{"id":2071,"date":"2021-08-09T19:35:48","date_gmt":"2021-08-09T19:35:48","guid":{"rendered":"https:\/\/thornrun.com\/health-policy-report-8-9\/"},"modified":"2023-08-08T21:25:36","modified_gmt":"2023-08-08T21:25:36","slug":"health-policy-report-8-9","status":"publish","type":"post","link":"https:\/\/thornrun.com\/health-policy-report-8-9\/","title":{"rendered":"Health Policy Report (8\/9)"},"content":{"rendered":"\n

Capitol Hill Update<\/strong>\u00a0<\/p>\n\n\n\n

Senators wrapped up another weekend session on the\u00a0bipartisan infrastructure deal<\/a>\u00a0as the Biden-endorsed effort inched closer to final passage. The $550 billion agreement cleared its final set of procedural hurdles on Sunday, with 18 Republicans joining all 50 Democrats in voting to end debate on the underlying measure. Senate Majority Leader Chuck Schumer (D-NY) had hoped to wrap up consideration of the measure late last week, but lingering disagreements over amendments have dragged out the process into the second week of August. <\/p>\n\n\n\n\n\n\n\n

Additional changes to the\nbill are possible, as Senate leadership continues to engage in talks on\npossible amendments related to cryptocurrency reporting, defense\ninfrastructure, and unused COVID-19 relief funds, among others. Final\npassage of the infrastructure passage is currently slated for early Tuesday\nmorning unless all 100 Senators can reach a unanimous consent agreement to call\nup the legislation earlier. However, this agreement been elusive due to\nobjections from Sen. Bill Hagerty (R-TN), who has been a vocal critic of both\nthe bill and the process. In any case, the measure is set to pass the Senate\nand head to the House, where Speaker Nancy Pelosi (D-CA) will need to work to\ncoalesce the competing interests within the Democratic caucus before a clear\npath to President Joe Biden\u2019s desk emerges. <\/p>\n\n\n\n

The Latest on the FY\n2022 Budget Resolution <\/strong><\/p>\n\n\n\n

Following consideration\nof the bipartisan infrastructure deal, the Senate will immediately turn its\nattention to a budget resolution for fiscal year (FY) 2022 as Democrats look to\ncraft a filibuster-proof package on key legislative priorities. The forthcoming\nreconciliation package will likely contain a series of sweeping health policy\nitems that touch on drug pricing negotiation, Medicare and Medicaid expansion,\nas well as funding for home and community-based services. Permanently rolling\nback the Trump-era Medicare rebate rule and reducing Medicare Advantage\nbenchmark rates are also under consideration as potential health-related\nfunding streams. <\/p>\n\n\n\n

Other aspects of the\nresolution could include: (1) a series of tax reforms aimed at offsetting some\nof the costs; (2) funding for domestic manufacturing, supply chains, and\nresearch & development; (3) American Families Plan<\/a> priorities on child care, education, paid\nleave, and nutrition assistance; (4) climate and clean energy provisions from\nthe American Jobs Plan<\/a>; and (5) immigration and labor reforms.  <\/p>\n\n\n\n

Senate Budget Committee\nChairman Bernie Sanders (I-VT) stated that the resolution could be unveiled as\nsoon as early as today. Assuming the budget resolution can clear the Senate, it\nis possible that House lawmakers would return at some point over the next\ncouple of weeks to pass the resolution and trigger the reconciliation process. While\nLeader Schumer believes that all 50 Senate Democrats will support the $3.5\ntrillion budget vehicle to trigger the reconciliation process, it remains to be\nseen whether the entire Democratic caucus will be able to coalesce behind a\nmulti-trillion-dollar bill given some uneasiness from centrist senators \u2014\nnamely Sens. Kyrsten Sinema (D-AZ) and Joe Manchin (D-WV), among others. <\/p>\n\n\n\n

CMS Finalizes Inpatient\nand Long-term Care Hospital Payments for FY 2022 <\/strong><\/p>\n\n\n\n

