Congress' last-minute $1.7 trillion omnibus package: 8 healthcare takeaways What makes reading the proposed bill difficult are the many subclauses that begin “Provided further…”
With that caveat, here are a few more provisions [the health content, except 1. below, start on page 989]:
1. There is hereby appropriated $2,000,000, to remain available until expended, for the Secretary of Agriculture to carry out a pilot program that assists rural hospitals to improve long-term operations and financial health by providing technical assistance through analysis of current hospital management practices.
2. $60,000,000 shall remain available until expended for grants to public institutions of higher education to expand or support graduate education for physicians. Preference will be given to areas with greatest need for primary care.
3. For carrying out titles III, XI, XII, and XIX of the PHS Act with respect to maternal and child health and 24 title V of the Social Security Act, $1,171,430,000.
4.For carrying out the program under title X of the PHS Act to provide for voluntary family planning projects, $286,479,000: Provided, That amounts provided to said projects under such title shall not be expended for abortions, that all pregnancy counseling shall be nondirective, and that such amounts shall not be expended for any activity (including the publication or distribution of literature) that in any way tends to promote public support or opposition to any legislative proposal or candidate for public office.
5. For payment to the Federal Hospital Insurance Trust Fund and the Federal Supplementary Medical Insurance Trust Fund, as provided under sections 217(g), 1844, and 1860D–16 of the Social Security Act, sections 103(c) and 111(d) of the Social Security Amendments of 1965, section 278(d)(3) of Public Law 97–248, and for administrative expenses incurred pursuant to section 201(g) of the Social Security Act, $548,130,000,000. [Medicare Parts A and B]
6. 1. PUBLIC HEALTH PREPAREDNESS AND RESPONSE For carrying out titles II, III, and XVII of the PHS Act with respect to public health preparedness and response, and for expenses necessary to support activities related to countering potential biological, nuclear, radiological, and chemical threats to civilian populations, $883,200,000.
About health insurance/insurers
Medicare Part B Spending on Lab Tests Increased in 2021, Driven By Higher Volume of COVID-19 Tests, Genetic Tests, and Chemistry Tests “Medicare Part B spending on laboratory (lab) tests increased by $1.3 billion in 2021, from $8.0 billion in 2020 to $9.3 billion in 2021. The 17-percent increase was the biggest change in spending since OIG began monitoring payments in 2014. The increase in spending in 2021 resulted from higher spending in three groups of tests: COVID-19 tests, genetic tests, and chemistry tests…”
New Poll of American Workers Reveals Tremendous Value Placed on Workplace Health Benefits “Ninety-three percent of respondents said they were satisfied with their insurance:
54% said they were “highly satisfied;”
87% called their plans affordable; and,
More than 70% agree their health insurance is worth what they pay for it.
When provided with a list of words to describe their coverage, respondents’ top three choices were:
Affordable,
High-quality, and
Comprehensive.”
Providers Did Not Always Comply With Federal Requirements When Claiming Medicare Bad Debts “Providers sought reimbursement of nearly $10 billion for Medicare bad debts on their cost reports with cost reporting periods ending during Federal fiscal years 2016 through 2018. Federal regulations state that Medicare is to reimburse providers 65 percent of deductible and coinsurance amounts for Medicare beneficiaries that remain unpaid (1) after the provider has made a reasonable effort to collect, (2) the debt was uncollectible, and (3) there was no likelihood of future recovery based on sound business judgment (‘Medicare bad debts’)…
Providers did not always comply with Federal requirements when claiming Medicare reimbursement for Medicare bad debts. Of the 148 Medicare bad debts in our nonstatistical sample, 86 were associated with beneficiaries whom providers had deemed indigent and for whom, therefore, no reasonable collection efforts were required. Providers did not comply with Federal requirements when claiming 18 of the remaining 62 Medicare bad debts. We identified four additional bad debts for which the amounts that providers claimed did not reflect the amounts owed by the beneficiaries. These 22 bad debts resulted in a total of $29,787 in unallowable Medicare reimbursement. The Centers for Medicare & Medicaid Services (CMS) inappropriately reimbursed these amounts because the Medicare administrative contractors (MACs) did not concentrate on reviewing bad debts when performing audits of cost reports during our audit period.”
About pharma
New compound shows promise in reversing dangerous fentanyl effects “…a lab at the University of Maryland has developed a new drug that shows early promise in reversing the effects not only of fentanyl, but methamphetamine as well—and potentially a whole host of other substances, too. The researchers described their findings in a study published Dec. 15 in Chem.”
CVS, Walgreens limit purchases of children’s pain-relief medicine “Increased demand has led CVS and Walgreens to limit purchases of children’s pain-relief medicine, the companies confirmed to CNN on Monday.
CVS is restricting both in-person and online purchases to two children’s pain relief products. Walgreens has limited online purchases to six over-the-counter fever reducers per transaction, but it does not have an in-store purchase limit.”
About the public’s health
Trends in Delivery Hospitalizations with Pregestational and Gestational Diabetes and Associated Outcomes: 2000-2019 “Pregestational diabetes increased over the study period, driven by a quadrupling in the prevalence of T2DM. Notably, the prevalence of chronic diabetes complications doubled concomitantly. Pregestational diabetes was associated with a range of adverse outcomes. These findings are further evidence that pregestational diabetes is an important contributor to maternal risk and that optimizing diabetes care in women of childbearing age will continue to be of major public health importance.”
Biden administration doesn’t appeal Texas court loss on LGBTQ protections “The Biden administration did not appeal a recent court loss in Texas regarding federal LGBTQ protections, a decision Attorney General Ken Paxton is celebrating as a win.
On October 1, U.S. District Court Judge Matthew Kacsmaryk declared unlawful two pieces of federal guidance: one that said the Affordable Care Act protects transgender patients’ access to gender-affirming care; and another that said employment protections for gay and transgender workers extend to policies like dress code, as well as what pronouns and bathrooms they use.”
About healthcare IT
Carta Healthcare Survey Reveals 83% of Patients Had to Provide the Same Health Information, or Duplicate Health Information, at a Doctor’s Office “Eighty-three percent of respondents reported they had to provide the same health information or duplicate forms with each appointment. Almost three-quarters of those surveyed reported completing more than two duplicate documents, and 42% said they spent 6 minutes or more recounting past medical history at every appointment. These results indicate that medical history is not shared between systems or displayed in a time-efficient manner. One in five respondents said having to repeat forms at a doctor’s office makes them less likely to return, which may impact healthcare costs since regular examinations and preventive care are less expensive than urgent care.”
New HIPAA rule from CMS would streamline transactions with attachments, e-signatures “The Centers for Medicare and Medicaid Services on Monday put forth a new proposed rule that would modify HIPAA to better support both claims and prior authorization transactions – providing standards for electronic signatures to be used in conjunction with healthcare attachments transactions…
If finalized, it would promote standards adoption for transactions with attachments for prior authorizations, including medical charts, X-rays and provider notes that document physician referrals. The modifications to HIPAA would also include a standard for the referral certification and authorization transaction.
The proposed rule could save $454 million a year in administrative costs, according to CMS, and is another instance of the agency's efforts to reduce paperwork burdens and streamline provider and patient experience.”
About health technology
FDA Approves First Gene Therapy for Specific Form of Bladder Cancer “The FDA has approved Ferring’s gene therapy Adstiladrin to treat adults with high-risk Bacillus Calmette-Guérin-unresponsive non-muscle-invasive bladder cancer — the first gene therapy approved for this patient population...
Adstiladrin (nadofaragene firadenovec-vncg) is administered through a catheter into the bladder once every three months.”