Congress Wraps up 2021, Develops Agenda for 2022
Congressional leaders took care of several priority issues that they needed to handle before the end of the year. Among these challenges were Fiscal Year 2002 spending, debt-limit increase, and Medicare provider cuts. Congressional Democrats were also hoping to use the budget reconciliation process to pass President Biden’s tax and spending measure known as the Build Back Better Act.
With regard to appropriations, Congress has yet to pass a majority of the FY 22 appropriations measures to fund government programs in 2022. However, On Dec. 3, President Joe Biden signed the Further Extending Government Funding Act (H.R. 6119), a continuing resolution (CR) that extends funding for federal agencies at FY 2021 levels through Feb. 18, 2022. Congress will need to act again before Feb. 18th or face a government shutdown.
Congress also passed legislation, which President Biden has signed, to avert large cuts that were looming for Medicare providers in 2022. The bill, the Protecting Medicare and American Farmers from Sequester Cuts Act provides delays in the Medicare sequestration cuts for 2022 and increases the rates under the Medicare Physician Fee Schedule (PFS). The bill delays the resumption of the 2% Medicare sequester for three months (Jan. 1–March 31, 2022), followed by a reduction to 1% for three months (April 1–June 30, 2022), while also providing a one-year increase in the Medicare physician payment schedule of 3%.
President Biden and Congressional Democrats have been working for months to garner support for their social tax and spending plan to be passed through the budget reconciliation process, which requires no support from Republicans in the evenly divided Senate. This strategy relied on getting moderate Democrats such as Sen Joe Manchin (D-WV) on board. Manchin has expressed concerns over the last several months with the size and scope of the package and in December stated that he would not support the legislation, leaving President Biden without enough support from Democrats to pass the bill.
Looking forward to the Second Session of the 117th Congress, we are expecting Congress/Administration to take additional action on Medicare Physician Payment. As mentioned earlier, Congress needed to step in for the second straight year in order to save Medicare from drastic cuts to physician payment. For 2022, Congress only was able to push through a partial reduction for the year, and no long-term solution to annual payment cuts were considered. There is a growing desire in Congress, however, to pursue a long-term solution to make Medicare payment more stable, and we are expending a series of Congressional hearings on this issue in 2022.
In addition, decisions will have to be made with regard to the extension of the public health emergency. The U.S. Department of Health and Human Services (HHS) extended the federal public health emergency on Jan. 14, 2022. This is the eighth time the declaration has been extended since it was announced Jan. 27, 2020. Federal declarations cannot be extended for more than 90 days at a time. It is possible at some point in 2022 the deceleration could end and that would mean the end to a number of waivers in health care policy that have been enacted during the declaration. Policy makers would have to make a decision on the fate of some of new policies (including telehealth and scope of practice expansions) that have been make temporary during the pandemic.
Finally, the No Surprises Act went into effect on Jan. 1, 2022, and several major provider organizations, including the American Medical Association and American Hospital Association, have sued HHS over their interpretation of the law in its final rule, suggesting the final rule did not follow congressional intent when outlining the arbitration process. The law aims to protect patients from being unknowingly billed by out of network providers. Its possible Congress could step in to resolve the dispute but likely not until the courts have made, at least, an initial ruling.