Congress Passes $1.5 Trillion Spending Package for FY22 that Includes Key Health IT Provisions

On Tuesday, March 15, President Biden signed the $1.5 trillion FY22 spending bill to fund the federal government at increased levels through Sept. 30, 2022. After reaching a deal on a framework for FY22 funding in February, the House and Senate had to overcome many hurdles to pass the omnibus bill before government funding ran out at midnight on Friday.

The government has been funded through multiple continuing resolutions at FY21 spending levels since the start of the 2022 fiscal year last October.

The FY22 omnibus package contains $1.5 trillion in funding, an $88 billion dollar increase over FY21, including a 5.6 percent increase in defense and a 6.7 percent increase in non-defense discretionary spending. The package also included $13.6 billion in aid to Ukraine but had to drop any COVID-19 supplemental funding at the last minute. Also included in the package are several policy priorities for the health IT community.

Telehealth Waiver Extension

With calls to end the COVID-19 Public Health Emergency (PHE) growing, the need to extend or make permanent Medicare telehealth flexibilities is becoming more urgent. The FY22 package includes a broad extension of most Medicare telehealth flexibilities for 151 days (about 5 months) after the PHE expires. Included in this extension are:

• Temporary removal of geographic and originating site restrictions,
• Expansion of eligible practitioners who can furnish telehealth services
• Extending FQHC and RHC ability to provide telehealth services
• Allowing for the furnishing of audio-only telehealth services
• Delaying the mandatory in-person requirement for mental health telehealth services

While this proposal isn’t the permanent expansion many had wished for, or even the one or two-year extension many had hoped for, this temporary extension does ensure needed telehealth access won’t be cut off to a majority of Medicare beneficiaries when the PHE expires. However much work still needs to be done to find a permanent solution and ensure these changes are available to all Medicare beneficiaries.

Data Modernization Initiative

The final agreement provides $100 million in funding for CDC’s DMI, an increase of $50 million over FY21, but still less than the $150 million included in the House passed Labor-HHS appropriations bill. 

The package also included report language, stating:

• Public Health Data Modernization-The agreement commends CDC for the progress made to date and includes an increase to advance efforts toward creating a modem, high-speed, networked public health infrastructure that will work for all diseases and conditions. The agreement recognizes that this effort is not solely about technological upgrades or about short-term solutions.

Patient Identity

Section 510, the long-standing ban on funding for a Unique Patient Identifier, was reinserted into the final omnibus bill. Despite both the House-passed Labor-HHS appropriations bill and the draft Senate Labor-HHS appropriations bill removing the ban, it was ultimately left in.

Report language states:

• General provision limiting funds for actions related to promulgation or adoption of a standard providing for the assignment of a unique health identifier does not prohibit the Department from examining the issues around patient matching, and reiterates the need for the report requested in the explanatory statement accompanying the Further Consolidated Appropriations Act, 2020 

We believe this may have been reinserted as a condition for bipartisan support for the Omnibus, particularly as Congress waits for the long-delayed, congressionally-mandated report on patient identification from ONC..

Patient ID Now, a coalition of more than 40 leading healthcare organizations including HIMSS as a founding member, issued a statement expressing disappointment that the U.S. Congress reinserted the long-outdated rider, stifling innovation around patient identification. The Patient ID Now coalition urges Congress to complete the progress it made toward protecting patient safety and privacy in FY22 and finally repeal Section 510 from its Labor-HHS appropriations bill within its FY23 federal budget.

"Once again, we are disappointed to see that Section 510 was not removed from the FY22 Omnibus Appropriations agreement. This long-standing, archaic ban has impeded our country’s ability to accurately match patients with their records, jeopardizing patient safety and resulting in significant financial strains on the U.S. healthcare system. The patient matching issues experienced throughout the COVID-19 pandemic underscore the urgency to finally address patient identification to improve care coordination and population health management,” said HIMSS President & CEO Hal Wolf. “HIMSS is undeterred and will continue working with advocates and policymakers to lift the ban and develop a nationwide patient matching strategy in the fiscal year 2023 appropriations."

Maternal Health

While the FY22 omnibus package didn’t include any Momnibus provisions, it did include $890 million for maternal and child health (MCH) programs, a 4 percent increase above the FY21 enacted level. It also included provisions from the Maternal Health Quality Improvement Act and the Rural Maternal and Obstetric Modernization of Services (MOMS) Act, both bills endorsed by HIMSS.

Together, these sections contain provisions including:

• HRSA grants to identify, develop and disseminate best practices to improve maternal health care quality and outcomes
• Training for health care providers to improve prenatal, labor, birthing, and postpartum care for racial and ethnic minority populations, including with respect to preexisting perceptions and biases.
• Improvements to rural and maternal obstetric care data
• Funding for Telehealth Network and Telehealth Resource Centers Grant Programs, authorizing the Telehealth Network Grant Program at HRSA to include providers of prenatal, labor care, birthing, and postpartum care services.