OVERNIGHT HEALTH: Scrambling for 'doc fix'

As the debate over the fiscal cliff goes down to the wire, so does the debate over the next "doc fix" — a temporary patch to delay a 27 percent cut in doctors' Medicare payments. The cut is scheduled to take effect at the end of the year if Congress doesn't act, and the Medicare agency began the formal steps Wednesday of putting that cut into place.

The Centers for Medicare and Medicaid Services (CMS), per its usual processes, sent doctors a note saying it had to begin planning for the 27 percent cut.

"The administration is disappointed that Congress has failed to pass a solution to eliminate the sustainable growth rate (SGR) formula-driven cuts, and has put payments for healthcare for Medicare beneficiaries at risk," CMS said. "We continue to urge Congress to take action to ensure these cuts do not take effect. Given the current progress with the legislation, CMS must take steps to implement the negative update."

The American Medical Association, meanwhile, called the stalemate "inexcusable" and implored Congress to avert the "crippling" cut to doctors' payments.

“Only 12 days before their Jan. 1 deadline, Congress continues to play a game of ‘political chicken’ with Medicare payments. Congress’s inaction will lead to a massive 26.5 percent cut for physicians, in communities across the nation, who care for more than 47 million Medicare patients," AMA President Jeremy Lazarus said in a statement.

The AMA's letter to lawmakers is here.

Economic impact: U.S. medical schools and teaching hospitals had a combined economic impact of more than half a trillion dollars and supported nearly 3.5 million jobs directly or indirectly in 2011, according to a new analysis. The consulting firm Tripp Umbach studied the issue for the Association of American Medical Colleges (AAMC) and found that the employment impact of its members has increased by 4 percent since 2008. The study also found that medical schools generated more than $34 billion in government revenues for states in 2011. AAMC usually weighs in on the looming doctor shortage, estimating that the United States will need more than 91,000 more primary and specialty physicians as Americans age. Read its economic impact report here

AAP backs gun control: The American Academy of Pediatrics wrote to President Obama and members of Congress on Wednesday urging further gun-control measures and bills to improve access to mental-health services. The group also called for a "national dialogue designed to reduce children's detrimental exposure to violence" in entertainment. The letter adds to the growing chorus of advocates urging leaders to take action in light of last Friday's massacre at Sandy Hook Elementary in Newtown, Conn. Obama is throwing his weight behind gun control with a new working group to be led by Vice President Biden. AAP called a bill that bans assault weapons and the sale of high-capacity magazines and strengthens waiting-period and background-check requirements a "necessary first step." Read the letter here.

In the cloud: A patient privacy group is urging the Department of Health and Human Services (HHS) to release more guidance for the healthcare industry as it moves its data to the cloud. Patient Privacy Rights wrote to HHS on Wednesday warning that the transition poses challenges for compliance with existing healthcare privacy laws and for consumers as they grapple with the possibility of security breaches. "Health providers will benefit from such guidance as they consider moving to cloud services and patients will benefit by knowing which data privacy and security protections should be in place — both will undoubtedly help increase trust and drive adoption," wrote Dr. Deborah Peel, founder and chairwoman of Patient Privacy Rights. Read her letter here.

Step by step: A bill from Rep. Anna Eshoo (D-Calif.) and Sen. Sheldon WhitehouseSheldon WhitehouseOvernight Tech: Uber exec says 'no justification' for covering up hack | Apple considers battery rebates | Regulators talk bitcoin | SpaceX launches world's most powerful rocket Overnight Cybersecurity: Tillerson proposes new cyber bureau at State | Senate bill would clarify cross-border data rules | Uber exec says 'no justification' for covering up breach Hatch introduces bipartisan bill to clarify cross-border data policies MORE (D-R.I.) ordering research frameworks for recalcitrant cancers is one step closer to becoming law. The measure was included in the final conference report on the defense authorization bill, which is expected to pass both chambers by the end of the week. The Recalcitrant Cancer Research Act mandates that federal health officials create scientific frameworks for addressing pancreatic and lung cancer, which have five-year survival rates of less than 50 percent. Read The Hill's coverage of the bill and its nearly six-year back-story here.

Thursday's agenda
The Senate Finance Committee will hold a hearing to consider the nomination of William Schultz for general counsel of the Department of Health and Human Services.

State by state
FDA and states discuss regulation of drug compounders

Tobacco companies, 17 states settle over payments

Alabama cut mental health budget by one-third since 2009

West Virginia lawmakers to look at mental health, school safety

Reading list
Three ObamaCare tax changes start in 12 days

After Newtown: What mental health system?

Opinion: To prevent massacres like Newtown's, expand Medicaid

Controversial bird flu work to resume soon

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Poll: Americans see police, mental health care more effective than assault weapons ban

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Sam Baker: sbaker@thehill.com / 202-628-8351

Elise Viebeck: eviebeck@thehill.com / 202-628-8523

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