This bill, HR 5796, prohibits the Department of Health and Human Services from implementing a proposed rule requiring minimum staffing levels in nursing homes. It creates an advisory panel of 15 members - including rural nursing home staff and experts - to study workforce shortages and report on access barriers for seniors, especially in rural areas. The panel must submit an initial report within 60 days, analyzing staffing challenges and recommending solutions to strengthen the nursing home workforce. These provisions directly aim to prevent nursing home closures (like the 129 that occurred in 2022) that threaten rural seniors’ access to care.
This bill clarifies that funds from Health Savings Accounts (HSAs) can be used tax-free for qualified long-term care services, as defined by existing tax law. It directly affects HSA account holders who pay for long-term care services like nursing home care or in-home assistance. The key change inserts specific language into the tax code to explicitly include these services under eligible HSA distributions, removing prior ambiguity. The amendment applies to distributions made after the bill's enactment date.
This bill provides continuing appropriations for federal government operations through January 11, 2024, ensuring funding for ongoing programs and activities. It includes $16 billion for disaster relief and over $21 billion in supplemental funding for Ukraine assistance, covering military aid, economic support, and humanitarian programs. The bill also extends funding for community health centers, Federal Aviation Administration programs, and the Temporary Assistance for Needy Families program through the same date. These funding measures maintain government operations and support critical domestic and international programs during the fiscal year.
HR 5663, the ALS Better Care Act, creates a new Medicare payment system to improve reimbursement for specialized care services provided to ALS patients. It establishes a $800 per visit payment rate starting in 2025 for qualified ALS care facilities, with annual increases based on market basket adjustments. The bill requires the Comptroller General to report on appropriate payment amounts and ensures this new payment is in addition to, not replacing, existing Medicare payments for ALS-related services. This aims to reduce wait times, support facilities in rural areas through telehealth access, and address funding challenges for ALS clinical trials.
This bill makes permanent Medicare coverage for telehealth services provided by Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs), including audio-only visits. It directly affects Medicare beneficiaries who use these services and the FQHCs/RHCs delivering them by removing location restrictions - allowing telehealth visits to occur regardless of the patient's geographic location. Key provisions include permanently covering audio-only telehealth (previously temporary), treating telehealth visits as equivalent to in-person visits for payment, and ensuring costs for telehealth are included in FQHC/RHC payment calculations. These changes simplify access to telehealth for rural and underserved communities while maintaining consistent Medicare reimbursement for providers.
The DRA of 2023 adjusts Medicare payment rates for specific durable medical equipment (DME) items that were part of the 2021 competitive bidding program but for which no supplier contracts were finalized. It directly affects DME suppliers and Medicare beneficiaries by establishing a new 2024 payment formula: 90% of the adjusted payment amount plus 10% of the unadjusted fee schedule for eligible items. The bill also extends a temporary transition rule for non-rural areas through December 31, 2024, while delaying a regulatory change until 2025. These provisions aim to stabilize payments for DME items that did not transition to standard pricing under prior rules.
The Maintaining Investments in New Innovation Act (HR 5547) extends the exclusivity period for certain advanced drugs from 7 to 11 years. It defines an "advanced drug product" as a drug using genetically targeted technology to change how genes work, such as drugs that suppress or activate gene function. The bill amends the Social Security Act to update the definition of "qualifying single source drug" to include these advanced therapies with the longer exclusivity period. This change directly affects drug manufacturers developing such advanced therapies and influences Medicare's drug coverage rules by delaying generic competition for these specific treatments.
This bill clarifies that Medicare must cover external infusion pumps and associated non-self-administrable drugs as durable medical equipment (DME) when specific criteria are met. It directly affects Medicare beneficiaries requiring home infusion therapy for drugs that must be prepared just before use, administered by a healthcare professional, or labeled for external pump use at least monthly. Key provisions require the drug's FDA labeling to specify external pump administration, safe home delivery by qualified suppliers, and preparation/administration requirements. The bill mandates Medicare coverage under existing rules (LCD L33794) for qualifying treatments, effective upon enactment or FDA approval, whichever is later.
HR 5376, the Share the Savings with Seniors Act, changes Medicare Part D drug cost-sharing rules for specific chronic medications starting in 2025. It limits what seniors pay for certain chronic care drugs (like anticoagulants, blood glucose regulators, and respiratory medications) by capping pre-deductible costs at the drug's net price and requiring coinsurance after the deductible to be based on that net price. This directly affects Medicare Part D beneficiaries taking these defined chronic medications. The bill aims to reduce out-of-pocket costs by tying payment limits to the negotiated drug price rather than list price or other benchmarks.
This bill changes Medicare payment rules for anesthesiologist services in specific rural hospitals. It requires Medicare to pay for anesthesiologist services in qualifying rural hospitals using the same "reasonable cost, pass-through" reimbursement method currently used for certified registered nurse anesthetists (CRNAs), rather than the standard physician payment rate. The bill directly affects rural hospitals and anesthesiologists working in those facilities, ensuring they receive comparable reimbursement to CRNAs under existing rules. The change applies to services provided during cost reporting periods starting after the bill's enactment date. This is a technical adjustment to payment methodology, not a new coverage benefit.
This bill changes how Medicare counts hospital stays for coverage of skilled nursing care. It treats time spent in outpatient observation (not admitted as an inpatient) as part of the required 3-day inpatient hospital stay. This means beneficiaries who received outpatient observation services will have that time counted toward the 3-day requirement, potentially making them eligible for skilled nursing facility coverage they might otherwise have lost. The change applies to services beginning January 1, 2024, with limited retroactive appeal options for services completed before the law's enactment. It directly affects Medicare beneficiaries needing skilled nursing care after hospital treatment.
The Preserving Access to Home Health Act of 2023 repeals a 2018 payment adjustment for Medicare home health agencies, restoring prior payment rates for 2024 and subsequent years. It requires the Medicare Payment Advisory Commission (MedPAC) to analyze how home health agencies' financial performance affects access to care, including reviewing spending and utilization data across Medicare, Medicaid, and other payers. Starting in 2025, the bill mandates home health agencies to report detailed data on visit volumes and payments by payer source (Medicare, Medicaid, private insurers) through updated cost reports. This data will help MedPAC assess payment policy impacts on access to home health services for Medicare beneficiaries.