Earlier this\nweek, the Centers for Medicare and Medicaid Services\n(CMS) finalized its annual rule<\/a> (<\/a>fact sheet<\/a>)<\/a> setting payments for inpatient hospital\nservices. In the rule, CMS finalized its proposal to repeal a\nTrump-era policy that would have set rates in\nthe Inpatient Prospective Payment System (IPPS) using data on\nhospitals\u2019 negotiated charges with Medicare Advantage (MA) payers. The\nrule also finalizes several provisions designed\nto help the program \u2014 including its providers and suppliers \u2014 manage\nthe COVID-19 public health emergency (PHE), such as by extending the New\nTechnology Add-on Payments (NTAP) for 13 products for which the NTAP\nwas scheduled to expire for fiscal year (FY) 2022. This rule also includes\npayment updates for the Long-Term Care Hospital (LTCH) Prospective roll\nout Payment System (PPS).    <\/p>\n\n\n\n

Similar to the other\nfour annual Medicare payment rules finalized last week, this rule\nincludes a new quality measure for COVID-19 vaccination among health\ncare personnel of providers covered by the\nrule.  CMS finalized a 2.5 percent payment increase for\ngeneral acute care hospitals that both participate in the\nHospital Inpatient Quality Reporting (IQR) Program and meaningfully\nuse electronic health records (EHR). The change reflects the projected\nhospital market basket update of 2.7 percent \u2014 reduced by a\n0.7 percent productivity adjustment and increased by a 0.5 percent adjustment\nrequired by statute. Hospitals may be subject to other payment adjustments\nassociated with quality and value-based purchasing programs.\nCMS anticipates the finalized changes will increase\nhospital payments in fiscal year (FY) 2022 by $3.7 billion, although\nthe administration expects a $1.4 billion decrease in Medicare\nDisproportionate Share Hospital (DSH) payments and Medicare uncompensated care\npayments.  <\/p>\n\n\n\n

CMS anticipates LTCH\nPPS payments will increase by 1.1 percent for FY 2022, or $42 million. FY\n2022 LTCH PPS payments for discharges paid the standard LTCH payment\nrate are expected to increase by 0.9 percent. This is primarily\ndue to the annual standard Federal rate update for FY 2022\nof 1.9 percent and a projected 0.8 percent decrease\nin high-cost outlier payments. FY 2022 LTCH PPS payments for\ndischarges paid the site neutral payment rate are expected to\nincrease by three percent. CMS estimates that discharges paid the site neutral\npayment rate will represent approximately 25 percent of all LTCH\ncases and 10 percent of all LTCH PPS payments in FY 2022.<\/p>\n\n\n\n

Additionally,\nCMS finalized a May 2021 interim final rule with\ncomment (IFC) period provision regarding rural reclassification through\nthe Medicare Geographic Classification Review Board (MGCRB). This will\nallow hospitals with a rural redesignation to reclassify through the MGCRB\nusing the rural reclassified area as the geographic area in which the hospital\nis located. Moreover, the final rule does\nnot finalize provisions included in the FY 2022 IPPS and LTCH PPS\nproposed rule related to DSH payments, organ acquisition costs, and\npayments to hospitals for direct graduate medical education (GME) and indirect\nmedical education (IME) costs. The agency indicated that\nthese policies will be addressed in future rulemaking\nefforts.   <\/p>\n\n\n\n

White House Announces\nNew Funding to Support Rural Health Efforts<\/strong><\/p>\n\n\n\n

On Thursday, the\nDepartment of Health and Human Services (HHS) announced<\/a> that it will provide $90 million in funding\nthrough the Health Resources and Services Administration (HRSA) to support\nrural communities’ efforts to combat substance use (SUD) and opioid\nuse disorders (OUD), as well as improve maternal health and obstetrics\ncare.   <\/p>\n\n\n\n

The HRSA’s Federal\nOffice of Rural Health Policy is making these awards through four key programs:\n(1) Rural Communities Opioid Response Program-Implementation ($78\nmillion); (2) Rural Communities Opioid Response\nProgram-Psychostimulant Support Program ($7.5\nmillion); (3) Rural Maternity and Obstetrics Management Strategies\nProgram ($2.9 million); and (4) Rural Northern Border Region\nPlanning Program ($760,000). Including its most recent\nallocation, the HRSA has invested nearly $384 million in community-based\ngrants and technical assistance over the last 3 years to promote the\nestablishment and expansion of SUD\/OUD prevention, treatment, and recovery\nservices in rural communities. <\/p>\n\n\n\n

