The House Appropriations Committee announced an agreement on omnibus appropriations legislation funding the federal government through the end of the current fiscal year. The legislation also includes provisions beneficial to hospitals and health systems.
The omnibus spending bill, with Ukraine emergency spending attached, has been combined into one package, and legislative language and a summary were released early this morning. House Democrats this afternoon pulled all COVID-19 relief that was going to be attached to the bill as some lawmakers expressed concerns about spending offsets for the additional COVID-19 relief funding supplemental package.
The House is expected to vote on the revised omnibus spending bill today. In addition, the House today is expected to approve a short-term continuing resolution funding the government. The Senate could try to clear the omnibus package by the weekend, but final passage may not come until next week. The Senate also is likely to clear a continuing resolution before current funding for the government expires at 11:59 p.m. ET on March 11. Watch for more details from the AHA.
We appreciate that Congress included important provisions in the legislative package related to telehealth, 340B and maternal health that will help hospitals and health systems enhance the health of their patients and communities. However, we are disappointed that Congress did not provide additional COVID-19 relief. We will continue to urge Congress to provide additional support to hospitals and health systems and their front-line caregivers as we enter year three of the COVID-19 public health emergency.
Based on an initial review of the legislation, the following are highlights of provisions that affect hospitals and health systems.
The legislation includes provisions to extend and expand telehealth flexibilities for 151 days after the end of the COVID-19 public health emergency. These include:
The legislation would require critical infrastructure sectors, including hospitals and health systems, to report cyber incidents within 72 hours and any ransomware payments made within 24 hours to the Cybersecurity and Infrastructure Security Agency at the Department of Homeland Security. Currently, hospitals and health systems are required to report cyber breaches affecting more than 500 people to the Office of Civil Rights at HHS “without unreasonable delay” and “no later than 60 calendar days from the breach.” More time is provided for reporting incidents affecting less than 500 people. The legislation would allow for some exemptions for certain entities that already report similar information on a similar timeline.
The legislation includes several important provisions to improve maternal health outcomes.
The legislation would provide for Public Health Service Act grants to develop and disseminate best practices with authorization of $45 million for 2023-2027; accredit health professional schools to train health care professionals about perceptions and biases with authorization of $15 million for 2023-2027; support states and tribal organizations for integrated health care services with authorization of $50 million for 2023-2027; and instruct HHS to include pregnant and postpartum women as part of their public awareness campaign.
This provision would amend the Public Health Service Act to improve rural maternal and obstetric care data collection and care networks with authorization of $15 million for 2023-2027, as well as establishes grants to support health care professional training and telehealth resources with authorization of $25 million for 2023-2027.
The legislation includes two Medicaid provisions.
This provision would extend the increased Federal Medical Assistance Percentage (FMAP) for the five U.S. territories through Dec. 13, 2022. Historically, the territories FMAP was 55%. This provision would maintain Puerto Rico’s increased FMAP at 76%, and maintain increased FMAP for the Virgin Islands, Guam, Northern Mariana Islands and American Samoa at 86%. The section also would increase Puerto Rico’s federal allotment by $200 million for fiscal year (FY) 2022.
This provision would provide state Medicaid programs with an enforcement mechanism to address third party liability for care provided to a Medicaid beneficiary. A large proportion of Medicaid beneficiaries have third party sources of insurance coverage and for these beneficiaries the third party source of coverage must pay for care provided before the Medicaid program will pay. This provision strengthens the Medicaid program enforcement to seek recovery for issued Medicaid payments. In addition, this provision applies to all potential denials on the part of commercial plans, including prior authorization denials, by not allowing commercial health plans to avoid payment by saying that the service failed prior authorization if the state had waived prior authorization for the same service.
The legislation would protect certain 340B hospitals that lost their 340B eligibility due to a drop in their disproportionate share hospitals (DSH) adjustment percentage below the required threshold for 340B eligibility to gain limited access to the program. Access to the 340B drug discounts would be available only from the date of the bill’s enactment through the end of 2022 and not retrospectively. This exception would apply only to 340B hospitals actively participating in the 340B program from the day prior to the start of the COVID-19 public health emergency (Jan. 31, 2020) and who subsequently lost eligibility during the cost reporting periods of 2020, 2021, and ending Dec. 31, 2022. Hospitals qualifying for the exception would be required to attest to the HHS Secretary that the reason for their loss of 340B eligibility was the result of “any actions taken by or other impact on such hospital in response to or as a result of the COVID-19 public health emergency that may have impacted the ability to meet the applicable requirement for the disproportionate share adjustment percentage.”
The omnibus appropriations bill would provide $1.5 trillion in discretionary spending for FY 2022. The package would fund various health-related agencies at the following levels, many of which reflect new investments in areas of interest for hospitals and health systems:
Separately, the legislation also would increase funding for the Food and Drug Administration (FDA) and the Federal Emergency Management Agency (FEMA):
If you have further questions, please contact AHA at 800-424-4301.