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Health Provisions and Achievements in End of Year Package

December 21, 2020
  • Ending surprise medical bills when you visit the ER or have a scheduled medical procedure, and, for the first time, requiring that patients be given a true and honest medical bill in advance of scheduled procedures, so patients know what to expect.
  • Medicare Extenders: Extends funding for critical Medicare programs related to quality measurement, assistance for low-income programs, and demonstration programs for three years.
  • Improving Support for Rural and Underserved Health Care: The needs of rural and underserved communities are prioritized in this package. Policies include:
    • Helping save rural hospitals by letting them become a new Rural Emergency Hospital, which gives them the Medicare funding and flexibility to offer health care services their community needs.
    • Extending payments to help physicians in areas where labor cost is lower than the national average.
    • Dedicating funding to train new doctors at rural and underserved medical schools.
    • Giving greater flexibility for rural and urban hospitals to partner and address the physician workforce needs of rural areas.
    • Reforming, in a comprehensive way, how Rural Health Clinics (RHCs) are paid.
    • Allowing RHCs and Federally Qualified Health Centers (FQHCs) to furnish and bill for hospice attending physician services when their patients become terminally ill and elect the hospice benefit.
    • Extending the Rural Community Hospital Demonstration and Frontier Community Health Integration Project demonstrations five years.
  • Helping local doctors survive the COVID pandemic by increasing their pay and stopping planned Medicare cuts.
    • To respond to specialists’ and other providers practicing in the Medicare program concerns about the effects of the CY 2021 physician fee schedule’s budget neutrality rules, the package includes a suite of mitigation provisions that benefit both them and all providers in the Medicare program.
    • First, the bill blocks a new code created by the rule for three years, which is projected to mitigate these cuts by a third.
    • Second, the bill injects $3B into the physician fee schedule in 2021, resulting in payment increases across the board. This will help all Medicare providers during the ongoing COVID-19 pandemic.
    • Third, the bill continues the current APM thresholds for two additional years, allowing more providers to qualify for the 5 percent APM payment who would otherwise have been disqualified because of statutory increases in threshold amounts.
    • Finally, the bill delays the 2 percent sequester cuts that were supposed to resume January 1, 2021, for three additional months. Together, these policies will greatly benefit all providers during the pandemic and mitigate at least two-thirds of the cuts to certain providers due to Medicare budget neutrality requirements.
  • Further Medicare Policies and Reforms: The end of year legislation contains a slew of Medicare priorities for House Republicans to improve the care of beneficiaries including permanent telehealth access to mental health services, nursing home improvement, drug coverage for kidney transplant recipients, hospice reform, and payment accuracy for Medicare Part B drugs.

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