The Consolidated Appropriations Act 2023 was passed into law on December 29, 2022. This Act had some important impacts on healthcare providers. The following is a summary of some of the key factors included in this bill for hospitals.

Rural Hospitals

Sections 4101 and 4102 of the bill extend both the Medicare Dependent Hospital and Low Volume Hospital program for another two years, through September 30, 2024.

Certain PHE Flexibilities Extended through 2024 - Hospital at Home and Telehealth Services

Section 4140 of the CAA extends the Acute Hospital Care at Home (AHCaH) program through 2024. AHCaH is an individual waiver and not a blanket waiver. CMS is accepting waiver requests to forgo certain hospital conditions of participation. The Hospital at Home program allows patients who need acute-level care to receive care in their homes rather than in a hospital.

The Act extended the telehealth flexibilities that were put in place during the Public Health Emergency (PHE) until the end of 2024. These flexibilities were popular for many Medicare beneficiaries, and Congress recognized the need for expanded telehealth to continue beyond the PHE period. Section 4113, “Advancing Telehealth Beyond COVID-19,” allows for:

• Removing geographic requirements and expanding telehealth in non-rural locations
• Allowing the home as an acceptable originating site
• Allowing for audio-only telehealth
• Expanding eligible practitioners to PT, OT, S/L, and audiologists
• Allowing Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) to continue telehealth services
• Delaying required in-person visits within six months of telehealth mental health services

Nursing and Allied Health Professional Education Payments

Section 4143 allows for a waiver on the cap on annual payments for nursing and allied health education payments. The bill also directs CMS not to seek reimbursement from nursing and allied health programs.

Medicare Provisions for Behavioral Health Services

The bill also increases funding for behavioral health services. Some key policies include:

• Beginning in 2024, Medicare will cover marriage and family therapist and mental health counselor services.
• Increase reimbursement for psychotherapy services provided in a mobile unit.
• Required HHS to conduct outreach to providers on the availability of behavioral health integration services as a covered benefit under Medicare.
• Provides guidance and assistance to states to continue the crisis response services.

Medicare Pay-As-You-Go Act

The planned increase to sequestration from a 2% payment reduction to a 4% payment reduction has been delayed until 2025. The 2% sequestration was extended until 2032 and may be increased after 2025.

This is just a summary of some of the changes enacted by the Consolidated Appropriations Act 2023. If you have questions or would like more information on any of these topics, please feel free to contact us.

Sources

Consolidated Appropriations Act, 2023 - https://www.congress.gov/117/bills/hr2617/BILLS-117hr2617enr.pdf

Consolidated Appropriations Act 2023: Impact on Healthcare Providers Webinar by PYA by Martie Ross & Kathy Reep https://www.pyapc.com/insights/webinar-hcrr42-consolidated-appropriations-act-2023-impact-on-healthcare-providers/