Congress Unveils $1.7 Trillion FY 2023 Omnibus Spending Bill Full of Health Care Provisions for Both Providers and Patients
With Christmas fast-approaching, the lame duck 117th Congress was working overtime this week to pass legislation funding the federal government through the next fiscal year, before a temporary continuing resolution (CR) expires Friday.
In the early hours of Tuesday morning, Congress released its long-anticipated fiscal year (FY) 2023 omnibus spending package. The $1.7 trillion bill includes $772.5 billion for non-defense programs and $858 billion in defense funding. The legislation provides $44.9 billion in emergency assistance to Ukraine amid Russia’s continued invasion, and $40.6 billion to aid communities across the U.S. recovering from severe weather events and natural disasters. It is expected that Congress will pass the legislation and President Biden will sign it into law before the CR expires this Friday, December 23.
In addition to funding federal agencies and operations, the legislation contains significant health care measures affecting a broad array of stakeholders. Key Medicare provisions include extending COVID-19 telehealth flexibilities in the Medicare program for two years, averting four percent Medicare PAYGO cuts that were slated to take effect in January 2023 for two years, and increasing the physician fee schedule conversion factor by 2.5 percent in 2023 and by 1.25 percent in 2024. This bill does not offer relief for providers from across-the-board Medicare payment sequestration cuts that Congress had suspended temporarily in the early days of the COVID-19 pandemic. Additionally, the bill will expand access to mental health care for Medicare beneficiaries by providing coverage of mental health counselor, outpatient services, and mobile crisis care services.
The omnibus also includes provisions aimed at strengthening the Medicaid program and providing coverage and support for children and pregnant women. These include making permanent the option for states to provide women with uninterrupted Medicaid coverage in the 12-month postpartum period, providing states with a glidepath down from the COVID-19 related Federal Medical Assistance Percentage (FMAP) bump and continuous enrollment provisions, and increasing the federal matching rate for the U.S. territories.
Additionally, the omnibus package makes investments in Substance Abuse and Mental Health Services Administration (SAMHSA) and Health Resources and Services Administration (HRSA) programs that provide support for mental health care and substance use disorder treatment. It also aims to bolster the mental health and substance use disorder workforce by increasing capacity and training. To prepare for future pandemics, the legislation provides new authorities for enhancing the Strategic National Stockpile (SNS). Further, it establishes the Advanced Research Projects Agency for Health (ARPA-H), a research entity aimed at accelerating innovation in health. The omnibus does not contain the VALID Act, legislation that would provide for Food and Drug Administration (FDA) regulation of in vitro clinical tests, but it does strengthen the FDA’s ability to regulate the safety of cosmetics and personal care products.
Bill text and committee summaries:
I. Bill text can be found here.
II. Senate Appropriations Committee summary can be found here.
III. Senate HELP Committee section-by-section summary can be found here.
IV. House Energy and Commerce Committee summary can be found here.
V. House Appropriations Committee summary can be found here.
CMS Proposes Rule to Streamline and Standardize Electronic Health Care Attachments and Electronic Signatures
The Centers for Medicare and Medicaid Services (CMS) issued a proposed rule that would create new Health Insurance Portability and Accountability Act of 1996 (HIPAA) standards for health care attachments transactions, such as medical charts, that document physician referrals and patient visits. The proposal would also modify the definition for “electronic signature” to make it as broad as possible, to ensure that it meets health care providers’ and health plans’ current needs and future electronic signature technologies. Public comments will be accepted until March 22, 2023.The fact sheet can be found here and the press release can be found here.
HHS Awards $130 Million in 988 Suicide and Crisis Lifeline Grants
The Department of Health and Human Services (HHS) will award more than $130 million in grants for the 988 Suicide and Crisis Lifeline. $47 million will go to states and U.S. territories to expand and improve 988 Suicide and Crisis Lifeline services, $21.1 million will go toward improving the 988 response in tribal communities, and $64.8 million will go to the 988 Lifeline administrator, Vibrant Emotional Health, to “manage and expand access to local and national 988 Lifeline crisis centers.” Additional information can be found here.
HHS Releases Ownership Data for all Medicare-certified Hospitals
In accordance to President Joe Biden’s Executive Order on promoting competition and transparency, HHS released ownership data for all Medicare-certified hospitals. The data includes enrollment information, such as the organization’s name and address; detailed information about each owner; and a numerical associate ID for each owner. The data can be viewed here.
