THIS WEEK’S DOSE
Congress moved toward the exit this week, unveiling and advancing an omnibus appropriations package to keep the government funded for the remainder of fiscal year (FY) 2023. The year-end package also included many healthcare policy provisions.
Congress Advances FY 2023 Omnibus Bill with Significant Healthcare Policy Provisions. On December 20, Congress released the text of the FY 2023 omnibus spending package, known as the Consolidated Appropriations Act (CAA), 2023. The 4,155-page bill also includes a large number of health policy provisions.
Lawmakers moved to advance the year-end package as the stopgap bill keeping the government funded approached expiration at midnight on December 23 and as a winter storm threatened to snarl holiday travel. The Senate took up the bill first, advancing the omnibus by a vote of 68–29 on December 22. The House is scheduled to vote the morning of December 23, which will send the bill to President Biden, who is expected to sign it quickly.
The CAA 2023 contains many healthcare policy provisions, found in Division FF of the bill text. Highlights include the following:
- Waiving the 4% Medicare Statutory Pay-As-You-Go Act of 2010 cuts for 2023 and 2024
- Partially mitigating provider payment cuts under the Medicare physician fee schedule for two years
- Extending some current telehealth waivers and flexibilities related to the COVID-19 public health emergency (PHE) for two years
- Extending the Advanced Alternative Payment Model bonus for one year, but at a lower payment rate of 3.5%
- Providing a two-year extension of the Hospital at Home waiver
- Addressing mental health and substance use treatment
- Decoupling the Medicaid continuous coverage requirement from the COVID-19 PHE
- Permanently providing 12 months of continuous eligibility for children in Medicaid, providing states a permanent option to provide 12 months postpartum coverage in Medicaid and extending the Children’s Health Insurance Program for an additional two-years to 2029.
Some healthcare provisions sought by stakeholders and their congressional champions were left out of the final package. Examples of policy items that did not make the final cut, but could be part of health policy discussions heading into 2023, include the following:
- Reforms related to the prior authorization process under the Medicare Advantage program, as set forth in the Improving Seniors’ Timely Access to Care Act
- Advancing the Verifying Accurate Leading-edge IVCT Development (VALID) Act to create a new regulatory framework for the review and approval of diagnostic tests to accelerate the development of new technologies
- Providing for additional COVID-19 and provider relief funding
- Addressing the future of COVID-19 waiver authority.
The CAA 2023 also includes community project funding (CPF), a source of grants for projects whose recipients and purposes are specifically identified by lawmakers through the appropriations process, commonly referred to as earmarks. The full list of approved CPFs can be found here.
Section-by-section summaries of the CAA 2023 from the Senate Finance Committee; the Senate Health, Education, Labor and Pensions Committee; and the House Energy and Commerce Committee can be found here, here and here, respectively.
A detailed summary from McDermott+Consulting can be found here.
CMS Releases Ownership Data for All Medicare-Certified Hospitals. On December 20, the Centers for Medicare & Medicaid Services (CMS) released ownership data for all Medicare-certified hospitals. This action supports the Biden Administration’s commitment to transparency and the president’s executive order on promoting competition. The public can now review detailed information on the ownership of more than 7,000 hospitals certified to participate in the Medicare program on the data page of CMS’s website.
The data elements include the following:
- Enrollment information such as organization name, type, practice location addresses (e.g., off-campus sites), national provider identifier and CMS certification number
- Details about each owner, such as whether the owner is an organization or an individual, and whether it is a direct owner or indirect owner (i.e., whether there is at least one subsidiary between the owner and the provider)
- A numerical associate ID for each owner to enable linkage to the enrollment file.
In its press release, CMS noted that it expects to release updated hospital ownership data on a monthly basis in a searchable format on data.cms.gov, in addition to a flat Excel file available for download.
- The US Department of Health and Human Services (HHS) announced more than $130 million in 988 Suicide and Crisis Lifeline grants, part of the $800 million provided to the Substance Abuse and Mental Health Services Administration under the Bipartisan Safer Communities Act that was signed into law earlier this year, to address the nation’s ongoing mental health and substance use crises. The CAA 2023 also contains resources related to 988 implementation and improvement.
- HHS announced the annual release of its National Plan to Address Alzheimer’s Disease, through which HHS and its federal partners work to improve the trajectory of research on Alzheimer’s disease and related dementias, support people living with dementia and their caregivers, and encourage action to reduce risk factors.
- The US Government Accountability Office (GAO) released a report titled “Medicare: CMS Needs to Address Risks Posed by Provider Enrollment Waivers and Flexibilities.” GAO identified 47 waivers and flexibilities that CMS issued to sustain Medicare’s provider workforce capacity and beneficiary access to services during the COVID-19 pandemic, such as changes to provider enrollment screening. GAO made recommendations to CMS including conducting fingerprint-based criminal background checks, increasing the pace of revalidating provider eligibility, and evaluating opportunities for improvement in planning for future emergencies.
- GAO announced the appointment of seven members to the Health Information Technology Advisory Committee. The committee was established by the 21st Century Cures Act to provide recommendations to the National Coordinator for Health Information Technology on policies, standards, implementation specifications and certification criteria relating to the implementation of a health information technology infrastructure.
NEXT WEEK’S DIAGNOSIS
With the CAA 2023 nearing completion, Congress will be in recess for the year-end holidays. Our weekly Check-Up will also be on hiatus for the final week of 2022. The 118th Congress will convene on January 3, 2023 and, with it, our weekly Check-Up will return for the new year. Happy holidays!
For more information, contact Debra Curtis, Kristen O’Brien or Erica Stocker.
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