Senate Appropriations\nCommittee Advances First Three FY 22 Appropriations Bills <\/strong><\/p>\n\n\n\n

The Senate Appropriations Committee\nheld a markup to consider several fiscal year (FY)\n2022 appropriations bills for Energy-Water Development (summary<\/a>; report<\/a>), Agriculture, Rural Development, and Food\n& Drug Administration (Ag-FDA) (summary<\/a>; report<\/a>), and Military Construction and Veterans\nAffairs (MilCon-VA) (summary<\/a>; report<\/a>). The bills traversed a wide variety of issues,\nincluding: (1) continued work on opioids; (2) increased inspections of\ncritical drugs and other medical products; (3) heightened bioengineered\ndisclosure standards; (4) increased medical and agricultural innovation and\nresearch; and (5) improvement of water infrastructure, among others.  <\/p>\n\n\n\n

Each of the\nthree appropriations bills were reported favorably by a roll call\nvote of 25-5. During the hearing, it was noted that no discretionary spending\ntopline had been established which is unusual for\nthe appropriations process, due to the absence of a FY 2022 budget\nresolution. With this, many Senators expressed their concern \u2014 and several\nvoted against the bills \u2014 as they felt that the budget process was moving\nforward without having a budget set in place. While Democrats showed firm\nsupport for the legislation, Republicans had concerns surrounding the structure\nof the FY 2022 appropriations process, the implications of a lack of resolute\ntopline spending allocations, and the need for parity between the rates of\nincrease for defense and non-defense accounts. <\/p>\n\n\n\n

Several amendments were\noffered during the markup by both Democratic and Republican senators. While\nfour were adopted, one of the amendments offered throughout the markup failed\nand three were withdrawn. Floor votes on the Energy-Water, Ag-FDA,\nand MilCon-VA appropriations bills for FY 2022, as well as\nmarkups on the remaining Senate Appropriations bills, will not occur until\nafter the Senate returns from its August recess. Congress\nremains behind schedule on funding the government for the next fiscal year, and\na short-term continuing resolution (CR) will likely be needed to avert the\nSeptember 30 deadline. <\/p>\n\n\n\n

Still No HHS Plan for\nProvider Relief After Senators Leave it Untouched <\/strong><\/p>\n\n\n\n

The\u00a0Department\u00a0of Health and Human Services (HHS)\u00a0has become the focal point of providers and\u00a0stakeholders\u00a0after unobligated provider relief\u00a0was not repurposed\u00a0to pay for the bipartisan infrastructure bill.\u00a0HHS\u00a0has yet to announce how it intends\u00a0allocate\u00a0to the remaining COVID-19 relief despite pressure from stakeholders and the Government Accountability Office\u00a0(GAO)\u00a0to act.\u00a0The\u00a0provider\u00a0relief\u00a0fund comprises 37 percent of the total COVID-19\u00a0relief\u00a0that Congress has appropriated to\u00a0HHS\u00a0since the start of the pandemic. Overall, GAO found\u00a0HHS\u00a0has designated a use for about 78 percent of the $324 billion in COVID-19\u00a0relief\u00a0that Congress appropriated last year, but so far only about half, $168 billion, has been allocated.\u00a0\u00a0 <\/p>\n\n\n\n

