Omnibus Spending Bill Summary & Potential Changes

January 23, 2023

At the end of last year, President Joe Biden signed the omnibus spending bill — a $1.7 trillion bill that he claimed...

At the end of last year, President Joe Biden signed the omnibus spending bill — a $1.7 trillion bill that he claimed in a Twitter post would “invest in medical research, safety, veteran healthcare, disaster recovery, VAWA funding—and [get] crucial assistance to Ukraine.”

As this bill is considerable in its length and scope, it will take several weeks to fully understand the implications of many aspects of this bill. However, while there are a considerable number of details that still need to be worked out, some of the bill’s many provisions already have clear implications for the healthcare industry.

In this piece, we’re going to perform a brief overview of what we currently know about how the new omnibus spending bill will affect the healthcare market, including a summary of the provisions laid out in the bill and a few specific changes that we can expect to experience in the coming months.

First, some of the concerns outlined in our previous posts have been addressed by this bill. For example, in multiple posts, we expressed concern about the scheduled 4.47 percent cut for calendar year 2023. According to this omnibus spending bill, there will be a partial relief for these cuts, meaning that there will only be a 2.08% cut from the 2022 conversion factor.

Furthermore, we had also previously discussed the 4% PAYGO Cut for Medicare Payments. Previously, Congress had passed a law that required automatic payment cuts of 4% if, over the course of five or ten years, a germane bill is projected to create a net increase in the deficit. Despite the rules of this PAYGO cut being triggered several times over, it has never been put into practice. Thanks to the provisions of the omnibus spending bill, this delay will continue, with the omnibus bill itself providing two years of relief from the possibility of a 4% cut.

One of the many areas that caused concern in discussions of proposed changes to the government's healthcare spending was the discussions surrounding telehealth.

When the pandemic first broke out, telehealth options were expanded to allow those seeking relevant urgent care to be able to quickly consult with a doctor.

Even though fears around the pandemic have largely subsided, telehealth has become an integral part of modern healthcare practice. Despite this, industry professionals held concerns that new legislation on the topic may ignore this increase in telehealth offerings, or do away with the recent expansions made to telehealth altogether owing to the possible expiration of the Public Health Emergency (PHE).

Thankfully, it seems that these fears have a little more time before they are realized. Part of the new omnibus spending bill extends telehealth provisions through the end of 2024, giving professionals nearly two full years to further utilize and share the benefits of these telehealth services.

Additionally, certain provisions surrounding telehealth have broadened in scope, making it easier for patients to receive care.

As part of the bill, geographic requirements were removed and originating sites were expanded. This means that beneficiaries can continue to receive telehealth services at any site regardless of type or location; for example, under the new provisions, a patient would be able to receive care from their home. The number of practitioners eligible to furnish telehealth services has also been expanded, including expanding telehealth services for federally-qualified health centers and rural health clinics, and allowing for the furnishing of audio-only telehealth services.

As telehealth services continue to be expanded, a portion of the bill is devoted to studying how these services and others implemented during the pandemic work in practice. If the evaluation is positive, there is a possibility that they will be given a full endorsement and inclusion into Medicare, rather than the provisional approval they enjoy now.

These are just a few details of the omnibus spending bill, but there are numerous other aspects that are of great importance to the healthcare industry. Over the course of the next few months, we’ll continue to share the important provisions of this bill and how we anticipate they will impact the healthcare market.

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