Lawmakers reached a deal Saturday evening to extend expiring healthcare programs, lobbyists close to the issue said. The package, floated Friday, is more robust than lobbyists expected.
The extensions in the package won’t be final until the House and Senate vote on the package this week.
The healthcare package includes a 2.5% payment boost for Medicare physicians for one year. The bump would counteract the 2.8% pay cut finalized in the Medicare physician fee schedule in November.
In a surprise win for commercially insured patients, the package includes a two-year extension of pre-deductible telehealth coverage for high deductible health plans linked to health savings accounts. In a version of the package circulated Friday morning, high deductible telehealth coverage was only extended for one year.
As expected, the final package also includes a two-year extension of Medicare telehealth flexibilities like expanding geographic and originating sites and allowing more provider types to bill for telehealth visits.
The healthcare package includes a five-year extension of the hospital-at-home waiver program that CMS has offered since the beginning of the COVID-19 public health emergency.
The House is expected to vote on the package early this week, and the Senate will vote later this week, if all goes according to plan.
Members of Congress have yet to reach a deal on a short-term continuing resolution (C.R.) that is expected to fund the government for 90 days. The government will run out of funding on Friday, December 20.
Lawmakers are in the throes of negotiating an end-of-year legislative deal before the government runs out of funding Dec. 20.
Telehealth lobbyists that spoke with Fierce Healthcare fielded phone calls throughout the day Thursday with conflicting information, 180-degree turnarounds and party leaders leaving the negotiating table for reasons that were unclear.
Even at the American Telemedicine Association’s policy conference, which was swarming with government affairs professionals and lobbyists, stakeholders were struggling to get on the same page on the latest updates on the negotiations occurring throughout the day.
Congressional staffers have told lobbyists that a deal will be reached by the end of the weekend so the House and Senate can vote on the deal before government funding expires next Friday, Dec. 20.
The latest healthcare deal, circulated among lobbyists Friday morning, is seen as solid and unlikely to change through the weekend, people who received the memo told Fierce Healthcare.
The package includes a two-year extension of Medicare telehealth flexibilities and a one-year extension of pre-deductible coverage of telehealth for high-deductible health plans linked to health savings accounts. The package also is likely to include a five-year extension of the Centers for Medicare & Medicaid Services’ hospital-at-home waiver.
As of Friday morning, the deal also included a physician pay bump and an alternative payment model bonus; funding for community health centers; a five-year reauthorization of the Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act; a one- to two-year reauthorization of the Pandemic and All-Hazards Preparedness Act; and the Medicare Multi-Cancer Early Detection Screening Coverage Act.
The memo notes that transparency in health plan coverage could be included but that hospital transparency will not. Other expiring health programs are likely to be extended by a year.
The major offsets that Congress will use for the package are a five-month extension of the Medicare sequester, commercial pharmacy benefit manager transparency (PBM), banning Medicaid PBM spread pricing and Medicare Part D delinking, among others.
It seems as though House and Senate leaders have come to an agreement on a wide-ranging end-of-year healthcare package, but the deal could still fall apart.
Congress must pass a continuing resolution to fund the government by Dec. 20. The C.R. is likely to fund the government for 90 days, through March. The C.R. is separate from the health package, but, in the event that a healthcare deal falls apart, expiring healthcare programs may also be extended for 90 days as part of the C.R.
Lobbyists say this scenario is no longer the most likely, but Congress should come to a decision over the weekend.