While the news\u00a0of untouched provider relief\u00a0is encouraging for\u00a0providers who are once again facing a surge in COVID-19 cases,\u00a0HHS\u00a0is left with\u00a0a large sum of unobligated funds\u00a0and the last distribution was announced about 10 months ago.\u00a0This may be due in part to the confusion that surrounds how much provider relief is left to allocate. The Health Resources and Serviced\u00a0Administration\u00a0(HRSA), the agency in charge of distributing the relief,\u00a0claims that\u00a0unallocated\u00a0provider\u00a0relief\u00a0totals\u00a0roughly $24 billion.\u00a0But a GAO report shows the HRSA has obligated $134.3 billion in\u00a0provider\u00a0relief, leaving nearly $43.7 billion to\u00a0be distributed.\u00a0HHS claims\u00a0that\u00a0the discrepancy between\u00a0HRSA\u2019s\u00a0estimate of the remaining\u00a0relief\u00a0and GAO\u2019s estimate stems from the difference between\u00a0the terms \u201cunallocated\u201d and \u201cunobligated\u201d funding.\u00a0GAO recommends\u00a0HHS\u00a0release spending plans with projected timeframes to obligate remaining\u00a0relief, but\u00a0HHS\u00a0told GAO it cannot\u00a0provide specifics for all relief because HHS needs to be flexible.\u00a0 <\/p>\n","protected":false},"excerpt":{"rendered":"

