Congress faces some major healthcare issues next year

Next year is likely to be a busy one for Congress, with potential action on several key matters important to healthcare providers.

Telehealth

Several telehealth flexibilities the Centers for Medicare and Medicaid Services granted during the COVID-19 pandemic are set to expire whenever the public health emergency ends. Although the declaration is scheduled to lapse Jan. 15, President Joe Biden likely will renew it for at least one more 90-day period because the coronavirus outbreak isn’t abating.

Congress is facing pressure to extend some waivers past the public health emergency, including one that allows Medicare patients to use telehealth services from their homes.

The most likely path forward appears to be expanding the flexibilities for a few more years so Congress can collect more data on costs and quality, lobbyists following the issue say.

Prior authorization

A bipartisan bill proposed by Reps. Susan DelBene (D-Wash.), Mike Kelly (R-Pa.) and 244 other members would streamline prior authorization in Medicare Advantage and require faster determinations for services routinely approved by plans. The legislation has enough cosponsors to pass the House if it were called for a vote.

Government funding

Congress aims to advance the fiscal 2022 appropriations bills early next year, which could devote nearly $400 million in earmarks for hospitals and healthcare facility projects.

Lobbyists are also hoping the package will include $10 billion for hospital infrastructure that Democrats cut from their social spending bills this year.

Mental health

Leaders of the powerful Senate Finance Committee are looking for ways to expand access to mental healthcare, potentially through building up the workforce and strengthening insurance coverage parity laws.

MACRA

The Senate Finance Committee is likely to hold hearings on the implementation of the Medicare Access and CHIP Reauthorization Act of 2015, which made several changes in payments to drive Medicare toward value-based care. Parts of the law expire next year, including a 5% bonus for Advanced Alternative Payment Models.