSAs and $19,550,000 for other reimbursements).

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Authorizing Language1

Legislation 2008 Amount Authorized 2008 Enacted 2009 Amount Authorized FY 2009 Budget Request
Research on Health Costs, Quality, and Outcomes:
Secs. 301 & 926(a) Public Health Service Act (PHSA)
SSAN $0 SSAN $0
Research on Health Costs, Quality, and Outcomes:
Part A of Title XI of the Social Security Act (SSA) Section 1142(i)2,3
Budget Authority (BA)
Medicare Trust Funds (MTF)4,3
Subtotal BA & MTF
Expired5   Expired5  
Program Support: Section 301 PHSA Indefinite $0 Indefinite $0
Evaluation Funds: Section 927(c) PHSA Indefinite $334,564,000 Indefinite $325,664,000
   Total appropriations   $334,564,000   $325,664,000
Total appropriation against definite authorizations - - - -

Note: SSAN = Such Sums As Necessary.

1. Section 487(d) (3) (B) PHSA makes 1 percent of the funds appropriated to the National Institutes of Health (NIH) and the Alcohol, Drug Abuse, and Mental Health Administration (ADAMHA) for National Research Service Awards (NRSA) available to AHRQ. Because these reimbursable funds are not included in AHRQ's appropriation language, they have been excluded from this table.
2. Pursuant to Section 1142 of the Social Security Act, FY 1997 funds for the medical treatment effectiveness activity are to be appropriated against the total authorization level in the following manner: 70% of the funds are to be appropriated from Medicare Trust Funds (MTF); 30% of the funds are to be appropriated from general budget authority.
3. No specific amounts are authorized for years following FY 1994.
4. Funds appropriated against Title XI of the Social Security Act authorization are from the Federal Hospital Insurance Trust Funds (60%) and the Federal Supplementary Medical Insurance Trust Funds (40%).
5. Expired September 30, 1994.

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Appropriations History Table

Year Budget Estimates
to Congress
House Allowance Senate Allowance Appropriation
2000 Budget Authority $26,667,000 $104,403,000 $19,504,000 $116,424,000
PHS Evaluation Funds 179,588,000 70,647,000 191,751,000 88,576,000
Total1 $206,255,000 $175,050,000 $211,255,000 $205,000,000
Rescission Budget Authority $26,667,000 $104,403,000 $19,504,000 $115,223,000
PHS Evaluation Funds 179,588,000 70,647,000 191,751,000 88,576,000
Total1 $206,255,000 $175,050,000 $211,255,000 $203,799,000
2001 Budget Authority $-0- $123,669,000 $-0- $104,963,000
PHS Evaluation Funds 249,943,000 99,980,000 269,943,000 164,980,000
Total $249,943,000 $223,649,000 $269,943,000 $269,943,000
Rescission Budget Authority $-0- $123,669,000 $-0- $104,816,000
PHS Evaluation Funds 249,943,000 99,980,000 269,943,000 164,980,000
Total $249,943,000 $223,649,000 $269,943,000 $269,796,000
2002 Budget Authority $-0- $168,445,000 $291,245,000 $2,600,000
PHS Evaluation Funds 306,245,000 137,800,000 -0- 296,145,000
Total $306,245,000 $306,245,000 $291,245,000 $298,745,000
2003 Budget Authority $-0-   $202,645,000 $-0-
PHS Evaluation Funds 250,000,000   106,000,000 303,695,000
Bioterrorism -0-   5,000,000 5,000,000
Total $250,000,000 $0 $313,645,000 $308,695,000
2004 Budget Authority $-0- $-0- $-0- $-0-
PHS Evaluation Funds 279,000,000 303,695,000 303,695,000 318,695,000
Total $279,000,000 $303,695,000 $303,695,000 $318,695,000
2005 Budget Authority $-0- $-0- $-0- $-0-
PHS Evaluation Funds 303,695,000 303,695,000 318,695,000 318,695,000
Total $303,695,000 $303,695,000 $318,695,000 $318,695,000
2006 Budget Authority $-0- $318,695,000 $ $
PHS Evaluation Funds $318,695,000 $-0- $323,695,000 $318,692,000
Total $318,695,000 $318,695,000 $323,695,000 $318,692,000
2007 Budget Authority $-0- $-0- $-0- $-0-
PHS Evaluation Funds $318,692,000 $-0- $-0- $318,692,000
Total $318,692,000 $-0- $-0- $318,692,000
2008 Budget Authority $-0- $329,564,000 $329,564,000 $-0-
PHS Evaluation Funds $329,564,000 $-0- $-0- $334,564,000
Total $329,564,000 $329,564,000 $329,564,000 $334,564,000
2009 Budget Authority $-0- $ $ $
PHS Evaluation Funds $325,664,000 - - -
Total $325,664,000 $ $ $

1 Includes proposed $5.0 million from the Public Health and Social Services Emergency Fund.

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