Capitol Hill Update\u00a0 Senators wrapped up another weekend session on the\u00a0bipartisan infrastructure deal\u00a0as the Biden-endorsed effort inched closer to final passage. The $550 billion agreement cleared its final set of procedural hurdles on Sunday, with 18 Republicans joining all 50 Democrats in voting to end debate on the underlying measure. Senate Majority Leader Chuck Schumer […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11,7],"tags":[],"acf":[],"yoast_head":"\nHealth Policy Report (8\/9) - thornrun<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/thornrun.com\/health-policy-report-8-9\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Health Policy Report (8\/9) - thornrun\" \/>\n<meta property=\"og:description\" content=\"Capitol Hill Update\u00a0 Senators wrapped up another weekend session on the\u00a0bipartisan infrastructure deal\u00a0as the Biden-endorsed effort inched closer to final passage. The $550 billion agreement cleared its final set of procedural hurdles on Sunday, with 18 Republicans joining all 50 Democrats in voting to end debate on the underlying measure. Senate Majority Leader Chuck Schumer […]\" \/>\n<meta property=\"og:url\" content=\"https:\/\/thornrun.com\/health-policy-report-8-9\/\" \/>\n<meta property=\"og:site_name\" content=\"thornrun\" \/>\n<meta property=\"article:published_time\" content=\"2021-08-09T19:35:48+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2023-08-08T21:25:36+00:00\" \/>\n<meta name=\"author\" content=\"Thornrun\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Thornrun\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"9 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/thornrun.com\/health-policy-report-8-9\/\",\"url\":\"https:\/\/thornrun.com\/health-policy-report-8-9\/\",\"name\":\"Health Policy Report (8\/9) - thornrun\",\"isPartOf\":{\"@id\":\"https:\/\/thornrun.com\/#website\"},\"datePublished\":\"2021-08-09T19:35:48+00:00\",\"dateModified\":\"2023-08-08T21:25:36+00:00\",\"author\":{\"@id\":\"https:\/\/thornrun.com\/#\/schema\/person\/2565f7fbcfeca70f7bbd34d7aca4c772\"},\"breadcrumb\":{\"@id\":\"https:\/\/thornrun.com\/health-policy-report-8-9\/#breadcrumb\"},\"inLanguage\":\"en\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/thornrun.com\/health-policy-report-8-9\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/thornrun.com\/health-policy-report-8-9\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/thornrun.com\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Health Policy Report (8\/9)\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/thornrun.com\/#website\",\"url\":\"https:\/\/thornrun.com\/\",\"name\":\"thornrun\",\"description\":\"\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/thornrun.com\/?s={search_term_string}\"},\"query-input\":\"required name=search_term_string\"}],\"inLanguage\":\"en\"},{\"@type\":\"Person\",\"@id\":\"https:\/\/thornrun.com\/#\/schema\/person\/2565f7fbcfeca70f7bbd34d7aca4c772\",\"name\":\"Thornrun\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en\",\"@id\":\"https:\/\/thornrun.com\/#\/schema\/person\/image\/\",\"url\":\"https:\/\/secure.gravatar.com\/avatar\/62ac3e22300d81a1b855333fa91058bc?s=96&d=mm&r=g\",\"contentUrl\":\"https:\/\/secure.gravatar.com\/avatar\/62ac3e22300d81a1b855333fa91058bc?s=96&d=mm&r=g\",\"caption\":\"Thornrun\"},\"sameAs\":[\"https:\/\/thornrun.com\"],\"url\":\"https:\/\/thornrun.com\/author\/thornrun\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Health Policy Report (8\/9) - thornrun","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/thornrun.com\/health-policy-report-8-9\/","og_locale":"en_US","og_type":"article","og_title":"Health Policy Report (8\/9) - thornrun","og_description":"Capitol Hill Update\u00a0 Senators wrapped up another weekend session on the\u00a0bipartisan infrastructure deal\u00a0as the Biden-endorsed effort inched closer to final passage. The $550 billion agreement cleared its final set of procedural hurdles on Sunday, with 18 Republicans joining all 50 Democrats in voting to end debate on the underlying measure. Senate Majority Leader Chuck Schumer […]","og_url":"https:\/\/thornrun.com\/health-policy-report-8-9\/","og_site_name":"thornrun","article_published_time":"2021-08-09T19:35:48+00:00","article_modified_time":"2023-08-08T21:25:36+00:00","author":"Thornrun","twitter_card":"summary_large_image","twitter_misc":{"Written by":"Thornrun","Est. reading time":"9 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/thornrun.com\/health-policy-report-8-9\/","url":"https:\/\/thornrun.com\/health-policy-report-8-9\/","name":"Health Policy Report (8\/9) - thornrun","isPartOf":{"@id":"https:\/\/thornrun.com\/#website"},"datePublished":"2021-08-09T19:35:48+00:00","dateModified":"2023-08-08T21:25:36+00:00","author":{"@id":"https:\/\/thornrun.com\/#\/schema\/person\/2565f7fbcfeca70f7bbd34d7aca4c772"},"breadcrumb":{"@id":"https:\/\/thornrun.com\/health-policy-report-8-9\/#breadcrumb"},"inLanguage":"en","potentialAction":[{"@type":"ReadAction","target":["https:\/\/thornrun.com\/health-policy-report-8-9\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/thornrun.com\/health-policy-report-8-9\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/thornrun.com\/"},{"@type":"ListItem","position":2,"name":"Health Policy Report (8\/9)"}]},{"@type":"WebSite","@id":"https:\/\/thornrun.com\/#website","url":"https:\/\/thornrun.com\/","name":"thornrun","description":"","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/thornrun.com\/?s={search_term_string}"},"query-input":"required name=search_term_string"}],"inLanguage":"en"},{"@type":"Person","@id":"https:\/\/thornrun.com\/#\/schema\/person\/2565f7fbcfeca70f7bbd34d7aca4c772","name":"Thornrun","image":{"@type":"ImageObject","inLanguage":"en","@id":"https:\/\/thornrun.com\/#\/schema\/person\/image\/","url":"https:\/\/secure.gravatar.com\/avatar\/62ac3e22300d81a1b855333fa91058bc?s=96&d=mm&r=g","contentUrl":"https:\/\/secure.gravatar.com\/avatar\/62ac3e22300d81a1b855333fa91058bc?s=96&d=mm&r=g","caption":"Thornrun"},"sameAs":["https:\/\/thornrun.com"],"url":"https:\/\/thornrun.com\/author\/thornrun\/"}]}},"_links":{"self":[{"href":"https:\/\/thornrun.com\/wp-json\/wp\/v2\/posts\/2071"}],"collection":[{"href":"https:\/\/thornrun.com\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/thornrun.com\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/thornrun.com\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/thornrun.com\/wp-json\/wp\/v2\/comments?post=2071"}],"version-history":[{"count":1,"href":"https:\/\/thornrun.com\/wp-json\/wp\/v2\/posts\/2071\/revisions"}],"predecessor-version":[{"id":3273,"href":"https:\/\/thornrun.com\/wp-json\/wp\/v2\/posts\/2071\/revisions\/3273"}],"wp:attachment":[{"href":"https:\/\/thornrun.com\/wp-json\/wp\/v2\/media?parent=2071"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/thornrun.com\/wp-json\/wp\/v2\/categories?post=2071"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/thornrun.com\/wp-json\/wp\/v2\/tags?post=2071"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}