Important health policy issues still pending for the “lame duck” congress.

Doctors, hospitals and health care groups press Congress on big issues before the end of the term.

Hospitals, doctors and health groups are pushing Congress to address some of their priorities before the end of the year.

Health systems have more motivation in the last two months of 2022. A new Congress will meet in January. After next week’s midterm elections, there may be new majorities in the House and Senate.

Beyond the question of whether Democrats or Republicans will control Congress, time is running out on some key hospital-backed bills. Some bipartisan support measures are nearing approval and are reaching President Biden’s desk. But if they are not passed before the end of the session of Congress, the bills will have to go through the legislative process again.

The period between the elections and the new session of Congress is referred to as the “lame duck” period. Hospitals hope they can be productive two months. Last week, the American Hospital Association sent a letter to congressional leaders urging them to address several issues.

Here is a rundown of some key issues important to hospitals, health systems, and medical groups.


Health care advocates are pushing for the extension of telemedicine flexibility. There is strong support for a bill that would extend telemedicine benefits and reimbursements from Medicare through 2024.

The House overwhelmingly passed the bill in the summer and supporters say there is bipartisan support in the Senate. But he still has to authorize the Senate before he can get to the president.

The use of telemedicine soared during the COVID-19 pandemic, but exemptions for virtual assistance are tied to the federal government’s public health emergency. At some point, the Biden administration may phase out the emergency designation.

While lawmakers have passed a five-month cushion for telemedicine waivers beyond the emergency, health groups want to see at least one extension until 2024.

Ultimately, health care advocates, such as the American Telemedicine Association, are seeking permanent telemedicine reforms.

Prior authorization

Doctors and health systems hope to see a bill passed that offers some relief from prior authorization. Doctors and health care groups have long complained about the process of getting payers’ approval before providing treatment or drugs, and say the process harms patients and increases physician burnout.

The House of Representatives passed a bill that would simplify part of the pre-authorization process in Medicare Advantage plans, which serve 28 million Americans. It is nicknamed “Improving Seniors’ Timely Access to Care Act”.

The measure would establish an electronic prior authorization process. Medicare Advantage plans should notify Centers for Medicare & Medicaid Services how often they use prior authorization and the approval and denial rate.

The Senate has yet to vote on the bill, but supporters note it has more than 40 co-sponsors.

Shortage of manpower

Hospitals struggled with manpower shortages during the COVID-19 pandemic, as some healthcare workers have left healthcare systems or simply walked out of the industry. Hospitals are paying higher labor costs, including to staffing agencies, to fill vacancies. Higher labor costs have added to the financial woes of hospitals and more than half of all hospital systems could end the year with negative margins.

Some health systems have reduced the number of beds due to staff shortages and hospitals say they have not been able to relocate patients due to staffing problems in post-acute care facilities. Hospitals are looking for a temporary per diem payment to cover the costs of caring for those patients.

Hospitals are also pushing for long-term solutions to address the shortage of doctors. They want Congress to pay for more Medicare-supported graduate medical training slots.

Pay according to consumption

Hospitals could see federal aid cuts due to automatic reductions under the federal spending law, unless Congress intervenes.

Pay-as-you-go (PAYGO) seizure requires mandatory programs not to add to the federal deficit. Right now, hospitals should see cuts from Medicare.

The American Hospital Association is pushing Congress to stop the PAYGO seizure in 2023.

Aid to rural hospitals

Rural hospitals have faced financial challenges for years and have been affected by the COVID-19 pandemic. Hospitals are pushing to preserve funding for two Medicare programs that provide $ 600 million annually to rural hospitals.

Those programs were supposed to end on September 30, but hospitals secured an extension until mid-December as part of a broader short-term spending plan. Hospitals are urging lawmakers to maintain such programs in the future.

Lawmakers in the House of Representatives sponsored a bill to extend the programs for another five years. A Senate bill is similar in many respects, but it would extend the programs permanently

The hospitals hope to support the Medicare-dependent Hospital (MDH) program, which helps smaller hospitals with a large share of Medicare patients. There are more than 170 hospitals with this designation. They are also looking to continue the designation of Medicare’s Low-Volume Hospital (LVH), which funds rural hospitals with a relatively small portion of Medicare patients. This program supports more than 600 hospitals.

Editor’s Note: This news was first published in our sister publication, Chief Healthcare Executive.

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