Medicaid Eligibility Checks, Pandemic Prep in Omnibus Bill (2)

Medicaid eligibility checks are slated to start again in April under a proposed government spending package that also includes a slate of health policy riders, according to bill text released early Tuesday.

The bill also includes provisions to boost the country’s pandemic response and improve the Food and Drug Administration’s oversight over medical products. The proposal comes as lawmakers near a Dec. 23 deadline to pass a sweeping government funding package.

“This is significant headway compared to the status quo that we were dealing with,” Sen. Ron Wyden (D-Ore.), chairman of the Senate Finance Committee, said on the health policy riders included in the omnibus bill.

Medicare physician pay would be cut by 2% beginning in January 2023 under the measure. The cuts would increase to 3.5% in 2024.

Physicians groups responded to earlier reports on the measure Monday by warning it could hurt Medicare patients and doctors’ practices.

“We are deeply worried that many practices will be forced to stop taking new Medicare patients: at a time when access to care is already inadequate,” Jack Resneck Jr., president of the American Medical Association, said. “Congress must immediately begin the work of long-overdue Medicare physician payment reform that will lead to the program stability that beneficiaries and physicians need.”

Read More: Congress Plans Funding Boost, No Abortion Changes in Omnibus

Telehealth, Mental Health

One bonus for doctors: Covid-era telehealth flexibilities, which have expanded online medical appointments in recent years, would be extended for two years under the spending bill. There’s also a slate of mental health and addiction bills in the package that will make it easier for doctors to prescribe addiction medication and expand federal mental health programs.

Earlier: Addiction, Mental Health Deal Gets Push as Time Ebbs in Congress

Proposals hitching a ride on the omnibus government funding bill include an agreement to allow states to restart Medicaid eligibility checks at the beginning of April. These checks have been halted since the beginning of the Covid pandemic and were expected to resume when the declared public emergency on the virus ended. Their resumption is expected to lead to millions of people losing Medicaid coverage.

Allowing Medicaid re-determinations, as they’re called, would save the federal government billions of dollars and were included in the package to offset the cost of expanding Medicaid coverage of women postpartum and extending the Children’s Health Insurance Program for another five years.

A bipartisan package of reforms seeking to improve how the country prepares for the next pandemic is also in the package. That proposal, from a Senate bill (S. 3799), would set up a mission control in the White House to coordinate the federal response to outbreaks and require Senate confirmation of the Centers for Disease Control and Prevention director. Lawmakers agreed to remove from the package a provision requiring a sweeping nonpartisan analysis of the nation’s Covid response.

Earlier: Time Running Out to Prepare for Next Pandemic, Lawmakers Warn

Drops Diagnostics Tests

The FDA will get tools to boost its oversight, but the package Tuesday didn’t include long-sought changes to how diagnostic tests are regulated.

The Verifying Accurate Leading-Edge IVCT Development, or VALID, Act would have created a new category of medical products called in-vitro clinical tests, allowing the FDA to oversee tests regardless of whether they came from clinical laboratories or from commercial companies. The medical device industry has embraced the FDA’s proposal, but the clinical lab industry decried it as double regulation, since labs must comply with the Clinical Laboratory Improvement Amendments, which the Centers for Medicare & Medicaid Services administer.

The legislation, which was previously included in a Senate health committee proposal to reauthorize industry user fees to the FDA, had been a longtime goal of retiring Sen. Richard Burr (N.C.), the top Republican on the committee. Congress ultimately reauthorized user fees for fiscal 2023 through 2027, which fund roughly half of the FDA’s budget, in a stopgap funding measure earlier this year that didn’t include any broader policy changes.

Lawmakers also gave physicians a break on Medicare cuts for 2023.

Physicians were facing a Medicare payment reduction of nearly 8.5% beginning Jan. 1, on top of the 2% Medicare payment cut phased back in this year. The spending bill will offset much of that, bringing the expected reduction of Medicare cuts to physicians down to 2%. Lawmakers also waived rules requiring cuts to federal programs including Medicare prompted by previous federal spending, known as PAYGO.