Digital Debut

Continuing Resolution Averts Government Shutdown

ASCs and other healthcare facilities avoid facing possible payment delays

BY STEVE SELDE | NOVEMBER 2019

On November 21, the president signed into law legislation that provides temporary funding for the federal government and avoided a government shutdown that could delay Medicare payments and affect ASCs. This was the second of such bills, in the form of a continuing resolution (CR) that Congress passed and the president signed this fall. While federal funding is extended only through December 20, 2019, this short-term funding certainly is something many families across the nation will be grateful on Thanksgiving, and provides more time for appropriators to reach compromises on full-year funding.

This pattern of stop-gap funding has been a common occurrence, with Congress resorting to CRs in all but three of the fiscal years since 1977. For the most part, this has been a successful tactic in staving off a government shutdown. The previous federal fiscal year was a notable exception due to the longest partial government shutdown on record, which despite the passage of CRs to buy Congress more time, occurred over 35 days from December 2018 through January 2019.

Finding partisan consensus on any issue has proved difficult this session of Congress, and while that was certainly the case in January, much has been going on the legislative front to pass full-term funding bills for fiscal year 2020. Over this weekend of November 16-17, House and Senate appropriations leaders reached an agreement on the top-line spending figures for each of the 12 appropriation subcommittees. If this agreement holds out, this gives a concrete starting position for appropriations work and greatly increases chances of passage for full-year funding. Beyond this behind-the-scenes development, both chambers of Congress have made progress in passing appropriations bills for the other chamber’s consideration.

In October, the Senate passed legislation that would have provided full-year funding for the Departments of Agriculture, Commerce, Justice, Transportation, Housing and Urban Development, Interior and related agencies. This built of all but two appropriations bills on the committee level in the Senate. The House nominally took up this multi-agency funding bill, modifying the provisions of the text into the CR that was signed on November 21.

The House of Representatives passed all but two appropriations bills this year. ASCA was successful in advocating for language in the report of the bill that provided funding for the Department of Health and Humans Services (HHS) and four other federal agencies. This report language directs HHS to submit to Congress a report on the migration of procedures to ASCs. For procedures that have not shown any significant volume shift, the report will evaluate factors that might be limiting migration into ASCs as well as potential incentives for ownership of certain Medicare sites based on reimbursement disparity.

Report language is one of the many differences between a full-year appropriations bill and a CR. As Congress continues its work on the HHS appropriations bill it is essential that this report language is not mitigated or otherwise struck, so that policy makers and regulators have the information they need to prioritize the high value care ASCs provide.