On March 10, 2022, the Senate passed a $1.5 trillion omnibus appropriations bill (the Omnibus Bill) to fund the federal government for fiscal year 2022 (FY 2022) that contained significant healthcare-related provisions impacting hospitals and health systems. The Senate’s vote followed passage by the House on March 9, 2022. The measure will be sent to President Biden, who is expected to sign the Omnibus Bill before March 15, 2022, when current federal government funding expires. Some of the most significant healthcare-related provisions relate to 340B eligibility, telehealth, maternal health, and increased healthcare appropriations. However, noticeably missing from the package was $15 billion in additional COVID-19 relief, which was pulled from the Omnibus Bill before it was passed by the House. Highlights of the Omnibus Bill’s healthcare-related provisions are described below.

COVID-19 340B Eligibility Exceptions. The Omnibus Bill would allow for limited access to the 340B Program through the end of 2022 for hospitals that lost their eligibility due to a drop in their disproportionate share hospital (DSH) adjustment percentage since the start of the COVID-19 public health emergency (PHE) but otherwise meet all other requirements. Hospitals seeking this exception would be required to submit an attestation to HHS describing the impact of the COVID-19 PHE on its ability to meet the applicable DSH percentage requirement.
Telehealth. The Omnibus Bill would extend a number of telehealth flexibilities for 151 days after the end of the PHE, including:

• Removing geographic requirements and expanding originating sites for telehealth services to include the patient’s home;

• Expanding types of practitioners eligible to furnish telehealth services;

• Extending telehealth services for federally qualified health centers and rural health clinics;

• Delaying the in-person requirements under Medicare for tele-mental health services;

• Allowing audio-only telehealth services; and

• Permitting the use of telehealth to conduct face-to-face encounters for hospice eligibility recertification.

The Omnibus Bill would also direct MedPAC to conduct a study on the expansion of telehealth services, direct CMS to publish utilization and beneficiary characteristic claims data for telemedicine services beginning July 1, 2022, and instruct OIG to submit a report to Congress on program integrity risks and recommendations.

Maternal Health. The legislation would establish a program to award grants to eligible entities to develop best practices to improve maternal health care quality and outcomes, improve maternal and infant health, and eliminate preventable maternal mortality and severe maternal morbidity. The Omnibus Bill would also fund training programs for healthcare providers targeted at reducing biases that affect the provision of maternal health services to minority groups and public awareness initiatives aimed at improving vaccination rates in pregnant and postpartum women. Additionally, the Omnibus Bill would provide support to states and tribal organizations for integrated health care services for pregnant and postpartum women. With respect to rural areas, the Omnibus Bill would improve rural maternal and obstetric care data collection and provide grants to support health care professional training and telehealth resources for maternal health.

VA Healthcare Workers. The Omnibus Bill’s RAISE Act would change the current salary caps and provide for higher maximum salaries for registered nurses and physicians assistants working at the Veterans Affairs Department in an effort to reduce turnover in the VA’s healthcare workforce.

Fiscal Year Funding Appropriations. Out of the $1.5 trillion in total discretionary spending for FY 2022, $108.3 billion, an increase of $11.3 billion from FY 2021 funding, would be allocated to HHS. Included in this appropriation would be funding for the following agencies:

• $4 billion to CMS in total spending;

• $1 billion to establish the Advanced Research Projects Agency for Health for scientific research related to various diseases;

• $45 billion in total spending to the National Institutes of Health with a focus on investments in research related to cancer, HIV, dementia, and other conditions;

• $8.5 billion in total spending to the CDC with an emphasis on improving the nation’s public health infrastructure;

• $6.5 billion in spending to the Substance Abuse and Mental Health Services Administration for mental health programs; and

• $8.9 billion to the Health Resources and Services Administration to improve healthcare access in underserved communities, to develop the healthcare workforce, and to improve maternal and child health outcomes.

These provisions and other health-care related provisions can be found in the full Omnibus Bill here.