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Healthcare Orgs Respond to $900B COVID Stimulus Package, Surprise Billing Legislation

Analysis  |  By Jack O'Brien  
   December 22, 2020

The year-end omnibus appropriations package had several key healthcare provisions included in it.

The House of Representatives and Senate passed a $900 billion coronavirus relief package Monday night, which President Donald Trump is expected to sign Tuesday.

The year-end omnibus appropriations package had several key healthcare provisions, including funding for coronavirus testing, changes to the Provider Relief Fund, and other policy adjustments not related to the pandemic.

Below are collected responses from key healthcare organizations and several industry stakeholders.

AHA: 'More must be done'

The American Hospital Association thanked Congress for the "welcome news for patients and their families" while also calling on federal lawmakers to address outstanding issues facing provider organizations.

"While we thank Congress for the additional support and relief this bill provides to hospitals and health systems, we continue to believe that more must be done to aid our response to the pandemic," the AHA said in a statement.

According to the AHA, the most important changes included in the bill are the elimination of cuts to the Medicaid disproportionate share hospital program for the next three years, additional flexibility and "modest additional funding" for hospitals through the Provider Relief Fund, the elimination of surprise billing, and investments in rural healthcare through the Rural Emergency Hospital legislation.

Prominent healthcare associations weigh in

The Federation of American Hospitals (FAH) called the $900 billion stimulus package "mission critical" as millions of Americans struggle through the ongoing pandemic.

"The bill throws a lifeline to caregivers by continuing the pause in the two percent Medicare sequester, and making adjustments to buffer the impact of an ill-conceived change in physician payments during a pandemic. It also includes an important delay of harmful Medicaid cuts for hospitals, which are part of the safety net for our most vulnerable patients," Chip Kahn, CEO of FAH, said in a statement. "Additionally, this bipartisan legislation assures that patients never again have to worry about receiving a surprise medical bill. The deal defines and limits patient cost sharing, while allowing for payment disputes between payors and providers to be settled reasonably – without arbitrary rate setting."

The FAH did say that the bill "falls short" on funding for the Provider Relief Fund and that it hopes Congress will revisit the issue in 2021.

In a statement released prior to the House's vote on the legislation, Beth Feldpush, DrPH, senior vice president of policy and advocacy at America's Essential Hospitals (AEH), said the bill offered "urgently needed relief" for providers.

"We thank lawmakers for using this legislation to avert disastrous Medicaid disproportionate share hospital (DSH) payment cuts, including by eliminating a $4 billion cut in fiscal year 2021 and delaying subsequent reductions for two additional years. These cuts would destabilize essential hospitals and threaten access to care as they grapple with the ongoing and intense public health crisis."

The Association of American Medical Colleges (AAMC) praised the inclusion of support for expanded Medicare graduate medical education positions in the bill.

"The provision to increase federal support for residency training will end a nearly 25-year freeze by lifting the arbitrary cap on Medicare funding for graduate medical education (GME) and adding 1,000 new Medicare-supported GME positions at both rural and urban teaching hospitals," David J. Skorton, MD, CEO of AAMC, said in a statement. "It will help to ensure that more physicians are able to care for patients and improve the health of communities across the nation."

Additionally, the American Society for Radiation Oncology (ASTRO) commended Congress for including a provision that delays the start of the Radiation Oncology Advanced Payment Model (RO Model) until January 1, 2022. 

In mid-October, CMS Administrator Seema Verma announced that the agency intended to delay the RO Model until July 2021.

"By driving essential reforms in the RO Model, bipartisan congressional leaders have once again demonstrated impressive support for cancer patients and radiation oncology," Thomas J. Eichler, MD, FASTRO, chair of the ASTRO board of directors, said in a statement. "ASTRO applauds Congress for responding to the radiation oncology community’s needs by including an RO Model delay in the critical year-end COVID-19 stimulus package."

House Energy and Commerce Committee praises Inclusion of No Surprises

Like several healthcare organizations, leaders of the House Energy and Commerce Committee, Chairman Frank Pallone, Jr. (D-NJ), and Ranking Member Greg Walden, (R-Ore.) praised the inclusion of the No Surprises Act.

"This is a historic day for patients and their families who will soon be protected from surprise medical bills, correcting a clear market failure that has burdened millions of patients with crushing medical debts through no fault of their own," Pallone and Walden said in a statement.

Meanwhile, Action for Health, a 501(c)4 nonprofit dedicated to "eliminating surprise medical bills the right way," criticized the inclusion of the No Surprises Act in the omnibus package.

Action for Health stated that three key issues: independent dispute resolution (IDR) factors, IDR initiation, and IDR lock-out, were not properly addressed in the bill.

"We see today's inclusion of the No Surprises Act in the year-end deal as the ending of the beginning. This is extremely consequential legislation, and we applaud the changes that have been made. Now with patients out of the middle and healthcare extenders paid for, it's time to start fine tuning the remaining flaws."

ACHP, Premier applaud congressional action

Finally, both the Alliance of Community Health Plans (ACHP) and Premier Inc. commended Congress for the bipartisan relief bill.

"ACHP appreciates Congressional efforts to improve care and coverage for seniors, many who are most vulnerable to the impact of COVID-19," Ceci Connolly, CEO of ACHP, said in a statement. "We applaud the improved access to Medicare’s mental health services via virtual care and look forward to working with Congress to extend telehealth flexibility and permanency across the entire Medicare program. In addition, at a time when health care expenses are historically high, we appreciate maintaining robust benefits for seniors and supporting primary care providers by temporarily halting the harmful sequester reductions."

Premier praised the temporary freeze of alternative payment model payment incentive thresholds for two years and addressing surprise billing through the arbitration process rather than through rate-setting.

"Premier also supports the three-month hold on sequestration cuts, and changes to the Provider Relief Fund reporting requirements, which will help alleviate the financial stress caused by the unparalleled strain on hospitals and other healthcare providers," Blair Childs, senior vice president of public affairs at Premier, said in a statement. "While we are thankful for the $3 billion added to the Provider Relief Fund, we are hopeful that lawmakers will act in the next Congress to provide additional relief to providers."

Jack O'Brien is the Content Team Lead and Finance Editor at HealthLeaders, an HCPro brand.


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