Congress includes Medicare, Medicaid and other health policies in omnibus spending bill for fiscal year 2022 | Manatt, Phelps & Phillips, LLP

After weeks of negotiations and months of interim funding bills since the start of the federal fiscal year in October 2021, on Tuesday the President signed the Consolidated Appropriations Act, 2022, an omnibus funding bill that includes government appropriations for fiscal year (FY) 2022 through September 30, 2022; $13.6 billion in aid to Ukraine; and a range of health policy provisions.1

The omnibus legislation for fiscal year 2022 provides $1.5 trillion in discretionary spending, including a 6.7% increase in non-defense spending from fiscal year 2021. For the Department of Health and Human Services Social Services (HHS), the omnibus provides a total of $108.3 billion, an increase of $11.3 billion. for the 2021 financial year.2 The legislation provides for a number of notable investments, including $1 billion to create the Advanced Research Projects Agency for Health (ARPA-H) within the Office of the Secretary of HHS, more than $2 billion in investments in behavioral health, $1 billion for programs to improve children’s health, and $3.9 billion for addiction treatment. Other discretionary programs — like Title X family planning — did not receive increases from fiscal year 2021. For the first time in more than a decade, the omnibus also includes congressional spending. or member-directed and “Community Project Expenses,” also known as Congressional Expenses. allocations, including limited capital funding for healthcare providers across the country, funding for workforce training, and support for providers to invest in health care equipment telehealth.3

The legislation also includes health policy changes in the following areas:

  • Telehealth. Extends a number of essential Medicare telehealth flexibilities for five months after the end of the public health emergency (PHE) so that Medicare beneficiaries can access services via telehealth. (To see accompanying newsletter for more information.)
  • Medicaid. Temporarily restores the 76% Medicaid match rate for Puerto Rico through December 13, 2022 and extends the 83% match rate for other territories through the same date. The bill also expands the state’s flexibility for Medicaid programs to recover funds when an individual has supplemental health insurance coverage through changes to third party liability and prior authorization requirements. in Medicaid.
  • Health Insurance. Delays by one year, from 2030 to 2031, a change to the annual updates to the overall cap for palliative care services. It also delays the timing of a Medicare Payment Advisory Commission (MedPAC) report on ambulance cost data to account for a data lag. The bill also reduces amounts allocated to the Medicare Improvement Fund, from $99 million to $5 million, to pay for some of the costs of other parts of the bill.
  • 340B. Maintains 340B eligibility for hospitals that would otherwise have lost eligibility due to changes in their payor mix resulting from the COVID-19 pandemic. Hospitals would be required to submit a self-attestation indicating actions they have taken (or impacts they have experienced) in response to or as a result of PHE COVID-19 that may have impacted the capacity of the hospital. hospital to meet the eligibility criteria.
  • Maternal health. In addition to investing $1 billion in new funds for the Health Resources and Services Administration to improve maternal health outcomes, the bill also includes new grant programs to fund bias training. implicit for health care providers, innovation in maternal health, and integrated care for pregnant and postpartum women. . The bill also enacts portions of the bipartisan Rural Maternity and Midwifery Modernization (Rural MOMS) Act (S.1491/HR 769) to expand access to maternal health care in rural and underserved areas.
  • Extension of fentanyl programming. Extends the ban on fentanyl-like substances by maintaining their classification in Annex I medications under the Controlled Substances Act from March 11 to December 31, 2022. Schedule I drugs are those that currently have no accepted medical use and have a high potential for abuse.
  • Synthetic nicotine. Amends Section 901 of the Federal Food, Drug, and Cosmetic Act to give the Food and Drug Administration (FDA) the authority to regulate products containing nicotine that is not manufactured or derived from tobacco ( synthetic nicotine) in the same way as other tobacco products. These amendments would come into force 30 days after their promulgation and would provide a transition period for synthetic nicotine products already on the market to submit marketing applications.

It is also worth noting the policies that are do not included in the legislative package. In recent months, supplier organizations urged Congress will extend the current moratorium on Medicare sequestration cuts through the end of the calendar year and provide additional COVID-19 relief funds in the face of threats of new cases from evolving variants and growing labor shortages. work. The White House also sent Congress a demand for $22.5 billion in COVID-19 relief earlier this month. However, none of these demands are included in the final legislation. Barring Congressional intervention in the interim, the Medicare sequestration cuts are expected to be phased in on April 1.


To note: More detailed information is available via Manatt on healthManatt’s premium information service.


1 A division-by-division summary of planned appropriations is available here.

2 For more information on HHS appropriations, see page 26 (Division H) of the House Appropriations Committee summary or page 3 of the House Appropriations Committee summary labor, HHS, and education funding arrangements.

3 The explanatory statement for the Labor, HHS, and Education Funding Divisions (available here and here) include tables with funding for community projects.

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