Senate Extends Moratorium on 2% Medicare Sequestration Cuts; CMS Will Hold April Medicare Claims Until House Acts
On March 25, 2021, after consideration of H.R. 1868, the Senate voted 90-2 to pass the bill as amended by Senators Jeanne Shaheen (D-NH)/Susan Collins (R-ME) substitute amendment. Therefore, the Senate-passed version of H.R. 1868 provides for an extension of the moratorium on the 2% Medicare sequestration through the end of the year in addition to some technical corrections related to rural health clinics and disproportionate share hospitals.
As we reported last week, the House passed H.R. 1868, legislation that would prevent the Medicare sequester cuts by extending the moratorium on the 2% Medicare sequestration through the end of the year and waiving the PAYGO rules to prevent the 4% sequestration cut to Medicare payments that would go into effect on January 1, 2022. As a reminder, the passage of the COVID-19 relief package, the American Rescue Plan Act of 2021, activated PAYGO statute reductions, which triggers cuts to a defined set of programs, including an additional 4% Medicare cut.
The House is expected to vote favorably on the Senate version when it returns in mid-April. The Centers for Medicare and Medicaid Services (CMS) will be instructed to hold off on processing April claims until then to avoid making reduced payments.
The medical community anticipates that legislation will be considered later in the year that addresses the 4% Medicare sequestration cuts scheduled to take effect on January 1, 2022.
Congress Extends PPP Application Deadline Through the End of May; President Expected to Sign into Law
On March 25, the Senate voted 97-2 to approve the PPP Extension Act of 2021 (H.R. 1799) which provides a two-month extension to the Small Business Administration’s Paycheck Protection Program (PPP) loan application deadline through May 31. The House passed the bill last week with bipartisan support.
President Joe Biden is expected to sign the bill into law, as the White House has indicated its support for extending the program.
Representative Raul Ruiz, MD Reintroduces Step Therapy Legislation in the House
On Tuesday, March 23, Representative Raul Ruiz, MD (D-CA), reintroduced the Safe Step Act (H.R.2163) that would provide patients and providers with a clear and transparent appeals process when subject to step therapy protocols instituted by insurers. Original co-sponsors of the legislation include Representatives Brad Wenstrup (R-OH), Lucy McBath (D-GA), and Mariannette Miller-Meeks, MD (R-IA).
Specifically, this legislation will require insurers to implement a clear and fair appeals process accessible on the plan’s website that allows step therapy to be bypassed in medically necessary circumstances. It would also establish a time frame in which insurers must respond to appeals to ensure that patients can receive appropriate treatment in a timely manner.
The bill mirrors the Senate version of the Safe Step Act (S.464) that was introduced last week. As a reminder, ASCRS joined the Alliance of Specialty Medicine in a letter expressing support for the bipartisan legislation.
Rachel Levine, MD, Confirmed as Assistant Secretary of HHS
On March 24, the Senate voted 52-48 to confirm Rachel Levine, MD, to act as the Assistant Secretary of Health and Human Services (HHS). Dr. Levine is a pediatrician who previously served as physician general and secretary of health in Pennsylvania.