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4 healthcare issues to watch as Congress faces a funding deadline next month

Congress is working to avert a government shutdown on Dec. 11, and providers are lobbying to ensure several of their healthcare policy priorities are addressed.

When lawmakers most recently extended the government funding deadline in September, they included one of providers’ top priorities by relaxing repayment terms for COVID-19 Medicare loans. Providers see several opportunities for getting other key policies included in Congress’ next must-pass bill.

Extend Medicare sequester suspension

Congress suspended sequestration cuts to Medicare in its third and largest COVID-19 stimulus package in March. While some policies that gave relief to providers are tied to the HHS secretary’s public health emergency declaration, a suspension of Medicare sequestration cuts expires at the end of 2020. Hospitals have argued that funds shouldn’t be cut now, as providers are simultaneously bracing for more surges and preparing to distribute vaccines in the coming months.

Physician fee schedule cuts

Medicare pay cuts for specialty physicians are set to go into effect Jan. 1, and providers are scrambling to head them off. Providers are pushing for Congress to waive budget-neutrality requirements so primary-care physicians can still receive boosted payments without requiring corresponding cuts for specialty physicians. A Senate GOP aide said it’s unlikely lawmakers will grant a full budget-neutrality waiver, as they would have to tack more cost-saving measures onto the package to pay for the changes. CMS could still make changes when it finalizes the policy, but the aide said lawmakers are skeptical CMS will address the issue.

Healthcare extenders

Funding for several Medicare and Medicaid programs also expires on Dec. 11, including a suspension of cuts to Medicaid disproportionate-share hospital payments. Ongoing funding for community health centers is also at stake, and it remains to be seen how long Congress will push the funding deadline. The package has been repeatedly bumped during 2020 as lawmakers had hoped to build consensus on reform to prescription drug costs and surprise medical bills, but legislation on both issues has stalled. The new extension date could set the pace for healthcare policymaking in 2021.

Stimulus bill

Lawmakers have failed to reach a compromise on another comprehensive COVID-19 relief package for months, but important benefits are expiring in December as portions of the country reinstate pandemic restrictions. President-elect Joe Biden has met with Democratic congressional leaders in recent days, which could change the political dynamic. If lawmakers aren’t able to reach agreement in 2020, a deal will likely have to wait until after results are tabulated in two Georgia Senate runoffs scheduled for early January that will determine control of the upper chamber. It’s unclear which policies both sides could agree on, but a deal could mean more funding for COVID-19 testing and tracing, vaccine distribution, and state and local governments.


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