Congress has completed action on federal fiscal year (FY) 2020 spending, and President Trump has signed the two domestic and national security funding packages into law. The major health care policy provisions included in the domestic spending package, HR 1865, the Further Consolidated Appropriations Act, 2020 (the Act), are summarized below.

Repeal of ACA Device, Insurance Taxes

The Act permanently repeals the Affordable Care Acts (ACA) 2.3% excise tax on the sale of certain medical devices, which has been a top priority of the medical technology industry. It also permanently repeals the excise tax on certain high-cost employer-sponsored health coverage (the so-called Cadillac tax) and the annual excise tax imposed on health insurer providers.

Medicare Part B Policies

The Act incorporates provisions of the Laboratory Access for Beneficiaries (LAB) Act, which delays the next round of clinical laboratory private payer data reporting for one year. The Act also directs the Medicare Payment Advisory Commission (MedPAC) to study how to improve this data collection.

In addition, the Act excludes certain complex rehabilitative manual wheelchairs (e.g., HCPCS codes E1235, E1236, E1237, E1238, and K0008) from the Medicare durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) competitive bidding program. The Act also bars CMS from using competitive bidding rate information to adjust payment for certain wheelchair accessories and cushions furnished with complex rehabilitative manual wheelchairs.

The Act reimburses acute care hospitals on a reasonable cost basis for furnishing allogeneic hematopoietic stem cell transplants. It also extends outpatient hospital pass-through status for a number of diagnostic radiopharmaceuticals.

Medicare, Medicaid, and Public Health Extenders

The Act extends through May 22, 2020 a number of Medicare, Medicaid, and public health programs and policies, including the following:

In addition, the Act funds the Patient-Centered Outcomes Research Trust Fund through 2029, with a requirement that research projects consider a broader range of outcomes data and an expansion of research priorities to include research with respect to intellectual and developmental disabilities and maternal mortality. The Act also establishes Medicaid funding policy for the territories through FY 2021.

Other Health Policies

Other policies addressed by the Act include, among others:

Note that the Statement of Managers accompanying the Act also includes nonbinding requests that CMS review a wide range of reimbursement and other policies, such as air ambulance policy, reimbursement for innovative drugs, inefficiencies in the Recovery Audit program, telehealth coding, CMS innovation models, and Medicare Part D performance metrics.

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FY 2020 Government Funding Bill Repeals ACA Health-Related Taxes, Extends Expiring Health Provisions, Makes Other Health Policy Updates - Lexology