Short-term spending bill includes rural hospital program extensions, nixes COVID-19 and monkeypox aid

A short-term spending package includes extensions for two key rural hospital programs into December but doesn’t include the Biden administration’s request for $27 billion in aid for COVID-19 and the monkeypox outbreak. 

Congress has until the end of the week to approve a continuing resolution or else face a government shutdown. The continuing resolution text released late Monday would fund the federal government until Dec. 16 and while it does include key reauthorizations providers didn’t get everything they asked for. 

The legislation would ensure that two pivotal rural hospital programs keep going. Congress included an extension for the Inpatient Hospital Payment Adjustment for Certain Low-volume Hospitals and the Medicare-Dependent Hospital (MDH) Program through Dec. 16.

The MDH gives eligible hospitals that have a high share of Medicare patients additional money if their costs are higher than inpatient payment rates. The low-volume program in turn helps hospitals with a low volume of Medicare patients with a pay boost. 

Both programs—which help prop up rural hospitals amid a continuing trend of closures—are going to expire at the end of September unless Congress acts. Hospital groups have been pressing lawmakers to extend the programs for five years.

The legislation would also extend an increased federal matching rate for American territories such as Puerto Rico through Dec. 16 and would reduce the Medicare Improvement Fund from $7.5 billion to $7.308 billion.

The fund was created to enable the Department of Health and Human Services Secretary to make improvements to Medicare fee-for-service. 

Lawmakers also included legislation to renew the Food and Drug Administration’s user fee program, where drug makers pay a fee when applying for a new drug approval and the agency uses that money to improve the review process. The legislation reauthorizes the user fee program for another five years through 2027.

Providers may be dismayed that the COVID-19 and monkeypox aid wasn’t the only item nixed in the final legislation, which is expected to be voted on later this week. 

Several physician groups have been imploring Congress to stave off a looming 4% cut to Medicare payments set to take effect next year under the PAYGO law, which mandates reductions if government spending reaches a certain threshold. 

Physician groups are also hoping Congress staves off a 4.5% cut to doctor payments under the Physician Fee Schedule.

Lawmakers will have one last chance in December during the lame-duck session to include any delays in the next government spending package.