You may have read that the Chronic Care Act, which has been praised by industry groups and telemedicine providers for paving the way for greater use of telemedicine, was included in the most recent Congressional budget.The legislation funnels more Medicare money into telemedicine by allowing Medicare to cover more services to treat chronically ill patients. Here’s a synopsis of some key items in the Bipartisan Budget Act of 2018 (BBA).
Signed into law on February 9, 2018, the BBA includes numerous health provisions, including standard appropriations for health-related extenders, which are programs that Congress must routinely renew.
Perhaps the most talked about items included in the bill were bipartisan measures championed by many lawmakers and stakeholders alike such as the CHRONIC Care Act and funding for CHIP, community health centers, opioid addiction and mental health treatment.
The CHRONIC Care Act largely focuses on expanding access to telehealth, improving care for the chronically ill, and increasing flexibility for Medicare Advantage (MA).
CHIP received an additional 4 years in funding, securing a ten-year extension following the passing of a 6-year reauthorization in January 2018. States will also be required to report on the core set of pediatric quality measures starting in FY2024. In addition, community health centers were reauthorized for 2 years and saw an increase in funding.
The BBA included many changes focused on Medicare. It fast-tracks the closure of the Part D coverage gap, or doughnut hole, by moving up the timeline for decreasing Medicare beneficiaries’ contribution to prescription costs while increasing the percentage of discounts that pharmaceutical manufacturers must provide. The ACA-enacted Independent Payment Advisory Board (IPAB), which was created to help control Medicare costs, was also repealed. In addition, the bill permanently repeals the cap on outpatient Medicare therapy services and includes provisions related to the independent accreditation for dialysis facilities.
Lastly, to ensure funding for these programs, premiums for Medicare beneficiaries with high annual incomes were increased.
Of note, the BBA did not include any ACA market stabilization measures, however, negotiations are currently ongoing for inclusion in the upcoming long-term spending deal, also known as an omnibus. Although ACA Congressional repeal efforts have seemingly stalled, changes to the law are not completely off the table. Any regulatory or executive action to undermine the landmark bill could potentially reduce the number of issuers for qualified health plans (QHPs). URAC has authority to accredit QHP issuers by the Department of Health and Human Services (HHS) in all 50 states and D.C.
