UPDATE: Jan. 3, 2023: President Joe Biden signed the $1.7 trillion omnibus spending bill into law on Dec. 29.
A sweeping spending bill announced by Congress on Tuesday includes numerous changes to federal health policy, including easing Medicare provider pay cuts, restarting Medicare redeterminations and extending federal rural hospital programs.
Lawmakers are rushing to speed up passage of the $1.7 trillion omnibus spending package as they near a Friday deadline for government funding.
The spending bill proposes a Medicare PAYGO physician pay cut of 2% beginning in January 2023, increasing to 3.5% in 2024. The new cuts avert a 4.5% cut to providers proposed in November.
The American Hospital Association praised the agreement, which follows intense provider lobbying to avert the scheduled cuts.
“The AHA is pleased that on a bipartisan basis Congress recognizes the immense pressure America’s hospitals, health systems and our caregivers are facing,” AHA president and CEO Rick Pollack said in a statement. “This legislation will deliver critical support and resources so we can better care for our patients and create healthier communities.”
Medicaid redeterminations, which were halted due to the COVID-19 public health emergency, will begin again in April 2023 under the bill, regardless of PHE status. The Robert Wood Johnson foundation found this month that as many as 18 million Medicaid enrollees could lose their health insurance once the PHE expires. In August, the HHS projected that as many as 15 million could lose coverage.
However, lawmakers extended funding for the Children’s Health Insurance Program until fiscal year 2029.
The bill also extends Medicare rural hospital program funding, including funds for the Small Rural Hospital Improvement Grant Program. Rural hospitals specifically have been hit hard by the COVID-19 pandemic, jeopardizing care access as many facilities face long-term pressures. In August, the HHS awarded $60 million to strengthen rural healthcare workforces. This year, the CMS also proposed a new rural hospital provider designation.
Telehealth flexibilities spawned by the COVID-19 pandemic and hospital at home programs have also been extended for two years under the bill.
Other funding initiatives in the bill include those to address mental health programs and allow doctors to more easily prescribe medication addressing substance use disorders.