T.The $1.7 trillion comprehensive federal appropriations bill enacted by Congress and President Joe Biden just before lawmakers left town won both praise and contempt. But its supporters, most congressional Democrats, and Republican opponents, who called it a budget buster, focused primarily on defense spending, emergency aid to Ukraine, and aid to various environmental crises. .
But equally important in the 4,155-page bill are spending provisions aimed at supporting hospitals and the healthcare system. allocates $9.2 billion to the Centers for Disease Control and Prevention for “basic public health activities,” adding $760 million in fiscal 2022. The appropriations bill also includes him $350 million as flexible funding for public health infrastructure.
Massive $1.7 Trillion Omnibus Spending Bill Passes House Despite Republican Opposition
However, funding for COVID-19 prevention and mitigation measures was not included in the bill. This is a blow to public health advocates who say the new coronavirus strain could wreak havoc this winter and beyond.
Still, Senate Majority Leader Chuck Schumer (D-New York) said the bill was the most important thing done in a long time.
“Omnibus is proactive, generous, and far-reaching healthcare, making it more affordable and far-reaching,” Schumer said.
In addition to increasing funding for the CDC and public health, the bill includes the following key provisions:
public health
The bill aims to improve public health through better data collection, vaccine development, and agency oversight.
The bill does not include a proposal to create a bipartisan task force, such as the 9/11 Commission, to examine the nation’s response to COVID-19. This is a politically sensitive issue that the soon-to-be majority House Republicans plan to address after running the committee. There’s plenty of room for investigation, but it’s unlikely to go in that direction.
payment to the doctor
This portion of the expenditure will cap the annual regulatory rule released by the Centers for Medicare and Medicaid Services, an approximately 4.5% reduction in the Medicare Physician Tariff. The reduced fee schedule was to come into effect in 2023. The Appropriations Act effectively tightens the 2023 cut to 2%, with a further 3.25% cut in 2024.
value-based care
The value-based care bonus sent to qualified physicians participating in the alternative payment model will be reduced from 5% to 3.5% next year. This health incentive is intended to compensate for lost revenue for physicians moving from reimbursement to value-based care models.
Medicaid
The measure would allow states to begin redetermining Medicaid in April. It is used by states to ensure that Medicaid participants are eligible for coverage through federal and state programs aimed at limiting health care costs for people with limited income and resources. It is the process of
States now have an indication of when redetermination should begin. States will also be allowed to begin excluding people from pandemic-enhanced Medicaid coverage in April.
telemedicine
The package gives doctors two years of flexibility to treat patients remotely via telemedicine. This is to give regulators adequate time to decide which flexibility should be made permanent. Still, the provision falls short of the blanket permanence demanded by many legislators.
Medicare and many Medicaid programs have expanded the types of originating sites a patient may have while receiving services via telemedicine. Other telemedicine changes include the postponement of certain in-person requirements and expanded coverage of voice-only services.
mental health
The spending bill includes several policies to improve mental health nationwide, including allowing Medicare to cover therapists and counselors, as well as increased funding for mental health-focused mobile health care units. It contains.
Over $1 billion will be used for the Community Mental Health Services Block Grant, in addition to increased funding for the 988 Mental Health Hotline.
mother and postpartum care
The measure also expands policies that allow states to offer one year of postpartum coverage to people enrolled in Medicaid and children’s health insurance programs.
Another provision, the Pregnant Workers Fairness Act, requires employers to consider pregnancy-related medical conditions. The second law, her PUMP Act, also requires employers to support mothers by providing a private, bathroom-free place to express breast milk.
rural health
The Medicare Dependent Hospitals and Low-Volume Hospitals programs will be extended through 2025, increasing payments to facilities with a high proportion of Medicare patients.
The bill also includes $2 million for a regional hospital pilot program to help improve current hospital management.
opioid
And $5 billion will go to efforts to reduce opioid misuse, such as relaxing buprenorphine prescription restrictions (which previously required additional certification). The legislation includes $1.6 billion to the state through state opioid response grants, medication-assisted treatment, and opioid overdose monitoring. at the CDC.
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increase in funds
The bill includes a 22% increase for veterans’ health care, totaling about $119 billion. Another provision would send his 5.6% increase of about $50 billion to the National Institutes of Health and $950 million to the Agency for Biomedical Advanced Research and Development.
It also establishes under NIH the Advanced Research Projects Agency for Health, which will receive $1.5 billion of the allocated funding.
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