Early Friday morning, the Senate passed a two-year budget agreement, combined with a bill to fund government operations until March 23, by a vote of 71-28. The House followed, adopting the deal in a 240-186 vote, passing key health policies and decisively ending a brief government shutdown before the workday began. President Trump signed the bill into law shortly thereafter. The deal includes several ACC-supported policies important to cardiovascular patients and their care team. The passage of this budget agreement poises lawmakers to more effectively complete the process of funding the government for the 2018 and 2019 fiscal years.

The bill includes a provision allowing physician assistants, nurse practitioners and clinical nurse specialists to supervise cardiac, intensive cardiac and pulmonary rehabilitation programs. This important policy has been a central talking point at ACC’s Legislative Conference in recent years. Though the provision will not be implemented until 2024 for budgetary reasons, this will provide cardiovascular disease patients with access to rehabilitation proven to reduce the risk of future cardiac events.

Additionally, the measure includes four more years of funding for the Children’s Health Insurance Program (CHIP). In conjunction with the recently approved six-year funding extension, Congress has now approved a decade of stable funding for this vital program that provides extensive health benefits and coverage to nearly nine million children across the U.S. 

The bill also creates a temporary transitional payment, beginning Jan. 1, 2019, for critical services associated with Medicare Part B infusion drugs. This transitional payment ensures that our most fragile patients do not experience a gap in care while the Centers for Medicare and Medicaid Services (CMS) works to finalize a permanent services payment from the 21st Century Cures Act, scheduled for Jan. 2021. This temporary and transitional payment will allow cardiac patients to continue home inotropic infusions as part of palliative, end-of-life care or as a bridge to cardiac transplantation.

Among other items, a provision included in the legislation would ease Electronic Health Record Meaningful Use reporting for doctors and hospitals by eliminating the statutory requirement for the Secretary of Health and Human Services to create “more stringent measures of meaningful use” over time.

The budget bill contains several other important policies, including the repeal of the Independent Payment Advisory Board and a provision providing technical amendments to the Merit-Based Incentive Payment System within the Quality Payment Program.

“This bipartisan budget deal, demonstrating the importance of access to quality health care for all Americans, is one we can all agree on,” said ACC President Mary Norine Walsh, MD, FACC. “There is no better time than Heart Month to see progress on so many policies the ACC has supported over the years to ensure patient-centered care and achieve our mission to transform cardiovascular care and improve heart health. It is so encouraging to see the inclusion of further funding for CHIP, increased access to cardiac rehab and the easing of significant administrative burdens on clinicians.”

Keywords: United States, Medicare Part B, Meaningful Use, Centers for Medicare and Medicaid Services, U.S., Nurse Clinicians, Medicaid, Physician Assistants, Electronic Health Records, Financial Management, Nurse Practitioners, Health Policy, Terminal Care, Patient-Centered Care, Heart Transplantation, Cardiovascular Diseases

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