As 2022 was winding down, Congress finalized negotiations on an end of year package to keep the government open. This bill would fund government agencies through Sept. 30, 2023. It includes $773 billion in domestic spending and $858 billion in defense funding. In addition, there is $45 billion in aid for Ukraine and $40 billion for disaster aid for communities impacted by recent storms and wildfires.
ANA staff went through the bill and pulled out provisions of interest to the nursing community that we have outlined below:
Nursing Workforce Programs
ANA has actively advocated for increases for the Nursing Workforce Development Programs and the National Institute of Nursing Research (NINR) for decades. In this package, Title VIII Nursing Workforce Development Programs received $300.472 million. This is a $20 million increase over Fiscal Year (FY) 2022 enacted levels.
The NINR received $197.693 million. This is a $16.831 million increase over FY 2022 enacted levels. In the report language, it highlights that $10 million of this is to support research “related to identifying and reducing health disparities.”
Opioids
ANA Chief Nursing Officer, Debbie Hatmaker, sent a letter to Congressional Leadership highlighting the need for certain bills and/or provisions to be included in this omnibus package. We are pleased to report that H.R. 7666, the Restoring Hope for Mental Health and Well-Being Act of 2021 was included. Specifically, ANA supported the inclusion of H.R. 1384, the Mainstreaming Addiction Treatment (MAT) Act. This legislation would eliminate the duplicative and burdensome requirement that providers, including APRNs, apply for a Drug Enforcement Administration waiver in order to dispense lifesaving buprenorphine to treat those suffering from opioid use disorder.
ANA successfully led the charge in 2018 for permanent prescribing authority of medication assisted treatment by nurse practitioners. A compromise was reached to give five years prescribing authority for Certified Nurse-Midwives, Clinical Nurse Specialists, and Nurse Anesthetists who take additional continuing education in the SUPPORT for Patients and Communities Act of 2018. The inclusion of H.R. 1384 will further ensure Certified Nurse-Midwives, Clinical Nurse Specialists, and Nurse Anesthetists will not lose prescribing authority for medication assisted treatment when the provision sunsets in October 2023.
Telehealth
The omnibus continues Medicare’s expanded access to telehealth by extending COVID-19 telehealth flexibilities for an additional two years, through Dec. 31, 2024.
Pandemic Preparedness
The omnibus provides language to improve the Strategic National Stockpile to ensure critical pandemic supplies are operational, resilient, and ready to deploy. This includes the replenishing sale/transfer mechanism that will provide useful predictability for domestic manufacturing of personal protective equipment. The bill also provides support to the public health workforce by encouraging investments in the next generation of health care workers through grants and public health loan forgiveness.
The bill includes $350 million in flexible funding for public health infrastructure and capacity, a 75 percent increase for the program that was established in fiscal year 2022 for the Centers for Disease Control to bolster public health infrastructure and rebuild the workforce at the state and local level to strengthen our capacity to be ready to respond to emerging public health threats.
Annual Medicare Payment Changes
Medicare providers were faced with 8.5% payment cuts slated to go into effect on January 1, 2023. The legislation prevents the 4% PAYGO cut as well as a portion of the 4.5 reimbursement cut resulting from expiration of previous congressional mitigation measures. Specifically, the cuts will be reduced by 2.5% in 2023 and 1.25% in 2024.
If you have any questions about these provisions, or anything else, please leave a comment or contact someone on ANA’s Policy and Government Affairs staff.