Hospitals and other providers waiting for Congress to complete a slew of overdue spending bills are pressing for swift action to eliminate financial uncertainty—which lawmakers themselves compounded with the odd double deadline they set for themselves.
Congress passed a short-term spending bill Thursday that established two deadlines: one on March 8 to pass a half-dozen full-year appropriations bills, including the Food and Drug Administration's, and a second on March 22 to approve the remaining six spending bills, including the one that funds the rest of the Health and Human Services Department. President Joe Biden signed the legislation into law Friday, preventing a partial government shutdown.
Related: Hospital, community health center funding in limbo amid talks
Congress is supposed to fund government operations before the beginning of every fiscal year on Oct. 1, but has been unable to agree on fiscal 2024 spending bills and has resorted to four stopgap measures. Each short-tem bill has come with its own wrinkles and complications, creating turmoil for healthcare providers reliant on federal money.
The uncertainty around the current deadlines is even greater because lawmakers are attempting to put together a healthcare package that would ride along with one of the spending bills and contain provisions hospitals, community health centers and others see as vital to their operations.
The widely held expectation of lawmakers and sources on and off of Capitol Hill is the package would, at a minimum, forestall planned reductions in Medicaid disproportionate share hospital payments, roll back a Medicare physician reimbursement cut and renew funding for community health centers.
Which deadline that package goes with, though, makes a big difference.
While Congress intends to erase up to $16 billion in DSH cuts over two years, the reduction is due to go into effect March 8. Similarly, community health centers, which were supposed to have been reauthorized in September, lose their federal funding March 8.
And while lawmakers and aides have expressed optimism that the healthcare package would be finalized and hitched to the March 8 funding bill, sources and senior lawmakers said it is not a done deal and could wind up riding with the March 22 bills, which include HHS appropriations.
"I'd have to get back to you on the vehicle," said Energy and Commerce Committee Chair Cathy McMorris Rodgers (R-Wash.) when asked shortly before the current stopgap passed Thursday if community health centers and hospitals were in line for the March 8 measure.
Providers are urging Congress to make sure they don't have to endure a two-week funding gap that would further strain their finances.
"We have consistently made the case that the funding uncertainty is already having an impact on health centers’ ability to plan services, hire staff and meet the growing demand for care," said Amy Simmons, a spokeswoman for the National Association of Community Health Centers.
"The impact is not in the future or in two weeks—it’s happening now," Simmons said.
Similarly, hospitals are reminding lawmakers that they also are in no position to endure a two-week cut in payments.
"It is now time to take action to protect patient access to care by extending critical hospital funding programs ahead of the upcoming March 8th deadline," said Charlene MacDonald, executive vice president for public affairs at the Federation of American Hospitals.
"Swift action to avert Medicaid cuts to hospitals and extend payment adjustments for rural hospital care will provide urgently needed stability to hospitals and the patients we serve in the face of today’s uncertain operating environment,” MacDonald said.
The concern also comes as hospitals and other healthcare companies are suffering challenges from the Change Healthcare cyberattack that has disrupted pharmacy operations. Change Healthcare, a division of UnitedHealth Group subsidiary Optum, said Friday it has stood up a temporary replacement system and offered financial assistance to affected providers.
The American Hospital Association has pleaded to HHS Secretary Xavier Becerra for help dealing with the Change Healthcare breach—including advance Medicare payments—and had advised hospitals to stay disconnected from Change Healthcare systems prior to UnitedHealth Group's Friday announcement.
Providers should learn this weekend whether their priorities will be addressed in time to prevent funding gaps, or be left out for the time being.
Among those waiting expectantly are doctors, although the timing is less critical because the Medicare pay cut took effect Jan. 1. While sources were not authorized to speak on the record about what physicians could expect, they said it would likely be similar to a partial restoration the Senate Finance Committee approved in November.
Still, healthcare providers would prefer to have their needs attached to the March 8 measure because it contains bills that leaders said they broadly agree upon, while the March 22 bills are more controversial and more likely to stall.
