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ARN Health Policy Digest - November 2023

Rehab Nursing Specialty

We are pleased to present the November issue of the ARN Health Policy Digest. This member benefit provides updates on health policy and legislative and regulatory developments that may be of interest to rehabilitation nurses. 

Updates on FY 2024 Funding

When Congress adopted the continuing resolution (CR) to fund the government through November 17, it ultimately led to the removal of Kevin McCarthy (R-CA) as Speaker of the House and three weeks of turmoil in the chamber. The House Republicans finally elected Mike Johnson (R-LA) to lead the caucus. As we neared the current funding deadline, Speaker Johnson faced his first significant test as leader.

House Republicans debated several strategies to prevent a government shutdown. Speaker Johnson proposed an approach he is referring to as a "laddered" CR that would extend four appropriations bills through January 19 and the remaining eight, including Labor-HHS, through February 2. Because this CR funds the government at FY 2023 levels and does not make spending cuts, Speaker Johnson needed support from House Democrats to pass the bill under the suspension of the rules. Despite not supporting the laddered approach to funding the government and the lack of emergency funding for Ukraine and Israel, many Democrats still supported the bill to avoid a government shutdown and preserve FY 2023 funding levels for the time being. One day after the House passed the bill, the Senate followed suit, sending the bill to the President's desk for signature. Therefore, final FY 2024 funding decisions will be deferred until the new year.

In related news, the House Committee on Appropriations released its FY 2024 Labor-HHS report on November 3. For FY 2024, the Committee recommends a total of $147 billion in current year discretionary funding—the 302(b) allocation—a decrease of $60 billion below the FY 2023 enacted level. This legislation includes significant cuts to health funding and is very different from the version that passed the Senate Appropriations Committee. The House was supposed to vote on the bill on November 15; however, it was declared that the bill did not have enough votes and therefore will not proceed with a vote until after Thanksgiving.

U.S. Senate Confirms Monica Bertagnolli as NIH Director

The Senate confirmed Dr. Monica Bertagnolli as director of the U.S. National Institutes of Health (NIH) on November 7, after two years without a permanent director. Dr. Bertagnolli previously served as the director of the National Cancer Institute (NCI), the Richard E. Wilson Professor of Surgery in surgical oncology at Harvard Medical School, a surgeon at Brigham and Women's Hospital, and as a member of the Gastrointestinal Cancer Treatment and Sarcoma Centers at Dana-Farber Cancer Institute. In a press release issued on her official first day in office, Dr. Bertagnolli, who will be the second woman ever to serve as NIH Director, said, "As NIH director, I look forward to ensuring that NIH continues to be the steward of our nation's medical research while engaging all people and communities in the research effort that includes informing medical practice that drives equitable access to health care for all." As NIH Director, Dr. Bertagnolli will have no shortage of tasks on her plate beginning with one immediate challenge of maintaining NIH funding levels as the House and Senate work to reconcile their spending bills for FY 2024.

CMS Finalizes CY 2024 MPFS and OPPS Rules

On November 2, the Centers for Medicare & Medicaid Services (CMS) issued the CY 2024 Medicare Physician Fee Schedule (MPFS) and Hospital Outpatient Prospective Payment System (OPPS) Final Rules. ARN provided comments on both proposed rules earlier this year. ARN's comments on the MPFS proposed rule focused on supporting payment for caregiver training services. CMS finalized this policy and stated that this action is consistent with the recent Biden-Harris Administration Executive Order on Increasing Access to High Quality Care and Supporting Caregivers and will help support care for patients by better training caregivers. ARN also commented in support of CMS' proposals for payment for new services to account for resources when clinicians involve community health workers, care navigators, and peer support specialists in furnishing medically necessary care. CMS finalized these coding and payment proposals to better account for resources involved in furnishing patient-centered care involving a multidisciplinary care team.

Additionally, ARN's comments on the OPPS proposed rule focused on supporting CMS' proposal to allow cardiac rehabilitation, intensive cardiac rehabilitation and pulmonary rehabilitation services to be provided under the supervision of a physician assistant, nurse practitioner, or clinical nurse specialist, beginning January 1, 2024. This proposal was included in the MPFS proposed rule as well. Fortunately, CMS finalized this policy as proposed. In their response to comments, CMS thanked commenters for their support for these proposals and reiterated that they believe these changes will help improve patient access to care to these critical services.

Notice of Funding Opportunities

Below is a list of other funding opportunities for interested ARN members.

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