Within the normal news cycle, legislation often gets ignored, especially in this hyper volatile election cycle we have begun. I’m expecting very little in terms of reform or new legislation on important healthcare issues to come forward, and, so far, I’m right. With near gridlock due to small opposing majorities in both houses of Congress, compromise will be kicking the same can down the road, a bit more. In other words, patches until a later period is about all that will get done.
Last week, there were a few legislative pieces that surfaced but again, most folk probably never heard news of their arrival or passage. Spending bills are the issue right now as a budget and a larger appropriation bill that normally accompanies some sort of budget legislation doesn’t exist and won’t this year. These larger packages are known as omnibus spending bills (covering everything). What we saw last week, and the President signed this weekend was a “mini-bus” spending bill. A start.
The mini-bus was a $460 billion spending bill that included a few healthcare pieces worth noting. The bill text is available here: HMS31169
- Stops the physician pay decrease implemented in the 2024 Medicare Physician Fee Schedule final rule by providing a 1.68% bump that, combined with an earlier increase from the end of 2023, totals a 2.93% payment increase that will run through the end of the year. More on the final rule for the fee schedule is available here: https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2024-medicare-physician-fee-schedule-final-rule
- An $8 billion-per-year cut to Medicaid disproportionate share hospital program payments that has been repeatedly pushed back by lawmakers would again be pushed back, this time to Jan. 1, 2025. Federal law requires that state Medicaid programs make Disproportionate Share Hospital (DSH) payments to qualifying hospitals that serve a large number of Medicaid and uninsured individuals. Certain rural and urban hospitals benefit from these payments.
- Hospitals stand to gain from an extension of the higher inpatient payment adjustment for low-volume hospitals and the Medicare-dependent Hospital program. To qualify as a Medicare Dependent Hospital, a hospital must be located in a rural area, have 100 or fewer beds, not be classified as a sole community hospital, and have had at least 60 percent of its inpatient days or discharges attributable to Medicare beneficiaries.
- Included in the signed legislation is $270 million in new funding for community health centers. The money is backdated to the beginning of the current fiscal year (10/1/23) and brings community health center total funding to $4.27 billion annually.
In a bill that will likely stall in the Senate, the House Ways and Means Committee approved a bill to go to the full Congress that would kill that SNF staffing mandate. Recall, skilled nursing facilities would have three years to provide a minimum of 3.0 hours per patient day of direct care under the proposed staffing mandate. The text of the bill is available here: H.R.-7513
Last week, I wrote about the American Health Care Association’ state of the nursing home industry report. That post is here: https://rhislop3.com/2024/03/07/penn-and-teller-and-the-disappearing-snf/ The comments from Ways and Means Committe Chair Jason Smith in a press release, cite data from this report. His comments are available here: https://waysandmeans.house.gov/chairman-smith-opening-statement-markup-of-health-care-legislation-and-budget-views-estimates/
Stay tuned for future updates as they come forth. Don’t expect a big release but more dribs and drabs like we saw this past week.