Wednesday, December 23, 2020

Very Brief Blog: A Very Brief Peek at Medicare Provisions in Budget Law

Many detailed analyses of the giant budget bill just passed by House and Senate will appear quickly.  It's 5593 pages (although only a svelte 7 mb, here.)

I'll just highlight a few headlines from Section "CC," healthcare law, at pages 4597 ff.

  • Page 4599, S. 102, Lengthy section on quality measures and quality measure funding ($20M/year).
  • Page 4631, S. 119, real-time benefits for patient prices.  Seems to require tools embedded in EHR's to help patients and doctors select services while knowing prices.  (Separately, of course, the bill contains a huge and complex section on surprising billing law.)
    • For some insights into this space, see a November 2020 sponsored article in MedCity by RxREVU on real time pricing - here; links to white paper.
  • Page 4642, S. 122, reduces copayments for colorectal cancer colonoscopy when it follows a positive FIT or Cologuard test or when it results in a biopsy.
  • Page 4644, S. 123, benefits regarding mental health diagnosis and therapy via telehealth.
  • Page 4647, S. 124, public-private partnership to fight fraud, including a third-party clearinghouse.  If Entity X commits healthcare fraud against one health plan, it would be quickly circulated to others.  This isn't entirely new but it sounds like it's being put on steroids.
    • See the HFPP 2018 report on "lab fraud" here.
  • Page 4656, S. 403, Medicare can direct-pay physician assistants (not only pay via a clinic or the name of the supervising physicians.)   
    • This is interesting law, a few words long, simply adds a date to make the current restriction apply only "for services before 1/1/2022."  That's about how long the amendment is.
  • Page 4771, S. 402.  Allows post-renal-transplant patients enrollment in Medicare Part B "solely for the purpose of immunosuppressive drugs."