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House passes CR, Medicare Loan Fixes, Health Extenders

September 25, 2020

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CONTACTS
Christa Wagner, Senior Legislative Analyst
Allyson Perleoni, Senior Legislative Analyst
Brett Roude, Legislative Analyst
Jason Kleinman, Senior Legislative Analyst, Govt. Relations

The House of Representatives passed a continuing resolution (CR) on Sept. 22 which would extend current government funding through Dec. 11, address challenges with the Medicare Accelerated and Advanced Payment Programs (MAAP), and extend funding for certain health programs.

The vote to avoid a government shutdown comes in advance of the Sept. 30 end to the fiscal year (FY).

The Continuing Appropriations Act, 2021 and Other Extensions Act (H.R. 8337) was passed by a bipartisan vote of 359-57  and would temporarily fund the government at FY 2020 levels. Following House passage, the Senate agreed on Sept. 24 on the motion to proceed to final consideration by a vote of 93-2, with a vote on final passage of the bill expected on Sept. 29.

The continuing resolution as passed by the House does not include additional supplemental emergency funds for public health agencies to combat the COVID-19 pandemic or other COVID-related relief or policies. The AAMC joined members of the higher education community in a Sept. 25 letter to House Speaker Nancy Pelosi (D-Calif.) urging Congress to include at least $26 billion in relief to research agencies in the next COVID-19 emergency supplemental, following reports that House committee leaders are working on a slimmed down version of the Health and Economic Recovery Omnibus Emergency Solutions (Heroes) Act, (H.R. 6800) [see Washington Highlights, May 15].

“COVID-19 has caused enormous disruptions to federally supported research and inflicted serious and detrimental impacts on our nation’s research enterprise. The relief that we are requesting would make significant strides in avoiding long-term and devastating impacts to federal research and its workforce which underpins the ability of our nation’s patients, doctors, innovation and energy industries, and farmers, ranchers, and fishers to have access to globally-competitive, American innovations,” the letter says.

The Ad Hoc Group for Medical Research, convened by the AAMC, also issued a Sept. 25 statement thanking the House for its efforts to avoid a shutdown while addressing the ongoing need for emergency supplemental relief to support medical research progress funded by the National Institutes of Health (NIH).

“We remain extremely concerned that funding for medical research supported by the NIH, the world’s premier biomedical research agency, remains in limbo despite ongoing challenges caused by the COVID-19 pandemic,” the statement says. “The Ad Hoc Group urges lawmakers and the Administration to include much needed emergency funding for NIH in the next COVID-19 relief package and to complete a robust FY 2021 appropriation for the NIH as quickly as possible.”

The CR does include language allowing the NIH to provide no-cost extensions to specific multi-year grants set to expire on Sept. 30 that were negatively impacted by the pandemic. The funds, available to grants obligated through FY 2015, would be extended through FY 2021

The legislation addresses challenges with the MAAP, particularly recoupment of funds. Under the CR, health care providers can request that recoupment of Medicare reimbursement to offset the loan begin one year, as opposed to 120 days, from initial issuance of payment. Once the process begins, for the first 11 months, recoupment from Medicare claims will be 25%, which will be followed by six months at 50%. After 29 months, the remaining balance of the loan is due. The CR also lowers the interest to 4%, and requires public MAAP data reporting, which includes total payments made, provider type payments, and payment recipients. The reporting will continue until all funds are recouped.

The CR also extends the Medicaid Disproportionate Share Hospital (DSH) payment reduction delay, and funding for the National Health Service Corps program, Teaching Health Center Graduate Medical Education (GME), and community health centers until Dec. 11, 2020 which are currently set to expire Nov. 30 [see Washington Highlights, March 27].

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