There is some positive vibes this week about progress toward an omnibus deal, which would mean a larger health package is in play.
What you say: Senate Majority Leader Chuck Schumer said Monday the talks were “positive and productive enough that both sides are moving forward in good faith.”
- Schumer added that the Senate should be ready to vote on a week-long CR later this week (as we expected) “so we can give appropriators more time to complete a full funding bill before the holidays.”
Yes but: There’s still no agreement on the funds’ top-line numbers. But Democrats held back the release of their own omnibus proposal Monday over progress in bipartisan talks over the weekend.
- Senator Richard Shelby said he spoke to Speaker Nancy Pelosi on Sunday and Monday, and the sides made “trade proposals on how to close the gap,” which he put at around $25 billion.
Here are the potential riders in healthcare:
1) diagnostic tests. A lot has happened with the VALID Act, which aims to modernize a patchwork of regulations on diagnostic testing.
- Negotiators last week enacted changes aimed at exempting some tests at academic medical centers that had objected to what they see as cumbersome new regulations.
- However, lobbyists say that the university hospitals are not yet convinced and that the proposed exemption does not go far enough. That continues to be a hurdle for the bill.
- Still, the bill is in the mix, and we previously reported that it could be part of a deal that comes with increased FDA oversight of cosmetics.
2) Vendor cuts. Physicians and other clinicians are still pressing for Congress to stop the entire Medicare payment cut in the physician fee schedule, and the American Medical Association and American Hospital Association stepped up their lobbying with face-to-face meetings in Hill last week.
- “I’ve felt pretty good about my visits,” AMA President Jack Resneck told Maya Monday. “I think although there is a long list of things to do, [lawmakers] understand how critical this is and that this cannot wait to be fixed next year.” Resneck said he was continuing advocacy talks this week.
3) Medicare benefit. We are still awaiting an updated CBO score for the Improving Seniors’ Timely Access to Care Act that would streamline Medicare Advantage prior approval.
- A new rule proposed by CMS should lower the bill’s price, but it’s not yet clear if CBO will make it official. Proponents are urging Congressional budget wonks to get involved, based on Axio’s conversations with aides and lobbyists.
4) Puerto Rico. Members of the Puerto Rican government and healthcare industry met with House and Senate leadership last week to discuss Puerto Rico’s Medicaid funding cliff, a congressional aide and a Puerto Rico federal affairs staffer confirmed.
- While the full details have yet to be determined once a top-line number is available, Puerto Rico’s Federal Affairs Administration executive director Carmen Feliciano said in a statement that the FMAP level is likely to be at the current level based on discussions with 76% will stay with Congress.
- “We believe that after this Friday there will be another CR that will extend FMAP to the current 76% and that FMAP will also be no less than 76% in any omnibus arrangement.”
5) Telemedicine. If telemedicine ends up on the omnibus, it’s likely just a year-long extension of PHE flexibilities, which end Dec. 31, said Krista Drobac, a partner at Sirona Strategies.
- That’s because the CBO score would be favorable for a year, and then could give more time for data and evidence to inform whether it should be extended further.
- In addition to pushing for continued Medicare telehealth flexibility, providers and some lawmakers are seeking to extend an exemption that allows people with high-deductible health plans to receive telehealth coverage before their minimum deductible is met.
- The pandemic-era directive expires Dec. 31, but a group of 30 House lawmakers on Monday sent a letter to the leadership asking for the waiver to be extended for another year.