Tag: PAYGO

Omnibus Spending Bill Includes Major Health Policy Measures

Member News

After the MHA’s recent visits to Capitol Hill to advocate for year-end member priorities, Congress has reached a major deal on a year-end omnibus legislative package. The package includes health policy measures related to Medicare and Medicaid provisions, telehealth and hospital-at-home programs.

Lawmakers are blocking the implementation of the Statutory Pay-As-You-Go (PAYGO) sequester which would have required a 4% cut to Medicare payments. In addition, both the Medicare Dependent Hospital and enhanced low-volume adjustment programs are extended for two years. The Medicare hospital-at-home program and pandemic-era telehealth flexibilities are also extended for two years. There is a one-year delay in lab payment changes stemming from the Protecting Access to Medicare Act of 2014.

Regarding Medicaid, the package separates the enhanced federal medical assistance percentage (FMAP) and the Medicaid eligibility maintenance of effort from the declaration of the Public Health Emergency. Beginning in April, states may remove those who no longer qualify for Medicaid, regardless of when the COVID-19 public health emergency ends. The enhanced FMAP, currently a 6.2% addition to state Medicaid matching rates, is gradually phased out through 2023. These changes help fund a year of continuous coverage provisions for children at risk of losing health insurance and standardizing 12 months of postpartum coverage.

Passage of the final legislation is likely to happen by midnight on Dec. 23, 2022. The bill text is public, giving high likelihood to the healthcare provisions outlined above. However, there is a possibility for last-minute changes.

For more information about the year-end omnibus legislation contact Laura Appel at the MHA.

MHA Visits Capitol Hill with Member Hospitals for AHA Advocacy Day

Member News
MHA and Michigan hospital representatives pictured with Rep. John Moolenaar (R-Midland).
MHA and Michigan hospital representatives pictured with Rep. John Moolenaar (R-Midland).
MHA and Michigan hospital representatives pictured with Rep. John Moolenaar (R-Midland).

The MHA visited Capitol Hill in Washington DC last week to emphasize year-end priorities to Michigan’s congressional delegation.

The MHA and several hospital representatives met with House members and with U.S. Senator Debbie Stabenow to deliver the message that pending Medicare cuts are unsustainable and unacceptable. Memorial Healthcare CEO Brian Long joined the group to request prompt action to prevent the forthcoming 4% Statutory Pay-As-You-Go (PAYGO) sequester and extend or make permanent the low-volume adjustment and the Medicare-dependent hospital programs. Without an extension, these critical rural programs expire Dec. 16 and will reduce reimbursement to Michigan hospitals by more than $12 million annually. The MHA also pushed for making permanent the expansion of telehealth services and extending the hospital-at-home program. The members of the Michigan congressional delegation were receptive to these requests and generally expressed optimism that the pending Medicare reductions would be paused or even repealed.

The MHA also took part in both the American Hospital Association and Children’s Hospital Association advocacy briefings, which concurrently took place in DC. Both associations discussed their central priorities as the lame duck session nears its end and a new Congress prepares to enter Capitol Hill.

Members with questions about end of year priorities or future advocacy days on Capitol Hill may contact Laura Appel at the MHA.

Advocacy Continues to Defend Healthcare from Harmful Federal Policies

Member News

President Joe Biden Dec. 10 signed legislation to postpone several proposed cuts in Medicare rates recently approved by Congress. The MHA and the American Hospital Association had urged lawmakers to delay the cuts that would have taken effect Jan. 1 due to the pandemic-related financial pressures healthcare providers continue to experience. Provisions in the legislation include:

  • Eliminating the 2% Medicare sequester cuts from Jan. 1 to March 31, 2022. The legislation would also reduce the cut to 1% from April 1 to June 30, 2022. Absent future legislation, the 2% cuts will take effect July 1, 2022. The package is being funded by increasing the sequester percentage in 2030.
  • Halting the 4% statutory Pay-As-You-Go (PAYGO) sequester for 2022 and adding them to the “2023 scorecard.” This will require additional advocacy with the Congress in late 2022 to eliminate these cuts again.
  • Mitigating the 3.75% payment cut to the Medicare physician fee schedule (PFS) payments finalized for calendar year 2022 by implementing a one-year 3% increase to the PFS conversion factor.
  • Delaying the Clinical Laboratory Fee Schedules cuts for one year, from Jan. 1, 2022, to Jan. 1, 2023. The requirements that certain hospital laboratories report their private payer clinical laboratory test codes, payments and volume data are also delayed.
  • Delaying implementation of the Radiation Oncology Model finalized in the 2022 Medicare outpatient prospective payment system final rule from Jan. 1, 2022, to Jan. 1, 2023.

Despite the limits on visiting Capitol Hill due to the COVID-19 pandemic, the MHA is continuing its work with the Michigan delegation using virtual connections to protect hospitals and other providers from detrimental payment cuts and other healthcare policies. Members with questions regarding payment implications should contact Vickie Kunz at the MHA, while questions regarding advocacy efforts should be addressed to Laura Appel at the MHA.