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September 22, 2020 08:00 PM

House passes government funding bill, including plan to extend Medicare loan repayments

Rachel Cohrs
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    The front of the United States Capitol building, in Washington D.C., against stormy clouds

    The House Tuesday night passed a bipartisan bill that will fund the federal government through Dec. 11 and relax Medicare loan terms for healthcare providers.

    Lawmakers passed the deal—359 to 57—after negotiating through the day to reach a consensus. The package is designed to avoid a shutdown on Oct. 1. While House Democrats and the White House decided to separate the funding bill from COVID-19 relief legislation, some policies that healthcare providers asked for were included.

    Hospitals have implored Congress to forgive or relax repayment terms for $100 billion in COVID-19 relief loans that Medicare gave out in the spring. CMS was supposed to start recouping the funds by cutting providers' Medicare fee-for-service reimbursement starting in August, but that hasn't happened.

    The bill would give providers one year after the Medicare Accelerated and Advance Payment Program loan was issued before recoupment would begin, an extension from 120 days under current law. The recoupment rate would also be lowered from its current 100% level to 25% for the first 11 months of repayment, and 50% for the six months afterward. Hospitals would have 29 months after payments to begin to pay back the funds in full before interest would begin to accrue. The interest rate would be lowered from the current rate of 9.6% to 4%.

    House Energy & Commerce Chair Frank Pallone (D-N.J.) and Ways & Means Chair Richard Neal (D-Mass.) on Tuesday wrote to HHS and CMS accusing the administration of expanding the Medicare Accelerated and Advance Payment Program beyond its congressionally authorized scope and failing to provide requested information to lawmakers. Pallone and Neal also asked CMS to provide clarity as to when the Medicare loans would begin to be recouped.

    The legislation also creates a new deadline for funding for several healthcare policies, including delaying cuts to Medicaid disproportionate-share hospital payments and extending funds for programs such as the Money Follows the Person demonstration, diabetes programs and community behavioral health clinics. The policies are set to expire on Nov. 30.

    The new deadline creates a potential vehicle for a last-ditch effort to ban surprise medical bills post-election as senior GOP lawmakers who have advocated for reform face retirement, though the White House is considering an executive order on the issue of surprise billing.

    Senate Majority Leader Mitch McConnell (R-Ky.) has said whether he will bring the package up for a vote, though Democrats acceded to Republicans' wish to add aid for farmers to the funding bill.

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