Detailed Summary of Health Provisions in Consolidated Appropriations Act, 2021

AHA Special Bulletin
December 22, 2020

Legislation includes helpful changes to Provider Relief Fund, elimination of some Medicaid DSH cuts and Medicare sequester cuts, and provisions to address surprise medical bills, among other issues

The House and Senate last night approved the Consolidated Appropriations Act, 2021. The legislation includes roughly $900 billion in COVID-19 relief, including a number of provisions beneficial to hospitals and health systems, and $1.4 trillion in spending that will fund the federal government for fiscal year 2021. President Trump is expected to sign the legislation.

AHA Take:

In a statement, AHA President and CEO Rick Pollack said, “America’s hospitals and health systems, and our heroic front-line caregivers, appreciate the continued support from Congress as our ongoing battle with the COVID-19 pandemic enters its second year. While this legislation is welcome news for patients and their families, and the hospitals that provide them and their communities with essential services, there is no question that additional relief will be necessary as we continue to battle the pandemic.” View AHA’s full statement that was shared with the media yesterday detailing its comments on specific provisions included in the legislation.

A detailed summary of provisions important to hospitals and health systems included in the 5,500-page legislative package follows under Key Resources.

Key Takeaways

Among other health care-related provisions, the package:

  • Provides helpful flexibility in Provider Relief Fund (PRF) reporting, including allowing the use of “budgeted-to-actual” lost revenue calculation and transfer of “targeted distributions” within a health system.
  • Adds $3 billion to the PRF.
  • Eliminates $4 billion in Medicaid DSH cuts that were scheduled to go into effect in FY 2021 and further eliminates the DSH cuts in the two subsequent years.
  • Eliminates the 2% Medicare sequester cuts through March of 2021.
  • Protects patients from receiving surprise medical bills.
  • Lifts the cap on Medicare-funded physician residency positions in teaching hospitals by 1,000, effective in FY 2023.
  • Provides billions in funding for COVID-19 vaccines, testing and contact tracing.
  • Establishes a new Rural Emergency Hospital Medicare designation.
  • Provides approximately $3 billion in increased payments for physician services under the Medicare Physician Fee Schedule for 2021.
  • Extends the availability of funds provided to states and localities by the Coronavirus Relief Fund through December 2021.

Notably, the legislation does not contain harmful provisions related to the Occupational Safety and Health Administration.