Health

four healthcare points to look at as Congress faces a funding deadline subsequent month

Congress is working to avert a authorities shutdown on Dec. 11, and suppliers are lobbying to make sure a number of of their healthcare coverage priorities are addressed.

When lawmakers most not too long ago prolonged the federal government funding deadline in September, they included one in every of suppliers’ high priorities by enjoyable reimbursement phrases for COVID-19 Medicare loans. Suppliers see a number of alternatives for getting different key insurance policies included in Congress’ subsequent must-pass invoice.

Lengthen Medicare sequester suspension

Congress suspended sequestration cuts to Medicare in its third and largest COVID-19 stimulus package deal in March. Whereas some insurance policies that gave aid to suppliers are tied to the HHS secretary’s public health emergency declaration, a suspension of Medicare sequestration cuts expires on the finish of 2020. Hospitals have argued that funds should not be minimize now, as suppliers are concurrently bracing for extra surges and making ready to distribute vaccines within the coming months.

Doctor price schedule cuts

Medicare pay cuts for specialty physicians are set to enter impact Jan. 1, and suppliers are scrambling to go them off. Suppliers are pushing for Congress to waive budget-neutrality necessities so primary-care physicians can nonetheless obtain boosted funds with out requiring corresponding cuts for specialty physicians. A Senate GOP aide stated it is unlikely lawmakers will grant a full budget-neutrality waiver, as they must tack extra cost-saving measures onto the package deal to pay for the modifications. CMS could still make changes when it finalizes the coverage, however the aide stated lawmakers are skeptical CMS will handle the problem.

Healthcare extenders

Funding for a number of Medicare and Medicaid applications additionally expires on Dec. 11, together with a suspension of cuts to Medicaid disproportionate-share hospital funds. Ongoing funding for group well being facilities can also be at stake, and it stays to be seen how lengthy Congress will push the funding deadline. The package deal has been repeatedly bumped throughout 2020 as lawmakers had hoped to construct consensus on reform to prescription drug prices and shock medical payments, however laws on each points has stalled. The brand new extension date might set the tempo for healthcare policymaking in 2021.

Stimulus invoice

Lawmakers have failed to reach a compromise on one other complete COVID-19 aid package deal for months, however necessary advantages are expiring in December as parts of the nation reinstate pandemic restrictions. President-elect Joe Biden has met with Democratic congressional leaders in current days, which might change the political dynamic. If lawmakers aren’t capable of attain settlement in 2020, a deal will doubtless have to attend till after outcomes are tabulated in two Georgia Senate runoffs scheduled for early January that can decide management of the higher chamber. It is unclear which insurance policies either side might agree on, however a deal might imply extra funding for COVID-19 testing and tracing, vaccine distribution, and state and native governments.


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