Washington Watch for December 2021

Congress Passes Bill to Reduce Cuts
Congress successfully passed the Protecting Medicare & American Farmers from Sequester Cuts Act (S. 610) last week. The bill, which was signed into law by President Joe Biden on Friday, partially staves off a 3.75% decrease in physician payments by providing a 3.0% increase for calendar year 2022 to the Medicare conversion factor for providers and would temporarily block sequestration cuts to Medicare and other mandatory spending programs. It suspends for three months, through March 31, 2022, the 2% automatic sequestration cut to Medicare payments, followed by a reduction to 1% for three months, through June 30, 2022. The legislation would also excuse for 2022 the 4% statutory pay-as-you-go (PAYGO) reduction to Medicare physician reimbursements.

Senate May Turn to Consideration of BBB This Week
Senate committees of jurisdiction have begun releasing their draft portions of the Build Back Better reconciliation package, including the Senate Health, Education, Labor, and Pensions Committee and the Senate Finance Committee. The updated text remains subject to a review by the Senate parliamentarian. Senate Majority Leader Chuck Schumer (D-N.Y.) stated in a letter to colleagues last week that he still aims to pass the Build Back Better legislation before Christmas. It remains unclear, however, whether this is a realistic timetable, given that Senators Kyrsten Sinema (D-Ariz.) and Joe Manchin (D-W.Va.) continue to express reservations about the bill after months of negotiation.

Senate Republicans Attempt to Overturn Vaccine Mandate
The Senate passed a resolution of disapproval of the administration’s vaccine mandate for large, private sector employers by a vote of 52-48 last week. Senators Joe Manchin (D-W.Va.) and Jon Tester (D-Mont.) were the only Democrats to join all 50 Republicans in support of the measure, which would block the vaccine order promulgated by the Occupational Safety and Health Administration (OSHA) through the use of the Congressional Review Act (CRA). The Democratic-controlled House of Representatives is not expected to take up the resolution; however, House Republicans plan to circulate a discharge petition to try to force a vote. Should the resolution be advanced to the president for signature, President Biden is expected to veto it. A federal court has already acted to halt the rule, which covers workers at companies with 100 or more employees. In related news, General Electric Co., Union Pacific Corp., and BNSF Railway announced last week that they have suspended their employee vaccine mandates following the recent court ruling halting the Biden administration’s order requiring federal contractors to get vaccinated. The courts have also put a halt to the government contractor vaccine mandate as well as the health care mandate proposed by the Centers for Medicare and Medicaid Services.

HHS Report Shows Drastic Increase in Telehealth Usage
A new report released by the U.S. Department of Health and Human Services (HHS) indicates that the number of Medicare telehealth visits increased significantly from 840,000 in 2019 to 52.7 million in 2020, while in-person visits to health care providers decreased by 11%. The full report from the Assistant Secretary for Planning and Evaluation (ASPE) can be found here.

Number of Omicron Cases Expected to Rise
More than 16 states have reported cases of individuals testing positive for the omicron variant of the coronavirus that was first detected in South Africa. Some patients who have tested positive have had no travel history, suggesting that community transmission of the variant is well-underway in the U.S. Many of the people who have tested positive were fully vaccinated and have thus far only experienced mild symptoms. Public health officials believe omicron is more transmissible than the delta variant and are working to determine whether it better evades immune protection from vaccines or causes more severe disease than other variants.

All Adults Now Eligible for Pfizer/Moderna Boosters
The Food and Drug Administration (FDA) has expanded the emergency use authorization (EUA) of the Pfizer-BioNTech and Moderna COVID-19 vaccines to include individuals 18 years of age and older. Centers for Disease Control and Prevention (CDC) Director Rochelle Walensky signed off on the Advisory Committee for Immunization Practices’ (ACIP) endorsement of expanding booster shot eligibility. The boosters, which are the same dosage strength as the other doses in the series, should be administered at least six months after completion of the primary series.

Doc Caucus Expresses Concern Re: Surprise Billing Regulation
The GOP Doctors Caucus is urging the Biden administration to revise its proposed regulation to implement the No Surprises Act. The lawmakers argue that the interim final rule (IFR) released on September 30 detailing the parameters of the independent dispute resolution (IDR) process “does not reflect legislation that could have passed Congress or the law as written.” The letter states that major revisions are needed to align with the statute and congressional intent, specifying that “the final law explicitly required an independent entity to consider a broad range of criteria and weigh all relevant factors equally when deciding appropriate payments for out-of-network services.”