Hospitals push Congress to pass healthcare bills in ‘lame duck’ session

Hospitals are counting on Congress to act on some vital issues before the end of the year.

Hospitals and other healthcare advocates are urging Congress to tackle several important bills and preserve programs that are slated to expire.

The period between the presidential election and the new Congress taking office next year is referred to as the “lame duck” session, but health systems need more than a wing and a prayer.

Some key programs and waivers vital to hospitals and healthcare providers are slated to expire Dec. 31. There are other important health bills that have gained some support, but if Congress doesn’t approve those measures, the legislative process will need to start all over next year.

Billions of dollars are at stake, and health systems could lose the ability to provide some services that patients utilize every day.

So healthcare advocacy groups are urging lawmakers to act on some top priorities as the year is rapidly coming to a close. The American Hospital Association sent a letter to congressional leaders this week urging them for action on key issues for hospitals. The American Telemedicine Association and HIMSS are also pushing for extensions of digital health programs.

Medicaid funding cuts

Hospitals are asking Congress to avert cuts in Medicaid Disproportionate Share Hospital Payments. The DSH program, as it’s known, is slated to be cut by $8 billion, with the cuts taking effect Jan. 1.

Health systems have convinced Congress to block the reductions in the past, and they are hoping to be successful again.

“The Medicaid DSH program provides essential financial assistance to hospitals that care for our nation’s most vulnerable populations — children, impoverished, disabled and elderly,” the AHA wrote in its letter to legislative leaders.

Funding programs due to expire

Two important Medicare programs that provide funding to hospitals are also slated to expire at the end of the year, unless Congress intervenes.

The Medicare-dependent Hospitals and Low-volume Adjustment programs both are scheduled to dissolve on Dec. 31.

The Medicare-dependent Hospital (MDH) program offers financial assistance to smaller hospitals with a larger percentage of Medicare patients. More than 170 hospitals benefit from the program.

Rural hospitals also rely on Medicare’s Low-Volume Hospital (LVH) program, which offers funds to hospitals with a smaller number of Medicare patients. That program supports more than 600 hospitals.

Both programs received a two-year extension in 2022, and hospitals are hoping they can convince Congress for another extension.

“These programs provide rural, geographically isolated and low-volume hospitals additional financial support to ensure rural residents have access to care,” the AHA wrote.

Prior authorization relief

Hospitals are also pushing Congress to pass legislation that would streamline the prior authorization process in Medicare Advantage programs.

Lawmakers have sponsored a bill, the Improving Seniors’ Timely Access to Care Act (H.R. 8702/S. 4532), that would require insurers to speed up decisions on request for treatment. Insurers would also have to disclose how often they’re approving and rejecting requests for treatment.

Hospitals and physicians say they’re running into an increasing number of delays and denials from Medicare Advantage programs. Lawmakers tried to pass similar legislation in the previous congressional session and it fell short of passage despite strong bipartisan support. Healthcare advocates are hoping for success in the lame duck session.

“The bill would streamline the prior authorization process in the Medicare Advantage program by eliminating complexity and promoting uniformity to reduce the wide variation in prior authorization methods that frustrate both patients and providers,” the AHA wrote.

• Read more: Most doctors say prior authorization delays care, causes patients to abandon treatment

Telehealth extensions

Hospitals and telehealth advocates have been pushing Congress to extend telehealth programs, as key waivers are set to expire at the end of the year.

The federal government eased restrictions on telehealth programs early in the COVID-19 pandemic and have extended those waivers repeatedly. Now, healthcare advocates are asking lawmakers for another extension.The American Hospital Association, American Telemedicine Association and HIMSS, among many others, are all urging lawmakers to maintain telehealth flexibilities. A measure with strong bipartisan support would offer a two-year extension for most telehealth programs, and a five-year extension for hospital-at-home programs.

Tom Leary, HIMSS senior vice president & head of government relations, told Chief Healthcare Executive® this week that the telehealth extensions need to happen, and advocates will be pushing hard.

“Between now and December 31, we just don't have a choice,” Leary says.

• Read more: HIMSS makes push on health equity

Reducing hospital violence

Hospitals are also pushing Congress for a measure that they say would reduce violent attacks of healthcare staff, which has been a growing problem in recent years.

The American Hospital Association is asking lawmakers to pass the Safety from Violence for Healthcare Employees Act (H.R. 2584/S. 2768). Under the bill, hospital and healthcare employees would gain federal protections similar to those afforded employees of the airline industry. Those attacking healthcare workers would face stiffer penalties.

Lawmakers in both parties have backed the legislation, but similar measures have stalled in Congress. The AHA hopes to avoid a similar fate this time around.

Other top issues

Hospitals, the American Medical Association and other advocacy groups are urging Congress to prevent cuts in Medicare payments to doctors slated to take effect in 2025. Physicians are looking at reductions of nearly 3%, following years of reductions, and doctors are pleading with Congress to prevent the cuts from happening. They’re also hoping Congress will look at more lasting reforms to physician reimbursement.

Health systems are also pressing against efforts for some lawmakers who want to change reimbursements for some outpatient care.

Some in Congress are pushing for “site neutral payments” for outpatient care, and they argue the policy would reduce costs for patients and save Medicare billions of dollars.

Hospitals argue such a policy would be unfair to health systems, because they offer outpatient care to those with more complex conditions and face higher regulatory requirements. Hospitals also note Medicare reimbursements are already insufficient for the services they provide.